early detection of language difficulties in young...
TRANSCRIPT
EARLY DETECTION OF LANGUAGE DIFFICULTIES IN
YOUNG MALAY-BACKGROUND CHILDREN:
IMPLICATIONS FOR SCHOOL PREPARATION
By
THERESA LOUISE FAUST
Thesis submitted in fulfillment of the
requirements for the degree of
Master ofEducation
.-\ugust 2002
ACKNO\VLEDGMENTS
First and foremost, words cannot fully express the deep gratitude to God my Lord and
Savior for giving me grace and strength to do this research. Furthermore, I am also
indebted to all the children and their parents who took part in this research. A special
thank you to the following organizations and centres for the use of their premise when
meeting the children:
Haji Ellias Hj Zakaria the Director of Pusat Islam; USM Min~en;
Puan Nor Aeshah Hamzah, Supervisor and Staff at Hadhanah Pusat Islam, USM;
Professor Ken Nakazawa and "\Is Khor Ai-Na, Directors of Asia Community
Service (ACS);
Coordinator and Staff of ACS First Step Intervention Centre, Penang;
Puan Ooi, Cik Sarima and Staff of the Occupational Therapy Unit, Penang_
General Hospital; and
Staff at Lion's Autistic Resource Centre, Penang.
My deepest appreciation to my supervisors, Associate Professor Dr Mildred Nalliah and
Dr Salasiah Che Lah who provided encouragement every step of the way. Last and by no . . '
means least, I would like to thank my family and friends for their support in enabling nie
the privilege to conduct this research.
It is my sincere prayer that this research would provide further help to people with
disabilities and their families as they face the many challenges in school preparation.
Towards that end, every travail and effort would then have been worthwhile.
11
ACKNOWLEDGEMENTS
LIST OF TABLES
LIST OF PHOTOGRAPHS
ABSTRAK
ABSTRACT
TABLE OF CONTENTS
CHAPTER 1: NATURE AND SCOPE OF THE PROBLEM
Page
11
Xl
XVlll
XlX
XXl
1.0 Background to The Study.......................................................... 1
1.1 The Importance of Language Acquisition... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1.1 Disorders of Communication... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2 Context of The Problem............................................................. 3
1.2.1 The Uniqueness ofMalaysia... .. . . .. . . . . . . ... ... ...... ... ... ... ... ... ... 3
1.2.2 Malaysia's Challenges.................................................... 4
1.3 Statement of The Problem ...................................... : . . . . . . . . . . . . . . . . . . . . · 6
1.4 Research Objectives.................................................................. 6
1.5 Research Questions................................................................... 7
1.6 Significance of The Study............................................................ 7
1.6.1 The Earlier the Better..................................................... 7
1.6.2 No Previous Research Available......................................... 8
1.7 Limitations of The Study............................................................. 8
1.8 Definitions of Terms Used in This Study.......................................... 9
1.9 Conclusion.............................................................................. 11
CHAPTER 2: REVIEW OF RELATED LITERATURE
2.0 Chapter Preview........................................................................ 13
2.1 Review of Related Theoretical Literature on Language Learning Models.... 13
lll
2. I . I Introduction ......... . 13
2.1.2 Nativist Versus Behaviorist ........................ . 14
2.1. 3 Psycho linguistic Theory........... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
2.1.4 Classical Theory............................................................ 16
2.1.5 Cognitive Theory........................................................... 17
2.1.6 Social Interactionist Theory............................................... 18
2.1. 7 Connectionist Models...................................................... 19
2.2 Early Historical Developments in the Pragmatics of Language................ 20
2.3 Current Development in Pragmatics of Language................................. 21
2.4 Related Research Literature.......................................................... 22
2.4.1 Review ofPre-linguistic Communication and Language
Development Links......................................................... 22
2.4.2 Review of Relationship to Developmental Disabilities................ 28
2.4.3 Conclusion of Relevant Issues in Pragmatics........................... 30
2.5 Definition ofNormal Language Development..................................... 31
2.6 Early Pragmatic Language Development........................................... 33
2. 7 Review of Development of Children with Down Syndrome..................... 37
2. 7.1 Overall Communication Strengths and Challenges.................... 38
2. 7.2 Development and Delays in Pragmatic Skills........................... 39
2.8 Review ofbevelopment of Children with Autism Spectrum Disorders....... 40
2.8.1 Overall Communication Strengths and Challenges.................... 41
2.8.2 Development and Delays in Pragmatic Skills........................... 42
2.9 Review ofLiterature on Parent Reporting Measures-
Significance and Reliability... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
2.9.1 General Analysis............................................................ 44
2.9.2 MacArthur Communicative Development Inventories................ 47
IV
.: I 0 Conclusion .............................................. . 50
CHAPTER 3: RESEARCH DESIGN Ai'ill METHODOLOGY
3.0 Introduction............................................................................. 52
3.1 Research Design......... .. . .. . .. . .. .. .. .. . .. . .. . .. . . .. . .. .. .. .. .. . .. . .. . .. . .. . .. . .. . .. . 53
Sampling ............................................................................... . 55
3.2.1 Sampling Technique....................................................... 55
3.2.2 The Population .............................................................. 56
3.3 Instrumentation......................................................................... 57
3.3.1 Preamble ...................................................................... 57
3.3.2 Early Social Communication Scales (ESCS)............... .. . . . . ... . . .. 58
3.3 .3 The Pragmatics Profile of Everyday Communication Skills
In Children... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
3 .3 .4 The MacArthur Communicative Development Inventories:
Words and Gestures .......................................................... 64
3.3 .5 Malaysian Developmental Language Assessment Kit .... , . . . . . . . . . . . . 67
3.3.6 Conclusion of Instrumentation............................................ 69
3. 4 Procedure... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
3.4.1 Preamble..................................................................... 70 ..
3.4.2 Procedure Phases............................................................ 72
3. 5 Analysis of Data ............. ~ ... _. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
3.5.1 ·Early Social Communication Scales...................................... 73
3.5.2 MacArthur Communicative Development Inventories-
Words and Gestures ........................................................ 76
3.5.3 Malaysian Developmental Language Assessment Kit.................. 77
3.5.4 The Pragmatics Profile ofEveryday Communication Skills in
Children.................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
v
3.6 The Pilot Studies ............... . ·············· ........................ 78
3 .6.1 The MacArthur Communicative Development Inventory (CDI)
Pilot Study .................................................................. 79
3.6.2 The Pragmatics Profile ofEveryday Communication Skills in
Children (PP) Pilot Study ................................................. 80
3.6.3 Conclusions from The Pilot Studies...................................... 81
3. 7 Final Conclusion... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . 81
CHAPTER 4: ADJUNCt TESTING INSTRillvfENTS RESULTS
4.0 Chapter Preview....................................................................... 82
4.1 Analysis ofResults from The Malaysian Developmental Language
Assessment Kit (lv:IDLAK). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
4.2 Analysis ofResults from MacArthur Communicative Development
Inventories (CDI) ....................................................................... 85
4.3 Discussion ofResults from MacArthur Communicative Development
Inventories (CDI) ....................................................................... 87
4.4 Analysis ofResults from The Pragmatics Profile of Everyday
Communication Skills in Children (PP)............................................. 88
4.5 Discussion of Results from The Pragmatics Profile of Everyday
Communication Skills in Children (PP).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
4.6 Final Conclusion .......... ." .............................................................. 93
CHAPTER 5: ANALYSIS AND DISCUSSION OF RESULTS
5.0 Introduction and Chapter Preview .................................................... 95
5.0.1 Introduction .................................................................. 95
5.02 Chapter Preview ............................................................... 98
5.1 Analysis of Results for the Pragmatic :Milestones of All Populations as
Measured from Early Social Communication Scales (ESCS) for Initiating
Joint Attention (IJA) and Initiating Requesting (IR).... . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
5.1.1 IJA and IR Analysis in Typically Developing Children................ 99
VI
5 .1.2 IJA and lR Analysis in Children with Down Syndrome .. 101
5.1.3 IJA and IR Analysis in Children with Autism Spectrum Disorders... I 03
5.1.4 Summary ofFindings for Present I Emerging Status in All
Populations for IJA and IR .................................................. 105
5.2 Discussion of Results for the Pragmatic Milestones of All Populations as
Measured from Early Social Communication Scales (ESCS) for Initiating
Joint Attention (IJA) and Initiating Requesting (IR) ................................ 107
5.2.1 Discussion ofiJA and IR Results in Typically Developing
Children ....................................................................... 107
5.2.2 Discussion ofiJA and IR Results in Children with Down
Syndrome... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
5.2.3 Discussion ofiJA and IR Results in Children with Autism
Spectrum Disorders .......................................................... Ill
5.2.4 Concluding Remarks ofUA and IR in All Populations................ 114
5.3 Analysis of Results for the Pragmatic Milestones of All Populations as
Measured from Early Social Communication Scales (ESCS) for
Responding to Joint Attention.(RJA) ................................................ 114
5.3.1 Pointing Behaviors (RJA) in Typically Developing Children......... 115
5.3.2 Pointing Behaviors (RJA) in Children with Down Syndrome........ 116
5.3.3 Pointing Bel)aviors (RJA) in Children with Autism Spe~rum
Disorder (ASD)......... ... ... . . . . . . . . . . . . . . . . . . . .. ... .. . . . . . .. ... ... . . . . .. 118
5.4 Discussion of Results for the Pragmatic Milestones of All Populations as
Measured from Early Social Communication Scales for (ESCS)
Responding to Joint Attention (RJA) ................................................ 119
5 .4.1 Discussion of RJA Results in Typically Developing Children........ 119
5.4.2 Discussion ofRJA Results in Children with Down Syndrome....... 120
5.4.3 Discussion ofRJA Results in Children with Autism
Spectrum Disorder. .......................................................... 121
5.4.4 Concluding Remarks ofRJA in All Populations........................ 123
VII
5. 5 Analysis of Results tor the Pragmatic ~vfilestones of All Populations as
Measured from Early Social Communication Scales (ESCS) tor
Responding to Requesting (RR) ...
5.6 Discussion ofResults for the Pragmatic Milestones of All Populations as
Measured from Early Social Communication Scales (ESCS) for
124
Responding to Requesting (RR) ...................................................... 126
5.6.1 Discussion ofRR Results in Typical1y Developing Children......... 126
5.6.2 Discussion ofRR Results in Children with Down. Syndrome......... 127
5.6.3 Discussion ofRR Results in Children with Autism
Spectrum Disorders .......................................................... 128
5.6.4 Concluding Remarks ofResponding to Requesting in All
Populations... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
5. 7 Analysis and Discussion of Results for the Pragmatic Milestones of All
Populations as Measured from Early Social Communication Scales
(ESCS) for Initiating Social Interaction (ISI) and Responding to Social
Interaction (RSI) ........................................................................ ·130
5.7.1 Analysis ofiSI and RSI Results ........................................... 131
5.7.l.i lSI Analysis ofResults inTypically Developing Children.. 131
5. 7.1.ii RSI Analysis of Results in Typically Developing Children ............................................................. 132
5.7.2.i lSI Analysis ofResults in Children with Down Syndrome.. 133
5.7.2.ii RSI Analysis of Results in Children with Down
Syndrome ........................................................... 134
5.7.3.i ISI Analysis ofResults in Children with Autism
Spectrum Disorders............................................... 135
5. 7.3 .ii RSI Analysis of Results in Children with Autism
Spectrum Disorders.............................................. 136
5. 7. 4 Concluding Remarks of Initiating Social Interaction and
Responding to Social Interaction (RSI) in All Populations........... 137
VIII
5.7.4.i Initiating Social Interaction (lSI) in Ail Populations........ 137
5.7.4.ii Responding to Social interaction (RSI) in All
Populations........................................................ 138
5.8 Final Conclusion....................................................................... 140
CHAPTER 6: CONCLUSIONS, IMPLICATIONS AND RECOMMENDATIONS
6.0 Chapter Preamble ........................................................................ 143
6.0.1 Chapter Overview .......................................................... 144
6.1 Perspectives Regarding Joint Attention Skills...................................... 144
6.1.1 Performance by Children with Typical Development.................. 144
6.1.2 Performances by· Children from the Special Needs Populations...... 146
6.2 Perspectives Regarding Requesting Skills........................................... 153
6.3 Perspectives Regarding Social Interaction Skills................................... 155
6.4 Perspectives Concluding Remarks................................................... 159 ·
6.5 Implications for Intervention.......................................................... 159
6.5.1 To Enhance Language Development and Social Competence for
School Preparation .......................................................... 159
6.5.2 To Provide Early Parental and Family Support .......................... 160
6.5.3 To Provide Closer Collaboration Amongst The Relevant
Government Secto~s ................................................ .' ........ 163
6.6 Limitations of The Study.............................................................. 163
6.7 Recommendations for Future Research.............................................. 163
6.8 Final Conclusion........................................................................ 164
REFERENCES ........ ~... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
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.-\PPENDlCES
Appendix A Receptive and ExpressiY~ Language Development.................. 177
Appendix B Borang Keterangan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Appendix C The Pragmatics Profile ofEveryday Communication
in Children (B. M. Version)... .. .. .. . .. .. . .. .. .. .. .. . .. .. . .. .. .. .. . .. . .. 179
Appendix D The MacArthur Communicative Development Inventories
(B. M. Version)............................................................ 188
Appendix E Grand Total ofESCS Scores .. .. .. .. . .. .. .. .. .... .. .. .. .. . .. .. .. .. .. .... 202
Appendix F.i Child Percentage Scores ofEarly Social Communication
Scales (ESCS) for Typically Developing.................. .. . . . . . . . . .. . 223
Appendix F.ii Child Percentage Scores ofEarly Social Communication
Scales (ESCS) for Down Syndrome ..................................... 227
Appendix F.iii Child Percentage Scores of Early Social Communication
Scales (ESCS) for Autism Spectrum Disorder......................... 231 .
Appendix G Services for People with Special Needs in Penang................... 235
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LIST OF TABLES
Table Page
3.1 ESCS Order of Presentation ....................................................... 59
3.2 Descriptive Statistics and Rater Reliability ofESCS. .. . . . . . . . . . . . . . . . . . . . . . ... 60
3.3 The Development of Pragmatics (from the Pragmatics Profile)............. 63
3.4.i Variability in Vocabulary Comprehension Scores on the
CDI/Words & Gestures ............................................................ 66
3.4.ii Variability in Vocabulary Production Scores on the CDI!Words &
Gestures......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
3.4.iii Variability in Gesture Scores on the CDI!Words & Gestures................ 66
3.5 Comparison of Pragmatics Profile with MDLAK, CDI and ESCS...... .... 70
3.6 MDLAK Screening Test Items .................................................... 71
3.7 ESCS Scoring System.............................................................. 74
3.8 MacArthur CDI/Words and Gestures Child Report Form
(Malaysian Version)................................................................ 76
4.1 Matched Triplets of Subjects...................................................... 84
4.2 Analysis of Results from 'MDLAK............................................. .. 84
4.3 Analysis of Results from All Populations on the MacArthur CDI ·......... .. 85
4A.i PragmaticsProfile's Section A: Communicative Functions.................. 89
4.4.ii Pragmatics Profile's Section B: Response to Communication............... 90
4.4.iii Pragmatics Profile's Section C: Interaction & Conversation................. 91
4.4.iv Pragmatics Profile's Section D: Contextual Variation........................ 91
5.1 List of Chiidren Participating in Study.......................................... 95
5.2 Ages for Emerging and Present Behaviors in Seven Typically
Developing Children... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
XI
5.3 Ages for Emerging and Present Behaviors in Seven Children
with Down Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 02
5.4 Ages for Emerging and Present Behaviors in Seven Children
with Autism Spectrum Disorder.................................................. 103
5.5 Present and Emerging Status for All 3 Populations........................... 106
5.6 Pointing Skills in Typically Developing Children............................ 115
5.7 Pointing Skills in Children with Down Syndrome............................ 116
5.8 Pointing Ski11s in'Children with ASD............... .. . ... . . . . . . . . . . . . . . . . . . . . . . 118
5.9 Summary ofRR for All Populations............................................. 125
5.10 Summary of Numbers of Children from All Populations
Engaged in lSI and RSI Behaviors.............................................. 130
Tables from Appendices
A. I Receptive Language Development at 8 - 18 Months..................... . . . . . 177 ·
A.2 Expressive Language Development at 9 - 18 Months... . . . . . . . . . . . . . . . . . . . . . .177
E.l.i.a Grand Total ofESCS Scores Case Reference: # A.1 (Typically
Developing) Initiating & Responding to Joint Attention (IJA & RIA).,... 202
E.l.i.b Initiating & Responding Requesting Behavior (IR & RR).................. .. 202
E.l.i. c Initiating & Responding to Social Interaction (IS I & RSI)... . . . . . . . . . . . . . . . . 202
E.1.i.d Case Reference Data............................................................... 202
E.2.i.a Grand Total ofESCS Scores Case Reference:# B. I (Typically
Developing) Initiating & Responding to Joint Attention (IJA & RIA)...... 203
E.2.i.b Initiating & Responding Requesting Behavior (IR & RR)... .. . . .. . . . . . . .. ... 203
E.2.i.c Initiating & Responding to Social Interaction (lSI & RSI)................... 203
E.2.i.d Case Reference Data ...................................... :........................ 203
E.3.i.a Grand Total ofESCS Scores Case Reference:# C. I (TypicaUy
Developing) Initiating & Responding to Joint Attention (IJA & RJA)... .. 204
E.3.i.b Initiating & Responding Requesting Behavior (IR & RR).... .. .. . ... ... . .. .. 204
Xll
E.3 .i.e Initiating & Responding to Social Interaction (lSI & RSI) ................. . 204
E.J.i.d Case Reference Data ............... . 204
E.4.i.a Grand Total ofESCS Scores Case Reference: #D. I (Typically
Developing) Initiating & Responding to Joint Attention (IJA & RJA).. .... 205
E.4.i.b Initiating & Responding Requesting Behavior (IR & RR)... .. . .. . .. . .. . . . . .. 205
E.4.i.c Initiating & Responding to Social Interaction (lSI & RSI)................... 205
E.4.i.d Case Reference Data ................................................................ 205
E.5.i.a Grand Total ofESCS Scores Case Reference: #E. I (Typically '~·.
Developing) Iriitiating & Responding to Joint Attention (IJA & RJA)... ... 206
E.5.i.b Initiating & Responding Requesting Behavior (IR & RR).... .. .. . . . . . . . .. . . 206
E.5.i.c Initiating & Responding to Social Interaction (lSI & RSI)................... 206
E.5.i.d Case Reference Data ................................................................ 206
E.6.i.a Grand Total ofESCS Scores Case Reference: #F. I (Typically
Developing) Initiating & Responding to Joint Attention (IJA & RJA) ...... 207
E.6.i.b Initiating & Responding Requesting Behavior (IR & RR).... .. ... . .. ... . .. .. 207
E.6.i.c Initiating & Responding to Social Interaction (lSI & RSI) ... _................ 207
E.6.i.d Case Reference Data ................................................................ 207
E.7.i.a Grand Total ofESCS Scores Case Reference:# G. I (Typically
Developing) Initiating &-Responding to Jo~nt.Attention (IJA & RJ~).. .... 208
E.7.i.b Initiating & Responding Requesting Behavior (IR & RR)... .. . ... .. . . .. . .... 208
E.7.i.c Initiating & Re~ponding to Social Interaction (lSI & RSI) .................... 208
E.7.i.d Case Reference Data ................................................................ 208
E.l.ii.a Grand Total ofESCS Scores Case Reference: # A.2 (Down Syndrome)
Initiating & Responding to Joint Attention (IJA & RJA)..................... 209
E.l.ii.b Initiating & Responding Requesting Behavior (IR & RR)................... 209
E.l.ii.c Initiating & Responding to Social Interaction (lSI & RSI)................... 209
Xlll
E l.ii.d Case Reference Data ........ . 209
E.2.ii.aGrand Total ofESCS Scores Case Reference:# 8.2 (Down Syndrome)
Initiating & Responding to Joint Attention (IJA & RJA).................. ... 210
E.2.ii.b Initiating & Responding Requesting Behavior (IR & RR)................... 210
E.2.ii.clnitiating & Responding to Social Interaction (lSI & RSI) ................... 210
E.2.ii.d Case Reference Data..................... . . . .. . . .. . . . . . . .. . .. . . . . .. . .. . .. . .. .. .. .. . 210
E.3.ii.a Grand Total ofESCS Scores Case Reference:# C.2 (Down Syndrome)
Initiating & Responding to Joint Attention (IJA & RJA).................. ... 211
E.3.ii.blnitiating & Responding Requesting Behavior (IR & RR)... ... ... ... ... .... 211
E.3 .ii.c Initiating & Responding to Social Interaction (lSI & RSI)................... 211
E.3 .ii.d Case Reference Data.:................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
E.4.ii.a Grand Total ofESCS Scores Case Reference: # D.2 (Down Syndrome)
Initiating & Responding to Joint Attention (IJA & RJA)......... ... ... . . . . .. 212 ·
E.4.ii.blnitiating & Responding Requesting Behavior (IR. & RR) ..................... 212
E.4.ii.c Initiating & Responding to Social Interaction (lSI & RSI)................... 212
E.4.ii.d Case Reference Data............................................................... 212
E.S.ii.a Grand Total ofESCS Scores Case Reference: # E.2 (Down Syndrome)
Initiating & Responding to Joint Attention (IJA & RJA)....... .. ... ... .. . .. . 213
E.5.ii.blnitiating & Responding Requesting Behavior (IR & RR)... .. . . . . ... ... .. .. 213
E.5.ii.clnitiating &Responding to Social Interaction (lSI & RSI)...... ... ... . . . . .. . 213
E.5.ii.d Case Reference Data............................................................... 213
E.6.ii.a Grand Total ofESCS Scores Case Reference:# F.2 (Down Syndrome)
Initiating & Responding to Joint Attention (IJA & RJA) ...................... 214
E.6.ii.blnitiating 15!- Responding Requesting Behavior (IR. & RR) ..................... 214
E 6 .. I . . . & ·R . . S . . S S ) . .u.c ruttatmg espondmg to oc1al InteractiOn (I I & R I . . . . . . . . . . . . . . . . . . . 214
E.6.ii.d Case Reference Data ............................................................... 214
XlV
E. 7 ii.a Grand Total of ESCS Scores Case Reference: # G.2 (Down Syndrome)
Initiating & Responding to Joint Attention (IJA & RJA)..................... 215
E. 7.ii.b Initiating & Responding Requesting Behavior (IR & RR)......... .. . . . . . . . . 215
E.7.ii.cinitiating & Responding to SociaJ Interaction (lSI & RSI) ................... 215
E.7.ii.d Case Reference Data ............................................................... 215
E.l.iii.a Grand Total ofESCS Scores Case Reference:# A.3 (Autism Spectrum
Disorder) Initiating & Responding to Joint Attention (IJA & RJA) ........ 216
E.l.iii.b Initiating & Responding Requesting Behavior (IR & RR)... ... ... ... ....... 216
E.l.iii.c Initiating & Responding to SociaJ Interaction (lSI& RSI) ................... 216
E.l.iii.d Case Reference Data ............................................................... 216
E.2.iii.a Grand Total ofESCS Scores Case Reference: # B.3 (Autism Spectrum
Disorder) Initiating & Responding to Joint Attention (IJA & RJA) ... '··. .. 217
E.2.iii.b Initiating & Responding Requesting Behavior (IR & RR)............... .. . . 217 ·
E.2.iii.c Initiating & Responding to SociaJ Interaction (lSI & RSI) .................... 217
E.2.iii.d Case Reference Data ............................................................... 217
E.3.iii.a Grand Total ofESCS Scores Case Reference:# C.3 (Autism Spectrum
Disorder) Initiating & Responding to Joint Attention (IJA& RJA) ........ 218
E.3.iii.b Initiating & Responding Requesting Behavior (IR & RR)... .. . ... ... .. . .. .. 218
E.3.iii.c Initiating & Responding to Social Interaction (lSI & RSI)....... .. . . . . . . .... 218
E.3.iii.d Case Reference Data.............................................................. 218 .
E.4.iii.a Grall:d Total ofESCS Scores Case Reference: # D.3 (Autism Spectrum
Disorder) Initiating & Responding to Joint Attention (IJA & RJA).... .. . 219
E.4.iii.b Initiating & Responding Requesting Behavior (IR & RR)... ... ... ... ... ... 219
E.4.iii.c Initiating_& Responding to Social Interaction (lSI & RSI) ................... 219
E.4.iii.d Case Reference Data.............................................................. 219
E.S.iii.a Grand Total ofESCS Scores Case Reference:# E.3 (Autism Spectrum
Disorder) Initiating & Responding to Joint Attention (IJA & RJA)....... 220
XV
E .:; iii.b Initiating & Responding Requesting Behavior (IR & RR) ................. . 220
E.5.iii.c Initiating & Responding to Social Interaction (lSI & RSI)............... ... 220
E.5.iii.d Case Reference Data.............................................................. 220
E.6.iii.a Grand Total ofESCS Scores Case Reference:# F.J (Autism Spectrum
Disorder) Initiating & Responding to Joint Attention (IJA & RJA). .. . . . . 221
E.6.iii.b Initiating & Responding Requesting Behavior (IR & RR)............... .... 221
E.6.iii.c Initiating & Responding to Social Interaction (ISI & RSI)............... .... 221
E.6.iii.d Case Reference Data.............................................................. 221
E. 7.iii.a Grand Total ofESCS Scores Case Reference: # G.J (Autism Spectrum
Disorder) Initiating & Responding to Joint Attention (IJA & RJA)....... 222
E. 7.iii.b Initiating & Responding Requesting Behavior (IR & RR)....... .. . . . . . . .. . . 222
E.7.iii.c Initiating & Responding to Social Interaction (ISI & RSI)............... .... 222
E. 7.iii.d Case Reference Data.............................................................. 222
F.l.i Child Percentage Scores of the Early Social Communication
Scales (ESCS) for Typically Developing Case Reference: # A.1... . . . . . . . . . 223
F.2.i Case Reference:# B.l............ ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . ... . . 223
F.J .i Case Reference: # C.l.............................................................. 224
F.4.i Case Reference:# D.1 .............................................................. 224
F.5.i Case Reference:# EJ .............................................................. 225
F.6.i Case Reference: # F.l...................................................... .. . . . . . . 225·
F. 7.i Case Reference: # G.l... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
F.8.i Scores/Percentages oflmitation Points During Social Interaction . . . . . . . . . . 226
F .1. ii Child Percentage Scores of the Early Social Communication
Scales (ESCS) for Down Syndrome Case Reference:# A.2 .................. 227
F.2.ii Case Reference:# B.2 .............................................................. 227
F.3.ii Case Reference:# C.2 .............................................................. 228
XVI
F -iii Case Reference:# 0.2 ........ . 228
F5 ii Case Reference:# E.2 ......... . 229
F.6.ii Case Reference:# F.2......................................................... .. . . . 229
F. 7.ii Case Reference: # G.2............................................................. 230
F.S.ii Scores/Percentages of Imitation Points During Social Interaction.......... 230
F.I.iii Child Percentage Scores of the Early Social Communication
Scales (ESCS) for Autism Spectrum Disorder Case Reference: # A.3...... 231
F.2.iii Case Reference:# B.3 .............................................................. 231
F.3.iii Case Reference:# C.3... .. . ... ... ... .. . . . . . .. ... ... ... ... ... ... .. . ... ... .. . ... .... 232
F.4.iii Case Reference:# 0.3......... ... .. . .. . . . . .. . .. . . .. . . . . . . ... .. . . .. . . . . . . . .. . . . . ... 232
F.5.iii Case Reference:# E.3 ........................ ·... ... ... ... ... ... ... . .. ... ... ... .... 233
F.6.iii Case Reference:# F.3... .. . . .. ... ... ... ... ... ... ... .. . ... ... ... ... ... ... ... . .. .... 233
F.7.iii Case Reference:# G.3... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... 234
F.8.iii Scores/Percentages of Imitation Points During Social Interaction........... 234
xvii
LIST OF PHOTOGRAPHS
Photo Page
3.1 Sample ofESCS Testing Items.................................................. 75
3.2 Example ofESCS Testing Environment....................................... 76
XVlll
PENGESANAN A WAL MASALAH BAHASA KANAK-KANAK MELA YU:
IMPLIKASI TERHADAP PERSEDIAAN PERSEKOLAHAN
ABSTRAK
Perolehan bahasa mungkin satu-satunya perkembangan paling asas diperoleh oleh kanak
kanak bagi menyediakan diri untuk pendidikan fonna1. Biasanya, kanak-kanak
memperolehi bahasa dengan mudah. Walaubagaimanapun, kadang-kadang sesuatu
kesilapan berlaku, sistem sokongan sangat penting untuk menolong individu dan
keluarga apabila masalah itu dijangka Apabila diketahui adanya risiko kebantutan at~m
masalah dalam perkembangan bahasa ( contohnya, bayi yang dilahirkan Sindrom Down)
keluarga akan diberi panduan dalam interaksi dengan bayi mereka, jadi potensi optimum
bayi boleh disedari.
Kesinambungan untuk perkembangan bahasa pragmatik bayi . berkembang maju dari
perkongsian perhatian dengan orang dewasa ( contohnya, kedua-dua melihat pada
pennainan bergerak yang sama), mengikut apa yang orang dewasa perhatikan,
( contohnya, orang dewasa menunjuk gambar dalam buku) dan mengarahkan perhatian
orang dewasa ( contohnya, kanak-kanak menunjuk ke arah pejalan kaki).
Oleh itu, kajian ini bertumpu kepada kepentingan kemahiran pra-verbal yang
mempengaruhi perkembangan kemahiran verbal kemudian hari. Kajian ini berfokus
kepada: Bilakah penggunaan bahasa pra-verba1 yang awal muncul pada bayi normal?
Adakah terdapat sebarang perbezaan pencapaian antara kanak-kanak normal dengan
kanak-kanak yang bermasalah dalam bieang pragmatik?
XIX
Kajian perintis ini bertumpu kepada rra-verbal tahap tinggi. kemahiran pragmatik untuk
menuding, memberi dan menunjuk. ESCS (Early Social Communication Scales) telah
dipilih sebagai alat ujian utama untuk diperhatikan, dalam tiga tempoh, interaksi antara
pengkaji dengan setiap satu daripada rujuh kanak-kanak yang normal, tujuh kanak-kanak
Sindrom Down dan tujuh kanak-kanak Autisme.
Kemahiran-kemahiran y_ang disebut sebelum ini wujud antara umur 10 - 16 bulan.
Manakala perbezaan dan kebantutan dicatat antara kanak-kanak normal dengan kanak
kanak istimewa.
Cadangan-cadangan diberi untuk membantu mengesan kebantutan awal pragmatik pada
kanak-kanak dengan keperluan khas dan mereka yang berisiko bagi menyediakan mereka
satu permulaan komunikasi yang lebih baik dan menyediakan mereka peluang untuk
alam persekolahan yang Iebih baik.
XX
ABSTRACT
Language acquisition perhaps is the single. most fundamental development acquired by a
child to prepare him for formal education. A child apparently and usually acquires his
Ianguage(s) with ease. However, when sometimes something goes wrong it is imperative
that a support system is in place to provide help to the individual and family as soon as
the problem is suspected. When there are known at risks for delays or disorders in
language development (e:g., a baby born with Down syndrome) then from birth onwards
the family can be guided in their interaction with their infant so that his optimal potential
can be realized.
The continuum for pragmatic language development is naturally infants progressed from
sharing attention with the adult (e.g., both looking at the same activated toy) to following
what the adult was attending to (e.g., adult points to pictures in the book) and finally to
directing the adults' attention (e.g., child points to person walking by).
This research thus aimed to detail the emergence of essential pre:.:verbal skills purported
to effect the development of later verbal skills. The research foci were; when did these
crucial and early non-verbal usages of language emerge in typically developing infants?
And then were there any differences between the performances of typically developing
children with the performances of children who have disabilities in the area of
pragmatics?
This pioneer research concentrated on the higher-level non-verbal, pragmatic skills of
pointing, giving and showing. The Early Social Communication Scales (ESCS) was
chosen as the main testing instrument to observe, on three occasions, interactions
XX1
c'c[\\een the researcher and each population of seven typically developing children:
5e\·en children with Down syndrome and seven children with Autism spectrum disorder.
The aforementioned skills were documented as emerging between I 0 - 16 months of age
while differences and delays were noted amongst and between the typically developing
children and the older-aged special needs children.
Recommendations were gtven to help in the early detection of pragmatic delays in
special needs children along with those who may be at risk for pragmatic delays thus
providing for them the necessary head start towards better communication and enhancing
their chances ofbetter school transition.
xxii
CHAPTER ONE
NATURE AND SCOPE OF THE PROBLEM
1.0 Background to The Study
1.1 The Importance of Language Acquisition
Language acquisition, essential to all areas of development cannot be overstated.
Language learning and language acquisition provides the foundation for all areas of
academic instruction (Tiegerman-Farber, 1995). Through language, a child gained
information, tested his ideas about the world, asked questions, related imaginative and
creative experiences, grasped values and attitudes as well as expressed feelings about self
and others. Through language, he released emotional tension, related with adults and
peers, role-played, and developed his self-image and awareness of others' feelings: He
moved beyond the· egocentric stage to meaningful relationships with others and his
Creator. In other words, he developed intellectually, socially, emotionally and spiritually.
It was probably the single most significant tool that a child acquired. Capute, Palmer,
Shapiro (1987) purported that "language is the single best predictor of future cognition in
a young child" (as cited in Rossetti 1996, p. 143). In fact, researchers understand that the
most significant developmental occurrence between birth and four years of age was the
acquisition ofthe language system (Tiegerman-Farb~r, 1995).
According to Tiegerman-Farber (I 995), if functional language was not acquired by the
age of five, the probability for normal language decreased dramatically for each six
months of life. After ·age eight, there was almost no chance for the child to acquire a
normal language ·system (Ibid, p. 7). In the area of linguistics, especially those who
purported the innatist theory of language acquisition also suggested a critical period for
language learning expiring sometime during early adolescence. Usually by puberty, if the
individual had not acquired a first language, doing so would become difficult or even
impossible (Berko-Gieason & Ratner, !998).
Likewise, this important link between communicative competence and school
performance cannot be overemphasized. In fact, Rossetti (1996) claimed, "age
appropriate communication skill is the single best predictor of school performance" (p.
!25). It was not surpri.sing that research literature emphasized then that the earlier
identification and intervention for · children with language delays or disorders,
developmental delays and those at high-risk for any delays was provided the better
would be their chances of acquiring language and transitioning into the relevant school
environment.
1.1.1 Disorders of Communication
Disorders of communication are the most common developmental disability in children,
.~ecting 3% - 15% of the population depending upon how broad or narrow one's
definition of language delay. Roughly 1% of the pediatric population in children will
experience a severe language delay. Within the 3- to 5-year range of children with
disabilities, 70% have speech and language impairments (Prizant, Wetherby, & Roberts,
1993 ascited in Rossetti, 1996, p. 129).
Communicative skills appeared to be the developmental realm that consistently divides
low-risk from high-risk or no-risk children, with greatest frequency, regardless of the
cause for risk. Some of the known risk factors according to Lockwood (1994) for the
development of communication disorders were: low birth weight (less than 1,500 g);
severe jaundice, hearing loss in family attributed to hereditary etiology; ototoxic drugs;
2
p<.:?rinatal infections like rubella; a r:unily history of speech problems or learning
disabilities (child's immediate family or tirst-degree relative); and other birth defects
(chromosomal syndrome, hydrocephalus. cleft lip/palate etc) (as cited and adapted by
Rossetti, 1996, p. 144). There also existed already known established risk children for
developmental delay (e.g., children with sensory disorders, atypical developmental
disorders, exposed to severe toxins etc). These children who were at risk for
communication delay or already known to have communication delay were also at high
risk for developing learning problems once they reached school age.
In the United States of America, Public Law 99-457, (1986) required children with
disabilities to be given IEP (Individualized Education Plan) services as young as three
years of age to five years old (Tiergennan-Farber, 1995). Should the need arise; they and
their family were helped even from birth of their disabled child under t~e IFSP
(Individualized Family Service Plan) (Ibid.). Some states in the U.S. have begun to
provide services for those infants and toddlers who were at high-risk for developmental
delay due to different biological or environmental factors (Rossetti, ·1996).
1.2 Context of The Problem
L2.1 The Uniqueness of Malaysia
When considering Malaysia's situation, the most outstanding characteristic was its
unique population that provided a primary example of a multi-racial society. Based on a
1991 census, Malaysia has 64 population groups with Malays and other Bumiputera
being the predominant grouping followed by Chinese and then Indians being the larger
minority groupings resulting in a total population of 17,567 (Hashim Isa, 1998, p. 66).
3
-\lonv with this very colorful ethnic mi". there existed a mosaic of languages at the very . :::;;
least. the same number as the 64 population groupings (lsa. 1998). Bahasa Melayu, was
the official language of the country, for over half of the population of Malaysia or for the
Malays, some Chinese, known as Babas. and some Indians called the Malacca Chetty
(Wong & Thambyrajah, 1991). For this group, however, there existed no formal
pragmatic language assessment for early detection of language delays in their primary
language. Therefore, for. this growing Ylalaysian population, one could only estimate the
number of children who would have significant language-use difficulties.
1.2.2 Malaysia's Challenges
Under Malaysia's present educational system, although it was encouraged that all
children start school at the age of six years or more, there was no law requiring that they
do so. Waiting until the child was in primary one seriously hindered the identp:ication
and treatment of children with language problems. Efforts were being made to help the·
school-age child with learning difficulties, for example, the provision of special classes
within public schools, . inclusion opportunities, and special schools run by non-
governmental agencies. These facilities, for the most part, were catering for the child
above six years of age. Identification ~d therapy must begin before thi~ time to ·ensure
optimal chance of habilitation and school readiness.
Furthermore, children growing up in Ylalaysia cope with more than one language, as
both Bahasa Melayu and English were compulsory subjects in the school system. Under
normal circumstances, bilingualism v.ill enrich one's life. However, based on the
researcher's experience, coping with rr.ore than one language when a child was already
experiencing difficulty in his primary }anguage could confuse him and slow down the
4
rate of first language acquisition. This was significant to the researcher as children with
language delay or disorders would benefit from I) starting earlier in the educational
system (i.e., pre-school settings); 2) repeating a grade or level (if necessary); and 3)
concentrating on one language until a good foundation has been achieved.
The problems were further compounded by the fact that even if a serious learning .
problem or learning di~ability was observed, there was no data base collection of the
number of persons with learning difficulties here in Malaysia, except for the voluntary
registration of disabled people with the Welfare Department. According to the
Department of Statistics, Malaysia the 1980 Census resulted in 0.8% of the populations
in Malaysia were disabled. In an unpublished report of the 1980 Census the estimated
number of disabled. were 106,798 persons but only 84,120 have been regist~red as·at
August 31, 1999 (Rahman, 1999). With limited incentives or benefits by reaistering
(coupled with the stigma associated ~1th having a differently able child), it was difficult
to know the true situation of how many persons with learning difficulties, disabilities or
delays exist. This would. also lead to insufficient educational services as well as lack of
trained teachers, speech and language pathologists and audiologists to adequately
provide services to children with language del<J.ys or disorders and their families.
Another area.of concern was the current work force of trained personnel. According to
Sandra Van Dart, Department of Audiology and Speech Sciences, Universiti
Kebangsaan Malaysia (Kuala Lumpur) there were only 60 qualified speech and language
pathologists in Malaysia (Chapman & Khoo, Sunday Star's Education section, December
16, 2001). This number was still grossly inadequate to cope with the ever-growing
5
dc;>rnands for aural, speech and language therapy especially smce the majority of the
:1bove were based in the Klang Valley (Ibid.).
In the area of special education, there are several specialist teachers' training institutes as
well as a few attempts by some local universities of late to train teachers for the slow
Ieamer, visually and hearing impaired populations, however, these were still too few to
meet the needs.
1.3 Statement of The Problem
To date there was no documentation available in Malaysia for Malay-background
children experiencing language delays or disorders in the area of pragmatics. During the
child's early stage of language learning when he was at the pre-linguistic stage, it was
important to observe how he communicated (i.e., gestural, nonverbal, looking, P.ointing,
vocalizing), how often did he communicate and under what circumstances did he
communicate or in other words, the pragmatics oflanguage.
Development of pragmatics occurs along a continuum. This research documented
specific key pragmatic skilled areas, such as, the appearance of requesting be~avior, joint
attention and social interaction as they emerged in typically developing children and
compared th~ir performance with special needs populations' of children with Down
syndrome or autistic characteristics in the same above areas.
1.4 Research Objectives
• To identifY the onset of specific,. early pragmatic skills m pre-linguistic typically
developing children within the Malaysian context.
6
• To describe the differences between the special needs population and the typically
developing children in specific pragmatic language skills within the Malaysian
context.
• To describe the differences within the population of children with special needs in
specific pragmatic language skills within the Malaysian context.
1.5 Research Questions
• When did these specific, early pragmatic milestones emerge m the typically
developing Malay background child?
• What were the differences in the development of these pragmatic milestones for the
Malay background child with special needs in comparison to the typically developing_
child's performance?
• What were the differences m the pragmatic performances between children with
Down syndrome and the children with Autism spectrum disorders?
1.6 Significance of The Study
1.6 1 The Earlier the Better
When intervention was conducted as early as possible, the chances were better for the
child to develop a normal language system. Early assessment played a significant role in
detecting infants and young children who showed early evidence of handicapping
conditions and/or significant delays, so that intervention or treatment was provided when
it was most likely to be effective. The earlier this initiative of intervention took place, the
smaller the educational problems over time, the less severe the child's difficulties would
be and the greater would be his integration or inclusion into the educational sphere.
7
fhe researcher quoted a study undertaken in the UK, which proposed that specific early
..:ommunicative behaviors predicted a ('hild's subsequent linguistic development. Liane
Smith concluded that certain behaviors at I 0 months reliably and effectively predicted
language attainment scores at age two. These specific behaviors included key pragmatic
skills such as initiating interactions. sharing experiences Goint attention), seeking
assistance (requesting) and providing interactive feedback (social interaction) (Smith,
1998). If such a reliable .early screening procedure were given to alert primary healthcare
services, so that monitoring of high risk infants would be possible at an early age, then
subsequently more appropriate referrals would be made to speech and language
pathologists with intervention taking place as early as possible.
1.6.2 No Previous Research Available
As has been stated, in Malaysia, no documentation of the emergence of key ~epping
stones in children's early use of their nonverbal gestural communication skills has been
made. There was also as yet no confirmation of the differences that existed between
typically developing children and children with disabilities in this domain of pragmatics
or use of language. Therefore research was vital in order to have assessment measures
available to detect at-risk or established risk children for communication delay I disorder
in Malaysia.
1.7 Limitations ofThe Study
• The sampling was restricted to the population of Penang with small numbers of
children tested· per category. The mental age was not directly tested.
8
• There could have been taboos or cultural faux pas that the researcher was not aware
of which could affect the testing sicuation. This was a limitation for the researcher.
being a non-Malaysian.
1.8 Definition ofTerms Used in This Study
Typically Developing Children: Children who are developing according to what is
known as normal.
Autism Spectrum Disorder: a widely used term that describes a large and diverse
group of children who have difficulties in social interaction, play and communication.
Specifically, autism then has an onset before three years of age with delay or abnormal
function in at least one of: social interaction, language for social communication,
- -
symbolic or imaginative play (Trevarthen, Aitken, Papoudi & Roberts, 1998).
Down Syndrome: a chromosomal abnormality occurring _once in about 800 - 1000 live
births. Some of the characteristics included: low muscle tone; flat facial profile; upward
slant to the eyes; abnormal shape of the ear; hyper-flexibility; and an enlarged tongue
{National Down Syndrome Society, New York, NY).
Communication: expresses needs, thoughts and ideas to make something happen. It
could involve language, speech, sounds, gestures, facial expressions and body
movements.
Speech: is the most common form of expressing language by the physical act of making
the sounds correctly and using good rh:.thm (intonation, stress, voice quality etc).
9
L;tnguage: is a system or code of arbitrary symbols used for human communication.
These symbols represented meaning and the rules that governed that code. Furthermore,
it involves understanding words, signs. gestures or symbols and being able to use these
to communicate thoughts, ideas and concepts in a systematic way.
Language Disorder: is an impairment or deviant development of comprehension and/or
use of a spoken, written, and/or other symbol system. The disorder may involve (I) the
form of language (phonologic, morphologic, and syntactic systems), and/or (2) the
content of language (semantic system), and/or (3) the function of language in
communication (pragmatic system) in any combination (Smiley & Goldstein (1998)
taken from the American Speech-Language-Hearing Association (1982) definition.]
Language Delay: is a developmental delay in so far that the language developm~nt was
normal in all ways (content, form and use) only that it began later than was expected and
proceeded more slowly than expected (Lahey, 1988). Thus the child used the same forms
to talk about the same ideas in the same contexts and for the -same purposes of the
typically developing child, the only difference being the rate of development.
Pragmatics: according to Bates (197-+), one of the early pioneers in this field, said
simply, "pragmatics refers to the study of the use of language in context, by real speakers
and hearers in real situations".
Pre-linguistic Communication: referred to that period of development before a child
has a linguistic system for acquiring language.
10
Social Interaction Skills: concerned rhe use of eye contact. gestures and affective
(emotional) signals to elicit and main£Jin turn taking (Mundy & Gomes, 1997 p I 14 ),
i.e., a toddler smiling, making eye contact showing an open hands gesture to indicate his
rum in a catch-the-ball game etc.
Requesting Skills or Behavior Regulation: concerned the use of gestures and eye
contact to direct attenti<?n and evoke help in obtaining an object or event (Ibid.) (e.g.,
giving a wind-up toy while making eye contact with an adult in order to get help _in
winding it up).
Joint Attention Skills: similar to requesting skills except that the child was directing the
adult's attention with the purpose of sharing the experience of an object or an event with
him and not to obtain help from him (Ibid.).
1.9 Conclusion
Investigation into the domains of early nonverbal communication-behavior (pragmatics)
did yield significant information to lead one to suspect a child at risk for a language
delay I disorder and did identifY a child as having an established risk for communication
di-sorder and/or developmental delay.
Therefore, m order for early identification and mediation of language disordered
children/at-risk children, it was imperative that this research focused on the early use of
communication in· the form of requesting, joint attention and social interaction in the
most natural context and at the earliest possible age. These key pragmatic developmental
11
~kills have been targeted because they retlected early nonYerbal communicative skills
rhat were particularly linked to early language development.
In addition, the researcher presented three populations who underwent this investigation
in order to compare the performances of typically developing children with special needs
children. The different pragmatic profiles of these populations have shed further
understanding to the lipkage between early language development and nonverbal
communication. This research has been instrumental in drawing up guidelines to
encourage early identification and intervention of children with language-use difficulties
to help ensure their appropriate school preparation and placement.
12
CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.0 Chapter Preview
This chapter began with an overview of particularly relevant language learning models
including the most common views of the nativist versus behaviorist controversy~ the
psycholinguistic theory~ the classical view~ the cognitive theory~ the social
interventionist theory and a relatively new theory known as the connectionist model.
Next the literature review featured a brief look at the past and current developments in
the field of pragmatics. Crucial issues related to pragmatics and the links between pre
linguistic communication and language development and their relationship to
developmental disabilities were also explained. Normal language development followed
along with early pragmatic skills from birth to 12 months and language development of
children with Down syndrome and Autism spectrum disorders. Finally Iiteratur~ on the
significance and reliability of parent reporting · measures ·such· as the MacArthur
Communicative Development Inventories (CDI) concluded this chapter, as this research
utilised one of the MacArthur Inventories and one parent interview-measure.
2.1 Review of Related Theoretical Literature on Language Learning Models
2.1.1 Introduction
How did the. typically developing child learn language? How did the child with special
needs differ from the typically developing child when learning to communicate? These
questions have no easy answers. Much variability in linguistic acquisition existed within
both the typically· developing child and the child who was differently able. Decades of
research have invested time and effort in order to understand the dynamics of child
13
language acquisition. This research was not made any easier by the fact that children
learned language rapidly, within only a few years.
Consider all that was involved in learning a language. First one must recognize the sound
system of the language; the rules used in combining sounds into words; and that words
represent objects, actions, and relationships from everyday experience. Then, one must
use specific rules to combine words into sentences to express thoughts; as well as apply
rules appropriately in the various usage's of language such as to get something, to
comment, to convince; to ask for information or clarification and for social niceties, such
as greetings.
There seemed to be similarities across languages of what was learned early or late. For
example Berko Gleason and Ratner ( 1998) cited that first words were similar in p.honetic
form and meaning, even two word combinations had similarities in thought and
intention, such as, phrases containing negation, recurrence and nonexistent type words.
Furthermore, across languages there appeared to be a predictable sequence of what was
learned first and so on (e.g., syntactic structures). Language learning theories must also
account for why and how children made mistakes along with how input effects their
learning.
2.1.2 Nativist Versus Behaviorist
In times past, language learning was always looked at from either the nativist or the
behaviorist stance." Briefly stated, the nativists believe that the human brain was designed
to learn language and that there were inborn mechanisms that made this possible. The
:>rinciples of language therefore were preprogrammed. Although primarily focused on
14
bic1logical factors (left hemisphere of the brain heing the center for language), nativists
would acknowledge that both genetics and the environment played a part in developing
the brain (Smiley & Goldstein, 1998, p 21 ).
On the other hand, the behaviorists or learning theorists focused on the processes of
acquisition and not on the linguistics or biological system. The learning theory behind
this approach viewed lan~age as ·a subset of other learned behaviours, or language was
acquired according to the general laws of learning and was similar to any other learned
behaviour. Language therefore was a learned or conditioned response to stimuli (Ibid, p
22) and developed as a result of the adults' reinforcement and gradually shaping the
infants' babbling.
2.1.3 Psycholinguistic Theory
The leading researcher for this theory ·was Noam Chomsky. He purported that the child
was born with an innate (biological) capacity, for example, "the language faculty'' or
"language acquisition device" (LAD) that predisposed the infant to acquire a language
system I systems. Yet the environmem activated the LAD thus allowing children to
develop and use the universal rules underlying language (Smiley & Goldstein, p 26).
Numerous researchers beginning in the mid-70's until the present have shown evidence
that infants are born with an innate ability to communicate with the feelings, interests
and purposes of other persons (Trevarthen, Aitken, Papoudi & Robarts, 1998 p 93). This
was not surprising, as even an unborn baby has learned to recognize the mother's voice
(DeCasper & Fifer, 1980 as cited in Trevarthen et al, 1998). Lecanuet & Granier-Deferre
(1993) proved that the unborn child could hear before he was born and could
15
demonstrate a preference for the mothers· voice shortly after his birth (as cited in Berko
Gleason & Ratner, 1998 p 356).
It was through the development of these abilities that the child would learn to share his
ideas, identify them with symbols and eventually learn how to explain them in the
language of the 'mother tongue'. Many experiments have proved that infants were
keenly alert to their surr<?undings and capable of remarkable discriminations among the
signals from people, especially those giving information about "states of mind" (as cited
in Trevarthen et al, 1998 p 93).
On the part of the infant, he showed emotions composed of facial expressiOns,
vocalizations and body postures in an organized manner with respect to environmental
events (Weinberg & Tronick, 1994). Even at birth, the newborn was cap.able of
matching the adults' oral gestures (e.g., tongue-protruding), thus capable of making very
early attempts at oral exploration of interesting objects (Jones, S. 1996 p 1952).
Needless to say, it was evident that the newborn had capabilities that could not have been
learned but must have some bearing on innate abilities in the infant.
2.1.4 Classical Theory
Classical thinkers believed that children's language formulation was creative and that
children learn the rules for combining linguistic units making hypotheses about these
rules and their applications (Chapman, Streim, Crais, Salmon, Strand, & Negri 1992 p 4).
Advocates would· even say that children have the ability to generate an infinite number of
well-formed sentences given enough time. However, to query this thinking, it could be
argued that this was an oversimplification of children's language learning. Nelson
16
1 !986). Peters ( 1984), Bruner ( 1978). and Snow ( 1977) have called attention to the role
of routine, predictable, interactive games of children with their parents. These social
activities included peek-a-boo games, reading the same books or playing with the same
toys over and over again. In these dyad and triad interactions, common expressions were
repeated so that in time the child would be able to produce first, his or her part of the
dialogue and later the parent's part too. Thus children did not always create utterances
out of thin air. More frequently they said what they either have said before in that
situation or what someone else has said to them (Chapman et al, 1992 p 5). Therefore, it
was more correct to say that children were both reproducers and creators of their
utterances rather than either one or the other.
This point was significant, as this research concentrated on activities done in a routine
manner to engage the child in the same social interaction and joint attention giliileS in
order to observe and record the child's reactions over time.
2.1.5 Cognitive Theory
A key factor not yet mentioned pertained to a child's cognition. When considering the
role cognition played in language development, cognitive theorists held to the belief that
language was a subordinate part of cognitive development. Numerous cognitive theorists
suggested first the child must learn about his world around him and then only could he
map language onto this prior experience (Berko Gleason & Ratner 1998 p 383).
Through physically moving about his world, the infant observed and developed · a
sensorimotor understanding of the space where he lived. Person permanence and object
pennanence were early time and causality concepts that the infant understood. The
development of these cognitive skills was necessary for language to be built upon later.
17
Piaget's perspective would place language embedded or mapped onto a person's set of
prior cognitive structures because principles of language \Vere no different from other
cognitive principles (Ibid. p 394).
2.1.6 Social Interactionist Theory
The social interactionist theory held that language as a facet of communicative behavior
developed through intera~tion with other people (Berko Gleason & Ratner, 1998 p 386).
It was not sufficient to have neuropsychological gifts (nativist position) nor exposure to
language (learning by observation and imitation, the behaviourist position) to ensure its'
development. But it was the special ways and language used by adults that enacted this
process as the adult finely tunes or tailors these to the specific cognitive and
communicative needs of the child (Berko Gleason & Ratner, 1998 p 386.) An example
of this was the role of child-directed speech or baby talk. Babies seemed to pr~fer the
- -adult to use many repetitions, simple synta:X, exaggerated intonation and slower high
frequency speech but this poor model did not inhibit the child's learning language over
time (Ibid. p 385).
Bruner (1985) suggested an alternative to Chomsky's LAD "language acquisition .· .....
device" in the LASS or "language acquisition socialisation system". Children, therefore,
were not relying on their LAD to decode the syntax of language around them rather they
were seen as social creatures who acquired language in the course of their need to
communicate with others (Berko Gleason & Ratner 1998, p 386.) What may strongly be
linked to a child's early word use was his own communicative goals of continuing the
interaction, of drawing the parent's attention to himself or to the world, of obtaining a
desirable object, or of protesting an undesirable action or object (Chapman, 1999 p 55).
18
This clearly related to early use of language (pragmatics, the tocus of this research) and
not initially to a system of linguistic mles
2.1.1 Connectionist Models (Parallel distributed processing or PDP model)
The final theory of language acquisition discussed was the connectionist model, a
relatively recent approach. This theory explored how infonnation may be built into a
system or into the chiJd's brain through neural . connections. Parallel distributed
processing (PDP) models claimed that connections and their statistical probabilities, not
rules, underly language development. :\ssociations were fanned in the mind, based on
the elements involved, and sufficient exposure to these elements led to the establishment
of neural networks. The power of the system came from how the units were connected
(Johnson-Laird, 1988 as cited in Berko Gleason & Ratner, 1998, p 387). A child
established such connections over time through exposure to the fonns of l~guage
associated with external events. That was why; clearly the activation· of one concept in
our minds had the capacity to bring up another (e .. g., lb/ sound, the concept ofbottle and
milk are all nodes that lead the child to relate to the word 'bottle' and the concept of
wanting a drink).
Ultimately those inter-connected associations became the meaning of the word. If for
example, the. particular construction appeared very frequently, then those connections
were stronger. If a particular sequence were statistically likely, the model would extend
previously noted regularities to the new data. This could explain how children often
made mistakes in .English with over-generalizations, such as 'showed, mowed, towed,
glowed' produces 'growed' for the paSt tense of' grow' (Berko Gleason & Ratner, 1998
p 388).
19
In conclusion, all theories were relati\ dy selective concentrating on one or some of the
phenomena involved in language leJrning to the possible exclusion of other key
considerations. Bruner ( 1975), the early entrepreneur of pragmatics, however, succinctly
summarized this issue of language learning. "Whatever view one takes of research on
language acquisition - however, nativist or environmentalist one's bias" (cognitive,
social, psycholinguistic or connectionist) - "one must still come to terms with the role or
significance of the child's pre-speech communication system" (as cited in Mundy &
Gomes, 1997 p 107). (Words in italics were the researcher's additions).
2.2 Early Historical Developments in the Pragmatics ofLanguage
Due to a trend toward nativist thinking Bruner wanted to be sure that the pre-linguistic
social and cognitive foundations for language development were not overlooked. ae
advanced an atmosphere of exploring the environmental and variable proces~es that
supported the infants' capacity to acquire language (as cited in Mundy & -Gomes, 1997 p
128). Furthermore, his rapt interest in infants' prelinguistic communicative behaviors
between the ages of 8 - 12 months concluded that there was communicative intent before
age one (Ibid. p I 07).
Iri the early 1970's Dore (1974) proposed that the child apparently did express some
primitive intentions before the onset of language. He hypothesised that before the child
acquired sentence structures, he possessed systematic knowledge about the pragmatics of
his language, which was best described in terms of "primitive speech acts" or PSA's
(1974, p 344). Dore identified 9 PS...\.'s, these were labeling, repeating, answering,
requesting for an action and requesting for an answer, calling, greeting, protesting and
practicing {Ibid. p 347).
20
communicative tunctions expressed by children between 9 - 18 months of age were
predominately requesting for objects and actions or information; protesting (rejecting);
greeting; and naming behaviors. The researcher focused on observing only some of these
functions during the course of the study because the age limits of the children studied
were below 18 months for typically developing children.
Dore studied two childr~n who used their primitive speech acts in very different ways.
M's acts were basically representations of the world to herself (acts such as labelling,
repeating and practicing words); whereas, J's acts were mainly to manipulate other
people, hence more instrumental in nature (requesting, answering a question, calling
someone or protesting). Thus in summary, M was mainly declaring things about her
environment while Jwas directly influencing his (Dore, 1974 p 350).
Nelson (I 973) referred to these two types of learning styles as the referential child (child
M who emphasised objects) and the expressive child (child J who attended to people and
feelings) (as cited in Berko Gleason & Ratner, 1998). This may have explained how
children differed in their own style of learning but intent to communicate remained a
vital part in this process of langyage acquisition.
2.3 Current Development in Pragmatics of Language
By the late 1970's and into the 1980' 5 this movement to the study of pragmatics was
dramatically shifting the study of language and communication development yielding
significant changes in the fields of special education and speech-language pathology
(Prizant & Wetherby, 1998). Previously it was thought that there was no need to assess
the early non-verbal language (pre-linguistic) development of an infant (age one year or
21
below) This was because generally children did not learn to talk before their first
birthday. However, this thinking that there was no need for a communication-based
assessment before the age of 12 months old was a grave misconception. The researcher
had often heard or read about parents having concerns for their child at quite an early
age. They were often told by various professionals or their family members and friends,
·not to be concerned about it', 'wait until the child was older' or even 'he will probably
grow out of it'. This notion was being challenged, as the following review of recent - . literature in this key area of pragmatics demonstrated.
2A Related Research Literature
2A.l Review of Pre-linguistic Communication and Language
Development Links
It was a well-established fact that delayed pre-linguistic development affected linguistic
communication or language development, which ultimately affected '! chil9.'s readiness_
for school. Yoder and Warren (1993) presented two primary reasons why targeting pre-
linguistic development will result in raised or increased linguistic development. First,
improving the child's use of vocalization and intentional communication should help lay
a foundation for utilisation of adult input in the language developmental process. And ..
second, as the child's frequency and clarity of communication improves, an increase of
adult-child interactions (tum-taking) result. Therefore, the outcome then was a better
overall language performance for the child (as cited in Rossetti, 1996, p 186).
Furthermore, facilitative partner's style that follows the child's attentional focus, offers
choices and alternatives within activities, responds to and acknowledges a child's intent,
models a variety of communicative functions (including commenting on a child's
activities), and expands and elaborates upon the topic of a child's verbal and nonverbal
22
.;~,.1mmunication resulted in higher rates of student-initiated interactions, question asking,
Jlld conversational initiation in students with autism (Prizant & Wetherby, 1998 p 338).
The reverse was also noted when a highly adult directive approach emphasized adult
selected topics and activities, frequent use of commands and test questions, and
intrusions on a child's behavior through a reliance on physical prompts of appropriate
responses, resulted in fe~er child initiations, less elaborate responses, a limited range of
communicative functions expressed, and conversational reticence or passivity (Ibid.).
Therefore it was necessary to study this inter-relatedness between pre-linguistic
communication and language development. Asma Hj. Omar (paper presentation, July
2000) in her case study with her grandson when he was aged 5 weeks up to 36 months
old supported the theory that early speech was the communicative socialised t}'Re. ·· She
labeled the pre-verbal stage at one to 5 months old when the infant responded to voice
and nursery rhymes; used body movements for affective I cognitive purposes; recognised
a few words from baby· language; produced monosyllables with -no fixed meaning and
simulated conversation. She divided the single word stage (linguistic stage) of 6 - 27
months in her case study into two phases. Phase 1 (from 6 - 16 months), th~ child
expressed meaningful exclamations like /hail; said full words with meaning (object
words and kinship words for grandparents) and discourse based words (eg., sudah makan
or finished eating; apa? or what? in response to his name); and understood commands
and questions (where; which one). In Phase 2 (from 17 - 27 months) a tremendous
Increase in vocabulary took place; he referred to sel( understood possession; responded
. '~erbally to questions and commands; understood discourse of other people and began to
form concepts (knowing things have names by pointing to them) (Ibid.).
23
.-\sma Hj. Omar concluded from the socialised speech of the child. one could detect the
child's learning of the social and cultural rules of his speech community, his affective
cognitive use of language, as well as his cognitive development. To the researcher's
knowledge this was the first Malaysian long-term study of this magnitude that
documented the Malay-background child's use of language at such an early age and for
such a long-term relationship.
Another recent study investigated the significance between certain early interactive
behaviours and children's subsequent communicative development. For example, a study
in press by Morales, Mundy, Fullmer, Yale, Messinger, Neal and Schwartz indicated that
responding to joint attention at 6, 8, I 0, 12 and 18 months was positively related to
individual differences in vocabulary development. This study also included a parent
report measure of language development showing agreement with the above voc.abulary
acquisition predictions.
Liane Smith from Canterbury, UK, looked at infant pragmatic signaling systems and
joint attention skills. During the course of the study, the frequency and distribution of
these early behaviours in a random sample of 145 ten-month-old infants were
in·vestigated and followed-up at ages 24 and 36 months. Ten early communicative
behaviours (from a total of 31-item assessment battery) had predictive validity for future
language development. These included 1) reacts to sounds; 2) reacts to speech; 3) copies
wave bye-bye; 4) defines by function (e.g., objects); 5) 'first words'; 6) feeds others
(sharing); 7) follows directional point; 8) 'shows' objects (initiating interaction); 9)
requests by reaching (seeking assistance); 10) hearing status (Smith, 1998 p 138).
24