A note of compassion, and a note of skepticism

Transcription

1 Language Impairment

2 Language problems Several conditions are related to difficulties in spoken language acquisition: Hearing impairment Intellectual impairments Autism/PDD Specific language impairment

3 A note of compassion, and a note of skepticism Keep in mind that: Something being wrong with your child is frightening--parents are motivated to seek solutions Any therapy costs $money$--other people are motivated to provide solutions The notion of evidence-based practice: if it really works, it should work in an actual experiment, not just for one person who writes a testimonial on a web site

4 Hearing impairment 1 million kids in US, 90% to hearing parents Most prelingually deaf Trouble developing oral language This cascades into difficulty in language comprehension, reading Difficulty is usually related to how profound the hearing loss is

5 Hearing impairment Problems in language development Phonology Not very intelligible, even with training CI: more intelligible, but still not great articulation Language development, lexicon Reading skills, vocab max 4th grade level Grammar Poor grasp of English syntax (e.g. passives, etc. that are hard for non-deaf children) Better to teach use of [written] language to communicate effectively

6 Universal Newborn Hearing Screening Identification by three months Amplification by six months

7 Hearing impairment Congenital or pre-lingual HL good candidates for Auditory Habilitation Concern is communication development How can we deliver language to the child? Make spoken language louder Deliver higher quality speech signal Provide language through another modality (e.g., signed language)

8 Hearing impairment Can we just fix it? Not exactly. Cochlear implants show some efficacy* Stimulate auditory nerve directly, past site of problem Still not the same as actual speech input Requires speech-language therapy Active area of research

9 How Does a Cochlear Implant Work? 2. The electrically coded signal is transmitted across the skin through the headpiece to the internal portion of the device. 1. Sound waves enter through the microphone and are converted by the sound processor a distinctive into a distinctive digital digital code. code. Photos provided courtesy of Cochlear Americas, 2009 Cochlear Americas 3. The internal device delivers the sound to the electrodes. 4. The electrodes stimulate the hearing nerve, and the hearing nerve sends the signal to the brain for processing.

10 Hearing impairment Just lip-read? Not as easy as it sounds. Some sounds not visible (Ex.: /l/, /g/, /k/) Some sounds look alike (/m/, /b/, /p/)

11 Hearing impairment Educational philosophies Oral/aural (auditory-verbal therapy) Can be effective if cochlear implant, residual hearing; resurgence due to implants Cued speech: handshapes to supplement lips Total communication Response to old oral/aural ed and bad outcomes Make up sign systems yoked to English (SEE) Bilingual/bicultural (bi-bi) Learn ASL first, then English as second language Good in principle, limited by teachers expertise

12 Hearing impairment Cochlear implants: controversy See improvements in language skills, esp. if implanted young, but Not like real hearing Still need lots of educational support Threat to Deaf culture Best solution: learn both

13 Cochlear Implants

14 Intellectual disabilities Down syndrome (poor language) Williams syndrome (preserved language?) Fragile X syndrome Range of cognitive difficulties Sometimes, physical difficulties Poorer categorization, generalization Early intervention!!

15 Intellectual disabilities Down syndrome Trisomy 21 Achievement related to working memory skills Look like younger TD children, mostly Behind by 20 mos at age 3 years; 24 at age 4 years Big trouble with English morphosyntax Later, pretty good narrative, pragmatic skills 10%+ diagnosed with autism

16 Intellectual disabilities Williams syndrome Deletion on chromosome 7, including elastin protein Characteristic appearance, health issues Old claim: bad cognition, good language (reverse of Downs) Language module idea New claim (see Karmiloff-Smith s work): language abilities in keeping with overall cognitive abilities; still behind for chrono age

17 Intellectual disabilities Williams syndrome