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Mary's Story
Mary can understand language better than she can speak it. Sometimes she can say the correct sound but other times cannot. Mary has trouble imitating sounds however when she does try to imitate sounds it comes out clearer than her spontaneous speech. Mary has childhood speech apraxia.

Here is Molly and her mom. Listen to their story and see what signs to look for as your baby or toddler is beginnning to learn to talk.

What is oral expression disability?
Oral expression is the ability to express ones thoughts, needs, wants and ideas using appropriate syntactic, pragmatic, semantic and phonological language structures. Oral expression is NOT reading aloud or reading fluently. To be certified as learning disabled in this area, the disability must adversely affect academic performance. If a deficit in oral expression does not affect academic performance the speech-language pathologist may better address the student’s needs.

Approximately 7.5 million people in the United States have trouble using their voices.
5% of School-Aged Population
52.4 % of All Students with Disabilities, Ages 6-21
Boys Outnumber Girls Four to One

Student Characteristics
Students may have trouble using or understanding the following areas of oral expression:
· Syntax
· Grammar
· Morphology
· Pragmatics/social language
· Semantics
· Phonology
Students may have difficulty:
· Sharing or retelling of stories
· Predicting/hypothesizing
· Expressing their opinions
· Stating main ideas or themes from stories and texts
· Communicating with peers during recess or in cooperative learning groups
· Asking questions in class
· Editing for grammar during oral language lessons

How is this disability identified? Assessments
· A 20-point split between the performance intelligence quotient and verbal intelligence quotient scores on the WISC IV with the performance being higher.
· The student has significantly low standard scores on language tests.
· Teacher observation and report that the student consistently demonstrates difficulty formulating age appropriate answers during classroom and small group discussions.
· Teacher observation and report that the student does not participate in classroom and small group discussions consistently across all academic areas over time.
· The student demonstrates their language deficit in written expression by scoring a standard score of 6 or below, which is the 9th%ile or below, on the Diagnostic Achievement Battery Written Vocabulary subtest OR scores at the 16th%ile or below on the Test of Early Written Language 2
· Significant discrepancy on the WJIII Oral Expression Cluster

How do these learners receive their education?
Decisions as to how instruction should be provided must be based on the individual needs of the child. Services must be provided in the least restrictive environment. The classroom teacher, special education teacher and the speech-language pathologist will all collaborate to develop oral expression goals and objectives.

What are best educational practices or strategies?
· Repeat sentences through strategies such as chunking
· Rephrase/retell
· Rhyme and use songs to remember classroom content
· Connect auditory information through visualization, mnemonics
· Provide frequent opportunities to practice syntax structures with peers and adults
· Daily oral language activities
· Sentence strips—words rearranged into correct order
· Grammar games such as Build a Sentence or Making Sense with Syntax
· Use graphic organizers to build vocabulary
· Buddy talk or pair-share strategies
· Cue students to respond to greetings
· Have student provide a sequential retell to a story
· Teacher Read Alouds
· Take 30 seconds a day to engage them in authentic conversation

Here's an interesting technique to use with students that have apraxia. Check it out!

· Consider that errors may be differences NOT disorders due to primary language structures
· Translate oral expressions into written form
· Give the child more time to formulate words/answers

Inclusive Practices
The classroom teacher, special education teacher and the speech-language pathologist will all collaborate to develop oral expression goals and objectives. The student should remain in the general classroom.

Special Challenges for General Education
It can be very hard for the teacher or students to understand a child when they have a type of oral expression disability. Talking is one of the main ways of communicating wants and needs to your teacher and peers and when there is a breakdown in this skill that can affect the entire classroom. There are times when the teacher will have to ask the student to repeat himself and the teacher has to figure out the best way to do this without causing embarrassment to the child.

Accommodations: Assistive Technology
· Books on tape/cd
· Oral Placement Tools
· Picture communication system or sign language

Are there any wraparound services?
Yes. There are advisory groups, after-school academic support and programs through health services.

Is this a school issue or life issue?
This disability affects both areas but tends to have a greater impact in school as oral language provides the foundation for literacy development which ultimately leads to success in reading and writing. Communication skills are critical for overall success in school. At home most families know their children well enough that communication is not always necessary to convey thoughts, needs or wants.
How does this affect home?
It’s important for the parents to continue support at home so the child is surrounded by consistency. If you know what your child is saying it is important to say it back to them so they can hear how it sounds correctly. It is important for the parents to do the follow-up activities at home to reinforce what the child is learning and doing in class and with the speech-language pathologist.
Individuals who have achieved greatness.
· Bruce Willis—(well known actor)had stuttering problems throughout his youth
· Tiger Woods—(famous professional golfer)had stuttering problems in childhood but got past it with hard work and practice
· Moses—was not an eloquent speaker according to the Bible
· Bill Walton—(professional basketball player)life long problem with speech and communication skills
· John Melendez—(radio and television personality)life long stuttering problem

What can you do to make a difference for the child?
Engage the student daily in authentic conversation! This is one of the most powerful interventions for developing oral language skills.

What can you do to support parents?
Work as a team with the parents. Share and exchange successful strategies and ideas with the parents.

· Bernstein & Tiegerman. Language and Communication Disorders in Children. Columbus, OH: Charles E. Merrill Publishing Co. 1985.
· **www.asha.org** (American Speech Language Hearing Association)
· **www.interventioncentral.org**
· **www.interactivereadalouds.com**
· **www.classroomtoolkit.com/dol.html** (Daily Oral Language & other resources)
· Rhea Paul. Language Disorders From a Developmental Perspective. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers. 2007.
· http://www.ehow.com/info_7897445_signs-child-learning-disability-classroom.html
  • See also the page on Speech and Language Impairment