Speech & Language Therapy

What is Language?

Defined by Richard Nordquist (2017), Language is a human system of communication that uses arbitrary signals, such as voice sounds, gestures, and/or written symbols.

What is receptive Language?

Mysti S. Frazier, (2011) defined receptive language is the ability to accurately comprehend what is said, written, or signed by others.

What is expressive language?

“Expressive language is the use of words, sentences, gestures and writing to convey meaning and messages to others” (Kids Sense, 2017).

What is Speech?

Speech is the verbal means of communicating (ASHA, 2017). Speech entails of the following:

  • Articulation

How various sounds in speech are produced (e.g., a child must acquire the skills of  how to produce the “s” sound in order to say “spoon” instead of “poon”).

  • Voice

Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).

  • Fluency

The rhythm of speech (e.g., hesitations or stuttering can affect fluency).

What is the difference between speech and language difficulties?

Trouble producing different sounds  result in Speech difficulties.  This could be due to physical problems such as cerebral palsy or cleft palate or due to the child learning a sound incorrectly. A child with language difficulties on the other hand has trouble understanding how others communicate with him or has trouble communicating his own thoughts and ideas. They can also have trouble following directions and using complete grammatical correct sentences. Also participating in conversation or social interactions with others.

TYPICAL DEVELOPMENTAL MILESTONES OF LANGUAGE AND SPEECH:

AGE RECEPTIVE SKILLS EXPRESSIVE SKILLS
Birth Turns to source of sound Cries
Shows preference for voices
Shows interest in faces
2 to 4 months Coos
Takes turns cooing
6 months Responds to name Babbles
9 months Understands verbal routines (wave bye-bye) Points
Says ma-ma, da-da
12 months Follows a verbal command Uses jargon
Says first words
15 months Points to body parts by name Learns words slowly
18 to 24 months Understands sentences Learns words quickly
Uses two-word phrases
24 to 36 months Answers questions Phrases 50% intelligible
Follows two-step commands Builds three- (or more) word sentences
Asks “what” questions
36 to 48 months Understands much of what is said Asks “why” questions
Sentences 75% intelligible
Masters the early acquired speech sounds: m, b, y, n, w, d, p, and h
48 to 60 months Understands much of what is said, commensurate with cognitive level Creates well-formed sentences
Tells stories
100% intelligible
6 years Pronounces most speech sounds correctly; may have difficulty with sh, th as in think, s, z, th as in the, l, r, and the s in treasure
7 years Pronounces speech sounds correctly, including consonant blends such as sp, tr, bl

 

DETECTION OF LANGUAGE AND SPEECH DELAYS:

AGE FINDING
Birth and at any age Lack of response to sound
Lack of interest in interaction with people
4 months Lack of any drive to communicate
6 to 9 months Loss of the early ability to coo or babble
Poor sound localization or lack of responsiveness
12 months No verbal routines
Failure to use ma-ma or da-da
Loss of previous language or social milestones
15 to 18 months No single words
Poor understanding of language
24 months Vocabulary less than 50 words
No two-word phrases
Less than 50% of speech intelligible to strangers
36 months Rote memorization of words or phrases
Frequent immediate or delayed repetition of others’ speech
Flat or stilted intonation
More than 75% of speech unintelligible to strangers
48 months Inability to participate in conversation
Stuttering of initial sounds or parts of words
6 to 7 years Immature or inaccurate speech sound production

 

COMMON SPEECH AND LANGUAGE DISORDERS:

Significant delays in language and speech development can result from Hearing Loss, Global Developmental Delay, Autism, Specific Language Impairment, Cerabral Palsy, Down’s Syndrome and Intellectual Impairment. Hearing loss can be suspected based on the pattern of the child’s understanding and production of speech sounds or language and speech delay. Global developmental delay can be suspected on the basis of other delays in cognitive or motor skills. If such developmental findings persist into school age, the child needs speech and language therapy.

Autistic disorder should be suspected when language is not only delayed but also is , different in terms of vocabulary, grammar, or communicative pattern from the language of typical development of younger children.  Language impairment can be suspected when language skills are lower than other cognitive abilities and can also affect only expressive language or both receptive and expressive language

EVALUATION OF THE CHILDREN WITH LANGUAGE AND SPEECH DELAYS:

Children presenting with language delay should get a full audio-logical assessment, using the assessment techniques that are appropriate for the child’s age. Children who have normal hearing and indications of impairments of cognitive or social skills should get a comprehensive developmental assessment. Early intervention program for children from birth to 3 years of age can provide an assessment of the child’s level of functioning in each developmental domain. Children who otherwise seem to be progressing normally can be referred to a speech-language pathologist for verification of the degree and nature of language or speech delay as well as recommendations for the frequency and type of treatment. The treatment of stuttering falls to the speech-language pathologist. Children who have language or speech delays in addition to other developmental delays or specific genetic or neurologic conditions also can benefit from the speech-language pathologist’s evaluation. Early intervention programs includes a speech-language pathologist on the evaluation team.

SPEECH AND LANGUAGE MANAGEMENT:

General Management Strategies

Children with speech and language problems are assessed and IEPs according to their individual needs are made. Early intervention plays an integral role in the development of language and speech delays. Individualized plans are developed for children with Autism, Cerebral Palsy, Intellectual Impairment and Down’s Syndrome after the assessment. Consistent benefits of early intervention and its effectiveness is shown in the children.

PROGNOSIS:

Early and appropriately treated Language and speech disorders and delays, usually progress over time.

CONCLUSION

Children who have genetic, chromosomal, or neurologic disorders require evaluation and treatment appropriate to the underlying condition. Children who have language and speech disorders need speech and language therapy sessions according to their need.

 

References:

Expressive Language (Using Words and Language, (2017). Retrieved from                        https://childdevelopment.com.au

Fraizer, M.S (2011). Receptive Language. Retrieved from https://link.springer.com

Richard Nordquist (2017, June 29).Cognitive Psychology: Connecting Mind, Research, and     Everyday Experience. Retrieved from http://www.thoughtco.com

What Is Language? What Is Speech?. (2017). Retrieved from http://www.asha.org

 

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