Emerging Language

Editor's Notes

• #2: Alright, welcome to assessment and intervention for emerging language, which corresponds with Chapter 7 of the Paul and Norbury textbook.
• #3: First we need to define what we mean by “emerging language.” Well, for typically developing children, this stage of language development occurs between one and three years old. Keep in mind that older children, such as those with autism, may remain in this stage as they pass their third birthday. Children from birth to age three who have developmental disorders are served under Part C of IDEA, and will have Individual Family Service Plans. Individual states provide services and determine eligibility. Children with disabilities or risk factors identified at birth may not need to meet other eligibility requirements. On the other hand, children identified later will require assessment to determine their current strengths and needs. On their third birthday, children transition to school-based preschools where they are provided with special education services.
• #4: Children with risk factors identified at birth are eligible for early intervention services. Sometimes an infant is readily diagnosed as being at risk, because they have syndromes like Fetal Alcohol or Down Syndrome, or were born premature, or have a hearing impairment. In other cases, children may not be diagnosed right away, because their disorders are more mild or are not as readily observable by health care providers until the child is a bit older. Pediatricians and Child Find programs can help to identify children who are eligible for early intervention services in the emerging language period.
• #5: A number of screening instruments are available to help us identify children who may have difficulties with language. For example, The Language Development Survey uses parents’ reports of vocabulary and word combinations to identify language delays in children at ages 18-35 months. It can be completed independently by a parent in about 10 minutes and requires only fifth grade reading skills. The Communicative Development Inventory is a checklist that contains words and gestures used and understood by children aged 8-36 months. There is even a version available for parents of children who use sign language to communicate. And finally, the Caregiver Questionnaire portion of the Communication and Symbolic Behavior Scales Instrument uses parent interviews to help gather information about a child’s language skills, including communicative behaviors like communicative functions, gestures, rate of communicating, positive affect, and gaze shifts. We’ll cover this instrument in more detail in class.
• #6: Transitioning to preschool services is a very important part of providing early intervention services, and is mandated by federal law. It is the responsibility of SLPs to provide parents with support and information in order to help involve them in decisions about transitioning. SLPs must know about the resources that are available to families, and should work as part of a team to help provide the best possible services to young children and their families. Preschool teachers will also need support as they take these children into their classrooms.
• #7: As we know, family-centered practices are tremendously important when working with any client, but especially those who require early intervention. SLPs must learn about the family’s vision for their child and what parents would like to see the child do as a result of intervention. We must find out what families expect from the program and discuss expectations in order to come to a consensus on the plan of treatment. It’s important to Include the family’s perceptions of the child in the assessment, and include choices and options for how families can be involved in the child’s program. We also must work with families to choose natural environments for learning, and review progress with families to make sure new skills are used in natural environments.
• #8: In toddlers who are developing typically, between the age of 8-18 months there is a lot of language development going on. From about 8-12 months, children may be preverbal, but they are also intentional communicators, who can use gaze, gesture, and vocalization to indicate what they want. By 15 months, a child can only say about 10 words, but he or she can understand about five times that many words. A few months later, around 18 months, children are producing up to 100 words, and using them in various two word combinations, such as “hi dada”. Many of the words in a child’s vocabulary at this age will consist of consonants and vowels, or consonants and vowels that are reduplicated, such as mama or dada. Children also begin to close syllables, adding another consonant to the end of a CV word.
• #9: As they get older, typically developing toddlers’ language increases in complexity. From 18-24 months, children can express, on average, about 100 words, although individual children may have no words yet, and some may have as many as 200 words. Multiword utterances increase in frequency, and new communicative intentions emerge related to discourse level functions, such as answering a question, requesting information, and acknowledging caregivers. The child’s repertoire of speech sounds increases, as do the use of CVC words and multisyllabic words. On average, children are about 50% intelligible at this stage.
• #10: From our observations of children’s langauge development over many years, we know that as they reach their second birthday, children begin to use two-word utterances that are very predictable. They can name people, objects, and actions, as well as possession, location, and attributes. For example, a child in this stage may say, “my cookie!” “good doggie.” They may also use words that indicate that they understand object permanence, such as “go home” or “bye-bye mommy.”
• #11: Then, between ages 2 and 3, typically developing toddlers increase the amount of words they can say and the complexity with which they use these new terms. At two years, the average toddler will be able to say 300 words, though some children may only have 150 words, while others have up to 450. Word classes now include more sophisticated object and action words, as well as kinship terms, spatial terms, question words, and color and shape words. Children also use grammatical morphemes, like –ing and –ed, though they may overgeneralize. For example, go becomes goed in the past tense. Grammatical forms for sentences such as questions and negatives are learned. Children can now speak several sentences at a time and are up to 70% intelligible.
• #12: Let’s talk now about assessing children in the emerging language stage. You’ll recall that in Multidisciplinary assessments, each professional does an independent assessment of the child and then the professionals get together to talk about the results and form the plan. In a transdisciplinary assessment, the child interacts with one adult, and team members suggest assessment activities and observe. The parent can be an important part of a transdisciplinary assessment, as she or he is most familiar with the child and how the child functions.
• #13: Certain gestural and play skills appear to be related to the development of intentions, first words, and word combinations. So it’s very important that we do not neglect children’s ability to play and their ability to use gestures in our assessments. During these types of assessments, we are observing the child at play or in their natural environment and comparing their nonlinguistic performance to that of their language skills. See your textbook for a detailed explanation of the many types of play and gestural assessments.
• #14: When we’re not sure about the extent to which children are using language appropriately in the emerging language stage, we want to assess the communicative basis for speech. If a child isn’t using much spoken language, we want to assess the range of communicative functions that the child expresses. Are they making requests or saying what they want or don’t want? Are they able to make comments relating to actions or things that are observed by other people? We also want to observe how often the child is intentionally communicating. By age 2, children should have more than 5 intentional acts per minute. We also want to assess how the child is communicating, including their use of gaze, gesture, vocalization, and speech.
• #15: When we begin the assessment process, we need to determine how we are going to gather our data. We don’t have very many standardized tests for children of this age, so we try our best to gather speech samples that represent the child’s communication. We can use audio or video samples that parents record at home, or we can ask parent’s to show us their records of their child’s language development, or we can collect data in the clinic when the child comes in for an assessment.
• #16: Given the strong correlation between phonology and lexical development, we need to know what sounds the child can produce to help choose words the child can learn. We can use the child’s speech sample to make a list of which consonants they can produce and we can use the number of consonants in this inventory to assess the severity of speech delay. Furthermore, we can assess whether the child is producing multi-syllabic words, or if they are deleting syllables, such as “nana” instead of “banana”.
• #17: When we assess children’s language, we want to look at their semantics and syntax; that is, the amount of words they have, how much they are combining words, and the types of words they are combining. If a child has a mean length of utterance less than 1.5 words, this suggests a language delay. We also want to examine the range of semantic relations expressed when children begin to combine words. There are many types of semantic relations, such as agent object, like “mommy juice,” agent action, such as “doggy play,” etc. There are several ways to conduct this type of analysis, such as Lahey’s (1988) content form analysis, and Lee’s Developmental Sentence Types (1974). You can also see Table 7-7 in the textbook. If more than 30% to 50% of the child’s utterances are not within the categories listed there, we can explore relations in other categories to determine if they are more or less advanced than those in Table 7-7.
• #18: Based on assessment data, we want to write goals to Develop play and gestural production Increase frequency of intentional and communicative behavior (including preverbal and verbal communication) Develop receptive language Increase vocal and phonological production repertoire (that is, increase production of sounds and syllables) Increase vocabulary production, based on the child’s phonological and syllable repertoire. We should focus on labels as well as verbs, relational words (like more, all gone ), as well as social interactional words (like hi, night-night ) Once expressive vocabulary reaches about 50 words, begin encouraging production of word combinations
• #19: It is tremendously important that we help provide families access to books through library, school, and community resources We can encourage families to select books that are developmentally appropriate and attractive to toddlers, and teach parents routine interactive reading strategies (like having children turn the next page) We can also encourage parents to use exaggerated intonation and stress during reading to highlight important elements in the text It’s also important to help parents develop play activities around the themes from storybooks read, and to help older toddlers talk about stories they have read when the book is not present.
• #20: Finally, we may suspect toddlers of having autism, and want to assess them accordingly. There are a variety of commercial screeners and measures that are discussed in your textbook. It is also necessary to collaborate with professionals who have the ability to diagnose autism, like psychologists.
• #21: When a child is diagnosed with ASD, our interventions should focus on both expressive and receptive language, as toddlers with ASD often have receptive scales at or below expressive level. It may also be beneficial to use applied behavioral assessment approaches to help elicit language production. We can also begin to address echolalia by using a third person model, using mitigated echolalia in which there is a little change to the echolalia instead of a direct repetition, and using scripts as part of therapy.
• #22: When children are older but are still in the emerging language stage, we need to modify assessments to accommodate motor limitations, examine maladaptive behaviors for their communicative intent, and consider concreteness of pictures in assessing comprehension skills. We want to continue to assess spontaneous communication for increases in vocal maturity; add vocal communication where appropriate through the use of AAC. When we implement an AAC system, we must consider motor as well as cognitive abilities of the client.
• #23: When we provide intervention for older clients with emerging language, we want to Include play and gesture, Increase frequency, range, and adaptiveness of expression of communicative intention, se functional communication training to replace maladaptive behavior with communication, and use indirect and aided language stimulation to increase comprehension. And of course, we also want to provide emergent literacy opportunities.