SLI/LD/Dyslexia/APD/ ADHD: Treatment Priorities for the Student Who Has It ALL

93 Pages·2007·2.79 MB·English

Alan Kamhi
Kenn Apel
Julie Masterson
Knowledge Explosion
 The knowledge base of developmental language
disorders has expanded at a rapid in the last 35 years.
 This expansion has been due to the increased
appreciation and understanding of the full scope of
language (syntax, morphology, semantics, phonology,
pragmatics, and written language), as well as the
natural progression of knowledge and specialization
that occurs in any discipline.
Making Clinical Decisions
 The amount of knowledge available about language
disorders and how to treat them may, paradoxically,
make it more difficult to make good clinical decisions.
 How does a clinician decide which assessment
instrument or treatment approach to use given all of
the choices available and all of the conflicting claims
about what does and does not work?
 How does a clinician decide what to work on when a
client’s language problems are not limited to one or
two areas?
 In other words, what does a clinician do with a student
who has deficiencies with morphosyntax, semantics,
conversation/narrative discourse, word-level reading,
spelling, listening comprehension, and writing?
Then vs. Now
 Clinical decisions seemed much easier 35 years ago
when language was limited to morphology, syntax,
early semantic relations, and the processing abilities
measured by the ITPA.
Clinician Orientations
 The Grammar Clinician
 The Conversational Discourse Clinician
 The Narrative Discourse Clinician
 The Comprehension Clinician
 The Literacy Clinician
 The Program Clinician
 The Kenn Apel Clinician
 The Julie Masterson Clinician
The Grammar Clinician
 Targets sentence-level morphosyntactic problems
(e.g., aux/cop omission/agreement) because these
errors are noticeable, persistent, and not
developmentally appropriate for a 7-8 year old.
 Believes that improving morphosyntax is important
for the student’s self concept and will have positive
effects on social interactions as well as reading and
writing.
Comments
 If morphosyntax is a problem, can’t it be targeted in
conversational and narrative discourse contexts as well
as through reading and writing activities?
 Unless there is an excellent team of professionals
working on other areas of deficiency, focusing solely
on sentence-level morphosyntax will not address other
deficiencies.
The Conversational Discourse Clinician
 One of the main purposes of language (conversational
discourse) is to establish and maintain social relationships.
Children who have difficulty initiating and maintaining
conversational discourse will often have difficulty in social
situations.
 Social interaction skills are more important than academic
skills. Children can learn to read and write a little late, but
positive social interactions are important for school-age
children.
Comments
 Yes, conversational abilities are very important for
establishing and maintaining friendships, but there
are many other factors that affect friendships (e.g.,
interests, personality, gender).
 Improving conversational abilities (turn taking, topic
maintenance/change) is not easy (see Brinton & Fujiki,
2005) and may not significantly improve social
interactions.