Language
Language involves using words (spoken, signed, symbols) and sentences to understand, think about and use information. We use language to share in interactions and engage with others.
Comprehension of language is also known as ‘receptive language’: this is ‘input’. This is the ability to understand meaning, instructions, concepts and make sense of the information we receive. This includes understanding of abstract language, such as being able to answer questions and the ability to infer what may happen and why.
Expressive language involves how we communicate using words, phrases and sentences: this is ‘output’. This can include spoken words, signs such as British Sign Language and Makaton, written words and picture symbols.
Children and young people may also use non-verbal communication and behaviour to express themselves.
Social communication skills
This refers to the way we use language and non-verbal communication to engage with others, such as turn taking in conversations, maintaining topics of conversation, and repairing when communication has broken down.
Speech
Speech refers to the sounds that we use to make words. We develop a sound system over a number of years. Typically, this sound system is fully developed by the age of 6 years. Speech sounds follow a developmental process, and new sounds develop as a child matures. This can vary greatly between individuals.
Speech sounds often develop within a typical pattern, however at times this can be delayed. Sounds will develop, but the child may need a bit more time.
Speech sounds can follow a different pattern of development which means that sounds are not typical.
When children are developing their speech, there are often times when it can be hard to understand them. This will vary for each individual depending on the speech sounds they can make. Older children and young adults can also have difficulties with speech sounds.
Childhood Apraxia of Speech
Childhood Apraxia of Speech (CAS) is a speech disorder which impacts on a child/young person’s ability to say sounds clearly because of difficulties with planning and carrying out the movements for speech. It has previously been known as Developmental Verbal Dyspraxia (DVD).
For children/young people with CAS sounds are often difficult to articulate and blend into syllables and words, even when they child or young person knows what they would like to say. They may say words inconsistently, for example, saying the same word differently each time. The individual may get further away from the target words when they are modelled by an adult and find spontaneous speech easier to produce.
Some children with CAS seem to struggle to find the right position of the tongue, jaw or lips to say the words. The look like they are struggling to speak.
Children and young people with CAS typically need support from a speech and language therapist at points in their childhood. 1 child per 1000 is estimated to have CAS.
Stammering
Stammering can involve the use of whole word repetitions, syllable repetitions, prolonging of sounds and blocking (when the word ‘gets stuck’ and more time may be needed to say the word). Additional behaviours may be present such as facial tension, extra body movements and disruption of breathing.
Children and young people may avoid situations and/or change the words in their spoken language. Stammering can be intermittent, unpredictable, and variable, meaning this may vary from day to day. Stammering can present as mild or severe and have various levels of impact on a person’s ability to communicate effectively. The severity of the stammer is not an indicator of prognosis, for example, a child with a more severe stammer may have less risk of a persistent stammering into adulthood.
Stammering is neurodevelopmental as we know that onset of stammering is often seen when children are developing their language skills. There can be a genetic link, meaning stammering can run in families. Around 60% of people who stammer have a family member who stammers or used to stammer. For each child or young person there will be an individual combination of factors. We do know that parents DO NOT cause stammering.
Selective Mutism
Selective mutism is when a child or young person has a high level of anxiety around using spoken and sometimes non-verbal language to communicate in the wider environment. This may involve the child or young person not responding to questions or speaking in school, college, nursery etc.
This can also be in the home environment if there is new person or adult present. It is important to remember that the child or young person with selective mutism wants to speak and engage with others. However, anxiety may stop this from happening.
Children or young people may use body gestures or whisper to familiar peers and/or familiar adults in some situations.
It is helpful to offer an alternative way (means) to communicate. This can reduce the pressure on the child or young person to speak. It can be helpful to allow the young person to write things down, but only if they find this easier. A younger child can be supported by offering a picture or symbol to choose a nursery rhyme, activity and/or snack.
It is important to reduce the pressure on the child or young person to use verbal communication. Develop a safe and secure environment which is understanding and supportive of the difficulties the individual is facing around using communication.
Support from a speech and language therapist or other qualified professionals can deliver strategies and training to support the child and young person.
DLD
DLD stands for Developmental Language Disorder. This is identified when a child has difficulties with language development that continue into school age (over the age of five) and beyond. 7% of children are estimated to have DLD. That is 2 in every class of 30.
We do not know what causes some people to have DLD. It is neurodevelopmental. There is some evidence that genetics are involved. However, it is not attributed to any particular gene, and there is not a test for it. It is not caused by another condition like hearing loss, autism, or brain injury.
It is NOT caused by parents not talking to their children, but there are lots of ways that parents can help.
There are many different areas of language and communication development. This means that children and young people with DLD can be affected in different ways.
There may be difficulties in using sounds, words and sentences to express meanings. These are often the most obvious signs. However, many children and young people also have difficulties with understanding of language (receptive language). These difficulties are often much harder to spot.
It can appear as if they are not listening, uninterested or misbehaving.
Difficulties can persist through childhood and adolescence into adulthood.
Children and young people with other conditions may also have a language disorder. We do not call this DLD, however, often the support needed is similar.