LANGUAGE DISORDERS AND PRAGMATICS

Receptive – Expressive Language Disorder

Does your child have trouble expressing himself with language? Or does he have trouble understanding language? These two language disorders can both appear in the same person, or a child may have only an expressive language disorder. (A language disorder is not the same as a speech disorder – children with language disorders can often produce speech sounds and intelligible speech, though they are often seen together in children.)

We begin developing language as soon as we are born. But sometimes children have difficulty understanding what people are saying to them. Perhaps a child is affected by a brain injury, perhaps other developmental problems, or by autism spectrum disorder, hearing loss, or learning difficulties. However, most often parents never find out the underlying reason their child does not understand what he hears or why he does not express himself as well as other children his age.

A child with a language disorder may have just a few of the following symptoms, or many of them. Symptoms can range from mild to severe.

Children with a receptive language disorder have trouble understanding language. They may have:

• A hard time understanding what other people have said
• A hard time understanding what gestures mean
• A hard time answering questions
• A hard time taking turns in a conversation
• Problems following directions that are spoken to them
• Problems organizing their thoughts
• Problems understanding the meanings of the words or concepts used by others
• Problems understanding meaning when words are imbedded into sentences
• Problems understanding complex sentences

Children with an expressive language disorder have problems using language to express their thoughts or needs. These children may:

• Have a hard time putting words together into sentences, or their sentences may be simple and short with the words in the wrong order
• Have difficulty finding the right words when talking, and often use placeholder words such as “um”
• Have a hard time asking questions
• Have a hard time learning songs and rhymes
• Have a vocabulary below the level of other children the same age
• Leave words out of sentences when talking
• Use certain phrases over and over, and repeat (echo) parts or all of questions
• Use tenses (past, present, future) improperly

How can I help my child with a language disorder?

A speech-language pathologist can work with your child to build his language skills. He’ll start with a thorough evaluation of your child’s communication skills. He may ask you to have your child’s hearing checked to rule out poor hearing as a root cause. Appropriate goals will be written with your input. Therapy will consist of activities designed to build on your child’s strengths in a fun, positive manner, and to target the needed areas.

What parents do at home is just as important, or more important, than what the therapist can accomplish in the therapy session. Working together is the key to success. Your child’s therapist will help you with activities to do at home to accomplish your child’s goals.

Pragmatic Language Disorder

Is your child having trouble navigating social situations? Does he hang back, or stand too close, or say too much, or the wrong things?

Pragmatic language involves the way we use language socially and practically to navigate our world. We all go through a complex process of figuring out what to say in various social, school, or work situations, and most of us still end up stumped or flustered once in a while. For some children, this is an area of life where they could use some serious help.

Pragmatic language involves three major communication skills:

• Using language for different purposes, such as greeting, informing, demanding, promising, and requesting
• Changing language according to the needs of a listener or situation, such as speaking differently in a classroom than on a playground
• Following rules for conversations and storytelling, such as taking turns in a conversation, introducing topics, staying on topic, using verbal and nonverbal signals, standing a certain distance from someone else during a conversation, and using facial expressions and eye contact

A lot of pragmatics comes down to being able to put yourself in the other person’s shoes, which is not easy for some children, and being able to notice what another person may be feeling.

Pragmatic skills include:

• Knowing it’s polite to answer when someone has asked you a question.
• Participating in a conversation by taking turns with the other speaker.
• Noticing and responding to the nonverbal aspects of language (body language, etc.).
• Introducing topics of conversation that the other person will share an interest in.
• Knowing how to initiate a conversation or respond to someone else’s initiation.
• Maintaining or appropriately changing a topic, or interrupting politely.
• Maintaining appropriate eye-contact during a conversation.
• Knowing how to talk and behave with a variety of people (formally with some, informally with others).

How can I help my child who needs help with pragmatics?

We work on how to use language effectively in every session. Depending on the child’s age and needs, we might start addressing pragmatic language use in individual sessions. Often, however, it becomes obvious that we need to involve peers. We facilitate home based programs that will help children with using language socially and pragmatically with peers, matching children with appropriate communication partners.