Communication Disorders


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  • D.4 Speech-Language PathologyPurposeSpeech-language pathology services are those services provided by speech-languagepathologists designed to support students whose education is adversely affected byoral communication difficulties (Reference: Ministerial Order 149/89, SupportServices for Schools Order).Speech-language pathology is defined in the Speech and Hearing ProfessionsRegulation 413/2008 and “the health profession in which a person provides, for thepurposes of promoting and maintaining communicative health, the services ofassessment, treatment, rehabilitation, and prevention of speech, language andrelated communication disorders and conditions, and vocal tract dysfunction,including related feeding and swallowing disorders.”The speech-language pathology services in a school district may include a full rangeof services encompassing prevention, identification and assessment, directinstruction for students (individually, in classroom settings, or in small groups asappropriate), consultation, collaboration with other educators regarding the student'sneeds in the classroom and other school environments, inservice training,information sharing with families and other service providers and public education.Any student with delayed, disordered or atypical speech and/or language skillsshould be brought to the attention of the speech-language pathologist.Speech and/or language difficulties may occur at any age and/or in any segment ofthe school population. Although they may occur in relative isolation from any otherspecial education considerations, they are often associated with intellectualdisabilities, autism spectrum disorder, physical disabilities, sensory impairments,severe emotional/behaviour problems, learning disabilities or other learningdifficulties. Not all children with these disorders will require direct intervention by aspeech-language pathologist, but information sharing and monitoring of needsSPECIAL EDUCATION SERVICES: A MANUAL OF POLICIES, PROCEDURES AND GUIDELINES____________________________________________________________________________D. SPECIAL CONSIDERATIONS: SERVICESB C M I N I S T R Y O F E D U C A T I O N S E P T E M B E R 2 0 0 932through collaboration among professionals and team management will ensure thatappropriate and co-ordinated services are provided.Providing primary assistance to students using English as a second language is notconsidered to be the responsibility of the speech-language pathologist, althoughthese children may have specific communication disorders that warrant intervention.Description of servicesAll districts are encouraged to use school-based teams to initiate and monitorreferrals for assessment and program planning, and a clearly defined pre-referraland referral process should be in place. A variety of identification and assessmentactivities related to speech and language difficulties are possible. Some districts mayelect to implement screening programs for students of a particular age or in aparticular program. Others may rely on a referral system that involves the schoolprincipal, teachers, parents or guardians, the learner and/or community agencies.Speech-language pathologists should use both formal and informal measures toevaluate a student's abilities relative to established norms, school expectations, theclassroom environment and the student's needs. A variety of standardized measuresshould be used in conjunction with samples of behaviour taken from the schoolcontext, observations of students and/or interviews with the student,parent/guardian and relevant others. The information obtained should be related toother assessment/planning activities undertaken as part of the learner's educationalprogram.A school district's speech-language pathology services should be directed towardsassisting educators as well as specific students in their attempt to provide supportfor students with communication impairments. Each school district should documentprogram goals and objectives, service priorities, operating procedures, reportingpractices and record-keeping systems. Program entrance and exit criteria should beestablished, together with follow-up policies and practices. Procedures for handlingand storing confidential records should be established. Documentation of programpolicies and operating practices should be clearly articulated and available for use inplanning, management and evaluation activities.In developing individual speech-language pathology services for students, careshould be taken to relate communication objectives to the student's total educationalprogram. Services for communicatively disabled students should be based ondocumented objectives and incorporated into each student's Individual EducationPlan. Parents/guardians and other educators should be informed of assessmentresults, be involved in plans for intervention, and assist in observing and evaluatingprogress toward stated goals. These partners should be active participantsthroughout the intervention process.Speech-language pathologists should have access to work spaces that are conduciveto effective instruction (i.e., in compliance with health and safety codes, quiet, andfree from distractions). It may be most appropriate for intervention to take placewithin the classroom context, in which case the speech-language pathologist will becalled upon to determine instructional approaches in collaboration with the classr
  • Communication Disorders

    1. 1. EPSE 317<br />
    2. 2. This is Nicholas (Kolya)<br />Kolya is 11 years old<br />In Grade 5 at Pitt Polder Elementary in Coquitlam<br />
    3. 3. Kolya’s family<br />Parents emigrated from Russia in 2000<br />They own a health-food store in Coquitlam where they work long hours<br />Family is very active in a Russian Evangelical Church located in Langley<br />Grandma emigrated with them and spends lots of time with kids.<br />Kids:<br />Anya, 14, born in Russia, now attending Coquitlam Secondary<br />Vladimir, 6, in Grade 1 at Pitt Polder<br />Family speak Russian at home. Kids speak English among themselves, but Granny has no English.<br />
    4. 4. More about Kolya<br />Born with a cleft palate<br />Repaired surgically when he was 11 months<br />Second surgery when he was 6 years old to improve quality of speech<br />Some problems with the formation of his teeth<br />Generally healthy but has had recurring bouts of middle ear infections and had tubes inserted when he was 8.<br />
    5. 5. Kolya has had speech therapy throughout his preschool years and during his primary years at Pitt Polder<br />His speech is now clear, but still a bit nasal<br />He is very talkative, always has been.<br />Increasingly it seems as though his speech is “cocktail chatter”—no real content.<br />
    6. 6. Socially<br />Kolya has no close friends at school<br />Never invited to parties or sleep-overs<br />Involved in Sunday School group Wednesday nights and Saturdays.<br />Teachers have noticed that he his very bossy in groups of children—always has to have things his way.<br />
    7. 7. School<br />Not a strength<br />Parents question why—they think Kolya’s very intelligent—he spoke early and lots<br />Slow to learn to read and shows poor comprehension<br />Barely meeting grade expectations in math<br />Difficulty in applying math facts, even when allowed to use a calculator<br />Argues with teachers<br />Tries to negotiate his own terms for assignments<br />Resists all attempts to correct mistakes<br />
    8. 8. No IEP<br />Parents (understandably) feel Kolya and they have had enough of experts for a lifetime.<br />They don’t want any more assessments or corrective interventions.<br />
    9. 9. The Future:<br />Kolya really likes motorbikes and guns.<br />Wants to be a policeman.<br />He’s a big kid, and can enforce the rules he sets other kids…<br />Get out your crystal balls…<br />
    10. 10. Communication Disorders<br />Speech Disorders<br />Articulation<br />Fluency<br />Voice<br />Language Disorders<br />Form of language (phonology, morphology, syntax)<br />Content (semantics)<br />Function of Language (pragmatics)<br />Hearing Disorders<br />
    11. 11. Communication Variations<br />Language (English as a second language)<br />Dialect difference<br />Augmentative/Alternative communication<br />Sign<br />Symbol systems<br />
    12. 12. Assessment and Identification<br />FNSA recognises Communication Disorder as a fundable designation<br />BC Ministry of Education does not, but:<br />“Any student with delayed, disordered or atypical speech and/or language skills should be brought to the attention of the speech-language pathologist.”<br />
    13. 13. Assessment and Identification, cont’d<br />“They are often associated with intellectual disabilities, autism spectrum disorder, physical disabilities, sensory impairments, severe emotional/behaviour problems, learning disabilities or other learning difficulties.” (MOPP&G)<br />
    14. 14. Referral procedures will vary from district to district but involve school-based team evaluation or a collaborative model including parents, administrators and teachers.<br />Some districts may use school-wide screening in early years.<br />Supports based on formal and informal assessment, and coordinated with other learning plans for student.<br />
    15. 15. Speech Disorders<br />Articulation and Phonological disorders<br />Can be due to physical structure of palate <br />Can be environmental—what child can hear, has heard, etc.<br />Lisps, omissions, insertions, mispronunciations<br />Can include effects of hearing loss, auditory processing, neurological and neuromuscular impairments (e.g., oral dyspraxias). <br />
    16. 16. Voice Disorders<br />Volume, quality, and pitch<br />Chronic hoarseness most common voice disorder among children<br />Resonance (stuffy nose sound, or twang)<br />Can mark a hearing loss<br />
    17. 17. Fluency Disorders<br />Stuttering<br />Cluttering (And he—oh, you know—took the the thing—the thing with the you know—the pencil—to write in the –er—the um—I don’t know—in the notebook…)<br />Prosody (speech rhythm), intonation (speech pitching)<br />
    18. 18. Stuttering<br />Various theories why<br />Neurological<br />Worsens with nerves<br />Give child time, don’t suggest words<br />Don’t let anyone tease kid who stutters or who has other speech problems.<br />
    19. 19.
    20. 20.<br />
    21. 21. Language Disorders<br />Form: how rules organise language<br />Morphology—structure of words (plurals, tenses, comparatives)<br />Content—semantics—meaning of words and word combinations<br />Syntax –ordering of words—vocabulary alone doesn’t do it: Consider<br />The dog bit the boy.<br />The boy bit the dog.<br />Same words, very different meaning.<br />
    22. 22. Use: (Pragmatics)<br />Not just spoken language<br />Register (what level of speech is appropriate for a particular setting)<br />Not overly formal among peers<br />Not overly casual among teachers, elders, …<br />Pace—turn taking, not interrupting<br />Politeness. Beginning and ending conversations.<br />
    23. 23. Adaptations/Accommodations <br />Practice in following directions<br />Pair students and practice descriptions (“I see something that…”)<br />Categorizing (sets of diverse items—sort various ways)<br />Facilitative play<br />Don’t be too helpful—don’t anticipate before a child asks. Get it wrong sometimes.<br />
    24. 24. Role play real life activities<br />Cloze activities—”We’re going to play baseball. We need a bat and a ____”<br />Music and play “Down by the Bay…”<br />Set up classroom for interactions. <br />Work with SLP<br />Give child opportunity to communicate with many people. (One may start to second-guess and scuttle language development.)<br />
    25. 25. Augmentative and Alternative Communication<br />Communication that doesn’t involve speech.<br />Augmentative—supplements existing skills<br />Alternative—other techniques in place of speech<br />
    26. 26. Augmentative and Alternative Communication (AAC)<br />Various combinations of:<br />Symbols<br />Aids<br />Techniques<br />Strategies<br />
    27. 27. Non-technical—communication boards, books<br /><br />
    28. 28. Technical<br />Dynavox<br /><br />iPhone<br />