Children with communication disorders

Communication that calls attention to itself, and/or inter­feres with relaying a message, and/or distresses either the speaker or the listener is considered disordered. Commu­nication is defined as the transmission of information. Language is the set of symbols used to represent the message being transmitted. Speech, a subsystem of lan­guage, is the physical process involved in producing the sound symbols of the language. Both communication and language can be nonverbal. Speech is oral.

Communication disorders can take two forms: delays and disorders. Delays are quite common and are usually resolved easily with proper treatment. Delays in language have the highest cure rate and the shortest time in need of special services of any of the conditions of exceptionality. Delays are often due to lack of language stimulation, bilingual or multilingual stimulation, or hearing impair­ments.

A disordered form of language is less common than a language delay and usually requires more treatment. Many language disorders are complicated by other areas of exceptionality (e.g., disorders of behavior, mentation, learning, audition, physical coordination). Language disor­ders may involve aphasia (no language) or dysphasia (difficulty with language). Language disorders may be due to disordered mentation or to anatomical defects such as cleft lip and/or palate, damaged vocal cords, defects of the lips, teeth, or tongue, or may be acquired after inju­ries—including brain injuries. Language disorders may involve receptive disorders (difficulty in understanding language) and/or expressive disorders (difficulty in ex­pressing oneself through language). The American Speech-Language-Hearing Association (ASLHA) has identified three underlying problems in language disor­ders: the form the language takes (involving rules and structural principles); the content of the language (involv­ing semantic meanings); and the function of the language in communication (involving practical, pragmatic usage).

Speech, the subsystem of language involving oral pro­duction of sound, may be disordered in one or more of three forms: articulation, voice, or fluency.

Articulation involves the functioning of muscles and nerves, of the tongue, lips, teeth, and mouth to produce recognizable speech sounds. Four possible ways in which articulation can be disordered are substitution of sounds, distortion of sounds, omission of sounds, or the addition of extra sounds.

Voice involves respiration by the lungs, phonation by the larynx and vocal cords, and resonance through the air passages of the nose to control sound quality. Two possible ways in which voice can be disordered are phonation (breathy, strained, husky, hoarse, no sounds) and reso­nance (hypernasality, hyponasality).

Fluency involves appropriate pauses and hesitations to keep speech natural, smooth, and understandable. Two possible ways in which fluency can be disordered are by cluttering (very rapid speech with extra sounds) and by stuttering (verbal blocks, and/or repetitions of sounds, especially at the beginning of words).

Each child can be expected to have his or her own unique differences in language reception and production and speech coordination. In addition, each child will com­municate differently, depending on personality factors, information-processing factors, and motivational factors. Assessment of when language and/or speech is delayed or disordered is, therefore, very difficult.

Speech-language pathologists are therapists who are prepared to help alleviate all the problems of language and speech. When a child is assessed as having a communication disorder, PL 94-142, and its amendment PL 99-457, entitle that child to free and appropriate speech-language therapy in the least restrictive environ­ment. Public Law 99-457 ensures services for infants, toddlers, and their families if a speech-language disorder is diagnosed early (e.g., cleft palate speech). Whenever a child receives special services for a communication disor­der, the therapy is more successful and shorter when there is parental involvement and transdisciplinary coop­eration. Individualized family service plans (IFSPs) and individualized education programs (lEPs) need to be an­nually updated to reflect the effectiveness of prior therapy, the new short-term and long-term goals, the changing nature of the communication disorder, and the special services required. Children with communication problems make up the second largest group of children in the United States receiving special educational services, after children with learning disabilities. The earlier each child begins therapy, the better the prognosis.

Therapy and transdisciplinary approaches to remedia­tion of communication disorders are the most common forms of intervention. However, for some children, speech-language therapy and family-school cooperation cannot cure or substantially alleviate the problem. For some children, intervention takes the form of augmented com­munication or facilitated communication. There are many new forms of augmentative and facilitated communica­tions. These include sign language, keyboards for typing words, computers with synthetic voices, talking picture boards, and talking beams. Which forms of augmented or facilitated communication are used with each child are ideally determined by a transdisciplinary team including parent, child (if old enough), teacher, and speech-language pathologist.

Dialects should not be assessed as communication disorders in and of themselves. It is possible, however, for a child with a communication disorder to have it compli­cated by a speech dialect. Special care must be made when assessing linguistically different students for inclu­sion in special educational services. To be communication disordered, the child should have difficulty in his or her mother tongue, not merely in English. Bilingual special education may provide remediation in both the mother tongue and English. Transitional programs help non-English-speaking children learn the English language sufficiently for instruction to take place in English.

The first article selected for this unit addresses techniques that work to promote language in early childhood. The second article defines programs and services for culturally and linguistically diverse learners in special education. The next article discusses nonverbal symbols that are used as a means of communicating thoughts and emotions. Nonverbal language is often used by school children in place of speech. The final article focuses on one of many forms of augmentative communication: a picture task analysis.

Looking Ahead: Challenge Questions

How can early childhood educators promote appropri­ate speech and language?

How can the learning environment be enhanced for culturally and linguistically diverse learners?

Can teachers understand the language of nonverbal behavior?

How can picture tasks be used to augment speech?