Speech and/or Language Delay may be considered to be ‘primary’ or ‘secondary’. The Speech and/or Language Delay is ‘secondary’ if a child has another difficulty which has impacted on the development of his/her speech and language skills, thus causing the delay. There are many diagnosis which can negatively impact the development of speech and/language development and examples of this are when children are diagnosed with Global Developmental Delay, Hearing Impairment, Autism Spectrum Disorder etc. In contrast, when a speech and/or language delay is considered ‘primary’ in nature, there is no other related and/or associated difficulty that can be identified to be the root cause of the problem. Either way, the way in which we communicate with our children during the natural course of the day during everyday routines spent with our children, can have a significant and very positive impact, upon the further development of speech and language.
To mindfully focus on the development of language within daily routines, one must be familiar with the aspects of communication that needs to be enhanced. Communication has two main facets: receptive language, (what is understood), and expressive language, (what we want to say and convey to another). These two facets of language, though very different, hinge upon each other and are equally important. As parents, if we are mindful of the natural process where understanding is achieved before ideas can be expressed, we automatically reinforce the first before encouraging the second during communication moments with your child.
So, how can this be done? As a start, always try and wait for eye contact with your child before giving an instruction even if this eye contact is fleeting in nature. Children with speech and/or language delays may have difficulty processing the language you direct at them, so it is best to simplify your language (i.e. usually just above the expressive language level of your child) and also, remember to limit the number of instructions you direct to your child at any one time. Once strategy that may work where multiple instructions are concerned, is to break up the instructions you want to direct to your child into meaningful sections. So instead of saying “Go and get your water bottle, put on your slippers and we are going to the playground”, break up the instruction into first obtaining the water bottle, then enabling the slippers to be worn before suggesting going to the playground. Another good strategy that works when a parent would like to check for understanding is to request the child to repeat the instruction. This allows the parent to check if the child has understood what has been said or not.
Another useful strategy is to use the ‘First/then’ concept, which often gives a child more information as to the order in which they need to complete the instructions that are being directed to him/her (i.e. “first finish your dinner and then you can watch television”). By being implicit about the order in which the instructions should be carried out, you leave the child to use his/her resources to decode the meaning of the words. The other strategy that works quite well to aid comprehension is to physically show your child what to do when you give them an instruction so that they actually ‘see’ what the instruction looks like. This can be done in many ways and may take the form of visual aids, pictures, gestures, body language or even facial expressions. The use of supportive visual measures can be used very effectively to assist a child’s comprehension and ability to recall an instruction because often, though children with speech and language delays have difficulty decoding what is said to them, they are usually quite competent at working out visual information.
To ensure that the level of focus is sufficient, take advantage of daily routines in which you inter-relate with your child and use these situations to describe what you are doing together using simplified language, of course. The emphasis of specific words during such situations can aid a child to build vocabulary banks and to further the understanding of concepts mainly because you would be using these words and concepts within context and in a functional, meaningful manner. This makes it easier for your child to learn.
Once you feel that your child understands what you are saying at a better level, you can then start focusing on improving the expressive language side of things. The easiest way to do this is to engage with play situations with your child on a regular basis. During this time, model how to play with toys, follow your child's lead and talk about what you/your child is doing with the toys at hand. You will also no doubt be talking to your child often throughout the course of the day about what you are doing, where you are going, what you are going to do, what you have just done – all of which will also contribute to the development of expressive language, if you allow/wait for responses from your child during the interaction.
Once your child starts to communicate verbally, try and remember to expand whatever your child’s says by repeating what was said and by adding one or two more words to the utterance that has been produced
(E.g. Child: "Cat";
Adult: "A soft cat").
One activity that I simply love is looking at books together. The shared pages allow for talk to surround pictures and/or the story which your child is interested in. In today’s world, this can also be achieved on an iPad.
Lastly, always be a good model to your child and provide good language models by taking what the child has said incorrectly and repeating it in the correct way.
Jennifer Peters-Lee is a Consultant Speech-Language Pathologist who has made meaningful communication, her life’s work.
The benefits of using declarative communication in your daily routines with your communication delayed child
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