Kindle Notes & Highlights
The appearance of more sophisticated comprehension skills is achieved through their ability to use nonlinguistic information to supplement their knowledge of language. These comprehension strategies allow the child to combine cues from gestures, facial expressions, and the way they know things usually happen with their understanding of words. The result is that children can appear to comprehend a long sentence such as, “Why don’t you go
close that door for me?” by combining their knowledge of the meaning of close and door with their understanding that adults usually ask children to do things (Paul, 2000a; Shatz & Gelman, 1973; Thal & Flores, 2001). Knowing this basic
TABLE 7.6 Summary of Comprehension Abilities in Children Up to 3 Years Old Age Comprehension Ability Comprehension Strategy 8 to 12 months old Understands a few single words in routine contexts Look at same objects as mother Act on objects noticed Imitate ongoing action 12 to 18 months old Understands single words outside of routine, but still requires some contextual support Attend to object mentioned Give evidence of notice Do what you usually do 18 to 24 months old Understands words for absent objects, some two-term combinations Locate objects mentioned, give evidence of notice Put objects
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• They have expressive vocabularies larger than 50 words. • They have begun combining words into sentences. • They have not yet acquired all the basic sentence structures of the language.
language functions in the period between Brown’s stages II and V.
seek the family’s perspective on the child’s strengths and weaknesses, identify the family’s concerns for the child, and find out what priorities the family has for the skills the child needs to learn to function most effectively.
Assessment should be completed over a period of time in a variety of contexts, using naturalistic activities
If the parents are worried that Jerry might have intellectual disability, even if the assessment team does not believe this is very likely, his cognitive and adaptive skills ought to be assessed.
Many researchers on reading disorders and dyslexia (e.g., Flax et al., 2009; Gooch, Hulme, Nash, & Snowling, 2014; Serry et al., 2008) suggest that, in addition to phonological processing delays, preschool language delays are key risk factors for the emergence of reading problems.
results of the standardized tests do not necessarily tell us what specific forms, functions, and structures to target. They identify areas in which the child is deficient, but they don’t pinpoint the specific deficiencies.
Standardized tests, particularly those designed to measure expressive skills, tend to use elicited production formats.
These formats tend to elicit performance that is substantially different from the performance of the same children in spontaneous speech. Not only do children produce different frequencies of errors in these imitation and citation formats, they make different kinds of errors too.
Criterion-referenced measures, such as language sampling and probes, are much more valid and effective for gathering information on the errors children make in real communicative situations.
Assessment can continue into the intervention period, because it is an ongoing part of the intervention.
Preschool Speech Intelligibility Measure (PSIM), which consists of having children repeat a list of words.
The clinician can also rate intelligibility in a short conversation by
estimating the proportion of intelligible words.
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of unintelligible words. Beltyukova, Stone, and Ellis (2008) report that this method shows high reliability and discriminatory power.
Children with speech sound delays should, then, be evaluated thoroughly to determine the full range of their needs for intervention.
Expected Relations between Age and Intelligibility in Typically Speaking Children Age Percentage of Intelligible Words 24 months old 50% 36 months old 80% 48 months old 100% Adapted from Gordon-Brannan, G., & Weiss, C. (2006). Clinical management of articulatory and phonic disorders. Hagerstown, MD: Lippincott, Williams, & Wilkins.
speech delay as a condition in children 3 to 9 years old who show a pattern of sound deletions and/or substitutions.
intervention is warranted, both to improve speech intelligibility and to help the child develop awareness of sounds so that risk for reading problems is reduced
A phonetic inventory tells us what sounds a child says without
comparing the child’s production with an adult target.
BOX 8.2 Groups of Sounds Ordered Developmentally Early 8: /m/, /b/, /j/, /n/, /w/, /d/, /p/, and /h/ Middle 8: /t/, /ŋ/, /k/, /g/, /f/, /v/, /t∫/, and /dʒ/ Late 8: /∫/, /θ/, /s/, /z/, /ð/, /l/, and /3/ Adapted from Shriberg, L. D. (1993). Four new speech and prosody-voice measures for genetics research and other studies in developmental phonological disorders. J Speech Hear Res, 36(1), 105-140.
Because many children with phonological disorders are difficult to understand, Shriberg and Kwiatkowski (1980) suggested that instead of using an open-ended conversational format for eliciting the speech sample, as we did when we got our initial general measure of intelligibility, we use a more structured task. We can give the child a complex picture with lots of different items in it to describe,
FIGURE 8.3Developmental sequence of phonological processes. Source: (Adapted from Grunwell, P. [1987]. Clinical phonology [2nd ed., p.
research (e.g., Hodge & Gotzke, 2014; Shriberg and Austin, 1998) suggests that 30% to 40% of children with language disorders also have speech problems, and children with speech delays often have concomitant problems in vocabulary, grammar, or both.
simplifications that are common in young children’s speech.) Phonological processing includes phonological awareness (skills such as the ability to detect rhymes, number of syllables, and first/last sounds in words), rapid automatic naming (such as, saying the days of the week quickly), and phonological memory (seen in the ability to repeat unfamiliar nonsense words).
children’s understanding of word meaning, even when they produce the word themselves, may be more limited than the adult’s understanding of the meaning of the same
word.
If there is evidence of a retrieval problem, focus intervention on practicing the recall and production of already known words,
providing strategies, such as using phonetic and semantic cues for retrieval
research on echolalia (Prizant & Duchan, 1981; Roberts, 2014) suggests that children with autism often use echoing as a response when they don’t know a more appropriate way to answer a question.
FIGURE 8.4A checklist for evaluating comprehension of question words. Source: (Adapted from James, S. [1990]. Normal language acquisition. Boston, MA: College-Hill Press.)
the “hiding game.” This procedure can be used to assess understanding of spatial prepositions. Normative data come from Boehm (1989). In the hiding game, the clinician arranges two identical cups on the floor or table so that one is inverted and one is right side up. The clinician gives the client a raisin to hide from a somewhat backward puppet. The catch is that the child must hide the raisin in the place the clinician indicates. The clinician then tells the child to hide the raisin in locations, such as in, on, under, beside, or next to a cup or between the cups. The child hides the raisin
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one in Figure 8.5, the clinician can assess the level of the child’s understanding of spatial terms and identify those that the child has trouble comprehending. These might be included as intervention targets. FIGURE 8.5A checklist for evaluating understanding of spatial terms. Source: (Adapted from Boehm, A. [1989]. Boehm resource guide for basic concept teaching. San Antonio, TX: Psychological Corp.)
Knowing that a child produces a sentence type does not necessarily mean that the child fully comprehends the same sentence if it is spoken to him in a decontextualized format.
rarely necessary to get all the information needed for a response from the words and sentences. Many other cues are available, including knowledge of what usually happens in situations (often called scripts or event knowledge
facial, intonational, and gestural cues; and objects and events in the immediate environment that provide nonlinguistic support, to name a few.
Knowing how comprehension contrasts with production can help us to decide whether to focus strictly on production skills in the intervention program or whether activities that foster both comprehension and production—such as, focused
stimulation and verbal script approaches (see Chapters 3 and 9 for details)—might be more appropriate.
a. If the child does better in the contextualized format, compare performance on comprehension to production. Target forms and structures that the child comprehends well but does not produce as initial targets for a production approach. Target structures that the child does not comprehend well for child-centered, focused stimulation, or verbal script approaches to work on comprehension and production simultaneously. b. If the child does not do better in the contextualized format, provide more-structured, less-complex input using more hybrid and clinician-directed activities for both
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BOX 8.3 Decontextualized Criterion-Referenced Activity for Probing Agent-Action-Object Sentences Clinician: We’re going to play a Simon Says game with my friends from Sesame Street (use a set of small figures from Sesame Street or some other commercial toys the child finds attractive). I’ll be Simon. I’ll tell our friends what to do. Your job is to help them do what Simon Says. (Give several examples of showing the client how to manipulate the toys to enact
“Simon’s” instructions.) Provide a set of simple agent-action-object instructions for the client to follow, and record responses. Simon says: Client response Bert pats Ernie. ________________________________________ Cookie pushes Big Bird. _________________________________ Zoe kisses Oscar. ______________________________________ Grover hugs Telly. ______________________________________ Murray touches Elmo. __________________________________ Zoe chases Cookie. ____________________________________ Oscar tickles Bert. _____________________________________ Bert hugs Big Bird.
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We said it was important to look at what children do when they don’t understand all the words and sentences in decontextualized activities. If they use strategies such as those used by normally developing children, we can feel more confident that comprehension skills are proceeding along a normal course. Naturalistic approaches such as indirect language stimulation and verbal script therapy are useful for increasing receptive skills.
If, on the other hand, clients are not using typical strategies, we might conclude that they are not able to take advantage of naturalistic communicative cues for comprehending and may need more structured input.
