SPEECH DELAY & Speech Disorder

The order in which children learn speech sounds and language forms is fairly predictable. Most children follow the same pattern of development. When a child is developing skills in this order but is doing it more slowly, he/she has a speech/language delay. Sometimes child does not have the same speech or language skills as other children his/her age and is not just slow in developing. They have gaps in development - they may have some skills that are age-appropriate but are missing some that should have been learned when they were younger. They may say use some sounds or forms that are unusual and never used by any child at any age. This is considered a disorder.

Children who do not develop language skills appropriately are language delayed or disordered. There are many potential causes for language delays/disorders in children, including hearing impairment, cognitive impairment, autism, physical handicap that prevents the child from interacting with their environment, and lack of stimulation. Often, there is no identifiable cause for a language disorder.

Children can have receptive language impairments, expressive language impairments or both. Some children do "catch up" to their peers but many continue to have difficulty and the gap between their skill level and that of their peers may increase over time. As there are multiple factors affecting outcome, it is hard to predict who will "recover" or how great the gains will be. Language disorders are changeable; at different stages of development children have different demands on their language systems. Children with language impairment in the preschool years may appear to catch up to peers by age 5 or 6 years, but then in later years when demands change and children begin to learn to read difficulties become apparent.

Receptive language impairments mean that a child has difficulty understanding language. They may have a limited vocabulary. They may not understand the meaning of word endings: that adding "s" makes a noun plural, or "'s" indicates possession, or that an "ed" ending on a verb means that the action is past. They may have difficulty understanding nonverbal signals, like body language. They may not understand sarcasm, or indirect requests (e.g., "it's cold in here" can mean "please close the window").

Expressive language impairments show up in how a child speaks. They may use only a few words in each sentence. They may leave off word endings, or the little words like "is" and "are". They may not know the names of many words. They may not always use language appropriately and appear to be rude by being too direct or blunt. They might not consider their partner's needs, using ambiguous referents (lots of "he", "she" and "it" when the subject has not been clearly identified), or changing topics abruptly.

Language therapy with preschoolers often focuses on working with families to create an optimal environment for learning language. The Hanen Centre in Toronto has developed an excellent program for helping families of children with language impairments. Their principles are widely used. As adults, we tend to do most of the talking when we are communicating with children. We're better at it, so why not? Think of a conversation you may have had with someone who did all the talking? Did you enjoy it? Did you feel they were hogging the floor? Did you get a chance to have your say, to talk about what you thought? This is how many children feel when speaking with adults. A child who appears to have nothing to say, may have lots to say but just doesn't get a chance. They may be communicating in other ways, not just speech. We need to look for the clues, the signals they send that show they are communicating then help them build on them. Have you every spoken with someone who uses big words, long complicated sentences? You have trouble understanding and keeping up and eventually give up and even tune out. This is how children respond when the language they are hearing is too far above their level. Remember that receptive language is usually slightly ahead of expressive language. If a child is speaking in 2 word utterances, he/she is probably able to fully understand 3 word utterances.

These are general suggestions for communicating with language impaired children. They also apply to all children.

Be at the same physical level. Get face to face.

Follow the child's lead. Let them choose the "topic".

Take turns. The child's turn may be a non-verbal one. Give them a chance to be an equal partner.

Use language that is at or slightly above their level. This provides them with models that they can try to imitate.

Expand what they say to show that you have understood and value what they've said and to provide them with a model of a more mature form. For example, child: "eating", adult "yes, he's eating"; child "dog", adult "big dog".