How children use words, sentences, and gestures to express their needs, wants, thoughts and ideas, and convey meaning to others refers to their expressive language abilities. These abilities allow children to combine words into sentences, label objects, ask and answer questions, use correct grammar, state opinions, and tell stories.

Signs:

In the classroom, children who experience expressive language difficulties may often:

• Give incorrect answers to questions.
• Have trouble describing directions for games, activities, etc.
• Speak in short, simple, or choppy sentences.
• Use non-specific language to express themselves making it difficult for the listener to understand what they are trying to say.
• Use an under-developed vocabulary compared to their peers.
• Make grammar errors when speaking.
• Not participate in classroom discussions.
• Become frustrated if the listener is having trouble understanding them.
• Have a hard time finding their words.

Strategies:

There are several ways you can support children who may experience one or more of these challenges. Here are strategies that can be implemented in the classroom:

1. Give children extra time. Children with expressive language difficulties may need more time to process and formulate their responses, comments, or questions.
2. Do not interrupt the child. If a child is having trouble expressing their thoughts, do not try to speak for them. Give them the time that they need and listen intently.
3. Reformulate messages in a conversational manner. If you notice a child making a grammar or sentence structure error when asking or answering questions, or making comments, model the correct form for them in a conversational manner while placing emphasis on the word or words that were challenging for them. For instance, if a child says, “There are two mouses in the story!”, you can reply, “Yes, there are two MICE in the story!”.
4. Provide phonemic cues. If a child has trouble retrieving words, you can provide them with the first sound of the word to help them recall it.
5. Give choices. Is the student having trouble finding their words or using proper vocabulary? Provide them with choices and model the vocabulary for them.
6. Do not leave questions unanswered. Is the child having a hard time responding? It would be best to give them a choice of answers as questions should never be left unanswered.
7. Provide accommodations for oral presentations. Those with expressive language difficulties may experience anxiety when having to present in front of the class. Allowing the child to select a few classmates they would prefer to present to or simply just to you, the teacher, may help in reducing their anxiety.
8. Pay attention to the types of questions you are asking. Questions that require a simple yes/no response or only have one answer (i.e., “Where did the woman go to buy food?”) are considered easier to answer for children with expressive difficulties compared to open-ended questions. When asking open-ended questions, support the child by giving the child extra time to formulate their response or modeling the response for them.
9. Help children prepare for responses. Let children know what questions they will be answering so that they can adequately prepare their response.   
10. Use the “self-talk” strategy. Self-talk involves talking aloud, narrating what you are doing, using an excited and animated voice to make it fun and engaging. As adults, it is something we tend to do naturally. In the classroom, for example, you can say, “It’s story time! Let me get the book. I found it! Let’s open the book and turn the page!”, etc. 

While some students may have access to verbal language, others may use different, or a combination, of modalities to express themselves. These modalities include American Sign Language (ASL) and Augmentative and Alternative Communication (AAC). Please refer to the Technology section for more information on AAC.

The ability to listen and to comprehend spoken language is a basic skill that enables students to learn and participate in the classroom. Students with receptive language difficulties experience significant challenges when it comes to listening and understanding what they are hearing. This may be due to a variety of reasons including but not limited to a language delay/disorder, auditory attention, auditory memory and/or auditory processing difficulties. 

Signs:

The following are some signs that a student does not understand what they are hearing in the classroom, particularly when they are observed consistently:

• Minimal responding, off-topic responding and/or not responding
• Acting out behaviours and/or withdrawn behaviours
• Frequent production of incomplete work or incorrectly completed work
• Frequent requests for repetition
• Student inattention, particularly during listening situations
• Student can only listen attentively for short periods of time (due to the effort associated with sustained listening)

While some students may be aware that they are having difficulties , many others are not conscious of their difficulty. While it may be easy to feel impatient with these students and attribute their behaviours to lack of effort, it is important to understand that they may feel intensely frustrated by their listening difficulties, and often become anxious around being in classroom listening situations. It is important to identify and acknowledge the difficulty and then to work with the student to compensate for the difficulty. 

Strategies:

Instructional Strategies for students experiencing listening comprehension difficulties:

• Monitor comprehension at all times (e.g. request feedback from student; request that student repeat what he/she has heard; listen for on-topic and off-topic responding)  
• Encourage students to request teacher repetition if they need it  
• Adjust rate and rhythm of speech (rapid, staccato and monotone speech creates a suboptimal listening context for the student)  
• Use shorter units of presentation: be clear, concrete and precise  
• Provide visual supports whenever possible (e.g. modeling/demonstration, 3D objects, pictures, videos, etc.) Spoken/verbal information is transient (once it’s gone, it’s gone); visual information is static (i.e., it can be referred to as needed).  
• Be prepared to repeat instructions, emphasizing key points  
• Pre-teach new vocabulary and concepts  
• Review previously taught information before presenting new information  
• Link concepts explicitly for the student  
• Give the student a few seconds to process information before responding to instructions or questions  
• Model and make explicit what effective listening looks like (e.g. looking with the eyes, body orientation, responding on topic, etc.)  
• Consistently utilize an FM System if it has been recommended for a student with CAPD  Eliminate or reduce the sources of extraneous noise  
• Assign the student to a location where noise-related distractions are minimized  
• Ensure that the student’s hearing has been evaluated by an audiologist -- even mild hearing loss can have a significant impact on the student’s ability to perceive speech

Reading

In today’s classrooms, there is much concern about student reading competence. Teachers and other educators are observing that many students struggle with learning to read. According to the Pan-Canadian Assessment Program (PCAP) 2016 scores: More than one in ten Canadian students do not meet the level of reading proficiency expected at the Grade 8 level. Some students with reading difficulties may be characterized as having a reading disability or dyslexia. Another term for dyslexia is Specific Learning Disorder with impairment in reading (accurate/fluent word recognition, decoding, and spelling).

Definition of Dyslexia (International Dyslexia Association): Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth in vocabulary and background knowledge. 

Signs:

Dyslexia affects 5-15% of the population. According to the International Dyslexia Association, students with dyslexia may present with difficulties in the following areas:

• Learning to speak
• Learning letters and their sounds
• Organizing written and spoken language
• Memorizing number facts
• Reading quickly enough to comprehend
• Persisting with and comprehending longer reading assignments
• Spelling
• Learning a second language
• Correctly doing math problems

Can reading difficulties, including dyslexia, be overcome?

The answer is yes, and it is never too late to intervene. Even adolescents and adults with severe dyslexia can benefit from specialized reading instruction delivered by a highly trained instructor. Students are most likely to benefit when teachers, parents, tutors, SLPs and/or reading specialists all work together to promote improved reading ability in the context of both individual and everyday learning situations.

General considerations for treating dyslexia and other reading difficulties:

• Early identification and treatment is key.
• Help from a teacher (tutor or therapist) who is specially trained in using a systematic, structured instructional approach.
• Consistent, explicit, focused, structured and systematic are key words to consider when implementing a reading intervention program. Research has shown that teachers who are systematic in their approach to teaching reading have significantly more success in teaching their students to read than those who do not. In fact, it doesn’t matter which program the teacher is using, as long as it is structured and systematic in its approach to building reading skills.

Strategies:

Classroom Strategies and Adaptations:

Although it may be difficult to implement intensive, consistent and systematic reading instruction at the same time as targeting curricular content, classroom teachers may weave in a variety of strategies to facilitate reading skill improvement in the context of everyday teaching. Here are some key areas that you will need to target regularly:

• Phonological Awareness. Explicit teaching about how speech and language map onto print.
• Use of multisensory programs and resources to build knowledge of sound-letter correspondences.
• Morphological Awareness. Explicit teaching about the meanings of base words (roots), prefixes, suffixes and inflectional markers.
• Daily opportunities to interact with print. In many classrooms, students spend the entire class listening to the teacher’s lecture. Teachers may opt to set aside a certain amount of class time to let students learn the material by reading independently to themselves.
• Daily opportunities to write (More information can be found in the writing section).

Writing:

Writing is the process of communicating ideas using printed symbols in the form of letters or visual characters, which make up words. Words are formulated into sentences; these sentences are organized into larger paragraphs and often into different discourse genres (narrative, expository, persuasive, poetic, etc.). Writing is one of the most academically demanding tasks for students.  Experts suggest that there are more than 25 skills that are implicated in the writing process.

Writing includes the following:

• Writing process—the ability to plan, organize, draft, reflect on, revise, and edit written text; the ability to address specific audience needs and convey the purpose of the text (e.g., persuasion)
• Written product—the end product of the writing process

Dysgraphia: 

Writing difficulties/dysgraphia may occur on their own as a single disability, or they may co- occur with dyslexia (reading disability) or with dysphasia (oral language disability, also referred to as Developmental Language Disorder). There is a mutually interdependent relationship between literacy and language, it is important to determine if the student’s oral language development is proceeding in a typical fashion. A student cannot be expected to express him/herself in writing at a level more advanced than his/her oral language skills.

Signs:

Some of the writing difficulties typically seen in students may include the following:

1. Spelling difficulties
2. Difficulty generating ideas
3. Difficulty with word choice (imprecise vocabulary)
4. Difficulty formulating grammatical sentences
5. Difficulty with conventions (punctuation, capitalization..)
6. Difficulty with discourse level writing (paragraphs, essays, stories, etc.)
7. Fine motor challenges:
8. Student can’t hold a writing implement
9. Student can’t use a keyboard
10. Student can’t form legible letters

Can writing difficulties/dysgraphia be overcome?

The answer is yes, and it is never too late to intervene. Even adolescents and adults with severe dygraphia can benefit from specialized writing instruction delivered by a highly trained specialists.

Alternatively, there are exciting new assistive technologies now available that permit students with a variety of writing difficulties to complete writing assignments that would otherwise be impossible for them. These technologies permit the student to function academically by giving them the tools to compensate for their writing difficulties, just as eyeglasses and hearing aids compensate for vision and hearing impairments. They are not a crutch; they are a necessity.

Strategies:

General Considerations for treating dysgraphia:

•   Early identification and treatment
•   Help from a teacher (tutor or therapist) who is specially trained in using a multisensory, structured approach
•   Consistent, explicit, focused and systematic are key words to consider when implementing a writing intervention program. Teachers who are systematic in their approach to teaching writing have significantly more success in teaching their students to write effectively than those who do not. In fact, it doesn’t matter which program the teacher is using, as long as it is systematic in its approach to building writing skills.

o   The 6+1 Writing Traits Model™ is a model that is being used in many Quebec classrooms.

o   “emPOWER” is another example of such a systematic approach (http://www.architectsforlearning.com/empower.html).

o   Structured literacy programs to help with spelling such as Wilson and Lexercise.

Free writing, such as journal writing, offers practice but is not as effective as a more guided, structured approach that is focused on building specific skills. Think of writing as you would any other skill to be learned. Guidance or coaching is a requirement, at least at the beginning, to build competence.

About Speech Sound Disorders

Speech is how we say sounds and words. Speech includes articulation, voice, and fluency.

Children may have some speech sound errors as they learn to speak. Most children can say almost all speech sounds correctly by 4 years old. A child who does not say sounds by the expected ages may have a speech sound disorder. You may hear the terms "articulation disorder" and "phonological disorder" to describe speech sound disorders like this.

Signs and Symptoms

Children may substitute one sound for another, leave sounds out, add sounds, or change a sound. It can be hard for others to understand them.

Causes

Many children learn to say speech sounds over time, but some do not.

Some children have speech problems because the brain has trouble sending messages to the speech muscles telling them how and when to move. This is called apraxia. Childhood apraxia of speech is not common but will cause speech problems.

Some children have speech problems because the muscles needed to make speech sounds are weak. This is called dysarthria.

Your child may have speech problems if he has

• A developmental disorder, like autism;
• A genetic syndrome, like Down syndrome;
• Hearing loss, from ear infections or other causes; or
• Brain damage, like cerebral palsy or a head injury.

Seeing a Professional

A speech-language pathologist, or SLP, can test your child's speech.

It is important to have your child’s hearing checked to make sure they do not have a hearing loss. A child with a hearing loss may have more trouble learning to talk.

SLPs can help you or your child say sounds correctly and clearly. Treatment may include the following:

• Learning the correct way to make sounds
• Learning to tell when sounds are right or wrong
• Practicing sounds in different words
• Practicing sounds in longer sentences

What is Social Communication?

We all make decisions about communication based on where we are, who is around us, and why we are communicating. We learn how to make these decisions by being taught directly (like being told to say “please” when asking for something) and through experience (like noticing when someone isn’t interested in what you’re talking about). The ability to make communication decisions like these is called social communication.

Social Communication Skills

There are three major skills involved in social communication:

1. Using language for different reasons, such as

• Greeting (saying “Hello” or “Good-bye”);
• Informing (saying “I’m going to get a cookie”)
• Demanding (saying “Give me a cookie right now!”);
• Promising (saying “I’m going to get you a cookie.”); or
• Requesting (saying “I want a cookie, please.”).

2. Changing language for the listener or situation, such as

• Communicating differently to a baby than to an adult or a friend;
• Giving more information to someone who does not know the topic;
• Knowing to skip some details when someone already knows the topic; or
• Communicating differently in a public place than at home.

3. Following rules for conversations and storytelling, such as

• Taking turns being a talker and being a listener;
• Letting others know the topic when you start talking;
• Staying on topic;
• Trying another way of saying what you mean when someone did not understand you;
• Using gestures and body language, like pointing or shrugging;
• Knowing how close to stand to someone when talking; or
• Using facial expressions and eye contact.

If someone has difficulty with the above skills they may have a social communication disorder:

Social (Pragmatic) Communication Disorder (SCD) is a new addition to the Diagnosis and Statistical Manual of Mental Disorders 5th edition (DSM-5). SCD encompasses problems with social interaction, social understanding and pragmatics. Pragmatics refers to using language in proper context. For example, it’s important for children to develop the ability to use language differently when playing with, say, a younger child versus a teacher.

Strategies for families

There are many activities you can do at home to encourage social communication skills in line with the goals you develop with your child’s therapist. For example:

• Take turns. Participate in simple turn-taking activities that mirror the flow of social interaction. Examples including rolling or throwing a ball back and forth. Or you can repeat words and other sounds that your child makes. Start simple with just a few turns between you and your child or your child and another person.  
• Read and discuss. Read a book with your child, asking and encouraging open-ended questions such as “what do you think about what he did?”
• Talk about the feelings. Books and stories provide a great opportunity to talk about feelings. Suggest why you think a character in a story is behaving or feeling a particular way. Try extending this to real-life situations, privately discussing what a friend or sibling might be feeling and why.
• What’s next? Have your child try to predict what will happen next in a story. Help him locate the clues. Or work backward. Once an event happens, go back and figure out the clues leading up to the event. Take, for example, a picture of spilled milk and food on the floor; ask what might have happened.
• Plan structured play dates. Begin with just one friend at a time and have a planned activity with a time limit – say, 60 to 90 minutes to start.
• Use visual supports. Many children with SCD – like many children affected by autism – process information visually. Visual supports can be particularly useful in helping your child understand expectations and schedules.

Augmentative and Alternative Communication (AAC)

AAC, which stands for augmentative and alternative communication, is a way for people to communicate when they do not have the physical ability to use verbal speech or writing. AAC systems are designed to help people express their thoughts, needs and ideas. They are used by children or adults who have speech and language impairments. AAC can be used as a temporary or permanent measure. AAC can be divided into low tech and high tech. 

There are different types of AAC

No-tech and low-tech options may include the following:  

• Gestures and facial expressions
• Writing
• Drawing
• Spelling words by pointing to letters, and
• Pointing to photos, pictures, or written words
• The use of Core Vocabulary Boards
• Videos on using Core Vocabulary Boards - https://coesld.ca/technology.htm

High-tech options may include the following:

• Using an app on an iPad or tablet to communicate and
• Using a computer with a “voice," sometimes called a speech-generating device
• Touch Chat and Proloquo to Go are some popular communication apps 

This website provides descriptions and reviews of the most commonly used communication apps. 

Working With A Speech-Language Pathologist 

There isn’t a one size fits all when deciding what system to use with children!

A Speech Language Pathologist can help find the right AAC system for your students. SLPs work with other professionals like assistive technology consultants, occupational therapists, and even physical therapists since different physical skills are involved in accessing some AAC systems. 

Some things to consider when using AAC: 

Age, Skills, and Timing

AAC helps people of all ages and skills. Typically there are no prerequisites when starting with AAC! One of the myths around using AAC is that it will stop someone from talking . However, research has shown that AAC can actually help language development.

Assistive Technology for reading and writing!

Assistive technology tools can help students who struggle with decoding, spelling, grammar, and with organizing and expressing their ideas. Assistive technology may have a significant impact in helping students with learning disabilities work towards achieving their learning goals. There are two ways in which assistive technology can help, either by helping students learn how to complete a task or by bypassing their challenges altogether. 

For more information about the types of assistive technology software click here:

https://www.readingrockets.org/article/assistive-technology-writing

https://www.ldatschool.ca/assistive-technology/