Language Disorder & Verbal Communication Problems

Some children have a specific difficulty expressing themselves verbally and understanding what others have said to them in words.

This is a problem because parents, teachers and friends might be tricked into thinking that the child is simply a slow learner. They may think the child is lacking intelligence because we tend to judge people’s ability based on the way that they talk with us. However, it is possible for someone to be highly intelligent even if they struggle to communicate in words. They may be able to learn quickly if they are shown how to do something or see it on a video.

Unfortunately, if a child isn’t given support for their language disorder they may fall behind in their learning because they will find it difficult to follow verbal explanations (most teaching at school is done verbally or in writing ).

Verbal issues can also cause social problems. It is more difficult to make friends if you can’t easily express your thoughts and feelings in words to others. Other children may even become frustrated with you if communication is difficult. For example, if you knock into them and fail to quickly apologise or explain what happened.

So how can we spot a language disorder?

Signs of a Language Disorder

The following list is from the American Speech-Language-Hearing Association (ASHA)

• Doesn’t smile or interact with others (birth–3 months)
• Doesn’t babble (4–7 months)
• Makes few sounds (7–12 months)
• Does not use gestures (e.g., waving, pointing) (7–12 months)
• Doesn’t understand what others say (7 months–2 years)
• Says only a few words (12–18 months)
• Doesn’t put words together to make sentences (1½–2 years)
• Says fewer than 50 words (2 years)
• Has trouble playing and talking with other children (2–3 years)
• Has problems with early reading and writing skills—for example, may not show an interest in books or drawing (2½–3 years)

What to do if you’re worried about a child’s language?

Listed above are indicators that a child may have a problem with language. If you are concerned about a child’s ability to communicate please take them to see a Speech and Language Therapist. The earlier that they receive help the better. The Malaysian Association of Speech-Language & Hearing has a list of qualified speech language therapists in Malaysia on their website.

If you’re not sure why a child is having trouble at school you could see a psychologist. Psychologists have access to specialist tests that we can use to evaluate a child’s non-verbal intelligence and compare it with their verbal ability. Tests are available for pre-school children but we tend to find those tests are less reliable for children under 5 years old in Malaysia. If they are too young for an assessment we can recommend strategies that would help the child whether or not they have a verbal communication problem.

How can you help you child if they have a language disorder?

The following strategies are from the Speech & Language Therapy Team at Salford Royal NHS Foundation.

General Strategies

• Give lots of opportunities for spoken language:
  • Try and make time for spoken communication, especially story telling. Tell stories (real and imagined) in formal, informal situations. Encourage children to tell you their stories. Encourage discussion, and giving of opinions.
• Wait for children to communicate:
  • Children with expressive language difficulties may need longer to
    construct an answer to a question. Give them as much time as possible.
    A useful strategy is to pause and silently count to 5 in your head
    before you say anything else.
• Respond to attempts at communication as much as possible:
  • If you understand the message, accept it.
  • Tell the child what you think you have understood so far, but give
    them a chance to tell you if you’ve got it wrong.
  • Listen carefully: show you’re interested, by commenting, and asking
    questions which encourage the child to tell you more.
  • If a child is telling you something, try not to turn it into a ‘test’ by
    asking too many questions. Sometimes a positive comment e.g “I think
    you and Daddy had fun at the swimming pool”, will prompt the child to
    say more
  • Try not to interrupt or change the topic.
• Model good communication (ie demonstrate good language models in your own speech):
  • If a child uses individual words or short phrases to communicate, repeat their words and add 1 more word to what they are saying eg:
    Child: red ball
    Adult: big red ball’
    By just adding one word it makes it easier for the child to copy you
    when they are ready
  • If a child uses words in an unusual or immature way, repeat them back
    the right way. You don’t need to make the child repeat the corrected
    form.
    Child: The boy’s fall out of the bike
    You: Yes, the boy’s fallen off the bike
  • If a child uses a general word, tell them the more specific word e.g.:
    Child: I went to see the man.
    You: Oh yes, you went to see the doctor

Specific Strategies

• Support good communication:
  • Invite children to tell you things e.g.
    -I bet you had fun on your holiday.
  • Ask questions that:
    • Clear up confusion e.g “so did you see nana at your house or at
      nana’s house?”
    • Help the child continue the story e.g “what did nana do then?”
    • Request specific information.
  • Make comments that:
    • Acknowledge what the child has said “So you were really upset when your swing broke”
    • Acknowledge that the child has spoken to you even if you struggle to understand. You may be able to identify the topic of their conversation “You’re telling me something about your car”
    • Show him that you’re listening “That sounds good fun”
    • Provide new information he can build on. “I think the monkey probably wanted to eat your banana”
• Support story telling skills using visual structures
  • Use a structured format of key questions* to organise story work and retelling events, appropriate to the age of the children you are working with. Colour coding the key words will help. Encourage the children to use this for both written and oral work:
    • Identify the topic: think of a title.
    • Who was there?
    • Who did this happen to?
    • Where were you?
    • Where did you go?
    • When did it happen?
    • What happened?
    • Why did things happen the way they did?
    • What happened in the end?

Supporting someone with severe language disorder

The following information is from an Augmentative and Alternative Communication (AAC) Factsheet from the UK Charity ICAN.

Augmentative and Alternative Communication (AAC) is the use of different types of
communication that don’t rely on only speech (but might be used alongside it). It is often
used when children and young people have more severe language disorders.

Signs and symbols support language learning by giving children a visual prompt to
help them understand what the adult is saying.

This can involve low tech aids, such as signs and symbols on card or paper, or more high
tech aids such as computer software which may use a computer generated voice and
have a symbol programme.

PECS: Picture Exchange Communication System

One example of AAC is The Picture Exchange Communication System, or PECS. It allows people with little or no communication ability to communicate using pictures. People using PECS are taught to approach another person and give them a picture of a desired item in exchange for that item. By doing so, the person is able to initiate communication.

iPad equivalent: Proloquo2

It is possible to get electronic AAC tools. Proloquo2Go is an iPad app that some users find really useful. Unfortunately, it is very expensive. You can find more information about Proloquo2go here.

There are a number of different AAC tools. Different children will respond to different AAC tools so it may be necessary to experiment to find which matches your child.

How can I get help if my child has a language disorder?

If you are concerned about a child’s ability to communicate you can take them to see a Speech and Language Therapist. The Malaysian Association of Speech-Language & Hearing has a list of qualified speech language therapists in Malaysia on their website.

If you’re not sure why a child is having trouble at school you could see a psychologist. You can find out more about the assessments that psychologists do on this page of our website. If you would like to arrange an appointment with one of our psychologists you can contact Vivian. You can call or send a What’s app Message to +60 12 5089910 or email vivian@resolve.my. You can find our more about our psychologists here.

Any questions or comments?

Did you find this article helpful? If you have any questions on this topic write them in comments section at the bottom of this page and I’ll reply to you as soon as possible. It would also be good to read any comments or opinions you may have.

If you’d like more advice on how best to help manage your child’s difficulties feel free to arrange an appointment with us.

Further Information …

I’ve included some links to websites that I have found useful below.

Elkan (UK)

Elklan writes and delivers accredited courses for parents and educational staff working with children with speech, language and communication needs. Their website has useful resources that can be downloaded.

Talking Point (UK)

Talking point aims to be the first stop for information on children’s communication. It has separate information sections for children of different ages.

ICAN (UK Charity)

The ICAN shop has a good selection of resources for parents and teachers that can be used to support a child with communication issues.

Afasic (UK Charity)

Afasic has a series of practical suggestions to help your child written by a Speech and Language Therapist.

Malaysian Association of Speech-Language & Hearing

The Professional Body representing speech-language therapists and audiologists. You can find a Speech and Language Therapist in Malaysia on this page.

American Speech-Language-Hearing Association

This page links to information from ASHA about detecting speech, language or hearing disorders.