Language Disorder in children

What is language disorder?

A child with a language disorder struggles to acquire and apply the rules of a language. For instance, the child may require a longer time to process and understand the language when communicating with another person. They may even find it challenging to express themselves through verbal or non-verbal means during communication.

What are some symptoms of language disorder?

‘She will get better over time. She just needs practice.’

 ‘Don’t worry, he will eventually grow out of this phase.’

It is natural for parents to dismiss their child’s linguistic deficiencies, assuming that it is just part of growing up. Sometimes, parents could be in a state of denial to recognise and accept the fact that their child may have a deficiency. Nonetheless, it is critical to still be aware of some language disorders indicators. If your child exhibits any of these symptoms, you should seek appropriate treatment as soon as possible.

Typically, most language disorder symptoms appear in a child’s formative years. A child psychologist uses the developmental age of the child as a key indicator to identify whether or not these impairments are a cause for concern. Here are some examples of language disorder deficiencies:

• Struggling to express oneself with full sentences
• Difficulty following instructions
• Difficulty understanding what was taught during class
• Having a limited capacity of vocabulary words

These symptoms may significantly impact the child’s daily functions, causing deficits in:

• Social contexts: e.g. problems with communicating with peers at school
• Intellectual settings: e.g. poor academic performance
• Occupational settings: e.g. poor work performance

How is language disorder diagnosed?

A multidisciplinary team approach that includes a child psychologist and speech and language therapist is optimal for diagnosis and treatment. The team will first eliminate other illnesses that could potentially cause similar language disorder symptoms.

To propose an individualized intervention plan, appropriate assessment tools will be used to identify your child’s areas of strengths and weaknesses in order to specifically address your child’s needs.

How is language disorder treated?

Children with language disorders can benefit from a variety of interventions, ranging from drill-based activities (clinician-directed) to activities that model play or other everyday activities (child-centered), or a combination of both approaches (hybrid).

Here are brief descriptions of some of the general approaches for tackling language disorders:

1. Speech-therapy approaches

Clinician-Oriented

The clinician selects the treatment goals, settings, and determines the stimuli to be used and the type and schedule of reinforcement* for accurate responses. These approaches utilize operant procedures and are often used to teach language form (e.g., syntax and morphology).

*Positive reinforcers are events that increases the likelihood of a behavior from occurring in the future (example: praises, favorite candy/snack when target behavior is observed). Negative reinforcers are events that decrease the likelihood of a behavior from occurring in the future (example: withdrawing a favorite toy when target behavior is not observed).

Child-Oriented

The clinician applies indirect language stimulation techniques and follows the child’s lead in more natural, everyday settings and activities to stimulate language growth. Examples include:

• Expansions—the child’s utterance is repeated in response, while the clinician adds grammatical and semantic detail;
• Recasts—the child’s utterance is recast, changing the mode or voice of the original (e.g., declarative to interrogative or active to passive);
• Build-ups and breakdowns—the child’s utterance is first expanded (built up) and then broken down into grammatical components (break down) and then built up again to its expanded form.

Hybrid

The clinician develops activities that are very natural, with opportunities for the child’s spontaneous use of utterances containing the targeted language forms. Examples include:

• Focused stimulation—the clinician produces a high frequency of the child’s target forms in meaningful and functional contexts
• Vertical structuring and expansion—the clinician presents a stimulus (e.g., a picture depicting a semantic relationship), asks the child to respond to the stimulus (e.g., What is this? What’s happening?), and then expands the child’s response into a well-formed sentence;
• Incidental teaching—the clinician applies operant approaches in natural settings to elicit and reinforce target responses; within the setting, the child selects the topic stimulus that initiates the interaction

Group therapy

Your speech therapist may suggest group therapy sessions with peers who are similar in age and have similar communication difficulties. These sessions aim to address and integrate the individualized speech targeted goals in a practice group setting.

2. Psychological approach

Your psychologist may conduct an assessment to identify whether there are any possible external factors influencing your child’s speech deficiencies. This includes anxiety projected onto self or by others/circumstances, stressful events, poor self-esteem, poor interpersonal relationships, and/or socio-emotional dysregulation. Following this, the psychologist may adopt appropriate interventions such as Cognitive Behavioural Therapy (CBT), behavioral management or group therapy to tackle these issues.

Cognitive Behavioral Therapy (CBT)

This treatment focuses on the cognitive and behavioral aspects of an individual. CBT aims to address unhelpful thoughts and behaviors that are intentionally avoided. Psychoeducation, relaxation exercises, problem-solving/self-evaluation strategies, and cognitive restructuring may be used by psychologists to address avoidance behaviors and thoughts. These approaches will be introduced in an age-appropriate manner, aiming to tackle the personal needs of your child.

Group therapy

Children may be introduced to group therapy where the child is given opportunities to practice the skills taught in CBT and behavioral management with similar-aged peers. This will broaden your child’s skillsets into other contexts, and teach your child important soft skills necessary to building new relationships with others.

For more information on other evidence-based treatments for language disorders, such as behavioral management, play-based approaches, and parental involvement, click here to find out more on how the experienced child therapists at Annabelle Kids can best support you and your child.

‘Am I to blame for my child’s language disorder?’

In short, no! It is difficult to pinpoint what causes your child to have a language deficiency. Language disorders can be a standalone condition or coexist with other illnesses and disorders such as ADHD or ASD. However, cognitive processing deficiency and genetic differences have been suggested as possible causes.

If uncertain, the best approach you can do as a parent is to seek professional help and get early intervention for your child. Speech therapy is often the first line of treatment for language disorders in children.

Remember that your health is just as essential as your child’s. Do not be afraid to ask family and friends for help and support. Alternatively, you may consider joining support groups.