I would like to discuss the topic of speech therapy, this will include why speech and language is important, normal developmental stages, some of the risk factors, and how to help children who have delayed speech and language skills. It is felt that this is a relevant topic for parents, teachers, counsellors, psychologists and other professionals so that they can be aware of normal developmental stages in children in terms of their speech, language and auditory perceptual skills, and would then know when to refer to a Speech/Language Therapist or to an Audiologist for a hearing assessment. The focus will mainly be on children in this article, although a Speech/Language Therapist (SLT) works with both children and adults.
Some of the areas that are focused on by a SLT include: articulation difficulties, expressive or receptive language delays, auditory perceptual problems, cleft palate ( which may results in speech difficulties), stuttering, low tone of the oral musculature which can results in speech or feeling/swallowing difficulties in young children, learning disability and developmental delay. In adults the Speech Therapist may work with stutterers, adults with neurological impairment, stroke or head injury, which may effect their speech or language skills, e.g. they may presents with aphasia, or dysarthria (unclear speech).
Firstly it is important to understand what communication is. Communication involves a speaker and a listener – the speaker sends a message to the listener, which he can hear and understand. If there is a breakdown in any of these areas it will result in a communication problem. The aim of speech therapy is to enable the person to communicate more easily and effectively than before. Language is therefore a process whereby we communicate with others. It involves elements of expression and understanding and is one of the most highly developed human skills providing us with a framework for thought and allows us to communicate.
A communication disorder, or disorders of speech and language, are extremely common and can range from a slight delay in development to a more significant or serious disorder. It is essential to know what normal development is so we can determine when a child is delayed in certain areas of his speech and language. It is also recommended that one should identify a problem in terms of communication as early in a child’s life as possible because this will increase the chances for improving communication skills. Even young non-verbal children can have speech therapy, although in this case, therapy would involve the parents by the provision of guidelines on how to help the child and stimulate his speech and language development. It is important to understand that a language delay may have significant effects on personal, social, academic or vocational life.
In terms of normal development of speech and language:
- From birth babies use cries and sounds to try and tell you what they want. It’s not long before you may hear the difference between your babies cries of pain, hunger and tiredness. Right from birth you can talk to your baby, it’s only by hearing others talk, that they will learn to speak
- Around 3 to 6 months, cooing or vocal play provides many hours of fun. Your baby will “coo” to himself and “coo” to get your attention. You can talk back and “have a conversation” with your baby.
- From 5 to 12 months, more sounds are joined together and repeated using different sing song patterns. This is babble and your baby is playing with sounds. You can copy the sounds your baby makes. The baby will enjoy watching your face and hearing your voice.
- Around 12 to 18 months, your baby will begin to see that certain words have certain meanings and that’s when the first words are made. The first words may not sound exactly like adult words, but mean a definite thing.
- From 15 to 24 months, more words are learned and your child begins to put them together and make 2 word “sentences” for example “mommy come” or “daddy go”.
It is important to remember that this is only a guideline, and there can be individual variations in children in terms of these speech and language milestones. There is also a difference between girls and boys in terms of their development.
In terms of risk factors, the following children should be assessed for speech/language problems as they would be considered high risk children:
- Children who were in neonatal intensive care units,
- Have diagnosed medical conditions, such as chronic ear infection, a hearing loss
- Biological factors such as fetal alcohol syndrome
- Genetic defects such as downs syndrome
- Neurological defects such as cerebral palsy
- Developmental delay such as delayed language.
- Feeding problems
- Cognitive delay
- Motor problems
- Autism
- Social emotional problems
- One also needs to look at the family history of speech/language/learning problems or history of hearing loss.
- Congenital problems
Children that don’t have any obvious risk factors should still be evaluated if their speech and language skills are not on the same level as other children of their age
How to help children and stimulate their language development (including some ideas of how to build up a child’s self-esteem):
There are many ideas that parents or caregivers can use to help the children who have delayed speech or language skills. In a speech therapy session the therapist will teach a child according to his developmental level. In young children play can be used to teach communication and other areas dealt with include the socially appropriate usage of language, or nonverbal skills of children such as turn taking, eye contact, learning not to interrupt. These areas can be worked on by parents as well.
- Talk to your child, even if he/she is not communicating much
- Listen to your child and look at a child when he/she talks to you and be interested in what they says
- Answer their questions
- Be a good model for your child, model correct articulation and grammar,
- Expand his/her vocabulary and sentences
- Get him/her involved in daily tasks, cooking, cleaning, bathing, shopping, These are all good opportunities for language stimulation.
- Read to your child, this is essential and valuable for language stimulation
- Do not allow your child to watch too much TV, play on I-Pads or computers, this can affect concentration – interactive games and reading are more beneficial
- Encourage descriptions and storytelling
- Ask questions that require more than a one word answer
- Don’t talk too much if you are not sure what a child is understanding
- If a child has a basic language issue, try to stick to one language if possible
- Allow a child to express his feelings
- Encourage a child to speak clearly
- Don’t make him/her too aware of their speech difficulty, you do not want them to withdraw from speaking situations
In terms of building up the child’s self-esteem, some further ideas are:
- Positive reinforcement is essential to build up a child’s self-esteem
- The child can be verbally praised – reinforcement does not always have to be something tangible.
- Focus on the positive aspects of the child’s performance, so that he will gain in self-confidence, in other words pay attention to positive rather than negative behaviour
- Be consistent, children feel secure when they know what is expected from them.
- Self-esteem can also be built up by developing good communication skills with your child. It’s important to really listen to what they have to say.
- Unconditional love and acceptance of the child
- Providing a predictable safe structure
- Allow your child to have choices and let him experience the consequences of the choices he has made.
References:
http://en.wikipedia.org/wiki/speech-language_pathology
http://www.parenting.com/article/speech-delays
http://www.kidshealth.org/parent/growth/communication/not_talk.html
http://speech-language-therapy.com/index.php?option.
http://health.ny.gov/community/infants_children/early…/ch3_ptz.htm
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