Mediscene

Words don’t come easy to these children

How do you reach out to children with language and learning disorders?
By Ayesha Inoon

Communication skills play a very important part in the life of a child. For a child to learn, he/she has to communicate and interact with peers and adults. Spoken language is the basis for written language, and as a child grows and develops, the two types of language interact and build upon each other to improve literacy and language skills. This process continues throughout his/her life.

If a child has a communication disorder, he or she is often delayed in other areas, such as reading and maths. The child may be bright but unable to express him or herself correctly, and the learning process can be affected negatively, says Shalini Wickremesooriya, who specialises in working with children with Speech, Language and Learning disorders, as she discusses language disorders and their symptoms with MediScene this month.

Specific Language Impairment (SLI)

Some children have language development deficits that cannot be linked to neurological, intellectual, social, or motor causes. The child's language skills grow much more slowly than those of typically developing children. While other children are speaking in complete sentences, using conjugated verb forms, the SLI child's speech sounds telegraphic, and lacks grammatical and functional morphemes (e.g., ‘He go store’ rather than ‘He goes to the store’.)

Their vocabulary remains relatively small while other children are adding new words every day. The SLI child often produces short sentences to avoid embarrassment and may have problems understanding complex or figurative structures, such as metaphors or multi-clausal sentences. Problems due to SLI can also lead to learning disabilities as the child fails to understand information being presented. Studies suggest that the cause of SLI is a biological difference in brain anatomy and development.

SlI can manifest as:

Receptive Language Impairments or RLI. This refers to the inability to comprehend spoken and written language. It often co-occurs with Expressive Language Impairment or ELI. Characteristics include Echolalia (repetition of previously heard words or phrases), inability to follow directions, re-auditorisation (repeating a question first and then responding to it), difficulty responding appropriately to: yes/no, either/or, who/what/where and when/why/how questions, not attending to spoken language, high activity level, speaking jargon or "unintelligible speech", using "memorised" phrases and sentences and difficulty understanding jokes and abstract concepts in school.

These children are unable to make sense of sounds, words or sentences they hear. Therefore they may not respond to their names, have difficulty following directions or point to a bell when you say ball. They may appear inattentive. Because children need to understand speech before using it effectively, those with this disorder may also have symptoms of expressive language disorder.

Expressive Language Impairment or ELI is characterised by having a limited vocabulary and grasp of grammar; especially with tense and time words. It is a childhood language impairment that puts the child out of the general level for his/her age and onto the level of a younger or less linguistically developed person. The child's receptive language skills however, may be at age level. Very often, these children will have difficulty remembering things. This is only for speech; non-verbal or non-linguistically based memory will be unimpaired.

The disturbance may be manifested by symptoms that include having a markedly limited vocabulary, difficulty recalling words or producing sentences with the developmentally appropriate length or complexity, delay in saying first words or in combining words into phrases/sentences, incorrect grammar, frequent use of non-specific words, telling stories both spoken and written, which are disjointed and miss details, difficulty breaking language into its parts, difficulty with the social rules of conversation and infrequency in initiating conversation. These children are often quiet and less responsive than their peers.

If Receptive Language Impairment and Expressive Language Impairment characteristics are both prevalent, then the disorder is referred to as mixed Receptive - Expressive Language disorder.

Treatment

These disorders are diagnosed through assessments and tests and can be treated through interactive speech therapy by a qualified speech therapist. Improved communication through speech therapy can result in a better educational, social, and emotional experience for a child.

Also, children who are able to overcome communication disorders feel a great sense of pride and confidence.

Developing oral language skills

Children must first hear language consistently. Listening is the groundwork for speech. Parents, teachers and caregivers can therefore enhance the development of a child's oral language skills through the following activities.

  • Talk to the child - Whenever you are together. This could be about the day's events, the activity being attended to, a story, or about the objects in the environment. Do not settle for single word answers, and avoid interrupting the child when he or she is talking. Encourage the child to ask questions.
  • Read to the child - With him/her on your lap or seated in a circle in the classroom. Use books with large colourful pictures and ask the children to point out the objects while you read aloud. This could be made even more interesting by acting or a puppet show.
  • Play rhyme games - Try games with words that begin with the same sound. Play broken records game by saying a word very slowly and broken into syllables. E.g. Co-lom-bo
  • Counting activities - Children learn to count early. Therefore use activities that involve counting. E.g. 'Bring me 1 cup and 2 plates.' Have the child repeat the instruction and match the items to the number requested.
  • Provide a print rich environment - Students with oral language difficulties have problems with learning to read, and adults can help by providing a range of different learning material.

Audio tapes and computers too can be used to make learning to read fun. Keep television to a minimum.

 
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