July/Aug. 2011 - Understanding Speech and Language Development in Young Children
By Lou Phelps
Staff
Speech and language development is a useful initial indicator of a child’s overall development and cognitive ability according to the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services.
Identification of children at risk for delay may lead to interventions, increasing chances for improvement. However, screening for speech and language delay is not widely practiced in primary care according to the department. And so, the department undertook a study to determine the strengths and limits of evidence about the effectiveness of selecting, testing, and managing children with potential speech and language delay in the course of routine primary care by pediatricians.
The most consistently reported risk factors include a family history of speech and language delay and learning difficulties, male sex, and perinatal factors.
The study concluded that there was no clear screening process yet developed. But, the researchers concluded that speech and language development is considered a useful indicator of a child’s overall development and cognitive ability by experts and is related to school success.
Also, identification of children at risk for developmental delay or related problems may lead to intervention services and family assistance at a young age when chances for improvement are best. This rationale supports preschool screening for speech and language delay, or primary language impairment/disorder, as a part of routine well child care – more needs to be done by pediatricians.
Speech and language development in children is a dynamic process. Language encompasses the understanding, processing, and production of communication. Language has been described as a code made up of rules that include what words mean, how to make new words, and how to combine words together. Understanding what word combinations are best in what situations is also part of the language code.
Expressive language delay may exist without receptive language delay but often they occur together in children as a mixed expressive/receptive language delay. Some children also have disordered language. Language problems can involve difficulty with grammar (syntax), words or vocabulary (semantics), the rules and system for speech sound production (phonology), units of word meaning (morphology) and the use of language particularly in social contexts (pragmatics).
Speech problems may include stuttering or dysfluency, articulation disorders, or unusual voice quality. Language and speech problems can exist together or by themselves.
Preschool children with speech and language delay may be at increased risk for learning disabilities once they reach school age. They may have difficulty reading in grade school, exhibit poor reading skills at age 7 or 8, and have difficulty with written language, in particular. This may lead to overall academic underachievement, and, in some cases, lower IQ scores that may persist into young adulthood.
As adults, children with phonological difficulties may hold lower skilled jobs than their non-language impaired siblings. In addition to persisting speech and language related underachievement (verbal, reading, spelling), language delayed children have also shown more behavior problems and impaired psychosocial adjustment.
Assessing children for speech and language delay and disorders can involve a number of approaches, although there is no uniformly accepted screening technique for use in the primary care setting, but concerns should arise if there are no verbalizations by the age of one year, if speech is not clear, or if speech or language is different from that of other children of the same age.
A specific diagnosis is most often made by a specialist utilizing a battery of instruments. Once a child has been diagnosed with a speech and language delay, interventions may be prescribed based on individual needs.
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