Tag: communication development

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1.5 Communication Development: Overview

Communication Development

A Brief Overview1

Being aware of language and communication milestones is important for parents and other caregivers.  We often hear statements like the ones listed below from parents whose children are not speaking “like other children”, or from professionals, including family physicians:

  • “My two year-old has yet to utter her first words, but since her pediatrician is not concerned, I guess I should not think about this too much.
  • My three year-old only uses one-word phrases, but so did his father. I guess this runs in my husband’s family and I should not be worried.
  • Leave your child alone. She will talk when she is good and ready. You are ‘making a mountain out of a mole hill’ (exaggerating).”

Nevertheless, the speech and language patterns of these children seem to be different than those of others their age. These differences show both in the way they talk, or the quality of their expression, and in quantity, or how many words they know and can put together into sentences.

It may be that some physicians are not aware of the early signs of speech and language delay in young children. They may want to avoid worry for parents so they reassure parents that their children will develop language at their own pace.

It is also true that some children talk earlier than others. These children usually fall within the typical range of speech and language development. At the same time, a parent’s concerns about their child’s speech and language development are always valid and need to be heard.  Parents need to consult with a public health nurse or a speech and language pathologist.

Signs of severe delay include:

  • Not talking at three years of age;
  • Speaking in only one word phrases at five years of age;
  • Not speaking clearly (e.g., having severe speech difficulties at seven years of age).

Resources:

Click here for a list of different speech, language and communication disorders.

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1.5 Communication Development: Expressive Language

Expressive Language

The Typical Language section of this course describes expressive language1 as a tool we use to get a message across to someone. It can be oral, like when we speak, or the use of signs or ‘non-verbal’ language (see full Glossary), like when we wave “bye-bye.”  Children develop their expressive language gradually and sequentially. Some children have a hard time learning how to use gestures, signs and words to communicate. These may be signs of expressive language delay. It is important to recognize them in order to address these delays as early as possible.

Some “linguistic” signs of delays in the area of expressive language include:

  • No babbling by  age 8 months;
  • No spoken words by 18 months;
  • Speaking in one-word phrases after age two years  (e.g.: “ball” for “play ball”);
  • Mostly using baby language after age four years;
  • Repeating what they hear over and over after age three years, or ‘echolalia’ (see full Glossary);
  • Talking to self most of the time after age three years;
  • Not taking turns when speaking, as if speaking in ‘circles’, after age three years;
  • Having difficulty stating their wants and needs after age four years;
  • Giving mostly one-word answers to open-ended questions (see full Glossary) like “what did you play at the party?” by age six years;
  • Using one word to name many things, or ‘over-generalizing’ (see full Glossary) (for example, calling most four wheeled vehicles a car).

Some “non-verbal” and “behavioral” signs of expressive language delay at 12 months may include:

  • Little or no eye contact;
  • No pointing to items or objects;
  • Little or no turn taking skills (see full Glossary);
  • Little or no joint attention (see full Glossary);
  • Little or no joint action (see full Glossary);
  • Throwing temper tantrums, or hitting (when not being able to get their point across to others);
  • Becoming easily frustrated when trying to communicate with others (e.g., crying, using a loud voice);
  • Not wanting to participate in activities with others;
  • Seldom starting a conversation with others.

As described in the Typical and Atypical Cognitive sections in this course, language and cognitive development are closely related. This is why it is so important to address expressive language delays in a child as early as possible.

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1.5 Communication Development: Receptive Language

Receptive Language

The Typical Language section of this course describes receptive language1 as the ability to understand and process language. It usually develops earlier than expressive language. The development of expressive language depends on the development of receptive language.

As part of our communication with others, receptive language is a large part of our life. Therefore, a delay in the development of receptive language skills will very likely influence the development of expressive language, as well as other areas of development.

Signs indicators of receptive language delay that appear by 12 months may include:

  • Not imitating others’ sounds or behaviors;
  • Not responding to name being called;
  • Appearing not to listen.

Some indicators that appear by age three years:

  • Appearing non-compliant (e.g. not following directions);
  • Showing delays in learning how to speak, or in developing expressive language skills.

Some indicators that appear by age five years:

  • Asking others to repeat themselves;
  • Finding it difficult to answer questions.

Some indicators that appear by age seven years:

  • Finding it difficult to make sense, or ‘process’ information (see full Glossary);
  • Not wanting to join in activities with others;
  • Having difficulty understanding stories.

Some indicators that appear by age nine years:

  • Having difficulties reading sentences.
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1.5 Communication Development: Articulation

Articulation

The development of articulation1 follows a sequence that takes several years to complete. Some speech sounds, such as “l” “r” , “s” and “i“, are especially difficult to learn how to say, or to pronounce (see full Glossary) (Fig. 1) and some children do not master the ability to make these sounds correctly until  they are seven or eight years old. Other speech sounds (e.g., “th” as in “this” and “zh” as in “pleasure”) are developed later on, by age 8. In order to find out which speech sounds develop at which age, please look at the Speech Sound Development Chart.

Articulation

Figure 1. The illustration shows what needs to happen inside the child’s body for pronunciation or articulation to happen

Some signs of articulation difficulties include:

  • Understanding of the child’s speech by only those who know the child well, by age 4;
  • Taking a long time to speak or answer questions;
  • Showing frustration when speaking (e.g., crying);
  • Avoiding to join in or to speak in groups or any social situation and conversations (because of speech difficulties);
  • Confusing and substituting sounds after age 6 (e.g. “wabbit” for “rabbit”);
  • Missing word beginnings or endings of words (e.g. “kool” or “schoo” for “school”);
  • Missing parts of words, or syllables (see full Glossary) in longer words (e.g. “cacuta” for “calculator);
  • Saying certain speech sounds in some situations but not others (e.g. saying “s” in school but not “s” in bus): this is a serious red flag.

A child’s self-esteem2 (see full Glossary) may suffer when growing up with speech difficulties. That is because these difficulties are obvious and may draw other people’s attention to them. Children with speech delays need a little bit of extra time when asked questions, so that they can be calm as they respond to questions. This prevents the child from feeling he/she draws the attention of others. The earlier a child receives professional help to work on his or her speech difficulties, the more chances for them to succeed in their language skills.

1 see References
2. References on child self-esteem on Kids Health, available at http://kidshealth.org/parent/emotions/feelings/self_esteem.html.
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1.5 Communication Development: Pragmatics

Pragmatics

Language experts use the term “pragmatic language”1 to refer to how we use language for social reasons. That is, when we use language to communicate our thoughts and ideas to those around us – and is not simply making sounds.

Some children may not know how to use language socially. Some signs of pragmatic language difficulties may include:

  • Having little or no turn-taking skills;
  • Getting very close to others when speaking, almost face to face;
  • Having little or no eye contact with others, not even caregivers, siblings or peers when communicating with them (unless dictated by one’s culture);
  • Finding it difficult to understand and answer questions after age 6;
  • Not taking turns when speaking, as if speaking in ‘circles’ after age 3;
  • Giving brief and short answers to all questions, after age 5;
  • Jumping from one topic in a conversation to another with no transition;
  • Not keeping up with the topic of the conversation, or “going off on tangents”.

Children who cannot make their language “work” for them in these ways find this very frustrating. They will need as much professional support as children who cannot understand or speak, or with receptive or expressive language delays.

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1.5 Communication Development: How Development In Early Years Affects Development in the Elementary Years

How Development in Early Years Effects Development in Elementary Years

Children who have difficulties with language in the early childhood years1 will very likely continue to exhibit difficulties with language in the elementary years and beyond. If these difficulties are not addressed, they will get more serious and will have a negative effect on practically all aspects of the child’s life. This applies to all aspects of language: receptive, expressive, pragmatic and articulation. Children with language delays do not “outgrow” them. With appropriate support however, they may acquire and develop many of the basic skills.

Children with language delays by age 5 years, at they begin the elementary school years (and beyond) may exhibit the following behaviours:

Children with difficulties with receptive language:

  • May look as if they do not pay attention, because they may not understand what is being asked of them;
  • May only hold a small number of words in their vocabulary;
  • May continue to experience difficulties in social situations, because of their receptive language skills difficulties.

Children with difficulties with expressive language:

  • May continue to find it difficult to be part of groups and  other social situations, and avoid them completely;
  • May continue to feel that they are “different” from others (e.g., things that are easy for others are difficult for them, both in and out of school situations);
  • May struggle with learning how to read and write, and have trouble with subjects like socials, sciences and math that are language-based.

Children with difficulties with pragmatics :

  • May continue to avoid social situations, because it is hard for them to be a part of a conversation;
  • May be avoided or made fun of by other children, because of their  difficulties with language when sharing with others;
  • May be aware of their language difficulties, continue to feel ‘bad’ (see full Glossary) about themselves.

Children with difficulties with articulation:

  • May avoid social situations, because of difficulties with some speech sounds
  • May choose not to talk to avoid other children making fun of them.
  • May be aware of their speech difficulties, continue to feel ‘bad’ about themselves.

Children with language delays who show these behaviours need additional support at school; otherwise, these behaviours could become more complex between 5 and 12 years old. Knowing of how these language difficulties may effect a child is important in any of the four aspects of language. Not being successful in language and communication skills may have long lasting effects. These difficulties may prevent the child from being included in activities such as school plays, debates or any other meetings, or just ‘mingling’ with children and adults. As adolescents and young adults, any daily life situations that include language and communication become difficult, for example, talking to a bank-teller or contacting one’s doctor.

1 see References

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1.6 Cognitive Development: Overview

Cognitive Development

A Brief Overview1

In the Typical Cognitive Development section of this course, we described how cognitive development involves the development of thinking or evaluation and coping, or ‘adaptation’ skills. Thinking or evaluation skills, such as “thinking outside the box2 (see full Glossary),” are related to the development of intelligence (see full Glossary). Coping skills involve the ability to adapt to changes in one’s environment.  Cognitive skills also look at creativity, the ability to learn new things, retain (see full Glossary) what one has learned, and how one applies information to new situations. Cognitive development also includes pre-academic and academic skills that children need in order to succeed at school. Examples might include the ability to sit quietly for certain periods of time, the ability to listen and follow instructions and the ability to perform paper and pencil tasks.

Some children do not develop these skills at par with their peers. They may develop some of these skills much later than others —or not develop them at all. In other words, atypical cognitive development involves difficulties with both the quality and quantity of certain skills (see full Glossary):

Severe cognitive delays often effect all other areas of development. Below are some signs of cognitive delays that can be observed in all areas of development between the preschool and school age years, around ages 3 – 5 years old.

In the domain of cognitive development:

  1. Children may experience serious difficulties in learning basic concepts (e.g. colors and shapes);
  2. Children may experience serious difficulties in learning advanced concepts (e.g. counting, reading and writing);
  3. Children may experience serious difficulties in generalizing what they learn from one situation to the next;
  4. Children may experience serious difficulties in adapting to changes in their environment and to new situations.

In the domain of social/emotional development:

  1. Children may trust others too easily and readily enabling others to take advantage of them;
  2. Children may not read visual or language cues as they their attempt to socialize with others.

In the domain of motor development:

  1. Children may exhibit delays in the development of their fine motor skills;
  2. Children may exhibit delays in the development of their gross motor skills

In the domain of communication development:

  1. Children may exhibit delays in the development of their receptive language skills;
  2. Children may exhibit delays in the development of their expressive language skills;
  3. Children may exhibit delays in the development of their pragmatic skills;
  4. Children may exhibit delays in the development of their articulation skills.

In the domain of adaptive skills:

During the preschool years:

  1. Children may be delayed in becoming toilet trained, and in extreme cases, may never be toilet trained.

During the elementary school years:

  1. Children may experience difficulties bathing and cleaning themselves properly;
  2. Children may experience difficulties with dressing and undressing.

During the high school years:

  1. Male adolescents may experience difficulties with knowing how and when to shave;
  2. Female adolescents may experience difficulties knowing how to handle their menstrual cycle.

Severe cognitive delays have been linked to developmental disabilities (also known as mental retardation and developmental challenges). Developmental disabilities involve global delays and affect all areas of development, including motor, language, social and emotional, and self-help skills.

1. see References
2. Source: University of Wahington, available at: http://faculty.washington.edu/ezent/imdt.htm

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