Language
What is Language?
Language refers to the way that we use and understand words, sentences and stories to communicate information. It can be broken down into two main categories:
- Receptive language refers to the way that we understand (receive) language.
- Expressive language refers to the way that we use or express our message using language.
How does language develop?
The brain contains specific areas that are called ‘language centres’. When babies are born, these areas are primed and ready to start taking in information, at an astonishingly rapid rate.
Birth - 12 months
Babies begin expressing themselves through early interactions that demonstrate a desire to connect with others. This includes:
- Babbling with changes in pitch and volume (e.g., “ba ba ba ba”), a skill that often develops from close interaction with parents.
- Recognising that objects exist even when they’re out of sight (e.g., enjoying games like peek-a-boo).
- Touching an adult to encourage them to continue an activity they enjoy.
- Starting to use familiar objects appropriately during play (e.g., a spoon or cup).
- Making connections between certain words and actions or routines, even without speaking true words yet (e.g. understanding what will happen when a parent says ‘change nappy’).
- Using gestures, vocalisations, and simple actions to gain attention
Typically, babies begin to say their first words at around 12 months of age.
12 - 18 months
During this time, children learn to:
- Use single words that are often context-dependent, such as “ball” or “milk”.
- Express a variety of communicative functions, including requesting, commanding, labelling, greeting, and gaining attention.
By 18 months, use at least 20 words. At this stage, it’s normal for children to simplify words (e.g., “buh” for “bus” or “duh” for “duck”).
18 - 24 months
During this time, children learn to:
- Mimic the activities of others in their play, such as cooking.
- Perform short sequences of pretend actions, like rocking a doll and then putting it to bed.
- Refer to objects or people who aren’t present.
- Begin asking for information and using combinations of words more frequently to express their needs and ideas.
By 2 years of age, children are typically able to use around 200 words and begin combining them into short sentences, such as “more juice” or “big car”.
2 - 3 years
During this time, children learn to:
- Comment on their own activities (e.g., “Get apple”) or on toys (e.g., “Baby sleep”).
- Start using basic grammar forms, including plurals (cats), verbs (running, jumping), and possessive pronouns (my, mine).
- Respond appropriately to many “wh-” questions (e.g., “What’s that?”, “Where’s the ball?”) and familiar “why” questions.
- Develop more complex grammar skills, using plurals, verbs, and pronouns to create increasingly detailed and meaningful sentences.
By 3 years, children are typically able to use a variety of short phrases and sentences and have built a vocabulary of approximately 600 words.
3 - 4 years
During this time, children learn to:
- Engage in detailed pretend play with connected actions (e.g., pretending to make dinner and then feeding it to a doll).
- Talk about the past and future using words like “I jumped” or “I wanna go.”
- Use more descriptive words to talk about things like shape, size, or colour (e.g., “big red car”).
- Understand sentences that are becoming more complex, including words that describe concepts like size or location (e.g., “big truck” or “under the table”).
- Develop grammar and sentence structure as they learn how to put words together. For example, they might say things like, “I hitted the ball”
By 4 years, children are typically able to use and understand sentences to share experiences with others.
4 - 5 years
During this time, children learn to:
- Follow three-part instructions (e.g., put on your shoes, get your backpack and line up outside).
- Understand time related words (e.g., ‘before’, ‘after’, ‘now’ and ‘later’).
- Tell simple, short stories with beginning, middle and end.
- Use and understand grammar components that improve overall sentence structure and allow a child to express their thoughts, feelings and ideas appropriately. For example, using past and future verbs correctly (e.g., ‘went’, ‘will go’), adjectives, pronouns, plurals, etc.
- Understand and use different word endings. For example, adding ‘er’ to the end of words (“big” –> “bigger”)
- Recognise some letters, sounds and numbers
By 5 years, children are typically able to use and understand sentences and stories for a range of communicative purposes.
Gestalt Language Processing (GLP)
Gestalt Language Processing is a term used to describe the way some children learn language by understanding phrases as a whole, rather than as individual words. Children who predominantly learn in this way are often referred to as Gestalt Language Processors (GLPs). This style of language learning is also called ‘natural language acquisition’.
GLP learners tend to repeat longer phrases as a whole, and, over time, learn that individual words from this phrase hold specific meaning and can be substituted for other words.
Common characteristics of GLP learners include:
- Frequently repeating common phrases, or copying what they hear others say
- Using phrases they hear in songs, or other speech that has a melody
- Using phrases that represent a certain intent or feeling rather than the literal meaning (e.g. Singing ‘Do you want to build a snowman?’ from the movie ‘Frozen’ to convey that they are feeling lonely)
- Using long strings of words that might be difficult to understand
GLP tends to be a more common method of language acquisition for Autistic children but is also used by non-Autistic children.
Bilingualism
There are many advantages for children who are bilingual (speak 2 languages) or multilingual (speak multiple languages). Maintaining communication and connection with family members who speak those languages is one of the most important reasons for children to learn the language of their culture.
A child’s skills in each language will depend on when the languages were introduced and how often the child is exposed to those languages.
It is important to note that speaking more than one language does not cause language disorders. There is no evidence to suggest that speaking more than one language negatively affects overall language development, even for children with existing developmental difficulties.
Parents and caregivers are encouraged to speak to their children in the language that they are most comfortable with and strongest in. It is vital that a child has a strong first language, even if it isn’t English, as it forms the foundation for their future language learning.
The following information is intended to provide a guideline only.
Many different factors influence whether a child may need therapy, and age is only one part of the picture. Other important considerations include the level of frustration a child may be experiencing, whether others are reacting negatively to their speech, whether their speech is very hard to understand, whether there has been little improvement over time, or if there are signs of broader difficulties in communication or other areas of development. These kinds of factors help us build a more complete picture of a child’s needs.
What is a Language Disorder?
A language disorder occurs when a person has difficulty using or understanding language in order to communicate with others. Language disorders can be developmental or acquired.
Developmental Language Disorder (DLD)
DLD is a neurodevelopmental condition which affects a person’s ability to understand (comprehend) and use language to communicate and learn in his or her everyday life. It is not due to other factors, such as hearing loss, articulation errors, Autism or Intellectual Disability.
Children with DLD take longer than their peers to develop language skills and often require adjustments to help them communicate with others or access the academic curriculum.
Acquired Language Disorders
Acquired language disorders occur when a person’s ability to understand and use language is compromised due to brain injury. Common causes include strokes and traumatic brain injuries (TBI).
The person is often said to have developed ‘aphasia’.
Aphasia impacts people in different ways and some people can experience more debilitating impacts than others. Aphasia can change a person’s speech, comprehension, reading and writing skills.
The two most common types of aphasia are Broca’s and Wernicke’s aphasia.
Broca’s aphasia (Non-fluent aphasia)
- Individuals have difficulty finding their words but often understand language well
- Speech is effortful and slow, and grammatically simplified
- Writing and reading are often less affected
Wernicke’s aphasia (Fluent aphasia)
- Comprehension of spoken and written language is impaired.
- Speech is smooth and grammatically correct but lacks meaning.
Apart from aphasia, people with an Acquired Language Disorder may experience co-occurring cognitive challenges, such as difficulties with memory, problem solving and attention.
What other conditions might impact language skills?
Auditory Processing Disorder (APD)
An Auditory Processing Disorder (APD) is when the brain has difficulty processing sounds and words accurately and results in an inaccurate interpretation of information.
APD is diagnosed by an audiologist but has many similarities to a receptive language disorder (which is diagnosed by a speech pathologist).
People with APD have difficulty understanding what other people are saying. Common challenges include:
- Difficulty carrying out multi-step instructions and remembering spoken information
- Needing more time to process information and delayed responses when providing answers
- Becoming easily fatigued or distracted during listening tasks
These challenges can result in frustration, behavioural challenges, and poor academic performance.
Selective Mutism
Selective mutism (also referred to as ‘situational mutism’) is a complex condition where children are capable of speaking comfortably in some settings but struggle to use their voice in other social situations, such as at school or with less familiar people. It is classified as a type of anxiety disorder and is diagnosed by a psychologist.
Speech pathologists and psychologists often work together to support children with selective mutism.
Speech pathologists are able to conduct a thorough speech and language assessment to rule out any underlying speech or language difficulties that may be influencing a child’s reluctance to speak. Speech pathologists can also help to identify any social or pragmatic difficulties that may be associated with conditions such as Autism Spectrum Disorder.
Hearing Loss
Hearing loss may be temporary (due to blockages caused by fluid or wax) or permanent (due to damage to nerves or receptors in the inner ear). Both types of hearing loss can affect the way that sounds are transmitted and processed into language.
Hearing loss can impact speech and language development in different ways, depending on when in development the hearing loss occurs, whether both ears or one ear are affected, and whether hearing loss affects all frequencies or only a few frequencies.
Global Developmental Delay (GDD)
GDD is a broad term used to describe children who experience delays in one of more developmental areas. Children who have GDD often reach their language and motor development milestones later than other children.
With targeted early intervention therapy, some children with GDD are able to resolve their language difficulties and communicate in the same way as typical same-aged peers.
Other children initially diagnosed with GDD may go on to receive diagnoses of Developmental Language Disorder (DLD), Intellectual Disability (ID) or Autism Spectrum Disorder (ASD).
Intellectual Disability (ID)
An Intellectual Disability is a neurodevelopmental condition that affects the way that a person learns and behaves. An ID is diagnosed by a psychologist and usually requires the person to undergo a cognitive assessment.
A person with an ID may take longer than their peers to learn language and have difficulty understanding and processing larger amounts of information.
Genetic Syndromes
There are many genetic syndromes that can affect language skill development, as well as other areas of learning.
Autism Spectrum Disorder (ASD)
Attention Deficit Hyperactivity Disorder
How do speech pathologists support people with Language Disorders or Language Difficulties?
Specific Therapy Programs or Approaches
In most cases, speech pathologists will provide individualised therapy support, tailored to the person’s goals. Some examples of formal therapy programs include:
- Hanen (It Takes Two to Talk and More Than Words) or Parent-Delivered Responsive Interaction training
- Story Champs
- Colourful Semantics
- Learn to Play
Augmentative and Alternative Communication (AAC)
AAC refers to something other than speech that a person might use to communicate. Evidence indicates that using AAC does not prevent or discourage people from using speech to communicate. In many cases, it can help to enhance a person’s spoken language. AAC allows users to engage in a wider range of activities or communicate more than they might otherwise.
There are many different types of AAC, which can be tailored to the individual communication needs of the person.
Key Word Sign (KWS)
KWS is an AAC strategy that uses signs from the local sign language (in Australia this is Auslan) to support communication by signing the most important messages in a phrase, accompanied with spoken words and natural gestures (such as pointing, facial expressions and/or body language.
Even though the signs used are the same, KWS is different from Auslan in that only the key words are signed (rather than the entire sentence) and the sentence order is the same as with spoken language. Sign languages (such as Auslan) have their own set of rules relating to sentence organisation and grammar.
Environmental Modifications
Speech Pathologists may teach the person or their communication partner about strategies to facilitate effective communication. Speech pathologists may also liaise with schools, kindergartens and early education spaces to recommend changes to the person’s environment or the type of language being used to support language development.
At Box Hill Speech Pathology, we believe in offering a range of evidence-based treatment options for both children and adults.
Please head to our contact page for more information or call 9899 5494 to book an initial consultation.