Week 2 Language Differences Preschool Student Version October 2024 (PDF)

Speech, language and communication difficulties in pre-school children HCS 2023/6304 Developmental Differences in Speech, Language and Communication 2024-25 Prof Judy Clegg, School of AHPN&M, Faculty of Health HCS 2023/6304 Pre-school speech, language and...

Speech, language and communication difficulties in pre-school children HCS 2023/6304 Developmental Differences in Speech, Language and Communication 2024-25 Prof Judy Clegg, School of AHPN&M, Faculty of Health HCS 2023/6304 Pre-school speech, language and 1 communication difficulties Outcomes from today Recognise the variation in preschool children’s speech, language and communication development Explain how speech, language and communication difficulties can present in pre-school children Discuss the difficulties in predicting which children will go onto experience persistent speech, language and communication needs Apply your knowledge of speech, language and communication development to identify speech, language and communication difficulties in video material of preschool children. Consider other terminology in this field, e.g., language differences, identifying strengths in a child’s speech, language and communication profile, older terminology of language delay and language disorder HCS 2023/6304 Pre-school speech, language and communication 2 difficulties Variation in children’s speech and language development There is wide variation in the rate children acquire speech, language and communication. See the week 1 resources and lecture to recap about the developmental milestones of children’s speech and language development. HCS 2023/6304 Pre-school speech, language and communication difficulties 3 An example: variation in speech, language and communication development (Bates et al., 1995) Comprehension/understanding of single words - Expected range at 10 months, from 0-144 words - Expected range at 16 months, from 80-300 words Saying single words - Expected range at 12 months, 0-24 words - Expected range at 24 months, 89-534 words Saying 2 word combinations - Between 16 months and 2 years of age HCS 2023/6304 Pre-school speech, language and communication 4 difficulties Activity 1: Some video material Let’s watch some pre-school children 2 year old children talking (about 4 minutes in length) https://www.youtube.com/watch?v=K-2eqkvGauU Consider the speech, language and communication development and abilities these children are showing and then compare with the next videos HCS 2023/6304 Pre-school speech, language and communication 5 difficulties Pre-school children with speech, language and communication difficulties Down Syndrome https://vimeo.com/399175714 Compare with the 2 year old children talking (slide 5) Note down any differences you hear about or observe in the children who have Down Syndrome HCS 2023/6304 Pre-school speech, language and 6 communication difficulties Pre-school children with speech, language and communication difficulties Speech difficulties https://www.youtube.com/watch?v=_5ph53B9UXY Compare with the 2 year old children talking (slide 5) Note down any differences you hear about or observe in the child who has speech difficulties HCS 2023/6304 Pre-school speech, language and 7 communication difficulties Pre-school children with speech, language and communication difficulties Developmental Language Disorder (DLD) (about 2 minutes, 30 seconds in length) https://www.youtube.com/watch?v=11cJmCy-ed8 Compare with the 2 year old children talking (slide 5) Note down any differences you hear about or observe in the child who has DLD HCS 2023/6304 Pre-school speech, language and 8 communication difficulties Pre-school children with speech, language and communication difficulties Children growing up in areas of social disadvantage https://www.youtube.com/watch?v=XzeDW_4qsHY Compare with the 2 year old children talking (slide 5) Note down any differences you hear about or observe in these children HCS 2023/6304 Pre-school speech, language and 9 communication difficulties Pre-school children with speech, language and communication difficulties Children with an autistic profile Google drive video Compare with the 2 year old children talking (slide 5) Note down any differences you hear about or observe in these children HCS 2023/6304 Pre-school speech, language and 10 communication difficulties Activity 1: Feedback Your thoughts and observations (Judy will collate these) here HCS 2023/6304 Pre-school speech, language and communication 11 difficulties Some risk factors for speech, language and communication difficulties in pre-school children Genetic and chromosomal syndromes of learning disability Family history of speech, language and communication difficulties/developmental differences/disorders Physical/motor difficulties, e.g., cerebral palsy Chronic illness including prematurity and low birth weight Sensory difficulties, i.e. hearing and visual impairments Environmental factors, e.g., social disadvantage, neglect Biological factors, e.g., gender/male, prematurity, low birth weight HCS 2023/6304 Pre-school speech, language and communication 12 difficulties Language delay and language disorder (this is old but important to know) Delay and disorder are terms that were used to describe more extreme variation than expected variation in children’s speech, language and communication development These terms are still used but there is a move away from using them (RCSLT 2020) to refer to children as having speech, language and communication difficulties or needs Therefore, it is helpful to understand the terms language delay and language disorder and why they are no longer preferred HCS 2023/6304 Pre-school speech, language and communication 13 difficulties Language delay (this is old but important to know) Follow the typical rate and progress of speech, language and communication development but it is slower than expected for the child’s age These children are expected to catch up, i.e., the delay resolves Language delay is common, up to 10% of 3 years olds have a language delay (Dale et al., 2003) There may be some factors that can explain the delay such as mild fluctuating hearing loss or there may be no obvious reason. Children with delays do not usually have significant medical factors such as a learning disability HCS 2023/6304 Pre-school speech, language and communication 14 difficulties Language disorder (this is old but important to know) There is often an obvious or clear cause for the disorder These children do not follow the typical rate and progress of speech, language and communication development These children will not catch up and the disorder will persist throughout the child’s life. Negative outcomes in literacy, education, psycho-social outcomes, well-being Some children with a language disorder will also have a significant learning disability Some children with a language disorder will not have a significant or other learning disability HCS 2023/6304 Pre-school speech, language and communication 15 difficulties Delay and disorder A continuum of delay and disorder Delay Disorder There is a point at which a delay becomes so severe that it is considered a disorder, e.g., a child who is 8 years old whose speech, language and communication development is equivalent to a 3 year old child. This is a very SIMPLISTIC and LINEAR approach. It is much more complex than this. HCS 2023/6304 Pre-school speech, language and communication 16 difficulties Critical Age Hypothesis If language difficulties (delay or disorder) are still present by age 5 years then they are much more unlikely to resolve than if the child is younger (Bishop 2004). When a language difficulty persists, we now usually use the term Developmental Language Disorder (DLD) HCS 2023/6304 Pre-school speech, language and communication 17 difficulties Developmental Language Disorder (DLD) 1. The child has language difficulties that create barriers to communication or learning in everyday life, 2. The child's language difficulties are unlikely to resolve by five years of age 3. This is complex. The language difficulties are not caused by a known biomedical condition such as brain injury, neurodegenerative conditions, genetic conditions or chromosome disorders such as Down Syndrome, sensorineural hearing loss, or Autism Spectrum Disorder or Intellectual Disability. 4. The language difficulties can co-occur with other neurodevelopmental disorders, e.g., DLD and ADHD, DLD and Autism (this makes point 3 complicated) 5. DLD can be identified before the age of 5 years Important note: this is complex and hard to understand, do not worry, we will cover DLD later in the module HCS 2023/6304 Pre-school speech, language and 18 communication difficulties Why is it important to identify children with speech, language and communication difficulties? A delay or being late to say first words and phrase level language is a common sign of neurodevelopmental disorders, e.g., autism, learning disability, chromosomal disorders, hearing impairment Identify children at risk of Developmental Language Disorder (DLD) who will need support Language delays (or being a late talker) do resolve, 50% of children at age 3 years with a language delay had resolved by school age (Dale et al., 2003; Rescorla et al., 2011) Inform how to target interventions to most in need Supporting pre-school children with speech, language and communication difficulties should help them with their learning and life chances HCS 2023/6304 Pre-school speech, language and 19 communication difficulties Activity 2: Speech, language and communication in a 2 year old child Watch the 10 minute video of a speech and language therapy triage appointment. Child, age 2 years and 7 months. Pre-school expressed concern about his language development. Triage appointment is a short appointment to identify which children need further assessment and intervention. Appointment based on case history with parent(s) and informal assessment. Refer to the Universally Speaking 0-5 years checklist What do we expect of a child who is 2 years and 7 months old? Write your thoughts down HCS 2023/6304 Pre-school speech, language and 20 communication difficulties Activity 2: Speech, language and communication in a 2:07 year old child Consider these areas of development: 1) Play 2) Listening and attention 3) Speech 4) Vocabulary 5) Expressive language/phrase/sentence level 6) Language understanding 7) Social communication HCS 2023/6304 Pre-school speech, language and 21 communication difficulties Activity 2 continued: to consider Consider other terminology in this field, e.g., language differences, identifying strengths in a child’s speech, language and communication profile What strengths does this child show in their speech, language and communication profile? What support/intervention could be appropriate for this child? HCS 2023/6304 Pre-school speech, language and 22 communication difficulties Activity 3: Discuss Read this short editorial Norbury, C. (2015). Editorial: early intervention in response to language delays – is there a danger of putting too many eggs in the wrong basket? Journal of Child Psychology & Psychiatry, 56, 8, 835-836. It is the week 2 folder Do you agree? If so, why? If not, why? HCS 2023/6304 Pre-school speech, language and 23 communication difficulties Activity 3: Discuss Children’s speech, language and communication needs are a public health need and not a clinical/medical condition Move away from diagnosis to supporting the whole population Recognise speech, language and communication as essential to life chances Speech and Language Therapy services adopt public health principles, e.g., prevention and intervention What would a public health approach to supporting speech, language and communication look like for pre-school children? Law J, Reilly S, Snow PC. (2013). Child speech, language and communication needs re-examined in a public health context: a new direction for the speech and language therapy profession. Int J Lang Communication Disorders. 2013;48(5):486–96. HCS 2023/6304 Pre-school speech, language and 24 communication difficulties Conclusions Much variation in pre-school children’s speech, language and communication development. Many resources available to understand speech, language and communication development. Language delay and disorder are older terms used to describe more extreme variation For some children, speech, language and communication difficulties resolve and so, the challenge is identifying these children accurately from those who will go on to have persistent speech, language and communication difficulties, e.g., Developmental Language Disorder (DLD) There are some risk factors we can use to aid in the identification of children who will have speech, language and communication difficulties Need to use our knowledge of speech, language and communication development to understand how to identify children with speech, language and communication difficulties Consider other terminology in this field, e.g., language differences, identifying strengths in a child’s speech, language and communication profile HCS 2023/6304 Pre-school speech, language and communication 25 difficulties Essential Reading Kersner, M., & Wright, J.A. (2012) Speech and language therapy: the decision making process when working with children. David Fulton Publishers. Read chapter 14 – working with children with language delay and specific language impairment (SLI). This is available as an e-off print on the electronic reading list Note on the above chapter: this is an older chapter but it does give a good introduction, SLI is now referred to as DLD RCSLT Briefing Paper on Language Disorder with a specific focus on Developmental Language Disorder (DLD) – this is in the week 2 folder Note on the above paper: have a read through this and go back to this when you do the session on DLD later in the module Gibbard, D., Roulstone, S., et al., (2024). A randomised controlled trial of the effectiveness of parent-based models of language intervention for 2 to 3 year old children with speech, language and communication needs (SLCN) in areas of social disadvantage. International Journal of Language & Communication Disorders, 59, 4, Note on the above paper: have a read through – it gives a good overview of pre-school children’s speech, language and communication needs and the role of parents/carers in supporting their children HCS 2023/6304 Pre-school speech, language and communication 26 difficulties