Wednesday, June 26, 2013
Introduction to Language Disorders
March 12, 2012
Case 2: Grace – Late Talker
Grace’s parents should not take a wait and see approach for Grace and ask for treatment immediately. In their article Recommending Intervention for Toddlers with Specific Language Learning Difficulties: We May Not Have All the Answers but We Know a Lot, Olswang, Rodriguez, and Tilmer argue that “toddlers who exhibit few positive predictors of change and many risk factors are more likely to have a true impairment and need intervention than toddlers who exhibit many predictors of change and few risk factors” (23). After reading the case, I determined that Grace is an individual with many risk factors (otitis media, low vocabulary, an older sibling with reading difficulties) and few positive predictors of change (tantrums, frustration, and “selective” listening and following directions). It is this writer’s view that Grace should therefore have access to services (at least for the short term) immediately that will help identify whether or not she has a true impairment, because she very well might and the language learning window is too small because of Grace’s age to wait and see. Grace’s learning would suffer and she will be behind her peers for much longer if her parents were to wait and see.
The authors of the article go on to review literature “designed to identify child behaviors that shape a profile of toddlers who should receive intervention” (24). They state that language production is one of these behaviors or “predictors of change.” They go on to state that “a two-year-old with few than 50 words is clearly at risk for continued delay; the risk grows as a child ages with little change in language production (24).” Grace clearly fits this description with less than 20 words that are difficult to understand at over 2 years old. The authors also indicate that “vocabulary in relation to comprehension” (24) is an indicator that there may be a language learning difficulty. Since Grace has trouble understanding her parents and throws tantrums when she gets frustrated, I would bet that she is having a comprehension difficulty. If her expressive vocabulary is only 20 words, her receptive vocabulary might be a little larger, but it’s not clear. Having her receive services would provide access to more concrete assessment tools and help clinicians understand more of what’s going on with her comprehension of language. The fact that Grace plays by herself and won’t sit for a story that is read to her tells me that there is a distinct comprehension difficulty happening with Grace. She can’t enjoy the story because she can’t understand it, and therefore looks to do something she can understand. Until she is seen by a clinic though, the degree of what she understands will never be known, diagnosed, and treated in the future.
The next red-flag that occurred to me when reading Grace’s case was the fact that she is dropping final consonants from the words she does produce. The authors say that phonology is also a predictor of a future language learning difficulty as well. They state “when children begin to produce their first words, the percentage of consonants that is correct has been a variable separating children developing language typically from those with future language learning problems” (25-26). They continue to site other articles and research with similar findings. Because Grace is dropping final consonants, I want to say that she may have expressive language difficulty that has stemmed from a receptive language difficulty; she may just not have understood what was being said to her and is repeating what she does understand. She may have a degree of hearing loss that could be corrected and treated with therapy implemented sooner rather than later.
Furthermore, the authors site heritability and otitis media as risk factors for language learning difficulties. They state “a higher proportion of relatives with histories of language impairment or learning disability in families of children diagnosed as SLI than in those of typically developing children” (27). The fact that Grace’s second grade brother is having difficulty learning to read pops out as another red flag in this writer’s eyes. There may be an SLI that is undiagnosed and untreated there too, and it puts Grace at risk for an SLI. With prompt treatment, her parents could have a better idea of what is going on and to take action. The authors also review articles that contradict each other about otitis media and its effect on hearing and future language learning, but they summarize in way that makes me think that because Grace has had bouts of ear infections, she should be seen because of her other risk factors and predictors of change. The article states “prolonged, untreated otitis media places a child at greater risk of continued language delay. Further, evidence suggests that toddlers with a history of persistent otitis media are at greater risk for difficulties with articulation” (28). Again, because Grace has had ear infections and having trouble with articulation of final consonants, she may be at risk.
The fact is that yes, Grace might be too young to determine whether or not she has a SLI and may outgrow many of her difficulties in years to come. However, she may not, and she has too many risk factors and not enough predictors for positive change not to be seen. Her parents may struggle with her at home, and why not correct the small problems now if the resources are present to do so. By having her evaluated now, her parents are setting her up for a pattern of future success. They are finding a possible problem and addressing it early before too much time passes. Skilled clinicians should be able to diagnose Grace’s specific learning needs and provide the therapy needed to help her better communicate, leading her to become less frustrated both expressively and receptively. Again, in the mind of this writer, it is best for Grace’s parents to ask for treatment immediately.
Source: Olswang, Lesley, Barbara Taylor, and Geralyn Timler. Recommending Intervention for Toddlers With Specific Language Learning Difficulties: We May Not Know All the Answers, but We Know a Lot. American Journal of Speech-Language Pathology. Volume 7. February 1998. 23-27.
Introduction to Voice and Articulation
January 24, 2012
Outside Speech Review: Lisa Ling at Georgia State University
Lisa Ling spoke to Georgia State University students and faculty members at the student center ballroom on January 24, 2012 at 3:00 pm. Ling gave the keynote address as a part of the 29th annual Dr. Martin Luther King Jr. Convocation. Ling is currently a reporter for the show “Our America” on the OWN network. The theme of the occasion was “learning from the dreamer…making an impact” and Ling spoke mainly about stories on which she had reported that she felt had changed her viewpoint on life significantly. She also gave a brief history of her career in the field, and what passionate people can do to change the world, to keep in the spirit of Dr. Martin Luther King Jr. Her purpose was to inspire her audience to keep Dr. King’s dream alive through their work, whatever their work may be.
Seeing as how her audience was primarily students, she adapted to them very well by stating that “you may be too young to remember this, but…” when she would recall something from her past career that she though might be too far back or before her audience was born. She made her remarks relevant and used humor to lighten the mood. She recognized an age difference and adapted well. She was well received. Ling is known in the field for her reporting on the “tough” issues facing our world today including but not limited to child sex trafficking and young boys involved in military associations in Afghanistan. She took criticism when commenting about 9/11 when working on the view. The vocal qualities I noticed most when listening to her talk took place when she was talking about the emotional times of her job. She would display a softer tone and a breathy sound when talking about the tough moments of an interview or rough story. This made her point that these were issues she cared about deeply. Ling is a very rapid speaker as well. When she was telling stories about herself, her rate of speech increased. She is a great articulator and was easily understood by her audience.
Ling was speaking to an audience of college students and faculty. She recognized this and used appropriate vocabulary and language. Although her rate was rapid, she did articulate well and used vocal contact and varied her voice tone to keep her audience’s interest. She spoke just as one would expect a reporter with 20 plus years of experience to speak: confident, loud, and clear. It’s hard to assess how eye contact was used in such a large room. She definitely looked at her audience often, but it was hard to tell if she was making individual eye contact or just generally looking at the room and how much they were admiring her.
My personal reaction was one of inspiration. As I listened, I thought to myself, “wow, this woman really loves what she does” and it must be nice to know from a very young age what you want to do and how to get it. I felt that she was honest and clear about what the reporter life was like and feel inspired to look at issues from a different angle. She referred to “American style glasses” that she was guilty of wearing at the beginning of each story she reports on, and encouraged each and every one of her audience members to remove those in order to learn more about their world, and I just thought it was a good reminder of some of the things that we as Americans often take for granted. Overall, I felt her speech was heart-felt and well delivered. While it didn’t necessarily give any information that was new to me, it did serve as a reminder to keep serving the communities and making a difference, just as Dr. Martin Luther King Jr. had dreamed we all do.
Introduction to Language Disorders
February 6, 2012
EXC 4320: Assignment 1
Are the Abilities for Language, Speech, and Communication Uniquely Human?
Anyone who has ever spent time around a dog can see that communication between a dog and a human clearly takes place. Dogs vie for attention, shoot glances when they want food, and display other actions to portray feelings. Since communication “refers to the sending and receiving of messages, information, ideas, or feelings” (Reed) dogs clearly communicate with humans and with other dogs. Using the dog example, it is safe to say that dogs also display an ability to use speech as well. Reed cites speech as “the oral expression of language that involves sensorimotor processes by which language users reproduce the coded symbols that are stored in their central nervous systems so that others can hear the symbols. Dogs bark, whine, and whimper, among other sounds, to convey different meanings for what they want to convey to their audience.
Dogs might even have language, considering language is “a code in which we make specific symbols stand for something else” according to Reed. A bark can convey happiness, and it can convey anger. A whimper can convey sadness, hunger, or desire. What dogs don’t have, however, is the ability to write down their coded symbol systems. Based on this example, it would be safe to draw the conclusion that the ideas of communication and speech are not uniquely human and can belong to various species of the animal kingdom. Language can sometimes be attributed to animals as well. Where language is uniquely human however, is the area of written language. It is this writer’s view that only humans can create a written “code in which we make specific symbols stand for something else.”
In addition, there are other examples of communication and speech, but not language among the animal population. According to Reed’s definition of communication, a bird’s chirp is certainly a sign of a sent message to another bird. It is also an example of speech. A primate can communicate in a more complex way than a bird or a dog, certainly, and some have even been taught simple signs to communicate even further complex ideas. Can a chimp write down those ideas? Probably in the same way a toddler would, in fits of scratches and scribbles. Sure, those symbols have meaning to someone that works with him on a daily basis, but not as an accepted language structure and coded written symbol system.
In their article titled Mechanisms Underlying Language Acquisition: Benefits From a Comparative Approach, Daniel Weiss and Elissa Newport acknowledge the divide between humans and non-humans with regard to each group’s capacity for language acquisition. Weiss and Newport state that “there is a broad range of shared features across species that have been co-opted for use by the language faculty, but these features did not specifically evolve for language” and “the differences between humans and nonhumans may be one of quantity as opposed to quality (2006.)” Their research goes on to hypothesize on the WHY of this divide, therefore recognizing that language IS uniquely a uniquely human trait. Weiss and Newport list studies of examples between species, specifically birds and non-human primates to illustrate their point as well. They state: “many songbird species acquire their species-typical vocalizations through a period of vocal learning that is similar in many ways to human language acquisition” and “primates show abilities similar to human infants in speech production (2006).” In other words, the Weiss and Newport believe that birds have the ability to vocalize (produce speech) and communicate (send and receive messages) but not to code their language in the way that humans can, because humans are more cognitively complex. This passage also illustrates that Weiss and Newport believe that primates possess abilities similar to that of a human infant when it comes to language—they can coo and babble (produce speech) and they can communicate basic needs, but can not write their symbols down or express complex thought.
Weiss and Newport elaborate to state: “There are a number of ways to conceptualize the underlying differences between species that could result in only humans being capable of acquiring communication systems like language” (2006) before listing and explaining those ways. One of the ways they list to conceptualize the differences between species suggests “large quantitative computational differences across species” (2006). One can only be left to assume that such “quantitative computational differences” is another way of saying how each species expresses its ideas, whether they write them down, use grammatical rules consistently, or aspects of that nature. In other words, Weiss and Newport state that only humans have the cognitive capacity to produce language, though other species can certainly produce speech and communicate effectively within their own species.
In a broader sense, Reed also states in her definition of language “although the symbols are arbitrary, the symbols and their appropriate referents must be mutually agreed on by members of a community using the code if the code is to be meaningful. In this sense, language is a convention (2012).” This point further illustrates why language can only be attributed to humans. Only humans have the cognitive ability to agree upon such symbols within their community as we do. It would be a fairly broad assumption to say that dogs talk with each other to decide what they are going to call that tree over there. They know the tree over there is a tree, maybe by possession, maybe by marking, but can not string sentences together to say so. A chimp can know that her mother is five feet away, and can maybe call to her because she wants to be fed, but can not string together a sentence to say so, and certainly can’t write it. Is that language? According to the definition in Reed, the two previous examples fit the definitions of communication and speech, but not language.
According to the definitions, language is really just a matter of degree. It could be said that communication is the broad overarching umbrella term that speech and language fall under. Language is the most specialized variety of communication. Animals have evolved to survive, and humans have evolved to do more than survive, but to live and thrive and entertain them selves. Language is simply a way to accomplish the tasks of living and thriving and entertaining ourselves.
Reed, Vicki A. (2012). An Introduction to Children with Language Disorders. (pp. 2-3). Upper Saddle River, NJ: Pearson Education, Inc.
Weiss, Daniel and Elissa Newport. (2006). Mechanisms Underlying Language Acquisition: Benefits From a Comparative Approach. INFANCY, 9(2), 241–257. Lawrence Erlbaum Associates, Inc.
Introduction to Language Disorders
April 17, 2012
Movie Review and Discussion: The Lookout
The Lookout tells the story of a young man who sustains a traumatic brain injury after a car accident. Over the course of the movie, the audience gets a glimpse into his life before and after the accident and how he changes and participates as the lookout for a team of people that decide to rob a bank. It’s named for the role the main character plays in a bank robbery. It isn’t a movie I would ordinarily watch, but provided a life-like glimpse into the life of a person struggling with the issues surrounding life after a brain injury, since this is not ordinarily something I experience on a daily basis.
The movie opens with the main character writing in his notebook. I remember learning that short term memory is often affected when a person sustains a traumatic brain injury, and this is illustrated when the main character is shown in all aspects of his life writing things down to remember in his note pad. We also talked about the fact that TBI happens more frequently in children and adolescent males due to risk-taking behavior. This was not an exception in the movie, as the accident occurred because the main character was driving fast at night with his lights off. I immediately thought of our discussion about risk-taking behavior and the fact that boys, more likely than girls, are apt to perceive themselves as “untouchable” with several lives. I couldn’t help thinking that the whole thing could have been avoided with a little common sense, but maybe that’s not the right way to think.
In class, we discussed how critical it is for the person that sustained the TBI to have a solid family support network. In the movie, the main character is financially supported by his parents but never really receives full emotional support, which is illustrated in a dinner scene when he becomes confused and agitated by the constant chatter that he is unable to understand. His best friend and roommate points out that maybe it might be better if he didn’t go home for a while. He knows this is the case, but never really wants to break ties for fear of losing the financial support that it comes with. This probably contributes to the decision to join the bank robbing team after a member of the team proclaims “he who holds the money holds the power.”
Another topic we discussed in class is the degree of functioning the affected person recovers after the injury and how it’s related to the functioning before the accident. The main character was a hockey star, athlete, and overall likeable guy before the accident, from what I gathered from the movie. Much of his frustration stems from the fact that he is unable to do what he used to be able to do. He talks about not being able to skate, and not being able to talk to his girlfriend, who is the only other survivor of the accident that night. His return to school was slow too. I couldn’t tell from the movie if he chose not to go back to school or he already graduated, but there are scenes in the movie that show the main character attending classes at a rehabilitation center where he works specifically on the act of sequencing events. He has an extreme amount of difficulty with this task and the task of telling a story in the order that the events happened at the beginning of the movie, but seems to get better with practice and repetition over the course of the movie.
The main character narrates most of the movie, and mentions once that his reading is slow and takes more time than it used to, which is frustrating. I couldn’t imagine not being able to read a menu at a restaurant, as he illustrates in a scene where he meets with one of his post-accident mentors and she asks if he would like to order some food before handing him a menu. He looks at the menu, looks up, puts the menu down, and asks what she is having. When she says that she is just having hot chocolate, he says to the waitress that he will have the same. I imagine that people have to make decisions like this all the time when they sustain a brain injury like this, and that it affects a person’s social life dramatically. There were also scenes where they showed him in a bar, trying to meet people. He writes down a pick-up line he hears someone else use, and then uses it later with another girl but it doesn’t quite sound the same or have the same affect. I’d imagine before the accident, picking up a girl in a bar would have been a piece of cake for this character. I’m sure this contributes to the frustration over simple communication situations like this one.
Another scene of note takes place in the kitchen. The main character is about to cook dinner, turns on the burner of the stove, and goes to find a can of something and forgot where he put the can opener. He finds the can opener, and realizes that he doesn’t know how to use it, and then realizes a few seconds later that this is not actually a can opener but another kitchen device used for another purpose all together. Meanwhile, the main character is getting frustrated and the stove is still on and the scene ends with him on the floor asleep discovered by his roommate, who knows how long later. I can only imagine what it must be like living with such memory loss. It must be exhausting always trying to re-learn and remember things and processes of daily living all over again.
We discussed in class how adolescents with TBI are grieving “major losses” and that is exactly what I saw throughout this movie. The main character is grieving the loss of a life he thought was possible but realizes will never be the same. He’s grieving the bank job he is unable to get and instead has to work as a janitor due to his communication problems. He is grieving the intimacy he can’t achieve due to his impulsiveness and lack of a verbal filter. He’s grieving the hockey he used to play and the friends he used to have. He starts to realize that he has made progress, but like we discussed, until he perceives it as true success and not just told that by the adults in his life, it will never truly be believed.
I can only conclude by saying that decision making is important and that if I ever have children they are going to understand that what they do today affects tomorrow.