Specific Areas of Speech and Language Development (page 2)

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).

Oral-Motor Skills

Oral-motor skills involve the development of the mouth and surrounding area in terms of its structure and functional ability. Weaknesses in this area often affect articulation development. An important part of assessing oral-motor skills is determining if a child has any problem with eating, drinking, or swallowing. The speech and language pathologist often works on oral-motor and feeding skills in conjunction with other professionals such as the occupational therapist (Mannix, 1987).

Voice

The physical health of the voice, as well as how it is used to communicate, is within the realm of speech and language pathology. Some aspects of the voice that are assessed formally and informally are the pitch (high or low voice), volume (loud or soft), and quality (such as hoarseness or extreme nasality) (Moore, 1986). The speech pathologist will recommend that a child be evaluated by an ear, nose, and throat doctor (ENT) if any aspect of the voice suggests a possible physical problem. This evaluation should be done before providing voice therapy (Lindfors, 1987).

Fluency

Fluency problems, often called stuttering or dysfluency, refer to interruptions in the flow of speech. Dysfluency consists of pauses, prolonged sounds, or repetition of sounds and words. In severe dysfluency secondary characteristics such as jerking motions or blinking often are present. It is important to note that a certain amount of mild dysfluency is normal for many young children. Children whose level of dysfluency interferes with their ability to communicate or the willingness of others to interact with them often require speech therapy services. The speech and language professional assesses dysfluency to determine whether it is a developmental stage or a true disorder (Owens, 1991).

Hearing

For most children, hearing is a primary means of learning to communicate. For this reason, when speech and language development is delayed or disordered, it is essential to find out if the child is hearing adequately (Oyler, Crowe, & Haas, 1987). Assessment takes the form of a screening or full hearing evaluation. If a hearing impairment is found, the speech and language pathologist often works with an audiologist or teacher of the deaf and hearing impaired to provide intervention services.

Play Skills

Children progress through developmental stages of play. Each of these stages of play relates to speech and language and cognitive milestones. A variety of play experiences should take place for language to develop, especially as the child uses more symbolism (Cheng, 1989). It is important for the speech and language pathologist to engage or observe children during play activities to better understand their level of speech and language development.

Problem-Solving Skills

Language assessment also includes consideration of how a child uses language to perform thinking and reasoning tasks appropriate to the child's age. In younger children these skills are manifested in abilities such as matching or naming. As children become older they should be able to analyze things they encounter in more complex ways. They should become able to use language to perform more difficult tasks such as explaining and predicting (Blank, Rose, & Berlin, 1978).