Language and Literacy Disorders in Children
The broad term language disorders refers to problems with any or all aspects of language, including understanding language, expressing ideas through appropriate vocabulary and grammar, reading, or writing. This group of disorders includes language delays, in which language skills develop more slowly than they should, and specific language impairment, a language disorder that occurs without any other known neurological, emotional, sensory, or intellectual causes. Language-based learning disabilities are literacy-related problems with reading, spelling and writing, and include dyslexia, which refers specifically to difficulty with reading.
Language disorders in children may occur suddenly when an injury or disease (e.g., stroke, traumatic brain injury, or tumor) damages language centers in the brain. More often, though, the disorders are developmental, gradually becoming apparent as the young child learns to use language. Language disorders are common in conditions such as autism, Down syndrome, malnutrition, hearing loss, or cerebral palsy, but often the cause is unknown. It is not unusual to find a family history of language disorders, so genetics also probably play a role.
Symptoms of Language Disorders in Children
Symptoms vary widely depending on the type of disorder, and may be mild to severe. Some general signs of a language disorder are:
- Begins talking late
- Trouble following or giving instructions
- Difficulty pointing to or naming pictures
- Problems understanding or telling stories
- Difficulty understanding age-appropriate humor, abstract concepts, and figures of speech
- Limited vocabulary; may frequently use non-specific words like thing or stuff
- Struggling to understand multi meaning words
- Problems with parts of grammar such as pronouns, plurals, and/or verb tenses
- Mixes up tenses when speaking
- Difficulty with certain social skills; e.g., staying on topic or taking turns
- Less talkative than peers
- Mixes up order of letters in words when writing
- Difficulty learning letters, or the sounds that go with letters
- Problems with math
- Problems telling time
- Does not hold books the right way, look at the pictures/words, or turn the pages
- Difficulty learning songs
- Trouble remembering/repeating strings of numbers, letters or words
- Problems breaking words down into sounds, letters or syllables
Assessing and Treating Language Disorders in Children
The Speech-Language Pathologist (SLP) may use a number of formal and informal tests to assess if a child's language skills are normal for her age. The testing tasks will vary depending on the child's age and the severity of symptoms. The SLP may look at the child's receptive and expressive language skills. Receptive skills may include the child's ability to identify vocabulary, understand meaning of different sentence structures, ability to follow directions, understanding of concepts (size, location, sequencing), and ability to understand wh-questions (who, what, where, when, and why). Expressive skills may include the child's ability to label items, to formulate questions and sentences, the ability to retell information, narrative skills, and overall ability to express thoughts and ideas. In addition, the SLP may look at the child's ability to perform reading and writing-related skills, play, and interact socially. He may also screen the child's hearing or speech skills, and/or assess cognitive skills.
Treatment will use a variety of activities to target the specific language skills that are impaired. Therapy tasks for young children may be based in games and other play activities; tasks for older children may be related to school coursework. The SLP may teach older children strategies to help them work around their language difficulties. He will educate parents about the child's problems and ways to work on language at home. He may also work with teachers to have them modify how they present information in the classroom, and encourage the child's use of strategies.