Language comprehension impairments - LLA - Jaunumilogopedi.lv/faili/faili/logopediem/valodas_sapratnes_traucejumi... · Language comprehension impairments. Suggestions for clinical

Language comprehension impairments

Varna, 28 August 2014

Rositsa Iossifova PhDLogopaedic Center “Romel”

New Bulgarian [email protected]

Let me introduce myself!

SLT (logopaedist) since 1992; Part time lecturer (NBU) since

1999;- Reading & writing disorder interventions;- Nonverbal communication disorders

PhD (social psychology) since 2007;

- Nonverbal communication

Let me introduce myself!

My research interests: Motor system, vision and language;- Ontogeny of a child’s spatial and temporal cognition;- Nonverbal learning disabilities;- Narrative interventions

My own CPD activities as lecturer:- CPD lecturer since 2008; training courses in

Bulgaria, Latvia, Greece, LithuaniaLanguages: Bulgarian, French, Russian, English

Our program!

Oral language comprehension onset (8 to 18-24 months); comprehension from 2;0-3;0 y.; from 3;0 to 4;0 y.; from 4;6 to 7;0 y. Diagnostic tools.

Language comprehension impairments. Suggestions for clinical practice

Resources:

Elizabeth Bates; Professor of Cognitive Science, University of California, San Diego

http://crl.ucsd.edu/bates/

Two interesting things to know about the child

language comprehension The word comprehension in infants

and adults has different neuronal organization;

It is difficult to study the early comprehension using “traditional” diagnostic tools.

1. Adult / children Comprehension as sensory integration (E. Bates, 1993)

“…RH lesions do have some effect on complex aspects of discourse processing, e.g. the ability to tell a coherent story, or understand the point of a joke ...

However, RH lesions typically do not lead to deficits in the comprehension of individual words.

And yet, our infant work suggests that RH lesions are sometimes associated with delays in word comprehension.

Comprehension as sensory integration (E. Bates, 1993)Why should this be the case? To

understand this paradox, we have to remember that one-year-old infants are learning to comprehend words for the first time.

For adults, comprehension of familiar words is an automatic process, one that takes place without awareness and with very little effort.

Comprehension as sensory integration (E. Bates, 1993)By contrast, one-year-old infants are still

in the process of "cracking the code". For these children, word comprehension may be viewed as a form of multi-modal problem solving, requiring the integration of many different sources of information including gesture, facial expressions, tone of voice, and a host of situational cues (e.g. we are having breakfast now).

Comprehension as sensory integration (E. Bates, 1993)…the right hemisphere plays a particularly important

role in the integration of sensory information… the same RH bias is operating in early childhood. We propose that sensory integration also plays a particularly important role in the first stages of language comprehension, when children have to use many different sources of information to figure out what words mean. If it is the case that right-hemisphere tissue plays a privileged role (though not an exclusive role) in sensory integration, then we might expect a correlation between right-hemisphere damage and delays in the initial stages of language comprehension.”

2. Why is there so little research oncomprehension? (E. Bates, 1993)

“I agree… that our field has neglected the early stages of language comprehension in human children. With very few exceptions … most of what we know about the first stages of language development is based upon the child's stumbling efforts to produce and reproduce meaningful speech. … The main reason why comprehension receives so little attention: it is notoriously difficult to study in this age range.”

Because of this difficulty an “alternative” approach is

needed! Looking at the role of early gestures.

All other things being equal, and given a typically developing child in a typical environment, motor development is a key participant in the process of language acquisition (Iverson , 2010, p. 27).

BODY AND HAND MANIPULATIONS AS TEACHERS!

Motordevelopment

Vision

Bodyscheme

Conceptualization of space Conceptualization

of time

Communication skills development

(from bubbling to narratives)

For more information:

http://www.jslp.uz.zgora.pl/files/jslp_2-2-_75-98.pdf

Rositsa Iossifova , Fernando Marmolejo-Ramos

Spatial and temporal deixis. The role of age and vision in the ontogeny of a child’s spatial and temporal cognition

Йосифова, Р. Движение и език, София, 2012.

E. Bates (1993)The onset of word comprehension between 8 - 10 months of age

is correlated with a host of changes inside and outside of language proper:

- imitation of novel models, - gestural routines (e.g. "bye-bye") - other communicative gestures (e.g. giving, showingand pointing), - changes in the ability to recognize a category shiftin a passive categorization task, - a decline in the ability to recognize phonetic distinctions that

are not in the child's native language, - advances in causal analysis and - the ability to use tools.

Bates and Dick (2002) They argue that i) the intended use of objects,

ii) the emergence of routine gestures (e.g., gesture bye), and iii) the protodeclarative pointing are the three most important prerequisites for the emergence of word comprehension.

Regarding the use of objects, de Campos et al. (2009) found that prematurely born children, children with cerebral palsy, Down syndrome, intrauterine exposure to the influence of cocaine, and with agenesis of the corpus callosum have subsequent problems with reaching and grasping of objects.

Language and gesture milestones, by age and with associated references

(Bates & Dick, 2002)

3 main things about links between motor and language

developmentEarly

communication

Babbling First word comprehension

First wordproduction

Early motor development

(non-linguisticbehaviors)

Rhythmic armmovements

Recognitory gestures

Protodeclarativepointing

Bulgarian children: Ontogeny of gestures (Todorova, &

Yakimova, 2006gesture boys girls

“bye” 9 m., 1 week 9 m., 3 weeks

pointing 11 m., 3 weeks

11 m.

Recognitory gestures & first word comprehensionUse of tools and first word comprehension: Indiscriminate and compulsive grasping (Atkinson,

Nardini, 2008) participates in understanding the function of objects and brings the child to the target usage at the age of 8 to 10 months (e.g. a child can move a phone to his ear or bring a cup to his lips). This transition from simple manipulation to a specific use of tools marks the understanding of the meaning of words that label those objects.

Recognitory gestures

“Recognitory gestures are actions that are brief, stylized versions of the actions typically produced on associated objects. For instance, when an infant between the ages of 0;9 and 1;0 first catches sight of a toy telephone among her play objects, she may pick up the receiver, touch it momentarily to her ear and then immediately set it down. Through this gesture, the child is, in effect, indicating recognition that she knows what the object is. Additional examples might include making a brief stirring motion with a toy spoon or touching a hairbrush briefly to the hair” (Iverson, 2010).

For recognitory gestures, thefollowing developmental

progression was noted by Nicolich, 1977

(1) Briefly carrying out an object-related activity to recognizeappropriate object use (e.g. briefly bringing a telephone receiver to theear).(2) Carrying out a familiar activity that is within the child’s existingrepertoire, but outside of its usual context (e.g. ‘sleeping’ with head onthe table).(3) Carrying out actions with others in which child’s role is reversed (e.g.rather than feeding himself, the child feeds mommy or a doll) orthat are typically associated with others (taking on an adult role; e.g.vacuuming, wiping the highchair tray with a cloth).(4) Carrying out an action with a substitute object (e.g. using a spoon as

a telephone).======================================Add: In adults these gestures are labeled illustratives; pantomimes…,

“empty hand” gestures

Pretend play

http://www.karenstagnitti.com/pretend-to-play/what-is-pretend-play-2/What makes pretend play distinct from other types of play is that

when children pretend there are three cognitive skills that can be observed.

These are: - using objects as something else (also called object substitution

or decontextualisation or transformation of objects), - attributing properties to objects (eg, the doll is asleep or the

tyre is flat), and - references to absent objects or places (eg, a sweep of the

arm indicates a door, or paying for food at the ‘shop’ with invisible money). Children can use these attributes when playing with toys as well as unstructured objects.

These three attributes are noted by several researchers as making pretend play distinct within all the types of play.

BODY AND VISION AS THEACHERS

The intended use of objects, i.e. the understanding of FUNCTION of objects together with the recognition of PHYSICAL ASPECTS (color, size, shape, etc.) guarantee some of the most important semantics features! What FOR is this object & how it LOOKS?

Images recognition

VISION AS A TEACHER!

- At 24 (25 months) the child is able to recognize images.

- By 28 months of age, it is possible to administer structured tests like the Peabody Picture Vocabulary Test to normally developing children (Dunn and Dunn, 1981)

- MacArthur Communicative Development Inventories

Next stages…

From 24 m. to 30 -36 months: transition from two words combination to three (concrete) words sentence. Onset of grammar.

After 4;0 / 4;6 years: transition from simple sentence to complex sentence. Learning of space and time concepts.

3 systems to be understood:“what”, “where”, “when”

Language assessment in children from 3 to 4 years

Diagnostics and prevention of Language from 3 to 4 years:

- The test of “Logopaedic Centre Romel”

DEMONSTRATION

Language assessment in children from 3;6 to 7;0 years

Comprehension of sentences in oral situation (0-52) – a test of Khomsi.

DEMONSTRATION

How to fill and analyze child’s answers

Instruction….

L M-S C D D1 P

… 1 1 1 1 2 2

…

Examples from language comprehension diagnostics

TOKEN TEST Ages: 3-0 to 12-11

Testing Time: 10-15 minutesAdministration: Individual

The Token Test for Children—Second Edition (TTFC-2) is a reliable and effective screening measure for assessing receptive language in children ages 3 years 0 months to 12 years 11 months.Administration is rapid, yielding raw scores, standard scores, percentile ranks, and age equivalents. The normed representative sample consists of 1,310 children, residing in 22 states.

TTFC-2 comes with 20 small tokens, varying in size (large and small), shape (round and square), and color (blue, green, yellow, white, and red). The child is given three opportunities to practice. The administrator then gives the child 46 linguistic commands, to which they must respond by manipulating the tokens. The commands are arranged in four parts of increasing difficulty, and must be administered in consecutive order.

Neuropsychological assessment in Bulgaria

What we evaluate?Demonstration

Therapy of comprehension impairments

GROUP WORK

Introduction of lexical categories and

subcategories in our practice

Group work

How to apply the knowledge about recognitory gestures and structure

of space and time in therapy?

Let’s range the lexical categories together:

1…

Thank you!