Language Disorders:from Infancy through Adolescence:

Listening, Speaking, Reading, Writing, and Communicating

Rhea Paul, PhD, CCC-SLPProfessor, Yale Child Study Center

New Haven, Connecticut

Courtenay F. Norbury, PhD

Senior Research Fellow Department of Psychology Royal Holloway University of London London,England

pages 316-328

pragmatic assessment

since pragmatics involves the use of language for real communication,we need to assess it in a more naturalistic context,and this inplies using criterion-referenced or informal procedures.

language goals would be taught first in structured activities.later,carefully scaffolded activities would work toward getting the child to use new language forms in more varied communicative contexts.the clinician would set up naturalistic situations in which the use of the new forms could be modeled for the child,then the clinician would provide opportunities for the child to use the new form in situations similar to the model.generalization of new forms to conversation cannot be assumed for the poor communicator,and structured generalization activities,such as those discussed in chap.3,are especially important.

when examining conversational skills in preschoolers:

social vs. nonsocial:proportion fo utterances directed to the listener,rather than self-directed.

topic initiation:the propotion of new topics introduced by the child rather than adult.

topic appropriateness:the proportion of topics that are appropriate to the interpersonal context.

turns/topic:the number of turns in which the child can maintain a topic

discourse management :the number of times the child interrupts another speaker or fails to take a turn appropriately.

contingency:the proprotion of the child's  utterances that relate to or are contingent on the previous speaker's remark.

a profile of pragmatic skills of children with language disorders

request(less likely to be grammatically complete;fewer indirect forms used;less flexibility in choice of form)

comment(less frequent than in typical populations;may be stereotypic in form)

presupposition(may have difficulty judging what listeners want/need to know;marking depends more on pronouns than does that of normal speakers)

turn-taking(more inadequate forms used in relating to preceding discourse;turns are shorter in length and involve less speech directed to others;utterances are less adjacent than those fo same-age mates(i.e.,children with language disorders take longer to follow up the previous speaker's  remark with a turn of their own;children with language disorders are less assertive about gaining turns)

respond(responses are variable;children with language disorders do not always provide a conversationally obligated reponse;do not consistently compensate for verbal limitations by using nonverbal responses;responses to requests for clarification are less focused on the informational needs of the requester;reaponses to other types of speech acts are more likely to be unrelated or inappropriate;responses are frequently incomplete,incorrect, unresponsive to interlocutor's intent,or pragmatically inappropriate.)

speech style adjustments and register variation(speech styly adjustments are made e.g., for younger speakers;modifications reflect fewer questions about listeners' internal states; adjustments of utterance length and complexity are less finely "tuned" to the needs of the listener.)

considerations for the older clients with severe disabilities and those with ASD at the developing language stage

older students with severe disabilities who function at the developing language level

advocating for consultative or collaborative services to increase the client's access and opportunity for participating to as great as degree as possible in mainstream activities with chronological agemates.

providing students with compensatory skills,including assistive technology,and adapting the environment to remove barriers to their participation.

responsiveness and assertiveness in conversational skills rating scale(p323)

verbal or paralinguistic(intelligibility;vocal intensity;voice quality;prosody;fluency)

nonverbal(physical proximity;physical contacts;body posture;foot or leg movements;hand or arm movements;gestures;facial expression;eye gaze)

topic(selection;introduction;maintenance;change)

turn-taking(initiation;response;repair and revision;pause time;interruption and overlap; feedback to speakers;adjacency;contingency;quantity and conciseness)

suggestions for assessing pragmatics

expression comprehension(communicative temptations;have client "bathe"and "dress"doll; give indirect forms of instructions why don't you wash her face? could you put on her hat?;record client responses as compliant or noncompliant.)

presupposition(barrier games referential communication in which partners cannot see each others' referents:client must encode adequate information for partner to identify referents;extended discourse:look at use of pronouns,articles,ellipsis,and conjunctions in tasks such as describing how to play a game;picture description:show client a  picture and ask for description.then show a picture that is just the same except for one obvious detail.client's description of second picture should take into account information presuppos-ed in first;e.g.,picture 1 the dog is running,picture 2 he's eating.)

social organization of discourse:analyze turn-taking;topic maintenance;and conversational initiation,termination,and repair in the referential communication task used to assess pre-supposition.

role-play situations in which client needs to initiate conversation(e.g.,asking for directions, asking for help in a store)

feign misunderstanding in conversation to assess client's ability to make repairs;use unclear clinician messages to assess client's ability to request clarification.)

meeting the communicative needs of the important environments in which the older.severely impaired clients function.assessing need for augmentative and alternative communication,using chronologically age-appropriate materials, and evaluating functional communicative needs.

we would not use dolls and toys to evaluate adolescents,even if they appear to function at the preschool level of language and cognition.we would want to use materials from the client's occupational training program or objects that they are learning to use form  self-care and daily-living activities or from leisure activities in which they like to engage.for example,assess use of basic subject-verb-object sentences or use of verb+particle by asking a client to tell what is done in each step as he or she makes the bed(i pull up the sheet,i pull up the blanket,i pull up the spread,i put on the pillow,i tuck in the spread)

ecological inventory let us ask the question,"what does this client need to be able to communicate sucessfully in this environment?"

when clients are severely impaired and we know that they will probably never complete the sequence,the pimary goal of intervention is to allow them to function as independently as possible within the world in which they live.

domestic,occupational,recreational,and general community

the main point to remember about assessment of functional communication for students with severe-to-profound disorders is that we need not only to assess our clients' ability to communicate,but also the demands of the environment in which they function.

language used in home(不用言辞表达/言语表达）

highest expressive language level(发声、单个词、短语、句子、对话）

methods of communication(sounds,speech,signing,drawing,spelling,facial expression,gaze, nods,gestures,actions,pointing,object manipulation,manipulates others,photo book,picture book/board,word book/board,computer with pictures,computer with word pridiction)

functions of communication(基本需求，routine，喜好，興趣，情感，experience，concerns，觀點，aspirations,humor,想法，current event，none,physical feelings ,social exchanges)

peanut butter protocol

child enters room;have cookies and crackers in view,but out of reach;give child tightly closed jar with cookie in it;ask,"how do you think we can get the jar open?";say,"do you want(mumbel)?";ask whether child wants peanut butter or jelly on the cracker; hand child the opposite of what he or she chose;put the peanut butter and jelly on the table ,ask,"what are we going to do now?";tell the child to put peanut butter or jelly on the cracker;tell child to get knife,which is out of sight;put peanut butter or jelly on cracker,eat it,get out and extra large toothbrush and brush teeth;converse with child,during this,pull a hidden string so that a doll falls off the table;ask"what happened?",ask "why did it fall?;during conversation,look for(answering;expanded answer,taking turns,attending to speaker,acknowledging,initiating a topic,change a topic,maintaining a topic);stop leading conversation and be silent,look for (initiating conversation,asking conversational questions);request clarification;as child leaves room

language comprehension task(example:p.327)