Early Speech and Language

Development
Processes, Benchmarks and the Impact of Disability

Appas Saha
SLP

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 Speech, Language,
Communication
(What is the difference?)

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 Communication: the exchange of information or ideas

 Language: a symbol system with rules that govern the use of the symbols

 Speech: the production of meaningful vocal sound patterns

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The Importance of Speech
and Language in Preschool
 Speech/language ability is related to academic success
 Speech/language delays or disorders may be the earliest
indicator of other problems
 Most young children with disabilities have a need for
intervention in the area of speech or language
 Preschool offers almost continuous language learning
opportunities

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The Major Systems of
Language
 Phonology
 Semantics
 Morphology
 Syntax
 Pragmatics

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Early Speech and Language
Development

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Early Perception of Speech
Sounds
 infants can discriminate between some speech sounds
as early as 1 month
 infants seem to be able to discriminate between
phonetic contrasts from many languages
 over time, however, they lose the ability to
discriminate between some contrasts that are not in
their language

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Early Production of Speech
Sounds
 0-3 months: reflexive vocalizations
 3-6 months: cooing and early consonant –vowel
combinations
 6-10 months: repetitive consonant-vowel sounds (da-da)
 9-12 months: conversational babbling
 12 months: first words

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As MLU increases, the complexity of
children’s utterances also increases
in very consistent ways

MLU is a better predictor of the

complexity of child language than
age

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Mean Length of Utterance

Age MLU

2 years 1.75
2.5 years 2.25
3 years 2.75
3.5 years 3.5
4 years 4.0

(McCormick & Schiefelbusch, 1990)

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Language Benchmarks

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Early Word Comprehension

 8-12 months: comprehends a few words in context

 12-18 months: comprehends some words outside of
routines
 18-24 months: comprehends words for absent objects
and 2 word combinations
 24- 36 months: comprehends simple sentences
supported by context

(Crais & Roberts, 2004)

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Early Word Production

 Approx. 12 months: first words

 13-15 months: ten words
 18-20 months: 50 words
(by 6 years, it’s 2,600 words!!)
 18-24 months: begins to produce 2 word utterances

(Owens, 2001)

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Early Language Use

 12-24 months: uses words to get attention, to get

objects or actions, to protest
 24 months: can initiate and change a topic of
conversation but very dependent on context
 3 years: can use language for a variety of functions

(McCormick & Schiefelbusch, 1990)

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Preschool Comprehension

 Growth and refinement in comprehension

of vocabulary as well as categorization
(semantic development)
 Growth in comprehension of grammatical
aspects of language (morphology and
syntax) such as word order, prepositions,
plurals, possessives, past and future tense
of verbs

(Crais & Roberts, 2004; Miller & Paul, 1995; Paul,

2001)

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Preschool Production

 Length of utterances increases

 Grammatical elements are added
–ing to verb (“me playing”)
–s for plural and possessive (“two books,”
“Mommy’s hat”)
articles and adjectives (‘this a big car”)
pronouns (her, him, you, me)
past tense (regular and irregular)
(“he ate it,” Sally played outside”)
future tense (“I will go home”)

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 Forming negatives (“I didn’t see it”)
 Forming questions (“Can we go to the
park?”)
 Combining clauses into complex sentences (“I went to the swing, but he
wasn’t there”)

(Brown, 1973; Miller, 1981; Owens, 2001;

McCormick, Loeb & Schiefelbusch, 2003)

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Preschool Language Use

 Growth in the ability to maintain a topic of conversation

across a number of turns without contextual support
 Growth in the ability to initiate a conversation and also
to end a conversation
 Growth in the ability to use language for a variety of
purposes

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Activity 2:
The Communication Chain
Understand Ideas and
meaning decide
Choose words
Understand sentence structure
(semantics)

Understand words
Choose sentence structure
(semantics)
(syntax)

Remember Select sounds

(auditory memory) Self- (phonology)
monitor

Co-ordinate speech
Listen/hear
muscles

Interpret non-verbal
Articulate sounds
communication
Speak
Look/Attend Speak
fluently
Appropriately
(pragmatics)
Speech/Language
Disability

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What can cause speech
problems?
 Chronic ear infections or hearing loss
 Auditory discrimination difficulties
 Oral mechanism problems
 Motor planning problems
 Learned patterns of mis-articulation
 What else?

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Intelligibility

There is a good deal of variation in how well children

produce speech sounds and also in how well they put
vowels and consonants together in streams of speech
One way to think about it, is to consider how intelligible a
child’s speech is to someone who does not know the
child well

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Deciding whether or not to
refer…
 Does the child have difficulty understanding or being
understood?

 Is this a source of frustration for the child?

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Gathering information for
the referral….
 How much of the child’s speech is intelligible ?

 Are there specific sounds/words that the child does not

produce correctly? If yes, what are they?

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 Does the child drool or have problems eating?
 Is the quality of the child’s voice unusual?

(nasal, breathy, hoarse, high-pitched, too

loud/soft?)
 Is the child’s pattern of breathing unusual?

(shallow or frequent breathing, audible

breathing?)
 Is the child frequently dysfluent, even when not
excited or upset?

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What can cause a language
problem?
 Hearing loss
 Chronic ear infection
 Fear or anxiety
 Lack of language experience
 Speech disorder
 Disability
 Genetic Issues

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Deciding whether or not to
refer…
 Does the child have difficulty understanding language?

 Does the child have difficulty expressing himself ?

 Does the difficulty cause frustration or impact the

child’s learning and development?

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Gathering information for
the referral….
 What is the basis for the concern?
Language production
Language comprehension
Language use
 Write down observations of the child’s language and
behavior that exemplify concerns

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Observational/Listening
Period
 Children do not speak, but instead listen to the new
language. They may use gestures, facial expressions or
sounds to communicate

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 Gathering information
 Consider the child’s language history

 Consider the child’s current language environments

 Gather information from the family about the child’s typical language at
home

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 Consider the child’s functioning in other
developmental domains in situations where
language comprehension is not required

 Consider information about the child’s hearing and

vision

 Consider whether or not the child has had

sufficient time to become accustomed to the new
social and language environment

(McLean, 2002)

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 Language and communication in
children with ASD

Verbal children with autism exhibit deficits in

virtually all types of language skills, including
phonologic, semantic, Dysphasia
morphologic, syntactic
and pragmatic skills.
In addition, there is one characteristic,
Echolalia, that appears to be unique to
children with autism.

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Mental Retardation
 LEARNING DISABILITY (LD)

It was described as a group of children who had

disorders in development of language, speech,
reading and associated communication skills
needed for social interaction.

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 Classification of LD

developmental academic

Lang. Spelling
Attention disorder d/s Reading
Memory disabilities
disorder
disorder Handwriting
Perceptual d/s
disorders
Thinking
disorder 36 Arithmetic
d/s
 Dysphasia

Dysphasia is a partial or complete impairment of the ability to communicate

resulting from brain injury.

Acquired dysphasia is a more common after effect of stroke and usually results
from damage to the left hand side of the brain, which is largely responsible for
language and communication.
Symptoms of dysphasia will quickly manifest after damage to the brain has
occurred, and will present in accordance to the particular type of dysphasia
suffered. Due to the proximity to areas of the brain that control motor
function, expressive dysphasias can be accompanied by noticeable motor
impairment. The majority of symptoms will be language related, including:

Difficulty remembering words

Difficulty naming objects and/or people
Difficulty speaking in complete and/or meaningful sentences
Difficulty speaking in any fashion
Difficulty reading or writing
Difficulty expressing thoughts and feelings
Difficulty understanding spoken language
Using incorrect or jumbled words
Using words in the wrong order
INTRODUCTION

• DEFINITION:
Specific language impairment is defined as language
impairment that exists in the absence of other clearly
identifiable problems such as hearing impairment, autism,
or intellectual disability. On the surface a child with SLI
appears to be normal except for language acquisition
which does not match that of his peers (Reed, 2005).
• It cannot be attributed to sensory, physical, emotional,
intellectual, neurological or social-motivational factors
(Kamhi, 1998; Leonard, 1998)

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PREVALENCE:
• The prevalence of SLI is about 7% (Leonard,1998).
• It can occur in young children as well as teenagers.
• SLI is more likely to be seen in males than in females.
• Children with SLI are more likely than other children to have
parents and siblings with a history of language learning
problems.
• Children with SLI are also at risk for reading disorders when
they reach school age.
• Children with SLI have both expressive and receptive language
problem.
• These can be oral, written or both.
• They can have difficulty with talking, listening, reading and
writing.
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 CHILDHOOD DYSPHAGIA
The following health problems make it more likely for a child to have problems
swallowing:
•Being born prematurely
•Cleft lip or cleft palate
•Compression of the esophagus by other body parts
•Dental problems, such as an overbite
•Developmental delays
•Diseases that affect how the nerves and muscles work
•Eosinophilic esophagitis, an allergic condition that affects the esophagus
•Gastroesophageal reflux disease (GERD)
•Having a foreign object stuck in the esophagus, such as a coin
•Having a tracheostomy, which is an artificial opening in the throat for breathing
•Large tongue
•Large tonsils
•Oral sensitivity or vocal cord irritation, which can happen if the child has been on a breathing
machine (ventilator) for a long time
•Problems with how the bones of the skull and the structures in the mouth and throat form
(craniofacial anomalies)
•Problems with how the digestive tract forms
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•Paralysis of the vocal cords
•Tumors or masses in the throat
Symptoms can occur a bit differently in each child. They can include:
•Arching or stiffening of the body during feedings
•Chest congestion after eating or drinking
•Coughing or choking when eating or drinking, or right after
•Drooling
•Eating slowly
•Feeling like food or liquids are sticking in the throat or esophagus; feeling like there’s a
lump in the throat
•Gagging during feeding
•Getting respiratory infections often
•Having food or liquids come out of the nose during or after a feeding
•Trying to swallow one mouthful of food several times
•Trouble sucking and swallowing
•Spitting up or vomiting often
•Irritability or not being alert during feedings
•Wet or raspy sounding voice during or after eating
•Weight loss

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Questions???

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Thank You!

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