Methods for Improving Communication Skills in Preschool Students with Communication Delays

Abstract

This study provides descriptive information on diagnoses, conditions and likelihood of later literacy learning difficulties as well as data to support the use of early childhood special education (ECSE) supports and services and the effects they have on children with Speech Language Impairments (SLI).

This study explores the experiences self-reported by current Speech Language Pathologists (SLPs) across Ohio.  Surveys were sent to SLPs who served children ages 3-5.  Respondents described materials and activities made available to children and the children’s communication behaviors at home as well as any medical/health information that was relevant for consideration by ECSE teachers.  Respondents also gave information related to classroom supports for teachers as well as home supports for parents/guardians.

Methods for Improving Communication Skills in Preschool Students with Communication Delays

Language is the use of systematic, arbitrary, and socially agreed upon signals (words and sentences) to convey meaning within a group or community for purposes of communicating (Feldman, 2005).  Receptive language refers to the ability to understand information communicated from an outside source (e.g. book, person) and expressive language refers to one’s ability to produce this symbolic communication. Developmental language disorders are persistent and present significant limitations on the ability to learn the language of the community.  Characteristics of language disorders include limited understanding or production of vocabulary, misuse of words, difficulty expressing or following ideas, immature grammatical patterns, difficulty following directions, or altered patterns of conversation (Feldman, 2005).

The question addressed by this research was what are effective communication strategies for improving communication skills in preschool students with communication delays?  The purpose was to a) determine types of communication disorders and the impact those disorders have on students, as well as to b) provide effective strategies for teachers, Speech Language Pathologists (SLPs), and parent/guardians.  The literature review answers the following four main questions that present the rationale for this study: What is communication and effective communication skills? What are communication disorders, including types, symptoms, causes, treatments, prevalence?  What are expectations for preschool children according to Early Learning Developmental Standards (ELDS)? And what are strategies for improvement?

Data to Support the Use of Early Childhood Special Education

Teachers in the professional community may learn helpful interventions they can use in the classroom to support students with communication delays.  For example, teachers, SLPs, and parents may learn the importance of early detection and therapy services in early years. Speech or language impairments are the most prevalent disability category for children ages 3-5 served under the Individuals with Disabilities Education Act (2004) and the second most prevalent disability category for students ages 6 through 21 (American Speech-Language Hearing Association, 2016).  Children ages 0-3 may be served for language delays through early intervention services of IDEA (i.e. Part B).  Children as early as the age of three are referred for preschool services through parent referrals, community or government organization referrals (e.g., Help Me Grow, Department of Developmental Disabilities) or physician referrals.  Often when intervention begins at this early age the need for speech-language therapy is diminished once the child has reached school age; in school-aged children who have no obvious genetic or neurologic condition, the prevalence of language disorders is only approximately 2% to 3% (Feldman, 2012).  Many of these students have Individualized Education Plans (IEP) in the category of Speech-Language Impairment.

Effective Communication

Language is the expression of human communication, either spoken or written, through which ideas, information, emotions, and beliefs can be shared (oxforddictionaries.com, 2017).  Children who are typically developing master the fundamentals of language and speech beginning at birth.  Language and speech skills serve a pivotal role in learning and social relationships.  Management and treatment can improve language and speech skills substantially and reduce the functional impact of persistent disorders.  Speech problems can include stuttering, substituting, adding or dropping off sounds (e.g. “poo” for “spoon”), mispronunciations of words, and unintelligible language that is unable to be understood by listeners.  Some examples of mispronunciations that may or may not be intelligible include making the “w” sound for an “r” sound (“wabbit” for “rabbit”), “d” for “th” (“dis” for “this”), or “t” for “c” (“tup” for “cup”) (American Speech-Language Hearing Association, 2016).

During the critical period of the first five years of life, children learn language by participating in back-and-forth interactions with the important adults and peers in their lives (Feldman, 2005).  When a child sends a message, whether it be with a gesture, a sound, a word, or through Augmentative and Alternative Communication (AAC) guardians’ responses serve as helpful feedback in the language-learning process for every child.  If a child is communicating less than others his age, he is unlikely to receive as much of this essential feedback.  Because he is not talking, adults naturally communicate with him less, which means he does not get the optimal, helpful input he needs to build his language skills.  This is why it’s so important not to ignore any sign that a child’s communication development may be delayed.  Some parents are advised that their child will likely “grow out of it”, and they simply wait for the child to catch up. But a “wait and see” approach can be very detrimental during this critical learning phase. Since children with delayed speech or language delays cannot participate fully during activities and conversations, they may fall even further behind if they are not provided with the help they need.  On the other hand, when a child with a speech delay or language delay receives extra support from the important adults in his life, he can make significant gains. Early speech therapy intervention is critically important for these children to develop the communication skills necessary for future success in their academic and personal lives (The Hanen Centre, 2016).

Risk Factors

Numerous factors can put infants and toddlers at risk for atypical developmental progress and outcomes.  Some factors are well established; others continue to be identified.  Some of the most common risk factors include genetic or congenital conditions (cleft palate, Down Syndrome, Fragile-X syndrome), severe sensory impairments (deafness, blindness), neuropsychiatric disorders (autism spectrum disorder [ASD]), and family history of disability.  Biological/medical risk factors include conditions such as low birth weight, respiratory distress syndrome, severe asphyxia, fetal alcohol syndrome, or severe brain hemorrhage, may result in immediate or later difficulties.  Environmental risk factors include conditions such as advanced or very young maternal age, parental substance use, parental psychiatric disorders, parental abuse or neglect, exposure to chemical toxins, or poverty.  Risk factors can occur singly or in combination and can result in a range of developmental difficulties (Paul & Roth, 2011). Therefore, identifying children who have language and speech delays in toddler-preschool period should be a priority (Feldman, 2012).

If it is determined that the child is eligible for services by an SLP as a member of the comprehensive evaluation team, the student will begin receiving speech therapy services.  Outside agencies may offer therapy services that take place in medical clinics and schools may offer school-based services during the day.

Communication Disorders

Effective communication includes verbal and nonverbal communication, body language, listening and speaking skills and visual communication.  Characteristics of language disorders include limited understanding or production of vocabulary, misuse of words and their meanings, difficulty expressing or following ideas, immature grammatical patterns, and difficulty following directions, or altered patters of conversation (Feldman, 2005).

Speech disorders are persistent delays and deficits in the development of speech skills and voice quality.  Speech disorders include problems in the production of speech sounds, disruptions in the flow or rhythm of speech, problems with voice pitch, volume or quality, and poor intelligibility (Feldman, 2012).

Some of the characteristics seen in students with language delays may include limited interest in social interactions, failure to respond when one’s name is called, babbling, limited use of gestures such as pointing, delayed acquisition of first words, slow growth of vocabulary or utterance length, poor speech intelligibility for development level and/or inadequate feeding and swallowing skills (Paul & Roth, 2011).  Many times a child’s parent or primary caregiver is able to understand them and their wants and needs, but other listeners cannot.   This is problematic because every child needs to be able to communicate his or her wants, needs and ideas effectively in all environments including home and school.

Table 1 summarizes typical language from birth to school age, according to Feldman and Boyse (2005) and Dosman et al. (2012).  From infancy a child should reach developmental milestones.  Some of these milestones include babbling beginning from three to six months; imitating sounds and saying one to two words at twelve months; between one and two years a child will begin to make his or her wants known and begin saying short sentences; and by preschool age a child should be able to recite nursery rhymes and tell short stories.

Table 1

Normal Milestones in the Development of Language and Speech from Birth to School aged.