Language disorders at primary age

Squid has done marvellously well. ‘Just outside the range of normal’ for understanding, grammar and language. Her NHS speech therapist wants to move her onto only speech sound targets for the next block.

Apart from ‘just outside the range of normal’ means that on every test they administer she scores between 5% and 10% less than lower bound of the very wide range of normal for a child her age. And she still struggles. So I think it would be wrong to consider this the end of language intereventions. But possibly it might be the right point to view her as receiving support ‘in context’ – i.e. parents and school.

 

I copied the below from http://www.asha.org. Does anyone have any other thoughts to add for a good flight-plan to support a language disordered primary school aged child?

Intervention For Elementary School Children (Ages 5–10)

The focus of language intervention for elementary school children with language difficulties is to help the child acquire the language skills needed to learn and succeed in a classroom environment. Interventions are curriculum-based, that is, goals address language needs within the context of the curriculum where these skills are needed. 

Interventions may also address literacy skills (e.g., improving decoding, reading comprehension, and narrative and expository writing), as well as metacognitive and metalinguistic skills (e.g., increasing awareness of rules and principles for use of various language forms, improving the ability to self-monitor and self-regulate) that are critical for the development of higher-level language skills.  See the treatment section of the Written Language Disorders Practice Portal page.

For children who speak a language other than English in the home, it may be necessary to use the home language as a mechanism for transitioning the child to using the language of the school. Planning and implementing an effective language intervention program is often a coordinated effort involving the SLP, classroom teacher(s), and other school specialists. 

Areas targeted for this population typically include 

phonology 

  • enhancing phonological awareness skills, 
  • eliminating any residual phonological processes. 

semantics 

  • improving knowledge of vocabulary, including knowledge of curriculum-related vocabulary, 
  • improving depth of vocabulary understanding and use, including
    • subtle differences in meaning, 
    • changes in meaning with context, 
    • abstract vocabulary, 
    • figures of speech; 
  • understanding figurative language and recognizing ambiguities in language (e.g., words with multiple meanings and ambiguous sentence structures); 
  • monitoring comprehension, requesting clarification; 
  • paraphrasing information. 

morphology and syntax 

  • increasing the use of more advanced morphology (e.g., monster/monstrous, medicine/medical, school/scholastic); 
  • increasing the ability to analyze morphologically complex words (e.g., prefixes, suffixes); 
  • improving morphosyntactic skills (e.g., use of morphemes in simple and complex clauses, declarative versus questions, tag questions and relative clauses); 
  • improving the ability to understand and formulate more complex sentence structures (e.g., compound sentences; complex sentences containing dependent clauses); 
  • judging the correctness of grammar and morphological word forms and being able to correct errors. 

pragmatics 

  • using language in various contexts to convey politeness, persuasiveness, clarification; 
  • increasing discourse-level knowledge and skills, including
    • academic discourse, 
    • social interaction discourse, 
    • narrative discourse, 
    • expository discourse, 
    • use of cohesive devices in discourse; 
  • improving the ability to make relevant contributions to classroom discussions; 
  • improving the ability to repair conversational breakdowns; 
  • learning what to say and what not to say; 
  • learning when to talk and when not to talk.”

I see the past 

I see the little boy who would get so angry that he wouldn’t be understood – but I need to blink him away. The real boy is up on stage projecting his voice so that the whole hall can hear him.

I see the little boy who would be too shy to socialise – but he’s grown. He’s leaving pauses in the speech so that the audience can laugh. A confident, perfectly timed arched eyebrow knowing he’ll get a response.

We’ve worked with him for over 8 years on his speech. While I was worrying about each little milestone, I didn’t realise that underneath it all we were growing a confident communicator.

He still has a lisp. Not all his sounds are consistent. But I’m the only one that hears that now. Everyone else saw the young thespian loving every moment on stage.

I need to make an effort to see that too. I remember the little boy – but I see the big boy too – and I will take a moment to be so proud of all of us for leveraging a weakness into a talent.

Twin-tastic pronouns

An idiosyncrasy of Junior’s speech is that she doesn’t use gender identifying pronouns correctly. He/she her/his all come out interchangeably. It never really bothered me that much, because it was easy enough to understand what she meant. However, I’ve now decided to make a project of it. I’m hoping it will be relatively easy to fix, and make her speech sound more natural to people who don’t know her so well. 

My allies in this are Topsy and Tim – the boy-girl twin starts of the CBeebies show with the same name. There is nothing in the show itself about pronouns, but we acquired the tie in magazine, and we’ve been playing with the toys and activities. A simple thing that’s worked really well is for me to say something about Tim (He has brown eyes) and then ask Junior to tell me the same thing about Topsy (She has brown eyes). And on and on on any theme or storyline you like, keeping the echo going to constantly compare and contrast the male and female pronouns. 

What helps a lot is that Junior is starting to read. We cut out the biggest pictures of Topsy and Tim from the magazine and wrote ‘She’ and ‘Her’ on Topsy’s tummy and ‘He’ and ‘His’ on Tim’s tummy. This improved her accuracy a lot. And a nice side benefit that her teacher thinks we’ve been super diligent teaching her sight words. Take the praise where you can get it!

+1 challenge 

Cutting up the kids’ food. A little parenting habit that you internalise. Then one day you’re at a work lunch and you only just stop yourself leaning across and offering to slice up your colleague’s chicken. 

Here’s another habit that I’ve absorbed – to build up my kids speech. Echo their sentences back adding a word. A therapist taught it to me when Junior was at two word sentence level and we wanted her to move on to three word sentences. I find it works for all stages. 

I think it helps gently nudge the kids towards more complicated sentence structures. More than that – it always makes me feel happier in myself – because it is a speech booster that is achievable on even the most stressful days.

I’m setting myself a challenge: echo and add ten times for ten consecutive days. I’ll report back.