Developmental Stages of Communication

Toddlers (18months-3yrs)

Children at this stage are beginning to develop their early communication and social skills.

 

Between 12 months, a child’s first words usually appear, and by 18 months to 2 years children use around 50 words and begin to develop intentional eye contact and turn taking skills. Between 2-3 years, sentences extend to 4 and 5 words. Children can recognise and identify almost all common objects and pictures, as well as use pronouns (I, me, he, she) and some plurals. Strangers can understand most words.

 

Some children, however, are slow to develop language. These children might present with no spoken words or a very limited number of words. As a rule, a two-year-old should be beginning to combine two words together in small sentences e.g., ‘mummy up’ or ‘big ball’. Stuttering which usually begins in early childhood is often identified at age two.  

 

At this age, the Speech Pathologist assesses preverbal/cognitive skills, play skills and the child’s current communication methods.

 

Therapy is usually in the form of parent training sessions or play groups. Parents are taught strategies that will maximise their child’s language learning opportunities. Strategies may include getting down on their child’s level, cutting down sentences, modelling and repeating new words. Parental involvement is crucial in therapy.

Pre-schoolers (3-5 years)

At this stage, Speech pathologists are able to identify children who are at risk of literacy impairments before they start formal education through the assessment of oral language expression, comprehension and processing. This means that potential difficulties with literacy can begin to be addressed prior to school and so help prevent future learning difficulties.

 

Therapy should begin as soon as possible. Children involved in therapy early (before 5 years of age) tend to have better outcomes than those who begin therapy later. This does not mean that older kids can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.

 

Signs of difficulties in preschool children may include any of the following:

Language:

  • not talking enough (only using short simple sentences)

  • reliance on gesture instead of words

  • small vocabulary

  • trouble finding the right word e.g., says ‘car’ for ‘truck’

  • making grammatical errors e.g., ‘mouses’

  • not following instructions or trouble following two-part instructions e.g., ‘put the ball on the chair’

  • not understanding simple stories

  • not using communication to socialise with other children

 

Speech/Articulation:

  • unclear speech (as a general rule, once a child turns 3yrs of age people outside of the family should be able to understand them with ease).

  • stuttering

 

Phonemic awareness:

  • Phonemic awareness is an understanding that words are made up of smaller units such as syllables and sounds. Phonemic awareness is a precursor skill for literacy development. When children are in their final year before school they should be able to clap syllables and identify rhyming words.

 

What occurs at speech therapy sessions will depend on a number of variables, including whether the session is 1:1 or involves a group, the age of the child and most importantly, the area of difficulty.

 

For example, individuals with early sound awareness difficulties might engage in tapping, clapping or rhyming activities. Individuals who have difficulties with comprehension might work on improving their vocabulary and understanding sentences and stories. There isn’t one set program to address the needs of all children. It is the role of the Speech Pathologist along with the family to work out exactly what level the child is at, what is best to target in therapy and how best to target that area.

Primary School Children (ages 5 - 11 years)

In the school-aged population, Speech Pathologists work closely with teachers and academic staff to maximise the learning potential of their students. Children who may not have had obvious difficulties with speech or language in the preschool years may be identified as having communication difficulties as they are faced with the increasing language demands of the classroom and the tasks of learning to read and write. Social Communication Difficulties may also appear at this stage in life as social relationships begin to form.

 

Primary School aged children with communication difficulties might present with any of the following problems:

Language:

  • Difficulty constructing complex sentences (using words such as after, while, unless, however, otherwise and although to join ideas within a sentence) 

  • Difficulty using more advanced vocabulary and may overuse words like ‘thing’ and ‘stuff’

  • Difficulty giving clear, well-sequenced instructions

  • Difficulty following instructions of 3 or more parts e.g., ‘take out your spelling books, open to page 27 and use a black pen’

  • Difficulty understanding school work and instructions

  • Difficulty completing work independently

  • Difficulty retelling events in chronological order e.g., telling what they did on the weekend.

  • Difficulty writing longer texts (poor content, poor structure, not age appropriate vocabulary, poor sentence structure, limited paragraphing, poor understanding of text purpose, limited ability to change language style according to purpose)

  • Problems fully understanding stories read to them (for example, difficulties identifying the main idea, remembering details, understanding characters’ thoughts and feelings, and predicting further events)

 

Phonemic Awareness, Reading and Spelling:

  • Difficulty with early literacy skills such as identifying the first and last sounds in words, breaking words into syllables and sounds, and recognising rhyming words.

  • Difficulty distinguishing between similar sounding words (for example, ‘all’ and ‘or’)

  • Difficulty saying long words (for example, says ‘ikstrology’ for ‘astrology’)

  • Difficulty ‘sounding out’ words when spelling and reading

  • Spells words backwards e.g., ‘was’ -> ‘saw’

  • A reluctant reader who has difficulty reading grade-level texts fluently and accurately

  • Poor reading comprehension (understanding what has been read)

  • Reluctant to read or write

 

Social Communication:

  • The primary school-aged child with a communication impairment may be reluctant to participate in group discussions, avoid answering questions, have trouble expressing opinions, may have few friends or have difficulty forming social relationships. Understandably this child may dislike school, refuse to cooperate or say school is ‘boring’. Parents often report that completing homework is a struggle.

High School Students (ages 12 – 18 years)

 

Some common concerns that are present in the adolescent population during high school years include:

  • Difficulties with language skills in the classroom environment.

  • Need for school and/or work accommodations.

  • Fluency of speech (stuttering, lisp)

  • Social skills training

  • Social communication difficulties

 

Some high school students may have very apparent language difficulties which have been identified earlier in their schooling. Other children may struggle in more subtle ways to cope with the increasingly sophisticated language use expected of them as they mature along with building social relationships. Either way, learning difficulties will be identified.

 

High school students with communication difficulties may show the following difficulties:

  • Poor comprehension of exam questions

  • Difficulty interpreting what is read

  • Immature vocabulary and problems learning new words

  • Poor written language so difficulty formulating essays and projects

  • Weak skills in English such as interpreting poetry and novels

  • Poor comprehension of Science and Maths concepts

  • Difficulty socially; making and keeping friends, solving playground problems, identifying fiction from fact. Poor interpretation of humour and sarcasm.

 

Therapy for the primary and high school aged child will vary depending on a number of factors such as the child’s presenting problem, age, attention levels and the services available.

 

Literacy Difficulties: If students present with literacy problems then therapy may focus on developing phonological awareness skills such as blending and segmenting, improving letter-sound knowledge for reading and spelling, fine-tuning processing of similar sounding sounds e.g., ‘t/d’ and vowel sounds.

 

Social Communication Disorder: Children within this age range may also be presenting with a social communication disorder which may impact on their learning and academics and building social relationships. Therapy can include working one-on-one with your child, helping them practice turn-taking, introducing and ending topics and other conversational skills. The clinician may use role-playing games and visuals, such as comic strips, to help your child learn strategies to manage social situations. The clinician also can train you in how to reinforce these skills at home.

For older students therapy may include learning rules of spelling e.g., ‘/ck/ follows a short vowel’. Understanding the associated spelling rules for using prefixes and suffixes may also be a focus. For children who are weak with oral and written language, therapy may include teaching the writing process (planning, writing a draft, editing, rewriting), improving their understanding of the purpose of texts and how this purpose influences the structure and language features of each text. Individual oral language goals may be addressed within the framework of each text type.

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