What are the different areas being assessed of speech-language delays/disorders?
Speech: Speech is the oral and verbal use of sounds and words.
Articulation: Use of the use of tongue, jaw, teeth, lips, palate, breath, and vocal folds in pronouncing sounds/phonemes (ex: p, t, b, etc)
-Organization of sound systems in the brain (not related to musculature of speech like articulation). -An error in phonology is called a "phonological process." One example of a phonological process is Fronting> Examples are: is saying "tat" instead of "cat" and "tey" instead of "key")
Intelligibility: Intelligibility is how much of a person's speech is understood by others.
Language: Semantics (what words mean), Syntax (Grammar), Morphology (Word structure). Some examples are: Putting words together to form sentences, Telling and understanding stories, etc.
Expressive: Sharing thoughts and ideas
Receptive: Comprehension of thoughts and ideas
Pragmatics: Social and Play aspect of language
What is speech and language disorder vs speech and language difference
Speech and Language Disorder:
-Delays in speech and language development, that do not mirror the norms of other people of the same age and language background in the child's community.
-Specific Language Impairment (SLI) is defined by atypical development that does not exist with another disorder
-Speech-Language Disorder can also coexist with other diagnoses (i.e.: Autism, Down's Syndrome, Cognitive Delays, etc.)
Speech and Language Difference:
-The speech and language development does not mirror norms of mainstream Standard English.
-Speech-Language difference is not considered a disability. Speech-Language Pathologists can not ethically treat a person with a Speech/Language difference.
-Misdiagnosis can lead to stigma, decreased academic opportunities, low self-esteem, and bullying, among other negative factors.
-An assessment from a qualified multilingual/bilingual Speech-Language Pathologist is critical in determining difference vs. disorder.
-A specialist in teaching ELL (English Language Learners) or ESL (English as a Second Language) can be one of the appropriate people to seek out for help with a speech-language difference.
What are some intelligibility red flags?
Intelligibility is how much of a person's speech is understood. The following percentages are the amount a child should be understood by both familiar listeners (people whom spend significant time with the child) and unfamiliar listeners (people with whom the child has limited contact)can.
2 years old: 50% intelligible
3 years old: 75% intelligible
4 years old: 100% intelligible
What are some red flags of an articulation disorder?
As different sounds exist in different languages, it requires a full bilingual assessment to determine if a person is producing age appropriate phonemes considering their bilingual background. The following are the norms for Standard American English dialect, as normed by the "Goldman Fristoe Test of Articulation - 2." Please click on my blog to read about norms for the other languages I evaluate.
2 years old
word initial sounds: /b, d, h, m, n, p/
word medial sounds: /b, m. n/
word final sounds: /m, p/
3 years old
word initial sounds: /f, g, k, t, w/
word medial sounds: /f, g, k, ng , p, t/
word final sounds: /b, d, g, k, n, t/
4 years old
word initial sounds: /kw/
word medial sounds: /f/
word final sounds: /d/
5 years old
word initial sounds: ch, j, sh, y /l, s, bl/
word medial sounds: ch, j , sh /l, s, z/
word final sounds: ch, j, ng, sh /l, s, r, v, z/
6 years old
word initial sounds: /r, v, br, dr, fl, fr, gl, gr, kl, kr, pl, st, tr/
word medial sounds: /r, v/
word final sounds: n/a
7 years old
word initial sound: th /z, sl, sp, sw/
word medial sounds: th
word final sounds: th
What are some receptive and expressive language disorder/delay red flags?
Receptive language proceeds expressive language. Therefore, the child understand the following norms before producing them.
3-6 months: Localizes sounds, Babbling /b, p, m/
6-11 months: Canonical and Variegated Babbling
12 months: Uses 1-2 words, understands name, imitates familiar sounds
18 months: Uses 5-20 words
1-2 years old: Uses 2-word sentences
2-3 years old: Has an approximately 450 word vocabulary, using noun+verbs to form sentences, emerging skills in using regular plural forms/-ing/locative words (in/on/inside/outside, etc)
3-4 years old: Attempting to relay personal events, 4-5 word sentence length, emerging skills using possessives
4-5 years old: Emerging skills using past tense, starting to ask questions such as why? where? and who?, expressing narratives of 4-5 word sentences, although it may not be sequential
5-6 years old: sentence length of 5-6 words, expressing narratives with some sequence, although there is a lack of relevant details
What are some pragmatic language delay/disorder red flags?
3-6 months: plays with rattle, momentarily looks at objects, attempts to imitate facial expressions, smiles at self in a mirror, reaches for objects, smiles and laughs during games, participates in games with adults, demonstrates anticipation of play activities, searches for hidden objects
6-9 months: does not bang and mouth toys, understands simple play routines, such as peek-a-boo
9-12 months: consistently tryies to secure an object out of reach, using one-step play schemas, increasing attention span to objects
12-18 months: communicates using gestures/facial expressions/sounds, imitates activities that are frequently modeled, self-talk during play
18-24 months: begins parallel play, understands increasingly complex play routines such as hide and seek or chase, begins to take turns
24-27 months: uses toys for their literal use, identifies and selects particular toys of desire, acts out related activities during a multistep play schema
27-30 months:engages by talking during play with other children, shares toys, uses imagination to have a toy represent non-literal functions
Some important notes to consider:
-Research has proven that children with disabilities can become bilingual, and treatment in the dominant or both languages is the best approach. Please click on my blog to learn more.
-All of the aforementioned disorders can exist alone or coexist
-Language can exist without speech.
-Deaf people have a rich language (sign language), although they may or may not produce clear speech.
- Some children may not speak traditionally, but can learn to use alternative augmentative communication (AAC) to speak. A famous example of this is Stephen Hawking. He has no language disorder. He can understand language and knows what he wants to say. However, he has a speech disorder, so he uses technology to speak out loud.
-Columbia University Bilingual Speech-Pathology Institute Certification
-Experience providing therapy and assessing/diagnosing children of various bilingual/bicultural backgrounds, including: monolingual English ; monolingual and bilingual Spanish/English ; monolingual and bilingual Mandarin Chinese ; monolingual and bilingual Portuguese; monolingual Tri dialect from Ghana (with aide of a translator, during a volunteer trip providing services in Ghana)
-Experience working with bilingual Spanish/English a variety of AAC (alternative augmentative communication) applications
-Experience collaborating with ABA therapists and Occupational Therapists to provide holistic therapy for all my patients
-I take the time to understand all my client's learning styles, and provide individualized materials and instruction that will yield the best results.