Early+Childhood+and+Language+Disorders

=**Early Childhood and Language Disorders**=


 * 1. Define the rules of language assignment.**

In writing, we show a verb in past tense by added “-ed” to the end of the word. However, in language, we add “t” sound or “d” sound when it makes speaking smoother or easier but an “ed” sound when the verb ends with a t or a d because you can’t have 2 consonant sounds back-to-back in English.

Nobody teaches these rules directly to children but they know it automatically by age 6. This is the paradox of language development: language is extremely complex and adults don’t teach it directly, yet children learn it quite quickly through exposure.


 * 2. Explain the following terms: phonology, semantics, morphology, syntax, pragmatics.**

Phonology – the sounds that make words Semantics – the meanings of words Morphology – the pairing of sound and meaning Syntax – using words in sentences Pragmatics – language use in social situations

Each of these components have specific rules and each component interacts with the others.


 * 3. Explain the development of language in infants, toddlers, preschoolers, and elementary school children.**

__Infants__ Babies can listen and discriminate vowel and consonant sounds by four weeks and syllables by four months. They are able to discrete phoneme contrasts that are not part of their native language by 6 months, an ability that is lost by 12 months.

Speech development, or phonology, begins with reflexive vocalizations (crying, grunting) at birth. By 2-4 months, infants move to cooing vowel-like sounds. At 4-6 months, infants engage in vocal play, changing pitch, loudness and stress. At 6 months, infants can combine vowels and consonant sounds into babbling. By 10 months, infants can jargon speak and produce correct stress and intonation, but no real words. First words with correct sounds usually develop by 1 year.

Pragmatics, or communicative intent, begins around 8-12 months with eye gaze, gestures, and vocalizations to regulate behavior (request or protest) and establish joint attention (call or comment).

__Toddlers__ During 8-12 months, there is an important period for language development where toddlers are enter a receptive phase and learn new words, mostly nouns. Between the age of 1 ½ to 6 years of age, children will learn 14,000 new words at 9 words a day. Between 12 to 26 months, toddlers enter an expressive phase and begin to say 1-2 syllable words with the first 50 words appearing slowly but then exponentially expanding their vocabulary. Between 18-36 months, toddlers begin the syntax phase where they learn word combinations (daddy fall, sit chair, cup table, my bear, etc.).

__Preschoolers__ Preschoolers develop phonology and being to correctly pronounce vowels by age 3 and individual consonants by age 8. Clusters of consonants develop later and preschoolers often drop or change consonants instead. During this time, inaccurate mental rules are dropped.

Preschoolers also develop morphology and use of grammatical words (the, a, is, was on, behind) and grammatical suffixes (-ed, -ing, -s) and develop Brown’s 14 morphemes. Preschoolers also develop syntax and are able to produce negative sentences, yes/no and “what, where, when, why” questions. They are able to embedded a phrase or dependent clause and conjoin two independent clauses. This process occurs with changes in morphology and utterance length.

__Elementary Schoolers__ By elementary school, kids begin to have semantic development focusing on multiple meanings (7 years) and abstract meanings (11 years) and begin to understand metaphors and idioms. Kids also develop morphology and learn to use derivational prefixes and suffixes to change the meaning or grammatical class of a word (re-, un-, mini-, -ly, -ish, -tion). Kids also have pragmatics development and learn conversational skills: 8 year olds can hold topics for multiple turns and by 9, they can repair conversational breakdowns. Kids learn to story tell; 6 year olds show complex causes for actions and, by 9 years, all pieces of narratives (character, setting, problem, plan, result) are included and developed.


 * 4. Explain the major language delays.**

__Phonological Disorder__ Phonological disorders are problems producing the sound of speech and may result form oral-motor difficulties, inaccurate mental rules, or both. Phonological disorders affect ~4% of kindergarteners and compose the largest % of caseload of speech/language pathologists.

__Language Learning Difficulties__ Language learning difficulties are problems acquiring language despite normal sensory/cognitive abilities. These disorders are slightly more prevalent in males than females (8% vs. 6%, respectively) but only 3% are ever referred/diagnosed. There is <2% comorbidity with phonological disorders. Kids with not outgrow their language problems and untreated problems will continue into adulthood.

//Semantics//: kids are slow to acquire first 50 words though vocabularies may catch up by elementary school. //Morphology/Syntax//: Problems using morphemes and use sentence forms later than peers. Their accuracy with morphemes and syntax is often inconsistent, reflecting confusion or low confidence in mental rules. //Pragmatics//: These kids may be more passive communicators because other kids are often aware of their language difficulties. //Literacy//: ~50% of kids with language problems have later problems with reading and writing.

__Autism/Pervasive Developmental Disorders__ Autism and pervasive developmental disorders are defined by language impairments. This may be due to lack of social interaction. These disorders affect about 15 / 10,000 children; diagnoses can be made at 2 years of age but are typically not made until age 6.

//Language//: These kids have small or idiosyncratic vocabularies with fixed sentence structure or conversational forms resulting in limited expressive language use. //Social Impairment//: Kids have lack of engagement in social interactions and often has poor eye contact. //Restricted Interests//: There is a characteristic fixation on ritualistic behaviors and excessive repetition of the speech of others.

__Secondary Language Problems__ //Hearing Loss//: Children with hearing loss experience language problems related to impoverished input, not cognitive disfunction. They have difficult phonology development with articulation marked by imprecise contact and/or nasality problems and frequent vowel errors. Semantics, morphology and syntax may also be affected. //Mental Retardation//: Language differences often appear in children with IQ scores <70. There are many errors due to delays in acquisition, resulting in language skills that match mental age better than chronological age. Other language probelsm may be related to specific mental syndromes:

Down Syndrome – language performance is below mental age and may have articulation errors as a result of tongue to oral cavity size proportion Fragile X Syndrome – Language is near or slightly above mental age though phonology and fluency are often impaired. Williams Syndrome – language performance is closer to chronological age than mental age. There may be mild to moderate morphological/syntax errors and moderate to severe impairment of pragmatic skills.

__Disfluency/Stuttering__ Disfluency or stuttering is marked by abnormally high number and/or duration of breaks within the flow of speech. Breaks may manifest as repetitions of sounds/syllables/words, prolongations of sounds, and total blockage of airflow. However, there is a difference between normal childhood disfluencies and true disorder.

__Voice Problems__ Voice problems are disruptions in vocal fold vibration resulting in rough, hoarse, and/or breathy quality. Any adult voice disorder may occur in kids including nodules (hard bumps on folds), polyps (soft blisters on folds), pitch irregularities, and asthma related vocal fold and breathing problems.


 * 5. Discuss appropriate referrals for language delays/disorders.**

If you and/or a child’s parent(s) have concerns for language development, make a referral. Earlier identification and intervention leads to greater improvement. Speech-language pathologists and audiologists specialize in speech, language, and hearing disorders and are available in hospitals, schools, and clinics (free through schools for kids 3 and older). Evaluations take between 30 minutes to 120 minutes and usually involve combinations of standardized tests and structured observations. Treatment focuses on behavioral and cognitive changes and are available for any communication disorder.