File Name: the handbook of language and speech disorders .zip
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Acquisition of communication skills begins early in childhood and is foundational to the ability to gain access to culturally transmitted knowledge, to organize and share thoughts and feelings, and to participate in social interactions and relationships. Speech and language skills allow a child to engage in exchanges that lead to the ac- quisition of knowledge in his or her community and the educational arena.
Communication skills are crucial to the development of thinking ability, a sense of self, and full participation in society. Most children acquire speech and language by a seemingly automatic process that begins at birth and continues through adolescence. Typically, basic communication skills are developed although not complete by the time a child enters kindergarten, enabling the child to begin learning from teachers and interacting fluently with peers and caregivers Oller et al.
Severe disruptions in speech or language acquisition thus have both direct and indirect consequences for child and adolescent development, not only in communication but also in associated abilities such as reading and academic achievement that depend on speech and language skills. When combined with other developmental risks, such as poverty Williams, , severe speech and language disabilities can Questions have arisen in both the media and policy-making settings regarding the appropriateness of SSI benefits for children with speech and language disorders.
As an example, the Boston Globe published a series of articles in December describing the experiences and challenges of families who either were currently receiving or had sought to become eligible to receive SSI benefits for their children. These articles focused on the growing number of children enrolled in SSI on the basis of speech and language disorders.
In response to issues raised in these articles, members of Congress directed the U. In that report, the GAO found that between and , the annual number of children applying for SSI benefits had increased from , to , Of these applications, 54 percent had been denied.
Secondary impairments were present for many of those found medically eligible. In ad- dition, the GAO estimated that in , 55 percent of children with speech and language impairments who received SSI benefits had an accompanying secondary impairment recorded; 94 percent of those recorded secondary impairments were other mental disorders. The GAO found an increase between and in both applica- tions and allowances applicants determined to meet the disability criteria for children with speech and language impairments GAO, During this period, the number of applications for speech and language impair- ments increased from 21, to 49,, while the number of children found to meet the disability criteria increased from 11, to 29, GAO, The cumulative number of allowances for children with speech and language impairments has continued to increase.
In December , , children were receiving benefits as the result of a primary speech or language impairment 16 percent of all children receiving SSI benefits SSA, The factors that contributed to these changes are a primary focus of this report and are discussed at length in Chapters 4, 5, and 6. How- ever, autism spectrum disorder is a distinct neurodevelopmental disorder with distinct clinical characteristics.
This study was requested to meet that need. It should be noted that this report is not intended to provide a comprehensive discussion of speech and language disorders in children, but to provide the SSA with information directly related to the administration of the SSI program for children with these disorders. In addition, this com- mittee was not charged with providing an evaluation of the SSI program or addressing any other questions related to policy or rulemaking.
Although the two studies have related statements of task and were both sponsored by the SSA, the work was conducted by two distinct committees, which held separate meetings and underwent indepen- dent report review processes. The following subsections describe how the committee used its state- ment of task to guide its review and analysis and to determine the inclusion or exclusion of related or noteworthy topics.
Speech and Language Disorders and Corresponding Treatments Numerous childhood speech and language disorders and other condi- tions associated with these disorders are worthy of rigorous examination. Similarly, many approaches are used to treat childhood speech and language disorders. As noted above, however, this report does not provide an ex- haustive review of all such disorders or of their corresponding treatments.
Therefore, the exclusion of any conditions or treatments should not be viewed as an oversight, but as a necessary narrowing of the focus of this study to the issues of greatest relevance to the SSI program. Data and Data Sources The committee consulted a variety of data sources to identify trends in the prevalence and persistence of speech and language disorders prevalence and trends in prevalence are discussed below.
These sources included data from clinical samples i. As a result, readers of this report will encounter numbers and estimates that appear quite different from chapter to chapter.
Recognizing the challenge this variation presents to readers, the committee carefully describes the dif- ferent types of data and how estimates were derived throughout the report. A full discussion of data limitations is included in Chapter 5. This absence of data included data sources and data collection efforts that do not currently exist, as well as data that were unavailable to the committee or to the general public.
At this time, no such national-level data sources or longitudinal data collection efforts exist for these conditions. However, these data were not available to the committee for the purpose of this study.
Finally, the committee had access to an analysis of MAX data that included limited analyses related to speech and language disorders see Chapter 5. Because these data are drawn from a study that was commissioned for another report see NASEM, , this committee was unable to conduct additional analyses, which would have allowed for comparisons between speech and language disorders and other health conditions.
In clinical research, severity may be measured according to how far below average children score on tests compared with children of the same age i. Chapter 4 includes an in-depth review of how children are evaluated for disability as part of the SSI eligibility deter- mination process. The committee used cutoffs two and three standard devia- tions below the mean that are consistent both with conventional definitions of severe disorders in medicine, psychology, and other fields and with the quantitative standards used by the SSA for defining severe speech and lan- guage disorders see Chapter 4.
Many researchers and organizations have noted the need to consider additional sources of evidence, including subjec- tive judgments of functioning, in addition to norm-referenced cutoff scores. Unfortunately, high-quality data from large, representative populations that have been assessed with both quantitative and qualitative metrics are not available. To identify trends in prevalence in these groups, the committee reviewed multiple estimates of point prevalence over time from a variety of sources, including studies using clinical samples, nationally representative surveys, and administrative or service data from federal programs see Chapter 5.
However, comparing trends in prevalence between these two popula- tions posed a number of challenges beyond a lack of longitudinal data.
These challenges, described in Chapters 4 and 5, include inherent differ- ences in the sample populations e. In addition, many of the estimates of prevalence and trends in prevalence presented in this report lack statements of preci- sion, such as confidence intervals or error bars. Recognizing this limitation, the committee provides detailed information regarding sample sizes and methods used to calculate estimates.
These can be found in Chapters 2 and 5 and Appendixes C and D. Despite the numerous challenges and limita- tions, the committee used the available data to describe changes in both groups7 over time, in accordance with its charge.
Poverty Because financial need is a basic condition of eligibility for SSI, the first step in determining eligibility is assessment of family financial status. As a result, the majority of children who receive SSI benefits are from families with a household income less than percent of the federal poverty level FPL. The number of families with incomes less than percent of the FPL changes over time.
That is, as economic conditions deteriorate, more families join the ranks of those with incomes at or below a defined poverty level. This most recently occurred following the recession in the United States. Table presents the absolute number of children under age 18 living in poverty and the percentage of children who were below the FPL annually from to The pattern shows that the percentage of children in poverty increased after , peaked in , and declined afterward, although by it was well above the level NASEM, This pattern suggests that more children would have met the financial eligibility criteria for SSI benefits during the period that followed the recession in the United States.
Thus, an increase in the number of children with speech and language disorders receiving SSI may not reflect an increase in these disorders, but instead may arise from an increased number of children with these disorders who meet the poverty threshold for SSI eligibility NASEM, Population Children Percent of Total 73, 13, Therefore, this report examines the interaction of poverty and dis- ability as well as changes in childhood poverty rates and the changes observed in the SSI program for children with speech and language disor- ders.
Additional data provided in this report allow for comparisons and analyses of SSI determinations, allowances, and total child SSI recipients as a proportion of low-income populations within the United States. This discussion can be found in Chapters 4 and 5. Therefore, data on redetermination at age 18 are not included in this report, although at age 18, SSI recipients must be reevaluated for eligibility to continue receiving SSI disability benefits as adults.
One notable exception is that the committee includes program data on children and youth with disabilities served under IDEA Parts B and C; these data, which could not be disaggregated, include children and youth aged Data related to topics beyond the scope of this review, such as continuing disability reviews and age redeterminations, were not made available to the committee by the SSA. The onset of a disorder and its chronicity may have important implications related to the burden placed by the disorder on an individual and his or her family, as well as the types and duration of supports an individual will require.
Chapter 3 reviews the evi- dence on persistence of speech and language disorders in children. However, the committee found that in most cases, a simplistic concept of onset does not apply to speech and language or other developmental disorders. The notion of onset of a condition implies that prior to the onset, affected individuals had these functions but then experienced a decline or loss of function. In general, developmental disorders are identified when expected functional skills in children fail to emerge.
These expectations usually are based on ages when children typically begin to show these skills. The crite- ria for determining that a child is presenting severe and long-lasting devel- opmental problems often allow for a period of uncertainty. For example, the babbling of infants who later display severe speech disorders often lacks the consonant-like sounds closants seen in typically developing children Oller et al. However, there is considerable variability in typical development, so that babbling features alone cannot be used as an accurate diagnostic test for speech disorder.
A major effort in clinical research on developmental disorders has been to identify early risk factors and subclinical signs, so as to support earlier identification and treatment. This research also supports the general assumption that for most developmental disorders, identification is likely to occur during very early stages of development.
Therefore, this report re- views what is known about the age of identification of speech and language disorders as it relates to expected developmental milestones.
This report highlights findings on gender distribution from clinical research and. However, the evidence base on the effects of gender on the efficacy of treatment and the progression or persistence of speech and language disorders is limited. In its review of the literature, the committee found that few studies examined differential effects of treatment on males and females or included longitudinal data that demonstrated gender differ- ences in the persistence or progression of speech and language disorders.
Through its examination of the evidence, the committee became aware that states vary considerably in the number and rate of applica- tions leading to determinations and in the rate of allowances.
This report includes some state-level data to provide an overall perspective, but it does not explore the potential factors contributing to state-to-state variation in the rates of SSI disability, which was beyond the scope of this study. Doing so would be beyond not only the scope of this study as laid out in the statement of task but also the expertise of this committee. Rather, the committee was tasked with gathering information and reporting on the current state of knowledge on the diagnosis, prognosis, and treatment of speech and language disorders in children, as well as trends in the prevalence of these disorders in children.
See Appendix H for biographies of the committee members. The committee met in person five times: two of those meetings included public work- shops to provide the committee with input from a broad range of experts and stakeholders, including parents and professional organizations; federal agencies e. In addition, the committee con- ducted a review of the literature to identify the most current research on the etiology, epidemiology, and treatment of pediatric speech and language disorders.
The committee made every effort to include the most up-to- date research in peer-reviewed publications. However, strong evidence was sometimes found in older studies that had not been replicated in recent years. In these instances, the older studies are cited. The committee also reviewed findings from a supplemental study using Medicaid data to create an approximate national comparison group for the SSI child population. All languages include words vocabulary , word end- ings morphology , and sentence structure syntax , and speech includes the pronunciation of the sounds phonemes of the language.
Language devel- opment also encompasses acquisition of the social rules for communicating and conversing in society pragmatics.
To help ensure the best outcomes for learners with autism spectrum disorder, speech-language pathologists SLPs and behavior analysts Bas need to work together to support positive behavior and effective communication. This book provides SLPs with a clearer understanding of applied behavior analysis ABA — and bridges the gap between the two fields with a comprehensive plan for collaboration. Through chapters co-authored by practitioners from both disciplines, speech-language pathologists will learn how to move past ABA stereotypes and controversies, incorporate the best ABA-based practices into their work- and break down the barriers to productive collaboration with Bas. Lois believes that all persons on the spectrum can learn how to use technology in a way that is relevant to them. Lois also coaches adults on how they can use prompting and reinforcement techniques to help establish and generalize skills learned, until students are able to consistently demonstrate the skills in various environments home, school, etc.
Children with language or speech impairments are often easily recognized in clinical practice. Cases that show these impairments, but have no mental retardation, pervasive developmental disorder, a physical handicap or a depriving environment, almost intuitively give the idea that some specific disorder exists. From a scientific point of view, however, the evidence for the validity of a category must be based on more than intuition. The category must be analyzed theoretically and empirically in detail, purifying it from invalid connotations and illogical elements. Amorosa argued that there are no qualitative differences between children with the specific developmental disorder of language or speech, normal children, children with mental retardation, or autistic children.
PLI can be diagnosed as a disorder in its own right, but it is more commonly a sign of other syndromes and language disorders. In fact, the term semantic-.
London, Ontario. This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. The first five chapters of Neurologic Disease and Therapy: Handbook of Neurological Speech and Language Disorders cover terminology, give useful schemes for bedside examination, and discuss classic syndromes, apraxia of speech, and basic anatomy. Beyond these basic chapters, the book proceeds into increasing detail discussing a wide range of dysphasia either by the pattern of dysphasia, for example, conduction aphasia, or by etiology, for example, head injury.
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The Handbook of Speech and Language Disorders presents a comprehensive survey of the latest research in communication disorders.Reply
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