Language -Learning Disorder

I hope this is an interesting topic for you, as much as it is for me. Until now, I’ve written about young children and communication strategies for them. Today, my intention is to share my journey (still learning) working with language difficulties in older kids, secondary and high school. My aim is to simplify the content, so that after reading this parents and professionals can put their thinking hats on and take action.

As Marie Forleo said “Action is the antidote to fear”

Ever heard of these phrases from parents/teachers, ‘simple language’, ‘immature language for his /her age’ ‘almost like he/she hit a wall after preschool’?

When I started working in schools, I was seeing a lot of children in this category. I couldn’t put a finger and say, this is where the breakdown is happening. Almost like they slipped under the radar during primary school and now into their teens, they are finding it difficult to follow instructions, respond to questions of topics discussed in the classroom, let alone narrate a simple story using the basic framework of story telling.

Language assessment test results were astounding, because 14-year olds were having language equivalent to a 10-year old child. The parents were shocked! They didn’t know what had happened.

How come they didn’t know earlier? How come the schools didn’t notice?

The well behaved and quiet child who is liked by everyone in class. Who is readily helped by his peers and teachers. Then, we do have children with less acceptance from their peers, poorer social skills and higher level of problem behaviors than a child with typical school achievement (Weiner, 2002).

The reason I am saying this is when I interviewed teachers and parents, the responses were “ We didn’t know X had a difficulty in answering a simple question, until we called him/her out during a discussion, he/she is always moving around, He is a shy child, He/She has not made friends in class, His/her speech sounds fine”.

So, what is going on with these kids?

The professionals would raise their hands and say its “Learning Disability”and they are right to an extent. However, not all learning disabilities are language-based. They could have specific difficulties with regards to math and graphomotor (cognitive and motor skills for writing) that may not be based on language weakness. So, those learning disabilities that primarily affect reading, writing and spelling are the ones we call Language-learning disorder.

What are the primary features these children exhibit?

  • Go back to their childhood– Delay in speech and language development during childhood is a good indicator for a language learning disorder. So ask their parents. These children may be able to learn the first few grades and manage the classroom lessons, because language during early years is simple and puts less demand on comprehension. However, as they go up their grades, their weak language skills cannot process complex grade-level material.
  • Speech sound based (Phonological) – Their speech sounds fine to the ‘naked ear’ or their speech is intelligible. However, their difficulty lies with speech perception. Let me explain it further. When we hear a word called ‘CAT’, our brain can automatically segment the sounds in the word as ‘/k/, /a/, /t/’, store it and retrieve these images for using in language. These children can find difficulty in naming the days of the week or repeat nonsense words like flipe or wid, they perform poorer than those with normal school achievement (Larrivee & Catts; 1999; Snowling 1996; Wesseling &Reistma 2001)
  • Comprehension and sentence structure (Syntax)– These children have difficulty understanding complex sentences. For e.g. ” Before you brush your teeth, put your towel away” in which the order of clauses (“brush teeth”, “put towel away”) is the opposite of what is expected. (first put towel away, then brush teeth). Typical children achieve this by 7 or 8 years of age.
  • Vocabulary (Semantics)– This is an important indicator, because these children have smaller vocabularies. Simple or immature language for their age. They have difficulty following instructions. Imagine someone is teaching you how to bake a cake. However, you do not know the words (vocabulary) like mixing, batter, flour, baking, oven, butter, etc. Will you understand? I don’t think so. Maybe bits and pieces, but not fully.
  • Conversation (Pragmatics)– These children do not talk much. Even if they speak, their responses are brief. They are less likely to respond to conversational exchanges between their peers. Furthermore, studies suggest that many children have trouble requesting and clarifying miscommunication.
  • Story-telling– Stories are told in different ways in different cultures. However, there is a general framework for all stories. Please read my post on stories. These children struggle with narrating a story. Research says, they struggle with literal and inferential comprehension in narratives. I love this example. “She was outside riding her bike when she heard a flapping of wings under the bushes. Tears came to her eyes. She ran inside to get a shoe box”?. Literal understanding would be, she heard a sound coming from the bushes whilst riding her bike. However, the inferential bit from the story is, the girl is trying to rescue an injured bird. It’s almost like these children can’t read “between the lines”.
  • Social and Emotional– As mentioned earlier, we do get children who are quiet and others who have behavioral and attention difficulties.

I use this as my general framework to identify children in schools. However, assessments should be done beyond that of speech and language, to gauge their overall functioning. A group of professionals like educational psychologists, speech language specialists, occupational therapists (attention and activity) and learning support specialists can form the A-team for these children.

I feel as speech and language therapists, our role in literacy is only emerging in this part of the world. The general consensus is, we only treat what is obvious to the human ear, like speech difficulties and language delays. Working with schools has opened new ways of learning, being part of a team and realizing the imperative role of speech language therapist in supporting children with listening, reading, writing and spelling.

Until next time..

Sources:

  • Language disorders from Infancy to Adolescence by Rhea Paul and Courtenay F.Norbury

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