Receptive, Expressive; Oral, Written - The L in SLP
Vlinder CT PLLC'Speech-Language Pathologist' is a mouthful to say. Which often leads to the use of terms like 'speech therapy', 'speech therapist' or 'speech teacher'. Which in turn (unfortunately) perpetuates the idea that SLPs only work with kids who struggle to say their /r/, /s/ or /l/ correctly. However, speech disorders are only part of what the field of speech-language pathology covers. Some SLPs do choose to focus on speech (e.g. specialize in treating apraxia or stuttering). In reality, it only makes up a small percentage of what I do.
Over the years I have had questions from parents, teachers, and other professionals along the lines of, "I understand Vanessa's speech just fine, why does she need to go to speech therapy?" The "L" in SLP is for "language". "Language" is a shared, rule-governed, symbolic system for communicating meaningful messages. That shared symbolic system can be: oral/speech, written, or another symbolic system such as sign language, gestures, or picture symbols.
We can break language down into four main areas:
- receptive language - oral (the ability to understand what others say)
- receptive language - written (the ability to understand written text)
- expressive language - oral (the ability to express oneself orally)
- expressive language - written (the ability to express oneself through written text)
You might be surprised to read that reading and writing difficulties are treated by SLPs. Children with speech/language disorders (particularly more severe impairments) are at risk for literacy difficulties. Certainly SLPs are not the only professionals involved in the treatment of literacy disorders. As the written word (whether being read or being written) is part of language - and a form of communication - SLPs bring a wealth of knowledge and skill to the intervention of literacy skills.
Within each of these four areas, a language disorder may involve the form of language, the content of language, or the use of language (or any combination of form/content/use).
The form of language is what we think of as grammar, and includes: phonology (the sound system of a language and rules about how sounds are combined), morphology (the structure of words and how words are formed), and syntax (how words are put together to form sentences).
The content of language (also referred to as semantics) is the meaning conveyed by words, phrases and sentences.
The use of language (also referred to as pragmatics) is how language is functionally used in context and the rules governing what is socially appropriate language for any specific situation.
Language development begins at birth. Children develop language at different rates, but by age 5, most children have mastered the basic elements of adult language. Early language milestones include [download handout (.pdf) here]:
By 1-year-old
- Listens when spoken to
- Recognizes words for common items (e.g. cup, show, book, juice)
- Begins to respond to requests (e.g. “come here”, “want more?”)
- Uses gestures to communicate; says a few words
By 2-years-old
- Points to a few body parts or pictures in a book when named
- Follows simple commands and understands simple questions
- Has a vocabulary of at least 100 words (which rapidly grows over the next year)
- Puts two words together (e.g. “eat cookie”, “my ball”)
- Uses some one- or two-word questions
By 3-years-old
- Understands words in relation to other words (e.g. go/stop, in/out, small/medium/big)
- Follows 2-step commands (e.g. “get the book and put it on the table”)
- Has a word for almost everything
- Uses two- or three-words to talk about and ask for things
By 4-years-old
- Knows to respond when you call from another room
- Answers simple “who”, “what”, “where”, “why” questions
- Talks about activities at school or friends’ houses
- Uses a lot of sentences with four or more words
- Usually talks easily without repeating syllables or words
By 5-years-old
- Focuses and understands most of what is said at school and at home
- Pays attention to short stories and answers simple questions about them
- Uses sentences that give a lot of detail (“I want the biggest piece.”)
- Tells stories that stick to a topic, says rhyming words, names letters and numbers
- Uses similar grammar as the rest of the family
Language development continues through adolescence (and vocabulary learning continues throughout our lives). Some language disorders may not be detected until a child is older and more language demands are placed upon them.
If a child has a language problem it is likely to have a significant effect on his/her social and academic skills, and behavior. The earlier language problems are identified and treated, the less likely that problems will persist or get worse. Early language intervention can help children be more successful with reading, writing, schoolwork, and interpersonal relationships.
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