8 Chapter 1
Fetal Alcohol Syndrome
Fetal alcohol syndrome (FAS) and a milder form of this disorder, fetal alcohol effect (FAE), are
common birth defects (Tharpe, 2004). FAS is a cluster of fetal defects including orofacial anoma-
lies, spine and limb malformations, intellectual disability, language delay, and other disorders
caused by ingestion of alcohol by the mother during pregnancy. The severity of the malformations
in the fetus appears to be related to how much alcohol the mother has consumed and for how
long. Current research suggests that there is no safe level of alcohol consumption for ex pec tant
mothers. Children with FAS and FAE have communication deficits ranging from mild pragmatic
and social- communication impairments to profound language delay.
Delayed Language Development
Toddlers with delayed language development are sometimes called late talkers. “In the
research lit er a ture, late talkers are typically defined as young children (between approximately
16 and 30 months) whose language skills fall below [ those of] 90 percent of their age peers” (Plante
& Beeson, 2004, p. 177). Plante and Beeson’s review of current research on late talkers suggests
that these children tend to be at risk for continued language prob lems, and that the earlier the
diagnosis is made, the better the outcome; young children fare better than older ones. In addition,
many children identified as late talkers tend to remain behind their peers in language develop-
ment. Plante and Beeson conclude that there is no consensus on the types of early language deficits
(e.g., poor comprehension, initial severity of the deficits, limited use of gestures and vocabulary)
that predicts whether late talkers will catch up to their peers. Clinical prudence suggests that early
detection, monitoring, treatment, and follow-up of late talkers will likely prevent language- based
educational, psychological, and social complications later in their lives. Nelson (2012) notes that
early intervention plays an impor tant role in the prevention of communication disorders.
Treating Language Disorders and the
Individuals with Disabilities Education Act
In 1975, Congress enacted Public Law 94–142, which guarantees students with disabilities
appropriate special education ser vices. In 1997, President Bill Clinton signed the Individuals with
Disabilities Education Act (IDEA) into law. These laws and other federal, state, and local regula-
tions dictate the nature and extent of special education ser vices provided to persons with disabili-
ties. They are particularly relevant to the diagnosis and treatment of language delay and disorders.
All eligible children with special needs are entitled to free and appropriate public education in
the least restrictive environment. To prevent the use of culturally discriminatory tests, language
testing must accommodate En glish as a second language. The tests should be given in the language
spoken in the home or administered with the aid of an interpreter. The Individualized Education
Plan (IEP), sometimes called the Individualized Education Program, specifies when the ser vices
begin, their anticipated duration, short- and long- term goals, and the criteria used to determine
when and whether the objectives have been met.
The IEP also details the extent to which the child can participate in classroom activities. IEP
meetings are held annually, and the child’s parents or guardians are pres ent. Sometimes the stu-
dent is also invited to attend. During the meetings, the IEP is reviewed and changes are made in
writing to address pro gress and deficiencies. All parties are required to sign it, although there are
provisions for absentees. Procedures are established to protect the parents’ and child’s rights. It
should be noted that over a 10- year period, issues related to IDEA were the most frequent sources
of litigation involving speech- language pathologists and audiologists (Tanner, 2003b; Tanner &
Guzzino, 2002).