By Dr. Noel Swanson
If your child shows difficulty with behavior, attention, learning, concentrating, and social interactions it may be that this is where the problem lies.Verbal communication is vital to human functioning, but it is tremendously complicated. In fact, speaking and listening well require a whole sequence of processes to work together effectively. A problem with any one of them will have serious, but often not obvious, consequences:
1. Obviously you have to be able to HEAR what the other person said. But hearing itself is complicated. Because of problems such as ear infections and allergies, many children have impaired hearing. It might not be that they are deaf, it might just be that they cannot pick up, for example, high frequency notes. This is like listening to people with a pillow over your head. It can be done, but it is hard, and requires concentration.
Needless to say, children with such hearing problems often lose the motivation to work so hard, and so may appear to drift off into a dream world – particularly in busy, noisy, classrooms.
2. Once you have heard, you then need to process these sounds and make sense of them. These are their “receptive language” abilities.
Again, many children have difficulty with this. They hear the words, but somehow cannot quite figure out what it is you are trying to say. So they keep asking “what?” and come across as being very dense or stupid. In fact they are not, they just have a very specific receptive language problem.
3. Having understood what it is you are trying to say, they then have to decide how they want to respond. This is not a language function. It has to do with motivation, personality and all those other factors that influence people in choosing this or that behavior – all the stuff I talk about in my book: www.good-child-guide.com
4. Having decided what they want to say in response, they then have to encode this into formal language structures – i.e. words and sentences. This is called “expressive language”. And again, many children have great difficulty with this. They get their words tangled up, their sequencing wrong, and eventually resort to simple one-word answers. The times you find yourself asking, “what on earth is he talking about?” may be indicative of a problem here!
5. Once they have the words all worked out, they then have to say the sounds. This requires the accurate movement of mouth, throat, breathing etc. and is known as “articulation”. Problems in this area are usually pretty obvious – children who cannot properly pronounce “r”‘s or whose speech is so difficult to understand that the parents have to act as interpreters all the time.
Causes of problems with articulation are numerous, but one common one is “tongue tie” in which the little bit of skin under the tongue is too tight, preventing proper movement of the tongue. This particular cause is very easily remedied with a simple operation.
the other main cause is faulty learning (often, surprisingly connected with hearing problems) that can be corrected with speech exercises. Why is it connected to hearing? Because you can only learn to say the sounds you have first heard. That is why deaf people talk so strangely – they have no sounds to copy. But if your hearing is not perfect, for example if you cannot hear certain frequencies, then your speech will also be imperfect.
Children with very “thick” sounding voices may well speak that way because of hearing problems when they were younger.
Since problems with receptive and expressive processing are not obvious to most observers (including teachers and parents) it often goes unrecognized. Instead the children are labeled as lazy, stupid, inattentive, rude, and so on.
And in response to that, many children then develop behavioral problems – they give up, they lash out, they get frustrated and depressed.
They can also end up being mis-diagnosed as having ADHD, Aspergers/autism, and so on. (Although many children can actually have both together, too).
So what do you do?
Clearly, the bottom line advice is, if you have any suspicion that you child is not hearing or processing spoken language as well as (s)he might, look into it further. Don’t just “hope it will go away” – that rarely works!
As with everything, the best place to start is to first do your own research. Don’t rush straight off to find a specialist. Even if you do eventually seek a professional referral, you will be able to make much better use of it if you go in their armed with some knowledge of your own.
So, where to start? Where else than the internet, of course! Become familiar with some of the terms and therapies available. then approach your local services, either through the education department/school board, or the local child guidance clinics to ask what services are available locally.
As ever, in this day of limited resources, you will need to be persistent to get the assessments and help that you need. But don’t sit back hoping it will improve by itself. It probably won’t.
Dr. Noel Swanson, Consultant Child Psychiatrist and author of The GOOD CHILD Guide, specializes in children's behavioural difficulties and writes a free newsletter for parents. He can be contacted through his website on Expert Parenting Advice.