Speech and Language Difficulties

Early speech, language and communication difficulties are an indicator of a number of other developmental difficulties such as dyslexia, Attention Deficit Hyperactivity Disorder, Autism or Aspergers Syndrome. They may also be experienced independently of other difficulties in the form of Specific Language Impairment (SLI). It is essential that early speech problems are identified and addressed as soon as they are evidenced to give the child the best possible chance of learning in school. Speech, language and communication (SLC) difficulties may affect up to 10 per cent of the population and can be identified by parents and professionals working with children. SLI itself may be a result of a number of underlying causes and a thorough assessment should be carried out by a speech and language therapist working in collaboration with the parents/carers and the educational setting. A further disorder which is associated with SLI is semantic-pragmatic disorder and is thought to overlap significantly with Aspergers syndrome as the social use of language is the overriding difficulty.

Language is a complex interactive system as it relies upon a communication exchange. It develops as a result of a number of developmental threads, namely:
  • Semantics or content of the language, 
  • Form of the language which include the phonology and grammatical structures and 
  • Its use, which are pragmatics. 
Any or all areas may be delayed in a child who is experiencing SLI. Language also involves interpretation in addition to use, hence a child may be able to interpret language, but may have difficulty in using or expressing him/herself or alternatively a child may have difficulty interpreting others whilst being able to express themselves coherently.

A child may for instance, be able to use appropriate semantics but may mis-understand others’ semantics as the content will vary according to context.

Speech and Language Therapists are able to provide intervention plans to schools regarding the language development of a child, including helping children with their: 
  • Articulation - how they produce sounds 
  • Phonology or speech sound system – how they interpret sounds 
  • Grammar and syntax (the rules combining words into sentences) 
  • Vocabulary development and range
  • Vocal use of language or pragmatics in differing contexts
  • Semantics – the meaning attached to words 
  • Listening, concentration and attention to develop discrimination and auditory processing 
  • Prosody – how loud/soft the speech is 
  • Utterance – what an individual says 
  • Social Communication - appropriateness of communication within social contexts
Verbal dyspraxia is where a child knows what they want to say but are unable to control the fine muscle groups to articulate the utterance coherently resulting in indistinct speech and often frustration or learned helplessness where the child gives up trying to speak.

Development of language is said to underpin the whole curriculum and is therefore essential to learning and development in many areas. Below is an outline of the indicators of SLI and what can be done to help.

Early Years: 
  • Lack of speech, late beginning to babble 
  • May have difficulty eating or swallowing 
  • May be a fussy eater only liking certain foods or textures 
  • May predominantly produce vowel sounds and lack clarity 
  • May only say single words when peer group are speaking in short sentences 
  • Limited vocabulary – may revert to pointing to obtain what he wants 
  • Limited understanding of others may make child appear to be in his own world – poor hearing may be suspected 
  • Child may lack eye contact 
  • Difficulty understanding abstract concepts such as more/less, number names 
  • May use grammar inappropriately (“I goes for a walks”) 
  • May be late in asking questions 
  • struggles with prepositions (e.g. between, behind, on top)
It is essential that a child is assessed for hearing difficulties within the early years where there is signs of any speech or language delay.

Primary years:
  • Difficulty in articulation and indistinct speech persists 
  • Difficulty in turn taking in speech 
  • Literal interpretation of speech 
  • May use irregular grammar incorrectly 
  • May struggle to understand or follow more than one instruction at a time 
  • May have difficulty understanding questions: who, what, where, when, why, how? 
  • May find it difficult to articulate thoughts and give up easily 
  • May find it difficult to word-find/word retrieval may be problematic 
  • May be disorganised
  • May appear inattentive and to ‘switch off’ 
  • May butt into conversation 
  • Speech may be too loud or quiet 
  • May use language inappropriately in certain contexts
  • Listening and concentration may be inhibited 
  • Child may have a short attention span and may wander off in a conversation 
  • Retrieval from memory of vocabulary may be restricted 
  • Difficulty in auditory processing may be evidenced through forgetfulness 
  • Continues to have difficulty asking questions for help or information 
  • May change topic completely out of context 
  • Gives up easily 
  • May be sensitive to background noise 
  • Will have difficulty understanding textual information
Secondary Years:
  • May find it difficult to understand the subtleties of spoken language 
  • Difficulty in maintaining concentration and following a thread 
  • Vocabulary may be restricted 
  • Will struggle to infer or make predictions
  • Will struggle with innuendo and hidden meaning
  • Will struggle to assign meaning to subject-specific vocabulary, restricting cognitive development within subjects with a wide range of subject-specific vocabulary (e.g. geography)
  • May over-generalise, applying a rule too liberally
  • May have ongoing problems with word-finding 
  • May appear in a world of their own and appear to switch off
  • May have difficulty maintaining concentration and attention due to the complexities of the language situation
  • May 'read' with ease, but struggle to understand the text - reading is mechanical and passive
  • May interrupt inappropriately during others when they are speaking 
  • May take language literally 
  • May misunderstand others 
  • Have difficulty generalising- will learn the rule but struggle to apply the rule
  • May over-generalise after learning a rule, may apply it to every situation
  • May continue to use immature grammar 
  • May continue to talk too loudly or softly 
  • May continue to have difficulty to articulate thoughts or experiences e.g. will struggle to answer 'why do you think that way?' or 'how did you find the answer?'
  • May struggle with interpreting exam questions
Beyond Secondary: 
  • May continue to experience difficulty in interpreting the subtleties of language through inference and deduction 
  • May find it hard to make and maintain relationships 
  • May misinterpret instructions when working leading to misunderstandings 
  • May continue to take language literally 
  • May continue to have difficulties in pragmatics; talking out of turn and using inappropriate conversation within contexts 
  • May develop social anxiety or social phobia due to language difficulties 
  • Literacy difficulties may persist as a result of language difficulties

Possible Access Arrangements:

·         Extra time:  processing difficulties, slow reading, slow writing, reading comprehension difficulties

·         Scribe/wordprocessor/voice activated systems: students with illegible handwriting or spelling

·         Reader/computer reader for: students with exceptionally slow reading or poor comprehension

·         Prompter for: students with distractibility/poor concentration

·         Rest breaks for: students who experience visual stress, test anxiety, poor concentration

·         Coloured overlays or modified papers for: students who experience visual stress

-         Oral Language Modifier: for students who struggle with the complexities of language