Frequently Asked Questions

• 6 in 100 children will at some stage have a speech, language or communication difficulty.
• At least 1 in 500 children experiences severe, long-term difficulties.
• Across the UK the lives of over 1 million children and young adults are affected by the hidden disability of speech, language and communication impairment

Where a child's difficulties are solely with speech or language, this is generally described as a primary and specific speech and/or language impairment or specific speech and/or language impairment. Specific in this context means that the difficulties are confined to speech and/or language.

Where a speech and language impairment is associated with other problems such as intellectual or physical disability, hearing loss, emotional problems or social deprivation it is often described as a secondary speech and/or language impairment or a learning difficulty.

Children with specific language impairment lag behind their peers in language production and language comprehension, which contributes to learning and reading disabilities in school.

A speech disorder is a problem with fluency, voice, and/or how a person says speech sounds.

• Fluency disorder - an interruption in the flow or rhythm of speech characterized by hesitations, repetitions, or prolongations of sounds, syllables, words, or phrases.
• Articulation disorder - difficulties with the way sounds are formed and strung together, usually characterized by substituting one sound for another (wabbit for rabbit), omitting a sound (han for hand), adding a sound or syllable (pelay for play) and distorting a sound (ship for sip). Children with problems in speech can have later difficulties learning to read and spell.
• Voice disorder - characterized by inappropriate pitch (too high, too low, never changing, or interrupted by breaks); quality (harsh, hoarse, breathy, or nasal); loudness, resonance, and duration.

A language disorder is a problem with understanding and/or using spoken, written, and/or other symbol systems (e.g., gestures, sign language). The disorder may involve

1) the form of language (phonology, morphology, syntax), 2) the content of the language (semantics), and/or the function of language in communication (pragmatics) in any combination:

1. 1. Form of Language
   
   • Phonology is the sound system of a language and the rules about how sounds are combined.
   • Morphology is the structure of words and how word forms are constructed.
   • Syntax is the order and combination of words to form sentences.
2. Content of Language
   
   • Semantics is related to the meanings of words and sentences.
3. Function of Language
   
   • Pragmatics is the combination of language components (phonology, morphology, syntax, and semantics) in functional and socially appropriate ways.

Developmental language impairment (sometimes called language delay) is a condition wherein a child does not learn language as quickly as his/her peers. For example, a 5-year-old child may speak and understand language like a 3 year old.

These children may have age appropriate intelligence, or they may have lower intelligence or non verbal ability (learning difficulty), which causes a language delay. Developmental language disorders in the absence of a learning difficulty or any other impairment may be hereditary, or genetic.

Children with developmental language disorders learn language in the same sequence as their normally developing peers, but the pace is delayed. For example, typically developing children produce first words between the ages of 10-12 months, increasing the number of single words produced by 12-18 months, speaking in two-word phrases between the ages of 18-24 months, and using 2-3 word phrases in the second year of life.

They use 3-4 word “adult-like” sentences in their third year of life. By the age of 5, normally developing children have learned 90% of the grammar they will need in life. Children with more moderate or severe language disorders show delays in these early milestones as well as delays in learning language in school (i.e. learning vocabulary words, spelling, reading, writing).
Children with milder, more “hidden” language disorders may not show signs of difficulty until they begin primary school (i.e. in learning to read and write). Language skills progress from more basic to more complex.

The demands for high order language increase across the years. This is the language that, for example, is needed to perform tasks involving such skills as interpretation and reasoning. In secondary school, speaking, listening, reading and writing are integral parts of education, and more abstract thinking is required. Some students do not become identified as language impaired until secondary school.

Treatment will vary depending on the nature and severity of the problem, the age of the individual, and the individual's awareness of the problem. Speech and Language Therapists assist children who have communication disorders in various ways.

• Assess the child’s strenghts and areas of need
• Provide direct individual or group therapy for the child
• Provide strategies and programmes for the teachers and school staff to conduct in the school context
• Consult and collaborate with the child’s teacher and other professionals about the most effective ways to facilitate the child’s communication in the class setting
• Work closely with the family to develop goals and techniques for effective therapy in class and at home.

For more information about speech and language therapy and to find a speech and language therapist, contact:

The Royal College of Speech and Language Therapists: www.rcslt.org
The Health Professions Council: www.hpc-uk.org