SLP in Kenya Finding New Meaning in Work

May 23, 2013 at 2:06 pm | Posted in Uncategorized | Leave a comment
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This story from Advance is really cool.  Christopher Merkley, a Speech-Language Pathologist,  became known as the  only “speaking specialist” in a large area of Africa.  People would come from far and wide to see him, and because of widespread cultural feelings, such that disabled people are possessed by evil spirits, he had to get permission from village elders for therapy.  He gives other details, including descriptions of a lack of electricity in their clinic, very few supplies, and a local thirst for knowledge that can help those of us in far different settings to give our vocation some much needed perspective.  Here’s the link:  http://speech-language-pathology-audiology.advanceweb.com/Features/Articles/Speaking-Specialist.aspx

The DSM-V is Out! So What?

May 20, 2013 at 7:56 pm | Posted in Uncategorized | Leave a comment
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On May 17th, the American Psychiatric Association announced the release of the fifth edition of the Diagnostic and Statistical Manual, the first major revision in almost 20 years to this, the “bible” of modern psychiatry.

Some of the changes:  Initial diagnoses of what was Asperger’s Syndrome will now be made under the larger umbrella of Autism Spectrum Disorder.  Note that this will only apply to people being evaluated for the first time.  Also, it does not mean that Asperger’s as a descriptor will necessarily go away; it will only be eliminated as a DSM-V diagnostic category.

There will be a new diagnostic category, called Social Communication Disorder.  Dr. Amy Weatherby is the first speech-language pathologist to serve on the DSM-5 board and helped to craft the language of this newly defined category. It highlights those with social communication/social pragmatic challenges who do not exhibit the more “restricted, repetitive patterns of behavior, interests, or activities” which has been one of the diagnostic hallmarks of ASD.  Here’s the official criteria:

A. Social Communication Disorder (SCD) is an impairment of pragmatics and is diagnosed based on difficulty in the social uses of verbal and nonverbal communication in naturalistic contexts, which affects the development of social relationships and discourse comprehension and cannot be explained by low abilities in the domains of word structure and grammar or general cognitive ability.

B. The low social communication abilities result in functional limitations in effective communication, social participation, academic achievement, or occupational performance, alone or in any combination.

C. Rule out Autism Spectrum Disorder (ASD). Autism Spectrum Disorder by definition encompasses pragmatic communication problems, but also includes restricted, repetitive patterns of behavior, interests or activities as part of the autism spectrum. Therefore, ASD needs to be ruled out for SCD to be diagnosed.

D. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities).

My initial reaction is that the criteria seems extremely subjective.  I can see many, many children who are socially awkward, or have behavior issues being diagnosed with this.  If a diagnostician can’t go into the home for a meaningful period of time (and they can’t), how does one effectively differentiate between social language issues which are the result of some interpersonal family issues, and an actual disorder?  How does one effectively determine that social issues are the result of what a child can’t do, versus what a child doesn’t want to do?  And even if a child isn’t able to effectively use social language, is it always because of a disorder, or is there an environmental component as well?

Nicaraguan Sign Language

August 8, 2009 at 7:56 pm | Posted in Uncategorized | Leave a comment

Nicaraguan Sign Language – Linguistic Holy Grail?

When, in the 1970′s and 1980′s, increasing amounts of Nicaraguan children without a common language were brought together in special education schools by a new government, one result was the invention of a completely new language.  These children had each been previously using unique forms of homesign or gestures to communicate.  Once brought together (after an initial period when their teachers unsuccessfully attempted to teach the native language), the children became part of a new and growing deaf community located in the capitol city of Managua.  Their newfound socialization necessitated creating a way to communicate; hence, Nicaraguan Sign Language.  The chance to study the formation of a new language in unprecedented ways appeared to many linguists to offer hopes of holy grail proportions.

nicaraguan sign language

Several researchers pounced on this unprecedented opportunity in hopes of finding clues about the formation of all human language.  Judy Kegl, an MIT trained linguist, and Ann Senghas, from Barnard College, were among the first prominent linguists to jump in.  Research on the early users of Nicaraguan Sign Language described some key aspects; the language was concrete, there were primarily only verbs and nouns,  and no complex sentence structure.  This group of early users became known as the “first cohort.”

The number of deaf kids entering the school in Managua increased incrementally each year after the Sandanista Revolution in 1979.  Soon there were hundreds of students with the new students communicating amongst the new and old using this rudimentary sign language.  A transformation occurred in the language after the arrival of this “second cohort” in the early 1980s.  It became quicker, more complex, and included grammatical aspects more like other sign languages than the gestural system used by the first cohort.  A language was born.

One thing has become clear from all of this:  the second cohort, and later incoming children, have generated much of what has become a complex system of communication.  Initially, at least, these aspects were not learned, but created.  Interestingly, studies have shown that earlier learners tend not to use aspects of the language created by later users, and that creations adding grammatical complexity occur only before age 10.  After that age, language advancement seems to occur by adding vocabulary, but not grammar.  Some have seen this as evidence supporting a “critical period” of language development, while others have seen this as supporting an evolutionary model of where language originated.  Research has yet to focus on the critcial reasons why the first cohort continues its use of a simpler language.  Is it that they can’t learn these things, or is that they don’t care to?  Is it that language itself is innate, or rather the desire to socialize coupled with the physical ability to talk, listen, and understand?  It seems certain that whatever else is hard wired into us, people are born with an innate desire to communicate.  

Some recent info on this subject can be found here.  Languagehat has a good post hereThis , from the National Science foundation, was also interesting.  This book chapter  from Ann Sengas’ web site has good detailed info.  At the  PBS evolution site you can find a good five minute long video on Nicaraguan Sign Language.

Brief Break

April 18, 2009 at 12:27 pm | Posted in Uncategorized | Leave a comment

Life calls, so I need to take a break from new posts for a short time.  I fully expect to be posting again in May, so please check back in a few weeks.  Some future topics that I’m planning include posts on Nicaraguan sign language, feral children, the reading-language link, and making language learning fun.  And as always, I’ll include language research updates, with commentary, implications, and links.  See you soon…

Child Language Assessments – Basic Descriptions

March 3, 2009 at 10:40 pm | Posted in Uncategorized | 1 Comment

What follows are some common language assessments used with very young children, along with basic information and descriptions of each.  In my next post I plan on doing the same for tests commonly used with both younger and older children.

Receptive Emergent Expressive Language Test (REEL)  reel3

Ages birth to 3.  The REEL (the latest edition is the REEL -3) is a checklist of language skills that uses a parent or guardian interview to determine expressive and receptive language function.  It can also be used as an informal checklist for older children with severe language delays.  It uses a language quotient that has a mean of 100 and a standard deviation of 15.  Click here for more information from the publisher, Pearson Assessments.

 Preschool Language Scale – 4 (PLS-4)

pls-4Ages birth to 6.  Uses pictures and objects to assess auditory comprehension and expressive communication across domains of syntax, morphology, semantics, and pragmatics.  This is a thorough, comprehensive test with good validity.  For a child over 6 with a very specific deficit in syntax, morphology or semantics, the CELF-4, CELF-Preschool-2, or CASL may be more sensitive.  Click here for more information from the publisher, Pearson Assessments.

 Clinical Evaluation of Language Fundamentals-Preschool-2 (CELF-Preschool-2)

celfp2Ages 3-6. Uses well drawn, color pictures. Good test for specific areas, and as second test for five and six year olds.  The CELF tests seem to have the best validity and specificity – it accurately identifies language disorders.  Core tests: Sentence Structure (Receptive); Word Structure (Expressive); Expressive Vocabulary. Additional subtests: Concepts and Following Directions (Receptive); Recalling Sentences (Expressive); Basic Concepts (Receptive); Word Classes (Receptive and Expressive).  Again, the publisher is Pearson – here’s more detailed information.

A Few Facts About… Negation

December 1, 2008 at 12:01 pm | Posted in A Few Facts About..., Uncategorized | 2 Comments
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One of the most common causes of difficulties in comprehension and following directions is specific difficulty with understanding varied syntactic negative forms.  Anything that can be said can, if necessary, be negated.  When this occurs, it adds a layer of complexity and difficulty.  Some facts:

  • There are basic negatives (e.g. no, not, never), negatives that affect varied tense (e.g. do not, did not, didn’t, don’t, won’t, etc.), and negatives in questions (e.g. “Won’t you..” “Can’t you..”, “Wouldn’t you…”).
  • Advanced negation requires increasing demands upon working memory, both with comprehension and production. Negative prefixes, such as un-, dis-, and non- may be difficult for advanced language learners.
  • The specific negative word a child uses may reflect the specific manner in which a parent uses negation to control behavior. Some parents use no frequently, while others employ don’t (Owens, 1996).  Parenting advice often encourages use of positive discipline (e.g., “Walk”, instead of “Don’t run.”) which may affect children’s comprehension of negation. Children who hear both positive and negative versions of the same request may be predisposed to earlier learning of the concepts of negation and opposition.
  • Children often simplify sentences with negation by eliminating subjects, and putting the simple negative form prior to the verb (L. Bloom, 1970).  Thus, an intended sentence such as “Mommy no go bye-bye.” may initially be produced as “No go bye-bye.”

Around the Web

November 8, 2008 at 5:16 pm | Posted in Uncategorized | Leave a comment

Clue Found for Genetic Contributor to Language Impairment

man-mic-and-gene-untitled-1-copyEd at Not Exactly Rocket Science has given a good description of a new study revealing a link existing between SLI (Specific Language Impairment), Autism and a gene called CNTNAP2.  The short version of the story is this:  higher prevalence of a certain type of CNTNAP2 = higher prevalence of SLI and autism.  Of course, as with any new research, cautions abound regarding the true nature of the cause and effect relationship as well as the need for more research.  Additionally interesting is that CNTNAP2 seems to be controlled by the notorious FOXP2 gene (A.K.A. language gene).  Although FOXP2 was originally hyped as a language gene several years ago because of its high correlation to language deficits, subsequent research has shown that it is present in other species and may be more of a “learning gene,” or “sequencing complex movements” gene.  As far as CNTNAP2 is concerned, despite it’s implication in language disorders, the presence of this connection seems to be much rarer than the disorders themselves.  This fits in well with my prediction that when the research dust settles, we will find that disorders like SLI and autism (much like stuttering has been found to be) involve complex interactions between genetic, behavioral, psychological, and environmental factors.  And, the amount of each of these contrasting, overlapping ingredients will be found to be highly variable from individual to individual.  In my own professional experience as a person who assesses child language, the contribution of persisting phonological production deficits in SLI has been seriously overlooked.

Not only has this study captured the attention of Not Exactly Rocket Science in this post, other bloggers have noticed as well, including AutismVox, and Anthropology.Net.

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