Young People with Communication Disorders

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Young people with
communication disorders
INFORMATION FOR HIGH SCHOOL
and UNIVERSITY STUDENTS
and their parents and teachers
Caroline Bowen

Private hell or safe haven?
For students with communication disorders, high school and university can feel like an interminable ordeal. But when supplied with appropriate information, insight, resources and time, and input from parents when necessary, teachers can provide structure, support, encouragement and an exciting learning environment for them.

Rather than being a student's private hell, school or university can become a welcoming safe haven and a place to develop and shine.

Verbal skills in adolescence
Robert J. Havinghurst (1900-1991) of the University of Chicago proposed eleven developmental tasks of normal adolescence (Havighurst, 1972), the fourth of which was "The adolescent must develop expanded verbal skills."

Discussing adolescents developing along typical lines, Gary Ingersoll explains:

As adolescents mature intellectually, as they face increased school demands, and as they prepare for adult roles, they must develop new verbal skills to accommodate more complex concepts and tasks. Their limited language of childhood is no longer adequate. Adolescents may appear less competent because of their inability to express themselves meaningfully.

For the adolescent with a communication impairment there are special difficulties, requiring special support, in accomplishing this and the other inter-related, including (Ingersoll again) task eight: "The adolescent must develop stable and productive peer relationships."

Although peer interaction is not unique to adolescence, peer interaction seems to hit a peak of importance during early and middle adolescence. The degree to which an adolescent is able to make friends and have an accepting peer group is a major indicator of how well the adolescent will successfully adjust in other areas of social and psychological development.

Young people challenged by language problems and language based learning disability, speech impairments, voice disorders, fluency disorders, and trouble with pragmatics, often have associated difficulties with social relationships in general, and peer relationships in particular.

Language
Language is a learned code that enables us to communicate ideas and express wants and needs. Reading, writing gesturing and speaking are all forms of language. Language has rules for:

Creating words out of sounds
Creating gestures or signs out of body movements
Modifying words by adding grammatical inflections (jump, jumping, jumped)
Combining words grammatically
Attaching meaning to words
Conversing and telling stories
Modifying the language used to suit the situation or the listener.

The main aspects of language are: (1) Receptive language function (understanding speech, writing, gestures). (2) Expressive language function (speaking, writing, gesturing). (3) Pragmatics of language use (interpreting and using speech, writing and gestures in “appropriate” ways).

A language disorder involves difficulty with receptive language, and/or expressive language, and/or the pragmatics of language use. Developmental phonological disorder, and specific language impairment are examples of language disorders.

Assessment and treatment
Language disorders in children, adolescents and adults can be assessed and treated by speech-language pathologists (SLPs). Assessment of young people's language skills usually comprises a case history interview in which you have a chance to talk to the SLP about your difficulties, as well as standardised language tests and other observations. There is a range of language tests for the SLP to choose from, for example comprehensive language assessments like the CASL or the CELF; receptive vocabulary tests; tests of word finding, and expressive vocabulary tests. Treatment options are then discussed with you. The treatment, or "therapy", itself depends on the outcome of testing and the nature of the problem. There is general information here about how SLPs plan treatment. A hearing test is usually required. Sometimes, as part of the assessment process, the SLP will refer you to other professionals for an opinion.

An invisible disability
In 1993, Frederick Patchell and Linda Hand published an article entitled "An invisible disability - Language disorders in high school students and the implications for classroom teachers".

Patchell & Hand (1993) is available as a .pdf document: click HERE (193KB). A related article, Patchell & Treloar (1997) is also available: click HERE.

The article begins with a fascinating exposition of the differences between the way teachers understand the term "language" in educational and classroom settings, and the way speech language pathologists understand it in developmental and clinical terms. This information must have come as something of a revelation, at the time, to many teachers and clinicians.

Nearly a decade later, even though there seems to be a better understanding by each group of the other's frame of reference, the points Patchell and Hand (1993) make in the article remain important, empowering, and thought provoking.

With the help of five case examples, the authors provide guidelines for identifying children with language disorders, and for developing practical classroom strategies.

As well as being informative for teachers, the article is full of insights for parents and other caregivers. Written by two speech language pathologists with extensive experience in high schools, the article is full of insights for the SLP / SLT seeking to appreciate the realities of school for adolescents with language disorders, and for the teachers working with them.

Speech
Speech is the spoken medium of language. The term “speech” refers to the process of producing the sounds necessary for verbal communication.

A speech disorder involves difficulty producing, and/or remembering, and/or organising speech sounds. Functional speech disorder, developmental apraxia of speech, and dysarthria are examples of speech disorders. Some speech disorders are associated with specific conditions such as cleft palate, cerebral palsy, tongue-tie / ankyloglossia, other cranio-facial anomalies, hearing impairment, paediatric stroke, traumatic brain injury (TBI), Down Syndrome, and other syndromes and developmental disabilities.

Assessment and treatment
Speech-language pathologists assess and treat speech disorders in children, adolescents and adults. For young people, the speech assessment involves a case history interview, an oral (mouth) examination, and an analysis of a sample of your speech. As with a language assessment, a hearing test is usually required, and other referrals may be necessary. The results of the assessment are discussed with you, and you and the therapist plan therapy together. The nature and duration of the therapy depends on the type of speech disorder and how it is affecting you.

Fluency
Stuttering (called 'stammering' in the UK and parts of the US) disrupts the fluency of speech. Hence, "stutters" are often referred to as "dysfluencies". The characteristics of stuttering include speech sound prolongations, blocks or interruptions to speech and sound, word and phrase repetitions. A less well known fluency disorder, cluttering, is described in an article called Cluttering Updated, and there is a bibliography here on the Stuttering Home Page, with some suggestions for helping. Other related fluency disorders are here.

Assessment and treatment
Speech-language pathologists assess and treat fluency disorders in children, adolescents and adults. There is a wide variety of treatments available. It is important to determine that the person offering the treatment is properly qualified and certified. There are rather a lot of bogus "cures" for stuttering out there, many of which are widely promoted on the Net. Caveat emptor!

Voice
See teen-nodules.

Assessment and treatment
Voice disorders in children, adolescents and adults can be assessed and treated by speech-language pathologists, once the client has been examined by an Ear Nose and Throat (ENT) specialist. Voice disorders include hoarse voices, voices that are too high pitched, voices that sound too "nasal" and voices that are easily "lost".

References
Dollaghan, C, & Kaston, N. (1986). A comprehension monitoring program for language-impaired children. Journal of Speech and Hearing Disorders, 51, 264-271.

Havighurst, R. (1972). Developmental tasks and education. (3rd ed.). New York : D. McKay Company.
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Ingersoll, G. M. (1989). Adolescents (2d edition). Englewood Cliffs, NJ: Prentice-Hall.
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Ingersoll, G.M. (Undated). Developmental Tasks of Normal Adolescence. <http://education.indiana.edu/cas/devtask.html> Accessed March 19, 2002.
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Patchell, F. & Hand, L. (1993). An invisible disability - Language disorders in high school students and the implications for classroom teachers. Independent Education.

Patchell, F. & Treloar, R. (1997). Meeting a Need: A Transdisciplinary, School-Based Team Approach to Working with Children and Adolescents with Language Disorders.

Downloads

Patchell & Hand 1993
An invisible disability - Language disorders in high school students and the implications for classroom teachers.

Patchell & Treloar 1997
Meeting a Need: A Trans-disciplinary, School-Based Team Approach to Working with Children and Adolescents with Language Disorders.

Page updated 13 May 2009

http://www.speech-language-therapy.com/adolescents.htm