Clinical Analysis Paper Briana Vincent CSD 146 Holly Koegler 4/26/13

On March 14, 2013 from 9 to 10 am in Ford Building I observed a group of young children who were in the 5-8 year old age range, for a speech and language session. The abbreviation for this group is ELG, stands for Early Language Group. This session was comprised of about 6 children and three teachers that worked on them for the duration of the session with their language and articulation of certain sounds. During my observation I found it slightly hard to understand what the teachers and children were saying at some points because they would divide into two groups to work with different children at a time. There were two children that stuck out to me the most during this session Jason and Nick (real names will not be used in this paper). Both of these boys had trouble working on their plurals and the g-sound that the teachers were focusing on during this session. Jason may possibly have a mild secondary language disorder because of ADD and Nick has a mild primary language disorder because it has some impact on his social and academic situations but they are still able to carry on conversations and function normally in society. Jason and Nick while both being able to hold substantial conversations with their teachers for their age level ranging from 6 to 8 year olds, both of these boys faced articulation errors when speaking during this session. For example, Nick had trouble pronouncing the /g/ sound and was told to put his tongue down on the lower part of his mouth in order to say the words, for example, pig and go. Jason on the other hand had trouble pronouncing the /s/ and /n/ sounds together and even had trouble pronouncing the phrase got it. Another language difficulty I observed during this session was that Nick faced problems with consonant deletion. As

mentioned above, he had a hard time pronouncing the word pig. Instead of adding the g sound on the end he would delete the consonant completely and just say pi. Additionally both Nick and Jason, as mentioned above were able to carry on conversations, but sometimes while doing this experienced a few articulation errors along the way. According the Robin Harwood during the ages from two to five the brain prunes the neural connections that arent used. This as a result makes more frequently used neural connections more complex (Travis, 2011). For example, when language is used around a young child often their language skills will develop at a more rapid pace because the strong connections in the brain are being utilized. According to our book and the chart that was comprised by Brown it states that by 27-30 months of age children should be able to acquire knowledge of forming plurals (s) like turning shoe into shoes (Brown, 1973). Unfortunately, both Nick and Jason had trouble accomplishing this tasks during the session. They had trouble turning words like cat and cookie into cat(s) and cook(ies). Overall, as a result could mean that these boys were late in developing language skills that their peers had developed at the appropriate time. During this clinical observation the teachers were working on the articulation of the gsound. When an individual faces an articulation error this means that the child (or adult) has difficult in producing certain sounds correctly (NICHCY Disability Fact Sheet 11, 2011). Jason and Nick both had trouble producing the g sound. The g-sound along with the k, f, t, d, and n sound are all milestones that should be reached by the ages of 2-3 in children (American Speech-Language-Hearing Association). Another aspect about these boys that I noticed was their difference in voices. Jason, when he would want himself to

be heard, would talk louder increasing the volume in his voice. Whereas Nick would speak in soft monotone sentences when asked questions by his teachers. Voice is a good indicator of how a person is feeling and can significantly convey a good amount of information to a person about how another is feeling (RCH Speech Pathology, 2010). For example, when Jason would raise his voice we could tell that he was extremely excited about something and wanted to actively participate. On the other hand, it was more difficult to tell how Nick was feeling because he had a more reserved and quiet volume when speaking to the teachers. As mentioned previously by 27-30 months children should be able to form plurals without any help. For Jason and Nick this was not the case. The teachers had to teach Jason and Nick when it was and was not appropriate to make a word plural. It is not uncommon for children to lag behind others in the language department. 1 out of every 20 children have symptoms of a language disorder (Medline Plus, 2011). While this is true, this is not the case for Jason and Nick. These two boys have delayed language, where they are developing language in the same way as other children, but at a later and slower pace. Therefore, I came to the conclusion that these children have an expressive language disorder. They both understood what was being asked of them when doing different play therapy activities and when talking to others, but sometimes could not form the right tenses of words or know what correct words to utilize when trying to form a complete sentence. For example when shown pictures of items like beach balls and cats, that had more than one of each on their, both boys would answer with either cat or beach ball instead of the plural form of each word.

While both of these children had difficulty with certain aspects of articulation and language I found something different in Jason than I did in Nick. I think Jason might have a secondary language impairment called Attention Deficit Disorder or ADD. While observing I noticed that he interrupted the teachers when they would be talking to the other children. Jason also would bring up other topics, like wanting to play a game, and disregard what the teachers would be asking him in that moment. A child with ADD will usually exhibit behaviors of hyperactivity, impulsivity, and even inattention. These are the specific behaviors that I noticed in Jason during my time observing. Although, in order to be diagnosed with ADD he must have had these behaviors occur over a span of at least 6 months (Morales, 2013). Jason had difficulty listening and following directions, which is another strong characteristic that is associated with ADD. According to our book it stated that the best way to treat children who have ADD is through medical or behavioral methods. I was unable to fully receive a full diagnosis of Jason on whether or not he actually had ADD, but according to what I have learned through our book, the teachers were using behavioral methods in order to keep Jason calm and focused on what was going on around him. In our book and in class we also learned that a secondary language disorder occurs as a consequence of another disorder (e.g. intellectual disability, hearing loss, and brain injury) (Koelger, 2013). Another fact that I noticed that was similar between what we learned in class and what I observed from the session is the explanation to the children on how they should produce the /g/ sound. The g sound is made by the dorsum of the tongue

hitting the soft palate (Koelger, 2013). What I had noticed in the session was that the teacher told both Jason and Nick to put their tongue down in order to successfully make this sound. Additionally, minor speech impairments were noticed when the kids spoke. As mentioned previously, one of their articulation disorders was the ability to effectively produce the g sound before the teachers helped them correct it. In class it was stated that articulation errors could occur in the initial, medial, or final positions of words (Koelger, 2013). From what I had observed this is true because both Jason and Nick omitted the /g/ sound in pig where the g is at the end of the word, and got it where the g is at the beginning of the word. Overall, during the observation I got to observe how children, who may be more difficult to deal with when trying to diagnose them or help them with their language impediments, are treated when going to therapy. I got to see and hear first hand how the teachers work with the children and how the children respond. I have heard about play therapy and I was happy that I actually was able to view a session that not only helped the children develop better language and communication skills, but also show the interaction between teacher and student. Interestingly, I liked how each teacher got to work with each child at least once throughout the session. Its vital that more than one supervisor sees these children because one adult might see a positive or negative aspect about the childs speech or language that the other had missed during their time with them. Conclusively, viewing the session has helped me further my decision about which career path I wish to take when I graduate from college. I definitely know that I want to work with children both hearing, deaf, and hard of hearing and help them acquire proper skills that will help

them become more successful in society because of their effective communication skills.

Works Cited