Many young children have difficulty with communication at some time in their lives. Most will eventually catch up. However, some will continue to have problems. Communication disorders include speech disorders and language disorders. Language disorders are discussed in this article. Some general guidelines are also given. This will help you decide if your child needs to be evaluated by a speech-language pathologist.
A child may have a language disorder if he has difficulty getting his meaning across through speech, writing, or even gestures. Some children have a language disorder even though they produce sounds well and have clear speech. Difficulty expressing meaning to other people is called an expressive language disorder. Difficulty understanding other people is called a receptive language disorder. A child might have difficulties with both. This is called a mixed receptive-expressive language disorder.
Types of Language Disorders
Receptive Language Disorder
A child may have difficulty understanding the words or sentences used by others. The child may seem to show poor attention to speech. This may cause difficulty following directions and learning.
Expressive Language Disorder
A child may have difficulty coming up with the right words when talking. The child may be unable to join words correctly into sentences. The child may have a small vocabulary or use words incorrectly. He may speak using short phrases and leave out small words, such as “the” or “is.” The child may say sentences but put them together incorrectly.
For both types of language disorders, the main problem may be with: content (words and their meanings), form (grammar or word order), or use (the ability to understand and use language appropriately).
Causes of language disorders may include hearing loss, cognitive disability, emotional disturbance, a lack of exposure to language in the environment, or brain injury. Often, the cause of the language problem is unknown.
Reasons for Concern
- If the child does not use any words by 16-18 months.
- If the child cannot follow simple instructions such as, "Give me your shoe" by 18 months.
- If the child cannot point to body parts or common objects when asked by 18 months.
- If the child has not started combining words by the age of 2.
- If the child does not use any complete sentences by the age of 3.
- If the child imitates or “echoes” parts of questions or commands instead of responding appropriately by age 3. For example, when asked "What's your name?" the child says, "Your name!"
- If sentences are still short or jumbled by the age of 4.
- If the child often uses words incorrectly by age 4. For example, a child may say "cut" for "scissors," or "dog" for "cow."
Causes of Communication Disorders
A child may be at risk for a communication disorder if there is a history of the following:
- Cleft lip or cleft palate
- Craniofacial anomalies
- Velopharyngeal insufficiency
- Dental malocclusion
- Oral-motor dysfunction
- Neurological disease or dysfunction or brain injury
- Respirator dependency, respiratory compromise, or tracheostomy
- Vocal fold pathology
- Developmental delay
- Prematurity or traumatic birth
- Hearing loss or deafness
- Note: Ankyloglossia (tongue-tie) rarely causes speech or language problems.
Treatment for Communication Disorders
Early intervention is very important for children with communication disorders. Treatment is best started during the toddler or preschool years. These years are a critical period of normal language learning, and strong speech habits have not yet been formed. The early skills needed for normal speech and language development can be evaluated even in infants. At that age, the speech-language pathologist works with the parents on stimulating speech and language development in the home. Active treatment in the form of individual therapy usually starts between the ages of 2 and 4.
If you have concerns with your child’s communication skills, discuss them with your child’s doctor. The doctor will likely refer the child to a speech-language pathologist for evaluation and treatment. All children with language disorders should also have their hearing tested.
Helping Your Child's Development
Children learn speech and language skills by listening to the speech of others, and practicing as they talk to others. Parents are the most important teachers for their child in the early years. They can help the child by giving lots of opportunities to listen and talk. This can be done by frequently pointing out and naming important people, places and things. They can also read and talk to the child during the day, especially during daily routines, interactive play and favorite activities. Parents can give the child models of words and sentences to repeat. Parents can also set up opportunities for the child to answer questions and talk. Listening to music, singing songs, and sharing nursery rhymes are also great ways to build speech and language skills while having fun with your child.
For more information, contact the Division of Speech-Language Pathology, 513-636-4341.
Web Resources on Language Disorder