Communication Disorders

Language Disorder

What is language disorder?

A child with language disorder has difficulties using or attaining the rules of a language. One can have difficulties in understanding (receptive language) or expressing themselves (expressive language).

Expressive language ability refers to ability to communicate personal intent through verbal (vocal speech, sign language) and non-verbal language (gestures, facial expressions). Receptive language ability refers to the ability to receive and understand expressive language from another person.

What are some symptoms of language disorder?

‘It is just a phase; he will grow out of it.’ – It is easy for parents to underestimate a child’s language deficit, thinking it is just a part and parcel of growing up. However, it is important to be aware of some symptoms of language disorder. Should your child show some of these presentations, you should seek adequate and early intervention.

Symptoms of language disorder surfaces during a child’s early developmental years. Symptoms tend to be more noticeable, and deficits are more accurately measured by the age of 4. The child’s present developmental age is used to determine if deficits are a cause for concern or not. Impairments may include:

Ψ Having reduced knowledge and use of vocabulary words

Ψ Having short and simple sentences compared to their peers of the same age

Ψ Difficulty using vocabulary and forming sentences to convey personal intent (e.g., opinions, thoughts, feelings)

Ψ Difficulty understanding and accessing the curriculum taught at school

These symptoms could manifest in the child’s functionality of life, resulting in impairments in daily living such as in social settings (e.g., Difficulties interacting with peers in school), academic settings (example: poor academic grades) and occupational settings (e.g., poor working performance and poor socialization with peers).

Aside from the visible language impairments, these symptoms may occur concurrently:

Ψ Physical expression of emotions/feelings (example: aggression, non-compliance, crying)

Ψ Looking confused when given an instruction

Ψ Taking a longer time to comprehend or understand what is being said to them and/or expressing personal intent

How is language disorder diagnosed?

A multidisciplinary team approach is best when it comes to diagnosis and intervention. This team includes a psychologist and speech therapist who will work closely with both the parent(s) and the child.

The psychologist and speech therapist will first rule out conditions that may produce similar language disorder presentations. Such conditions include:

Ψ Normal language development variations

o   Note: Cultural, social, and ethnic variations are taken into consideration here

o   Example: The use of dialects, the norm of being bilingual, language used in the household

Ψ Sensory impairments

o   Example: Hearing difficulties, Speech-motor difficulties

Ψ Other developmental disorders

o   Example: Intellectual Developmental Disorder, Autism Spectrum Disorder – may experience language regression*, Epilepsy

*Language regression refers to the loss of previous language abilities – commonly observed in children with ASD, occurring around the age of 3.

A screener or assessment tools may be used to identify the strengths and needs of your child. Following this, an individualised intervention plan with specific targeted goal(s) will be set to address your child’s areas of difficulties. A speech therapist will work closely with your child and parents.

There are several different approaches and strategies for individuals with language disorders. Interventions range from drill-based activities (clinician directed) to activities that model play or other everyday activities (child centered), or a combination of both approaches (hybrid). Here are brief descriptions of some of the general approaches for addressing language disorders.

1) Speech-therapy approaches

2) Psychological approaches

Your psychologist may conduct an assessment to determine any possible external factors influencing the speech difficulties your child may be facing. This includes anxiety projected onto self or by others/circumstances, stressful events, poor self-esteem, poor interpersonal relationships and/or socio-emotional dysregulation. After better understanding the needs of your child and determining some psychological-influence to your child speech difficulties, the psychologist may adopt approaches including Cognitive Behavioral Therapy (CBT), Behavioral management and Group therapy.

3) Speech-based and psychological approach

Behavioral management

This approach focuses reducing problem behaviours by teaching functional alternative behaviours. This approach follows the principles of learning and is accompanied with verbal reinforcers (example: praises for good attempts/ successful attempts).

4) Play-based approach

Depending on the age of your child, a play-based approach that is naturalistic/semi-structured may be adopted in sessions. Playing with items of interest can help to keep your child engaged. The speech therapist creates learning opportunities or hop onto naturalistic learning opportunities during play.
 

5) Parental involvement

Your speech therapist may have a parent-involved session with your child to teach simple relevant skills for the parents to carry out at home. Parents can also take this opportunity to communicate with the speech therapists on the improvements and concerns to keep the therapist in the loop

**These approaches are not exhaustive and may differ based on the discretion and professional opinion of respective speech therapists.

“Is my child’s language deficit(s) caused by me?”

The cause of spoken language disorders is difficult to determine. Language disorders may be a primary disability or may exist in conjunction with other disorders and disabilities (e.g. ASD, ADHD, selective mutism, etc.). A number of factors have been proposed, including cognitive processing deficits and genetic variations.

The best course of action is to reach out and seek professional evaluations. Click here for more information on speech therapy.

Remember that your well-being is as important as your child’s, do not hesitate to reach out for external support from family and friends. Alternatively, you may consider checking out these social support groups.

The development of language in any child can be influenced by their external environment. These are some ways you can cultivate healthy language development in your child:

1) Teaching alternative/fixed communication methods

You can teach your child to say specific words or sentences when they have a difficulties understanding what was said. For example, simple sentences such as ‘I need more time.’ Or ‘Can you repeat?’ can be taught to your child. Alternatively, parents and children can have a prior-agreement on ‘codes’ to signify something. For example, simple codes such as ‘Think Time’ can be established for more time needed to process instructions. These phrases can be shared with external representatives, such as school teachers, to ensure your child’s needs are met in core external settings.

2) Preparing your child beforehand

Help your child familiarize with new environment or arrangements with prior engagements addressing some of those changes. This can be done through picture cards and/or personalized stories. This can help your child manage his emotions better and reduce potential anxiety-episodes that may interfere with communication abilities.

3) Model your way

Help your child gain some of the new skillsets through modelling. Be more mindful of how you present yourself when you engage in conversations around and with your child – nonverbal body language and grammatically correct sentences. When you notice your child emulating certain good communication behaviours, don’t forget to give him a praise or a high-five!