Specific Areas of Speech and Language Development

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When a young child's communication skills are evaluated, the areas discussed below are generally considered to be important parts of the total picture and are compared to typical developmental patterns. These areas include general behavior and the ability to pay attention, and prelinguistic, receptive language, expressive language, articulation, oral-motor, voice, fluency, hearing, play skills, and problem-solving skills.

General Behavior and Ability to Pay Attention

When evaluating communication skills, it is important to consider a child's general demeanor and activity level. The speech and language pathologist notes how a child reacts to new people and situations and may encourage a brief separation from the parent during the evaluation. The child's ability to make or maintain eye contact with others is also observed. In most cases, when given appropriate toys and materials children exhibit curiosity and interest in touching and playing with them. The child's ability to pay attention to age-appropriate activities is noted as are the activity level, level of distractibility, impulsiveness, or perseverance. The child's frustration level when faced with a challenging task is also evaluated (Creaghead, Newman, & Secord, 1989).

Prelinguistic Skills

A number of skills prerequisite for a child to develop language are usually mastered during the first year of life. These skills are considered when assessing very young children or those who exhibit significant language delays. Prelinguistic skills include:

• The ability to pay attention to visual and auditory information;
• The ability to imitate gestures and sounds;
• The development of object permanence (understanding that an object still exists even when it is removed from sight);
• The ability to take turns;
• The ability to understand that objects have intended purposes (understanding of cause-and-effect relationships);
• The use of basic communicative gestures and the ability to associate a word a child hears with its meaning. (McCormick & Schiefelbusch, 1990)

A child who has a severe language delay but talks is often found to have inconsistent prelinguistic (also called pre-symbolic) skills (Owens, 1982). "Missing links" in the full set of prelinguistic skills often underlie difficulties with more complex language skills (Cantwell & Baker, 1987).

Receptive Language Skills

Receptive language refers to understanding language, also called comprehension. Receptive language skills include:

• Understanding vocabulary (words);
• Understanding sentences and grammatical structures;
• Following directions;
• Understanding concepts (e.g., prepositions, sizes, colors, numbers);
• Understanding questions (e.g., "What?" "Where?" "Who?").

Children may demonstrate much better skills in some of these areas than in others. They may be able to speak relatively well yet have receptive language deficits.

Expressive Language Skills

Expressive language refers to the language a child produces. A commonly accepted model of expressive language consists of three parts: