Language Delay
Language Delay

Language is an important part of our developmental and learning process. Speech and language impairment might directly or indirectly impede the development of higher order thinking ability as well as affecting higher-level academic learning, e.g. Chinese, Mathematics and Liberal Studies. 
 
According to the findings of child development research, language development comes after the development of body, sensory and emotional intelligence.     Hence, if there are gaps or omissions in the progress of child development, (e.g. insufficient body coordination, retained primitive reflexes, insufficient sensory development, insufficient self-awareness and emotional exchange) child language development would be affected to a certain extent. In addition, the development of higher order thinking, (e.g. abstract thinking, reasoning and information organization, and planning) is after the language development. Therefore, the maturity of language development would directly affect the efficiency of learning and completing daily tasks.
 
Speech Therapy Characteristics 
We highly emphasize overall child development and insist on using the natural human development path as the foundation of treatments. Through assessment, we attempt to identify obstacles in the student’s language ability as well as any other existing developmental deficits that might affect his/her language development to provide targeted treatment to the student.
 
Palliative Therapy:
Language is the symbol that we use to describe what we do, think and feel. It also helps us in logical reasoning, organizing and planning, and decision making. 
 
Language development comes after the development of body, sensory and emotional intelligence. Therefore, before expanding student’s language structure, content and application, we need to plug the loophole of his/her development. We first investigate the relationship between the variation of children’s brain function development, and their speech and language impairments. then, we provide trainings for consolidating the foundation of their sensory and motor ability, e.g. self-awareness, sense of sight and hearing, relaxation and stretch of body (which might also affect voice production and stuttering), motor planning, and the ability to handle action and language at the same time. 
 
After a student reaches a certain level of sensory motor and emotional intelligence ability, we then would provide training targeting language expression, sentence pattern, organization, comprehension and social interaction. Training would be provided through games, structured language activities, sharing and discussion of story/video, imitation of daily activities (e.g. planning, negotiating and carrying out the activities that student is interested in such as food and model production, making plans and interview, and mini party activities). training would be designed based on the individual characteristic and fundamental need of the student so it would be more effective to solve his/her problems.
 
Radical Therapy:
Before solving the student’s underlying problem, we would first provide remedial training based on the most urgent need of the student so they could learn the relevant skill or knowledge framework and alleviate social interaction and academic problems. We also coach parents in alleviating the most urgent problems with the student’s social interaction and academic study at home based on their need and progress.     
 
Content of Speech Therapy 
1. Basic Brain Function Training
Training, e.g. body, sensory and motor, visual and auditory processing, exploration and thinking, would be provided based on student’s need to facilitate the development of their body, mind and intelligence, and consolidate the foundation of language, communication, social interaction and academic study.   
 
2. Target-oriented Speech Therapy
Training goal and strategy would be tailor-made for every student based on their individual level of language development, personality, and characteristics. The below problems could be improved after training:  
 
Articulation Disorder
Slurred speech might be directly related to the ability of oral motor and body coordination. Appropriate motor training with pronunciation training would help improve the related problem.
 
Expressive Language Disorder
Unable to express one’s need using verbal language, circumlocution, stuttering, poor expression, lack of coherence, limited vocabulary or wrong use of vocabulary are common problems. Identifying the developmental factor influencing their language development and providing target-oriented and systematic language training can improve the problem gradually.      
 
Difficulty in Comprehension
Difficulty in both verbal and written comprehension might be related to the cognitive, auditory processing and memory, and verbal thinking ability. Identifying the developmental factor influencing their language development and providing target-oriented and systematic language training can improve the problem gradually.      
 
Impaired Social Interaction 
Fear of interacting with strangers, excessively passionate, pursuing a conversational topic regardless of others’ reactions, and insensitivity in interpersonal relationship/ failure to understand the perspective of others and their feelings are common problems. These problems can further influence the learning of abstract vocabulary and psychological vocabulary. In addition, self-awareness, body sensory, balance and emotion might be directly related to social development. Relevant basic training with practical speech therapy can improve the problem gradually.
 
Reading Difficulty
Unable to understand word form, pronunciation and meaning in the writing system, or unable to understand the relationship and regulations of language and literature, as well as hidden visual function might also lead to the problems that influence reading ability, e.g. skipping words and lines while reading, and eye fatigue. Therefore, identifying the root cause of reading difficulty problem as well as providing related speech therapy such as. word and vocabulary structure, and language and literature regulations would be essential for a good treatment outcome.    
 
Writing Difficulty
Unable to understand word form, pronunciation and meaning in the writing system, impairment of body division and coordination as well as visual coordination can also influence writing ability. Therefore, training would be targeted at understanding the word form, pronunciation and meaning in the writing system (through speech therapy), and helping student find the most effective learning approach alongside basic training, e.g. body division and coordination, relaxation, and sense of sight, at the same time.
 
Stage of Language Development: Language Use, Communication, Expression and Common Problems
   
Preschool
After birth, starting from crying, people rapidly develop the ability to freely express one’s thought. It looks easy, but the communication between people is very complicated, even adults might also find difficult to handle.     
 
When your child has already spoken, you might need to be aware of whether his/her language development is matured e.g. whether he/she is able to communicate with others effectively/express thoughts and ideas confidently. Let’s see the below categories. if your child still has the below problems at/after 2.5-3 years of age, you might need to seek help from speech therapist
 
Social Communication

  1. Rarely communicate with peer or elder actively Children should be able to bring up different conversational topics
  2. Unable to have different discussion with different people Children should be able to bring up a conversational topic based on the listeners who he/she is talking to, e.g. they would discuss the latest cartoon episodes with friends or what they want for dinner with mother, which they rarely pursue a conversational topic regardless of others’ reactions
  3. Weak in noticing or understanding others’ facial expression/body language/intonation Sufficient communication not only primarily focuses on language level, but also relies on other non-verbal clues. 
  4. Lack of facial expression Rarely laugh heartily. Children would not express worry when others are upset.
  5. Unable to express in another way when other don’t understand his/her speech During conversation, when the listener finds difficulty in understanding our speech, we would try to modify our speech. First, we would repeat the sentence(s) by slowing down and pausing more. If the listener still doesn’t understand after repetition, we would try to use another words with same/similar meaning.
 
Comprehension
  1. Unable to understand daily conversation
  2. Unable to recognize and correct others’ mistakes during conversation For example, he/she should be able to notice your mistakes during conversation that you have already gone to Chung Wan, but not Sheung Wan
  3. Unable to understand instructions with 2-3 procedures unable to complete the instruction or only remember part of it 
  4. Not interested in story reading/ listening He/she rarely tells you what he/she has read in the storybook, or he/she is impatient at listening to the development of the story, as well as unable to answer questions related to the content of the story
  5. Unable to understand cartoon unable to laugh when watching funny and interesting scenarios  
  6. Unable to take the role of a story character unable to understand verbal content, unable to take the role of a story character and understand the story characters 
 
Expression
  1. Failure to ask questions e.g. “Where do you go?”,  “Who is calling?”, “Is mum going to work?”
  2. Always use words with unclear meaning He/she always use “this”, “that”, “like this” such kind of wordings during conversation, instead of naming the object and describing the situation directly
  3. Rarely use pronoun always say his/her or others’ name, instead of using “I”, “you”, and “he/she” 
  4. Unable to express his/her feelings by using language Children should always verbalize their mood, e.g. when seeing food during dinner, they should say “Food makes me happy!”
  5. Unable to describe the story plot Children should be able to verbalize the story that they are familiar with according to the pictures in the storybook
  6. Rarely share past experiences actively Children should always verbalize recent events, e.g. when you finish work and go back home, he/she might come and tell you “I wentto the park today, and I got bitten a lot by mosquitoes.”
  7. Unable to verbalize the solution of problem If you tell he/she that the toilet floor is wet and don’t go inside, he/she should be able to find a sandal and say “wearing sandal can help”.   
 
School-Aged
Many parents believe that their children are able to express themselves by using language and hence they never imagine that children need speech therapy. However, not only students with obvious difficulties in communication need speech therapy, but also many other primary and secondary school students need help from speech therapy as they might have hidden problems, which are not easily identified but might influence their thinking and learning. These hidden problems might manifest with the need of academic studying and development. If the hidden problems could be identified and intervened at the earliest stage, students would find easier in learning and social interaction. The below is the example of common problems:    
 
Pursue a conversational topic that they are interested in
Some students are very talkative, but they are only able to communicate with you when focusing on the topics that they are interested in (or even pursue a conversational topic regardless of others’ reaction). The topics that they are interested in might be in different area, e.g. train, dinosaur, tourist attraction, number and alphabetic characters. Once the conversational topic is not related to those that they are interested in, their expression ability would be diminished, e.g. they find difficulties in speaking, their conversation content become less, and even others are not able to understand their speech.  
 
Digression from the conversational topic
Children are cooperative to answer your questions, but their responses are off-topic and not related to the questions that you asked, as they might have wrong interpretation, be unable to express their thoughts or change their mind during conversation. 
 
Example:
Therapist: Why was the boy’s clothes y torn? 
Children: I want to color it with blue color, not white color, the new clothes that my mother bought me last time isn’t white color…
 
Have limited vocabulary/ Have difficulty in memorizing vocabulary
Some students always find difficulty in memorizing vocabularies, even as simple as different body parts, e.g. elbow and knee, or common daily necessities, e.g. electric equipment that we use every day, e.g. hair dryer. They are not able to name the objects accurately/ find the right word to say or even make a very general description by using “this”, “that” or “the device that blows warm air”. They would find it more difficult to learn written language and four-word Chinese idiom as they are unable to memorize the vocabulary no matter how hard they try.   
 
Have difficulty in verbal comprehension 
Due to the difficulty in verbal comprehension, student who has good expression ability might have difficulty in reading or listening comprehension. For example:
●     Unable to understand others’ speech
●     Unable to understand the context
●     Unable to understand jokes, parables or ironies
●     Always confuse words with similar meanings (e.g. kindness and intimacy)
●     Unable to understand the meaning and central idea of statements
 
They might be unable to take the role of a story character, understand the story from different perspectives e.g. subject and object, process different information, process information with time sequence (need visual clues), lack the concept of social relationship or be unable to integrate the story environment, identity and background of character(s), and related limitation and thought. Therefore, they might be unable to understand the ideas of the character(s) in the story.
 
Expression (including oral and/or written)
●     Lack of coherence
Some students have weak organization skills and they might tell something unrelated during conversation. Therefore, acquaintances often need to reorganize what they say to understand its meaning. Normally, when they complete a task, they might not be able to complete the whole task in one go.
●     Unable to express oneself
●     Unable to explain and discuss personal experience (including what you see and what you hear)
●     Unable to explain one’s own situation
●     Lack of logic/ lack of one’s own opinion and idea, only copy from others 
 
Example 1
Teacher: Why does the mice feel happy?
Student: It is because it is very happy.
 
Example 2 
Teacher: Why don’t you like the movie?
Student: It is because the ending is old-fashioned, and the content is ambivalent. (Student’s response seems substantive, hence teacher asks further questions)
Teacher: What is old-fashioned? What is ambivalent?
Student: Er…..
Teacher: How about XXX? Do you like it?
Student: It’s quite good but it is also a bit old-fashioned. (Later, therapist discovers that student’s parent has shared his/her opinions towards the movie, and students just copy his/her opinions without understanding the opinions.)
 
 
Question/ Inquiry
Please feel free to contact us via email pda@pdachild.com.hkor call Ms Liu at 2528 4096. You are always welcome to contact us if you have any questions. 



Case Sharing
Ben‧ 言語治療


Related Articles
1. 口肌及發音困難的辦識 及 介入
2. 男仔遲識講說話?
3. 真的語言發展遲緩嗎?
4。
講說話女仔比男仔叻?
5。懂得說話的小朋友及學童 , 還需要語言治療嗎 ?-學前編
6。懂得說話的小朋友及學童 , 還需要語言治療嗎 ? -學齡編


Language Delay


Language Delay