Childhood Speech, Language, and Listening Problems

Patricia McAleer Hamaguchi

• Publisher: Wiley
• Year: 2010
• Print ISBN: 9780470532164
• eBook ISBN: 9780470630525
• Edition: 3

The essential, up-to-date guide for helping children with language and listening problems

Does your child have trouble getting the right words out, following directions, or being understood? In this revised new edition of Childhood Speech, Language, and Listening Problems, speech-language pathologist Patricia Hamaguchi-who has been helping children overcome problems like these for more than thirty years-answers your questions to help you determine what's best for your child. This newest edition: *

Expands on speech and articulation issues affecting toddlers *

Includes a new chapter on socially "quirky" children

• Explains how to get the right help for your child, including when to wait before seeking help, how to find the right specialist, and how the problem may affect your child academically, socially, and at home
• Covers major revisions in educational laws and programs and insurance coverage as well as current information on new interventions and cutting-edge research in the field
• Updates information on autism spectrum disorders, neurobiological disorders, and auditory processing disorders
• "Provides valuable information for parents of children with speech, language, and listening problems."-Sandra C. Holley, Ph.D., Former President, American Speech-Language-Hearing Association (on the Second Edition )

More than 1.1 million children receive special education services each year to address speech and language problems, and many others struggle with language and listening to some degree. If your child is one of them, this book gives you the crucial and up-to-date guidance you need to help him or her both in school and at home.

PART I

What You Should Know and How to Get Help

1

Speech, Language, and Listening

How They Develop

When you said “Good morning” today and someone answered in kind, the exchange didn’t strike you as particularly complicated. In fact, you were using your highly developed powers of speech, language, and listening—all part of your hard-won ability to communicate. As a parent, it is important to remember that communication is not always as easy for your child as it is now for you as an adult. After reading this chapter, you’ll have a deeper appreciation of just how complex a child’s path to effective communication really is.

Children start on the road to successful communication as soon as they are born. However, they progress at different rates. Some advance seemingly overnight from speaking single words to forming complete sentences that make sense. Other children take a slow, steady course with small steps, gradually adding words and building up to sentences. Often, both types of travelers reach their destination—learning to communicate equally well—in their own time, without any special attention. Members of a third group, however, need a little extra help along the way.

How is your child’s communication journey going? Is he or she traveling more or less in step with one of the first two groups; that is (the dreaded question), is he or she “progressing normally”?

When discussing childhood development, the word normal projects a powerful aura of good and right, perhaps because abnormal is not a label we want attached to our children. Please understand, however, that normal , as used by educators and therapists, is a nonthreatening statistical term, better defined as typical or average. Developmental standards for what the professionals call normal have been established after years of observation and study of children who are considered to be free of such handicapping conditions as deafness or cerebral palsy. Indeed, within the parameters of normal, you will find a wide range of proficiency.

How can two children who exhibit different language abilities both be considered normal? Because, even within each age group, each child has an individual developmental timetable. For example, Roberto may acquire the language behaviors of the 2-to-3 age group just before his second birthday, whereas Mark may only be beginning to display those behaviors as he approaches his third birthday. Both of these boys fall into the normal category. Just because two children of the same age have markedly different communication patterns does not mean that one of them has a problem, particularly in the younger age groups.

Later in this chapter, I explain how children learn to communicate. Then I detail the important communication milestones for the many age groupings, ranging from birth to adolescence. First, however, we need to share a common vocabulary. Just as we “pros” have our own sense of normal, so, too, do we have our own definition of communication. Actually, our communication is much like the everyday variety. It is best understood through the three central skill components: speech, language, and listening. Knowing what’s involved in these three areas is the first step in understanding what difficulties your child may be having, and thus is the beginning of being able to help.

What Is Speech?

Speech refers to the sounds that come out of our mouth and take shape in the form of words. You realize just how complex the speech process really is when you study it or if you lose the ability to produce speech effortlessly.

Many things must happen in order for a child to speak:

• There must be a desire to communicate.

• The brain must have previously heard and learned words in other contexts.

• The brain must create an idea it wants to communicate to someone else.

• The brain must then send that idea to the mouth.

• The brain must tell the mouth which words to say and which sounds make up those words. Intonation patterns and accented syllables must be incorporated.

• The brain must also send the proper signals to the muscles that produce speech: those that control the tongue, the lips, and the jaw.

• These muscles must have the strength and coordination to carry out the brain’s commands.

• The lungs must have sufficient air and the muscles in the chest must be strong enough to force the vocal cords to vibrate. The air must be going out, not in, for functional speech to occur.

• The vocal cords must be in good working condition for speech to sound clear and be loud enough to be heard.

• The words produced must be monitored by his hearing sense. This helps him review what is said and hear new words to imitate in other situations. If words are not heard clearly, speech will be equally “mumbly” when reproduced.

• Another person must be willing to communicate with the child and listen to what he says. If no one is listening and reacting to his speech, he will not be motivated to speak.

For most children, these processes happen naturally, if proper stimulation occurs, without conscious thought. For some children, this sequence breaks down. Once the source of the breakdown is identified, these steps can be facilitated in a direct and conscious manner.

What Is Language?

Language refers to the content of what is spoken, written, read, or understood. Language can also be gestural, as when we use body language or sign language. It is categorized into three areas: receptive, expressive, and social. The ability to comprehend someone else’s speech or gestures is called receptive language. The ability to create a spoken message that others will understand is called expressive language. The way in which language is used with others is called social language or pragmatics.

In order for children to understand and use spoken language in a meaningful way, these things must happen:

• Their ears must hear well enough for the child to distinguish one word from another.

• Someone must show, or model, what words mean and how sentences are put together.

• The ears must hear intonation patterns, accents, and sentence patterns.

• The brain must have enough intellectual capability to process what those words and sentences mean.

• The brain must be able to store all this information so it can be retrieved later.

• The brain must have a way to re-create words and sentences heard previously when it wants to communicate an idea to someone else.

• Children must have the physical ability to speak in order for the words to be heard and understood when used.

• Children must have a psychological or social need and interest to use these words and communicate with others.

• Another interested person must reinforce attempts at communication.

Children with receptive language problems may have auditory (listening) disorders as well, since listening is the most common way we receive language information. It is our brain’s input. A child with a receptive language problem may find activities such as listening to classroom lectures, comprehending stories heard or read, following conversations, or remembering oral directions confusing and frustrating at times.

If a child’s receptive language is not developed, the entire language learning process stalls before it even begins. Parents tend to be more concerned if their child isn’t talking the way they expect, but speechlanguage pathologists also want to find out if the child is hearing clearly and understanding language. If not, meaningful speech (expressive language) is not going to develop efficiently. That is why “speech” therapy often focuses on strengthening receptive language skills, even if the concern is that the child isn’t talking properly.

Speech is the physical process of forming the words; expressive language is what that speech creates—the output, or the product. Even if we have the capability to produce understandable speech sounds, we cannot communicate if what we say is meaningless or confusing to others. We must use words that others can comprehend and put them together in sentences that have order and flow. These words and sentences can be spoken, written, or gestured. Children with expressive language problems may use words incorrectly (e.g., “He falled down”); they may have difficulty organizing and sequencing their thoughts, as well as learning the names of things; and they may dislike engaging in lengthy conversations. It is also not uncommon for children with expressive language problems to have difficulty pronouncing words.

Many children with language problems have difficulty with both receptive and expressive language. They may also possess weak listening skills, since strong listening abilities are needed to receive and develop language.

What Is Listening?

Listening is an active process of hearing and comprehending what is said. As with speech, several steps must occur for a child to listen to speech:

• The child must attend to the speech signal.

• Sound waves must carry the spoken words to his ears.

• The sound must travel through the outer ear canals without obstruction.

• The sound must then pass through the eardrum and the middle ear without being distorted by fluid from colds, infection, or allergies.

• It then must travel through the inner ear, which must be functioning properly as well.

• This sound must travel via the auditory nerve to the brain.

• The brain must try to compare what it hears to previously stored sounds and words to make sense of the message.

• The brain must take in visual information (e.g., lip movements, facial expressions).

• The brain must hold on to the information long enough to process it.

Good listening is as critical a part of the communication process as are speaking clearly and choosing the right words, because communication is a two-way process. One person sends a message, and, ideally, someone else receives it the way it was intended. Who likes to talk to someone who doesn’t pay attention to what is said? Who enjoys repeating things over and over without the desired response? Who wants to be misunderstood? No one, of course. A child with a listening disorder will certainly test your patience, but she is probably even more frustrated than you are.

Your child’s frustration may translate into behaviors that can be misunderstood as ignoring you, not paying attention, or stupidity. A child with listening problems will have difficulty coping in a classroom situation, because so much of the information teachers give to students must be heard. With the right help, however, a child can learn to cope and to improve listening skills.

If the brain can’t stay focused on the task of listening long enough to translate the information, the message will be lost. This is what happens with an auditory memory problem. With an attention deficit problem, the brain works on too many projects at once and can’t stay with a message long enough to finish comprehending it. If the brain has difficulty storing old information, it will not know how to integrate the new information or make sense of it. An auditory comprehension or auditory processing problem may result. These are examples of just a few listening disorders.

How Do Children Learn to Communicate?

You may think communication begins with a child’s first words, but a great deal of preparation must take place before that first word is uttered.

Communication Begins with You

Babies need someone to interact with them and encourage them in a loving way. Placing a baby in front of a television exposes a child to some language, but it’s a passive process. A baby needs to be actively engaged with people in order for the communication experience to be meaningful. I can’t overstate the importance of a parent’s interest in and interaction with a child, from infancy on, in developing a child’s communication skills.

The receptors in a child’s brain need to be stimulated, particularly during the early learning years. These receptors are stimulated when the child is touched, spoken to, and shown pictures, objects, places, and people. Without proper nurturing, a child may experience learning delays or speech, language, or listening disorders.

In many cases, a parent’s stimulation can make the difference between a child with below-average communication skills and one with above-average communication abilities. Information must have a way of getting into the brain. If no one helps to put information in, the brain will not be adept at processing it once information is received in school. Unfortunately, many children do experience communication problems, regardless of the amount or quality of early stimulation.

The Communication-Learning Process

Babies practice using their brains to produce the sounds that come out of their mouths. For infants, the first sounds are crying. As infants’ lungs and mouths develop strength and control, they can make the cr...

Table of contents

• Title Page
• Dedication
• Copyright Page
• Acknowledgments
• Introduction
• PART I - What You Should Know and How to Get Help
• PART II - Speech, Language, and Listening Problems
• APPENDIX A - Resources
• APPENDIX B - Suggested Reading
• Index