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Language development and advice for children with language development difficulties

HIGHLIGHTS:

  • Expressive language is the ability to generate symbolic output. It involves the communication of ideas, intentions and emotions.
  • Receptive language is the ability to understand information. It involves understanding the words, sentences and meaning of what others say, or what is read.

 

Language development and advice for children with language development difficulties

Language development is one of the most important components of a child’s development. Language is the foundation of skills such as knowledge acquisition, intellectual ability, problem-solving and socializing including engaging in and contributing to relationship with others. Language can be defined into 2 areas:

  • Expressive language is the ability to generate symbolic output. It involves the communication of ideas, intentions and emotions. This includes not only words but also the grammar rules that dictate how words are combined into phrases, sentences and paragraphs as well as the use of gestures and facial expression.
  • Receptive language is the ability to understand information. It involves understanding the words, sentences and meaning of what others say, or what is read. Receptive language includes auditory comprehension (listening), literate decoding (reading), and mastery of visual signing.
Age (months)Development
0 – 3 months
  • Alerts to voice
  • Social smile
  • Cries
  • Coos
4 – 6 months
  • Responds to voice and turns head towards sound
  • Laughs out loud
  • Squeals
  • Blows raspberries
  • Begins to babble
7 – 9 months
  • Responds to their name
  • Searches for sources of sound
  • Expresses their moods by sound and body language
  • Makes long, more varied sounds
  • Repeats syllables
10 – 12 months
  • Understands “no”
  • Understands gestures
  • Follows 1 step commands with gesture
  • Waves “bye bye”
  • Shakes head for “no”
  • Knows their own names
  • Says “Mama” and “Dada” appropriately
  • Says first few words other than mama/dada
13 – 15 months
  • “Follows 1 step commands without gesture
  • Identifies familiar people or objects
  • Protodeclarative pointing
  • Immature jargon
  • Uses 4-6 intelligible words
16 – 18 months
  • Points to 3 body parts
  • Points to 1 picture
  • Uses 10-20 intelligible words, mostly nouns
  • Chatter and imitate, use some echolalia (repetition of words and phrases)
  • Makes animal sounds such as “moo”
19 – 24 months
  • Follow 2 steps commands
  • Uses 20-50 intelligible words
  • Speaks 2 word sentences
  • Able to ask the ‘what’ questions
25 – 36 months
  • Knows their own gender and age
  • Understands the function of objects
  • Can tell their name
  • Able to ask “who” and “where” questions
  • Uses 3 word sentences
  • Speech is 75% intelligible
3 – 4 years
  • Understands size and length concepts
  • Identifies 4 colors
  • Understands most of what they hear
  • Can group objects such as foods, clothes and animals
  • Tells stories
  • Answers “what”, “where” and “why” questions
  • Usually talks easily without repeating syllables or words
  • Speech is 100% intelligible

Red-flag signs for a child who may be at risk of language development difficulties and should be evaluated to identify the causes

  • 0–4 months – not responding to sounds when fully awake
  • 5–7 months – not cooing
    – does not use his/her voice to attract attention
  • 9–12 months – not turning towards a voice
    – not responding to his/her name
  • 18 months – no words other than mama/dada
    – no understanding of simple commands
    – no pointing to what he wants
  • 24 months – vocabularies less than 10 words
  • 30 months – no 2 word phrases
  • 36 months – no 3 word sentences
    – problems understanding the child’s speech less than 75%
  • 48 months – unable to converse in sentences
    – unable to tell a simple story

Causes of delayed speech or language

  1. Hearing impairment
  2. Intellectual disability
  3. Autism spectrum disorder (ASD)
  4. Cerebral palsy
  5. Developmental language disorder (DLD)
  6. Environment risk factor; e.g. poverty, lack of parental stimulation
  7. Other causes

Treatment

  1. Depends on the nature of the child’s speech or language impairment.
  2. Advice their parents on how to encourage language development, for example,
      • Speak clearly to your child as you are their good role model
      • Talk about things that your child is interested in
      • Elicit conversations with your child by using complex grammars and rich vocabulariesAdvice their parents on how to encourage language development, for example,
      • Provide your child with the names of objects or actions.
      • Practice speaking in a natural manner, such as using open-ended questions, expand on what your child answers, be a good listener, without rushing or putting pressure on the child. Provide your child with positive reinforcement
      • Give your child the opportunities to learn through different activities, for example, reading novels and through role-play activities
      • Limit time for electronic media. (The children, who are younger than 2 years old, are not allowed to watch television at all. The children, who are older than 2 years old, are allowed to watch less than 2 hours of quality program a day.)

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