A language delay is a delay in language development constituted usually by standardized language tests comparing children to normative data of same aged peers. A delay in language could appear on any or all of the five categories of language: pragmatics, semantics, syntax, morphology, and /or phonology.
For more information: www.asha.org/public/speech/development
What is a speech delay?
A speech delay is a delay in the ability to produce sounds clearly and precisely (phonemes) by a certain age. Errors can consist of omissions, substitutions or distortions. See list for ages of customary sound production and mastery.
When children have difficulty producing 1 or 2 phonemes, but are otherwise understandable (intelligible) in running connected speech, they would be exhibiting an articulation delay.
However, sometimes children’s production of phonemes breakdown in running connected speech because of the immaturity of their ability to auditorally process and or produce each phonemic variation at a much faster rate. This effort is referred to as ‘intelligibility’. The variation of phonemic productions in running connected speech is a much greater challenge to a young brain than producing individual sounds in isolation. Segmenting each sound heard by a child from an adult’s utterance requires sophisticated phonological awareness. The ability to repeat adult productions in running connected speech is difficult for most children from 2 to 3 years of age. Usually, by 3 years of age, children should be understandable to an unfamiliar listener approximately 80 to 90% of the time.
Phonological processes are repeated patterns of errors made by the child when attempting to produce an adult form (usually in single words and in phrases/utterances). Some continue after 3 years, but will need monitoring by a speech language pathologist if not cleared by 4 to 7 years of age depending on the process.
How do I know if my child has a delay?
A delay in language or speech development would be determined by a speech language pathologist who would diagnose a delay using standardized tests.
If you think your child has a delay, call Mountain View Speech Therapy for a consultation appointment or to schedule an assessment.
Two very good websites documenting developmental norms are www.babycenter.com www.babycenter.com
The link in babycenter.com is www.parentcenter.babycenter.com/refcap/preschooler/pdevelopment and www.asha.org/public/speech/development
What do I do next?
After contacting a speech therapist and scheduling a consultation/screen/evaluation, expect a report to be written within a couple of weeks and another meeting to go over the results. A report should consist of results of the evaluation, including your child’s developmental history and factors that could impact a delay, a summary and recommendations with goals. At that point, it is your decision to enroll your child in speech therapy.
Who do I contact first?
After talking with friends and family, most people talk with their pediatrician about developmental norms; however, it is highly recommended to consult directly with a speech language pathologist. Speech language pathologists know this area better than anyone and will be able to help you much faster than your pediatrician. Additionally, speech language pathologists have more resource information including telephone numbers, names of agencies and other doctors/clinics.
Should I seek assessment through the schools or pay privately?
All services in any domain coming from the government are generally standard quality and make take a long wait period to get results. Private services will generally give a more specific level of service to your child at a much faster rate. Although, the government funds can only go so far, it is a good idea and highly recommended that you always contact the schools to see if your child qualifies for services. Even if your child qualifies under the government eligibility guidelines, there is no guarantee that the therapist assigned to your child or the time frames available will be a good match. Just like any service in life coming from public monies, your choices may be limited and more narrow. Mountain View Speech Therapy serves children privately who are also receiving services through the local school districts.
Should my child stay in regular preschool/school with a delay or communication disorder?
Where your child is educated and receives socialization is your decision as a parent. Depending on the nature of your child’s communication disorder or delay determines the best match for academic/social needs. These issues should always be discussed with your speech language pathologist. Onsite visits and consultation about your child’s educational needs are part of the service from Mountain View Speech Therapy.
Does my child need group or individual speech therapy?
The needs of your child determine this. Group therapy works best for children who are shy and timid. The effect of ‘group’ therapy in many settings has been proven to be very effective. Sometimes children are not ready to be confronted and put on the spot in an individual therapy setting. Group therapy is thought by some to be more true to life in that we are social beings functioning together; not isolated.
Individual therapy works best if children have attention problems or are moderately to severely autistic. In some cases, if children need mild articulation treatment for a couple of articulation errors, progress can happen faster with direct teaching in individual sessions. Additionally, some children are extremely apraxic and need more concentrated effort from the therapist. In those cases, individual therapy is more appropriate.
What is Autism?
“Autism is a physical disorder of the brain that causes lifelong developmental disabilities. Positive, supportive environment can help all children grow and develop. However, strictly from a medical or biological perspective, there is no cure for the brain differences found in children with Autism. The goal of early intervention is to minimize the effects of Autism that can further delay developmental in infants, toddlers and preschoolers." (Children with Autism A Parent’s Guide, p.3, 29, 183, Michael D. Powers, Psy.D.2000)
Each child with Autism is unique with his or her own individual range of symptoms and behaviors. However, extensive research over many years has identified some basic general statements about what children with Autism are like as a group.
Failure to develop normal socialization
Disturbances in speech language and communication
Abnormal relationships to objects/events
Abnormal responses to sensory stimulation
There are five types of Autism.
*Autistic Disorder
*Asperger’s Disorder
*Rett’s Disorder
*Childhood Disintegrative Disorder (CDC)
*Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
What is Asperger’s Disorder?
The diagnostic definition from the Diagnostic Staticstics Manual IV for Asperger’s Disorder is very similar to the definition of Autism. Children with Asperger’s Disoder have noticeable problems with social interaction, communication, unusual behaviors and interests. However, they tend to develop speech at the right age, and generally do not score within the mental retardation range on IQ tests. They have the three major symptoms of PDD:
Impaired social interaction
Impaired communication
Repetitive, stereotypic, or Odd Patterns of behavior, unusual interests, or responses to their environment.
Asperger’s Disorder is different from Autism in that children with Asperger’s Disorder do not have the same level of communication problems as children with Autism and are generally brought to the attention of their pediatrician at a much later age (7-9 years) and are diagnosed later in life than children with Autism.
Their verbal abilities are generally better than their non-verbal abilities, and they have a basic interest in people (although their social communication skills are often inappropriate and/or unusual). (Children with Autism A Parent’s Guide, p.17-21 Michael D. Powers, Psy.D.2000)
What is Apraxia?
Apraxia is a motor speech disorder resulting in the inability to speak words or produce phonemes clearly. Children with childhood Apraxia will often grope to make sounds only to remain silent after concentrated efforts fail.
Childhood Apraxia is the result of a disruption in the motor strip cortex located in the left frontal-temporal lobe of the brain. Bleeds during delivery or trauma to the infant's head can cause damage to this area. Sometimes, there is no history identifying why a child has Apraxia. Children need intensive speech therapy as soon as the diagnosis has been made. Intensive therapy will include auditory bombardment of sounds in isolation and word position so the child’s brain can have the opportunity to hear these sounds at a rudimentary level before expecting to produce them.
What is Sensory Integration?
Sensory Integration is a concept and proven fact that to apply stimulation to the body’s senses will increase brain development and enhance the growth of neural pathways. Occupational Therapist have been using sensory integration techniques for many years to stimulate development in children and adults. A child can attend much better to a speech language therapy session when a child’s sensory/ vestibular system is grounded. Child love the fun techniques used to enrich the body’s senses and generally attend much better to speech language therapy.
Should my child go on the DAN protocol?
The DAN protocol is a carefully selected diet to reduce the allergic reactions that certain foods may cause in the body. Many children with Autism and ADHD have found a direct correlation between their diet and the severity of symptoms associated with these diagnosis.
DAN stands for Defeat Autism Now formally known as Cure Autism Now. To find out more about the diet visit the website: "http://www.autism.about.com/od/causesofautism" www.autism.about.com/od/causesofautism or the Autism Research Institute at www.autism.com/ari.
What is ADHD?
ADHD is a defined behavior disorder that results in a child being either inattentive/ hyperactive and impulsive or all three. There are no high-tech blood tests or brain scans that can diagnose ADHD. The diagnosis must be based on the way a child behaves. In some cases, this is easy when the child shows ‘text book’ symptoms. It must be diagnosed by a clinically sensitive team of experts over time, hours of observation and parental/teacher interviews. Clinically, I have experienced that some preschoolers with ADHD may indeed have language delays because their attention spans do not allow them time to process language; however, there are children with ADHD that process language well and do not exhibit learning disabilities in school.
Does my bilingual home affect my child’s language development?
Generally, children from bilingual or multilingual homes have an initial delay in the onset of language phrases, but usually explode with a variety of vocabulary and a wider and varied range of expression by the time they are 4 years of age. This explosion is referred to in the second language acquisition research as ‘additive bilingualism’.
If your child was raised in mono-lingual home for several years and moves to a total emersion environment in a second language, a silent period may occur. A silent period may give the appearance to a general education teacher that the child has a learning disability. This needs to be ruled out by an experienced bilingual speech language pathologist in early elementary school aged children. The speech pathologist does not need to speak the child’s first language, but must know the rules and research behind second language acquisition. Just because a school psychologist or speech language pathologist speaks the child’s first language does not ensure an accurate differential diagnosis or identification of a learning disabled child.
Silent periods can last from 6-8 weeks or up to one year depending on the age of when the child entered into the second language environment. Language loss of the first language can also occur. Subtractive bilingualism is when the child learns the second language (L2) at the expense of the first language (L1). The amount of time the child is applying new vocabulary from another language to academics, is an ‘opportunity cost’ to apply his native vocabulary to new learning. After a few years, it is believed that the child does not have sufficient vocabulary in either language to perform up to their cognitive potential and fall behind in opportunity for ‘new learning’ to occur.
Research has consistently shown that children who experience subtractive bilingualism will experience cognitive and academic deficits.
Basic interpersonal communication skills (BICS) take approximately 2-5 years to master in a total emersion environment. Cognitive Academic Language Proficiency takes approximately 5-7 years to master.
| FOR MORE INFORMATION, VISIT www.sarc.org www.asha.org www.losaltos.k12.ca.us www.mvwsd.k12.ca.us www.cupertino.ca.campusgrid.net/home www.c-a-r.org http://www.geocities.com/kiddoland/ www.autism-society.org www.cureautismnow.org www.add.org www.devminds.com www.autism.about.com/od/causesofautism
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