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Language

Aberdeen City Health and Social Care Partnership

What is Language?

Language development is a broad term which encompasses both what a child understands (comprehension) and what a child says (expression). A child who has difficulty with their comprehension of language may struggle to understand and make sense of the words that they hear and may also struggle to follow instructions. Children with expressive language difficulties find it difficult to express their ideas, wants or feelings. They may have a small vocabulary for their age or have difficulty producing sentences and using correct grammar.

The development of language and communication skills in the pre-school years is key to ensure that the foundations are in place for success with later learning, literacy and forming friendships. Children will learn to communicate, understand and use language at different rates and many children do struggle to develop their communication skills. There is a wide range of what is typical when considering language development, but as with all areas of children’s development, we have general milestones for children when they are learning to talk.

When should my child start talking?

By 6 months: your baby should be making sounds, cooing, and babbling to themselves and you. They will make noises to gain your attention, show excitement when they hear your voice and watch your face as you talk to them.
• By 12 months: your baby’s babble will sound more speech-like, using strings of sounds such as ‘ma-ma-ma’ and ‘ba ba’ and they may begin to use their first word at this stage. Your child will generally be communicating in more ways- through making noises, pointing and looking to get your attention. Your child should also be understanding words within daily routines (e.g. ‘up’ and ‘bye bye’) and words for familiar objects (e.g. ‘teddy’ and ‘cup’).
• By 24 months: your child’s understanding of words will really develop at this stage. They should understand between 200 and 500 words and will be using approximately 50 single words. Joining of words also emerges at this age, saying short sentences such as ‘bye bye doggy’ and ‘more biscuit.’ You may observe that your child becomes frustrated if they have not been understood.
• By 3 years: your child should be able to understand and respond to simple ‘Who?’ ‘What? and ‘Where?’ questions. They will be putting 4-5 word sentences together e.g. ‘me want go play’ and will be asking you lots of questions. It is typical that your child will continue to make some speech sound immaturities at this stage (e.g. calling their ‘snack,’ a ‘nack’). Your child will be playing more with other children and joining in their games.
• By 4-5 years: your child will understand and say lots of sentences now, taking turns in longer conversations. They will ask you lots of questions to find out more information and will be able to describe events that happened in the past e.g. ‘we went outside and played in the sand. It was very cold.’ Your child’s speech should be intelligible to both family and unfamiliar listeners.

When should I be worried?

Your child may benefit from support from the Speech and Language Therapy team if:

  • They are not meeting the developmental milestones discussed above.
  • They are struggling to understand words or sentences that others say at home or in nursery.
  • They are unable to follow instructions that they hear or retain what has been said.
  • They are using a limited vocabulary or are unable to put words together to form sentences.
  • They demonstrate difficulty finding the right word to express their ideas.
  • What your child says is very muddled and disorganised and difficult for someone to follow, impacting their ability to engage in back-and-forth conversation.

How Can I Help At Home?

Parents play a really important role in supporting their child’s language and communication skills to develop in everyday life by joining their child in play, as this is where children learn best. Below are some strategies you can put in place during everyday interactions at home to support your child’s language to develop:

  • Get your child’s attention by saying their name or tapping them gently on the shoulder, before asking them a question or giving them an instruction.
  • Follow your child’s lead when communicating with them. By observing what they are interested in playing with/ looking at, you can communicate about something they want to talk about. Following their lead also takes away any pressure for them to speak. When following your child’s lead, it is really useful to comment on their play. Comments provide a much better language model than asking your child questions. For example, instead of asking ‘what are you doing?’ change this to ‘wow, you rolled the ball!’ or change ‘what colour is the bus?’ to ‘that’s a big, blue bus!’ This matches the language you use to what your child is interested in, helping them learn new vocabulary in context.
  • Keep your language simple to help your child to understand. It can be really useful to use your facial expression, gestures, pictures or objects to support what you are saying e.g. pointing to your mouth or showing your child their plate when saying, ‘It’s time for snack!’
  • Encourage any form of communication your child uses with you and others e.g. pointing, facial expression, gesture, drawing and words.Communication is about more than just words!
  • Make the most of everyday routines for language development. Talk about what you are doing during activities like breakfast time, bath time and make these fun, language filled times.
  • Help them to learn words by giving them choices. Offer two things to choose from whilst modelling the word, for example “do you want milk, or juice?” as you hold them up in front of your child. Questions like these are better than ones that only require a yes/ no response such as ‘do you want milk?’

What If My Child’s Difficulties Persist Into School-Age?

If your child continues to have difficulties with their understanding and/or use of language beyond the age of 5 years and it is felt that their difficulties are likely to have a significant impact on their progress at school, or on everyday life, then they may be diagnosed with a language disorder. Children can have a language disorder which is associated with other known conditions such as a brain injury, neurodegenerative condition, genetic condition or chromosome disorder such as Down Syndrome, sensorineural hearing loss, Autism Spectrum Disorder or an Intellectual Disability.

Where the cause of a child’s language difficulties is unknown, they may be diagnosed with Developmental Language Disorder (DLD).

What is Developmental Language Disorder (DLD)?

  • DLD means that you have significant, ongoing difficulties understanding and/ or using language for no obvious reason. There is no known cause for DLD although it may run in families.
  • DLD is not caused by other medical conditions, such as, hearing loss, autism, physical impairment or brain injury.
  • Children with DLD may also have other difficulties, such as, attention deficit and hyperactivity disorder (ADHD), dyslexia and/or speech sound difficulties.
  • DLD impacts everyday life at home and at school.
  • DLD can affect literacy, learning, friendships and emotional well-being.
  • DLD is relatively common affecting about 2 children in every classroom. It is more common than autism although not as widely known about.
  • DLD was previously known as Specific Language Impairment (SLI).
  • The term DLD is used when a child’s difficulties with language are likely to carry on into adulthood and are unlikely to catch up without help and support.

Possible Signs of DLD

Your child may have some or all of the following: 

  • Difficulties understanding and/or remembering what has been said to them.
  • Difficulties learning and/ or remembering new words.
  • Difficulty expressing him/herself verbally.
  • Immature language so they sound like a younger child talking.
  • Difficulty finding the words they want to use.
  • Difficulties with reading and/or writing.
  • Difficulty producing words correctly. They may miss out or substitute a sound in a word e.g. producing the word ‘dog’ as ‘do’ or ‘dod.’
  • Greater success learning through practical activities and when supported by visual cues.

How Can I Help?

  • Get your child’s attention by saying their name before asking them a question or giving them an instruction.
  • Keep your language simple to help their understanding.
  • Use visual supports such as facial expression, gestures, signs, pictures or objects to support what you are saying.
  • Talk slowly and give them time to process what you are saying before expecting a response.
  • You may need to repeat or rephrase an instruction if it has not been understood or remembered.
  • Encourage any form of communication with you and others e.g. pointing, facial expression, gesture, signing, drawing and words.
  • Try not to interrupt when they start talking as this can interrupt their thinking.
  • If sentences contain some errors e.g. incorrect word order or grammar just model back the correct form e.g. if child says “him kick ball” you could say “yes he kicked the ball!”
  • Help them learn skills to play with other children. For example, play games at home to support turn taking and listening to others.

I'm Worried What Next?

It is important to seek support from a Speech and Language Therapist as early as possible so appropriate support can be put in place. If you have concerns about your child’s speech, language or communication skills, please call our helpline or request assistance from the Paediatric Speech & Language Therapy service by making a request. 

Support from family, speech and language therapists and teachers can make a significant difference to children with language difficulties or DLD. Working together, we can help children to develop skills and strategies to optimise their communication potential.

Trusted Websites and Resources

Preschool:

Tips and advice – BBC Tiny Happy People This website has a wealth of information on language learning, child development and bonding. There are lots of useful videos and play ideas from a range of professionals.

www.ican.org.uk  ICAN is a charity which supports children’s communication development. The site contains information and resources about language development at all stages.

 

School-aged:

www.radld.org This “Raising Awareness of Developmental Language Disorder” site contains lots of information, resources and videos about DLD  

www.afasic.org.uk Afasic is a charity which provides advice and support for families of children with speech, language and communication needs. 

www.dldandme.org. This site was developed to raise awareness about DLD and to offer support and resources for parents, teachers and individuals impacted by DLD.