Context
In recent years we have seen an increase in our clinical practice of children with very low levels of language. More and more teachers in the Early Years are talking to us about children who don’t speak at all.
However, this issue is not confined to the early years or even to primary schools. We are also seeing children in secondary schools whose language is at a level that doesn’t allow them access to learning. Only recently our team have picked up many children, just starting secondary school, often with significant reading difficulties. When we assess these children, we find huge gaps in their understanding and use of spoken language.
In our speech therapy practice we work a lot in areas of social disadvantage, so we anticipate higher numbers due to the higher risk these children experience for language difficulties.[1] However, I am seeing higher numbers and complexity of language needs than I have experienced throughout my almost 40 year career as a speech and language therapist.
Reasons
Some children may not have any underlying condition, they may just be slower to learn language than their peers.
In the early years, children who are younger chronologically may have relatively immature language and behaviour skills and many are not yet ready to meet the academic and social demands of the classroom. We found this research article on this topic interesting.
Some children may have Developmental Language Disorder (DLD) with the most obvious difficulties being with aspects of language such as using words and sentences to express meanings and/or difficulties with understanding of language. For more information on DLD NAPLIC.
Children may have language disorders associated with other conditions, such as Autism, Learning difficulties, Hearing impairment and ADHD and some may have complex communication needs associated with broader learning and development.
Some children may present as having very low levels of language for different reasons. For example, children with selective/ situational mutism. This is an anxiety disorder where a person is unable to speak in certain social situations. Often their underlying language skills are good, but extreme anxiety around talking in certain situations prevents them from using their language. For more information SMIRA.
Identification of need
It is useful to understand what typical development looks like. The universally speaking booklets are a good starting point and free to download. They give detail of language development from birth to 18.
We also like the Early Years Journal for children with very low language. This gives small steps for development, not just for language but across all areas.
It is useful to think about foundational skills and watch out for some key factors, such as:
Joint attention
Use of gesture
Sharing space
Showing attention to another person
Taking turns in play activities
Using and responding to facial expressions and body language
Using vocalisations meaningfully
In older children, look out for verbal understanding, literacy gaps and children who are struggling with social interaction or wellbeing.
It is important to understand that children with the lowest levels of language may not acquire language in the typical way or take a typical route. We need to look out for their attempts to communicate, start at their starting point and respond to their communication, whatever that may look like. Getting to know the children and tuning into their areas of interest is a great start.
Some things to do
Consider Adult Talk – 6 top tips
1. Contingent talk – using talk based in the moment and related to what the child is interested in supports language development.
2. Work towards multiple turn interactions/two way ‘conversations’ – these don’t need to be verbal, but sharing the child’s interest and following their lead.
3. Consider tone of voice, facial expression, gestures etc. while interacting.
4. Use fun activities - singing songs, playing games, sensory toys to encourage exploration.
5. Use the child’s name to gain attention. Give space and time for them to respond.
6. Watch and learn what they are interested in – build on this for interactions.
A communication supportive environment is key – this would include adult talk as well as providing opportunities for children to talk. The physical environment is also important, with visual support really helping those children with limited language to make sense of their environment.
Professional learning for teaching staff so they understand the level of language the children are using and can adapt their own language to ensure the children are included.
Dynamic assessment – there is no silver bullet for children who are struggling to learn language in this way. It is therefore useful to try out different strategies whilst carefully documenting how they are working. Using a dynamic assessment model in this way can be very helpful to clearly identify what is working and build on success.
Specific programmes / techniques can be very useful. We’ve listed some of our favourites below, though these are not exhaustive. We’ve added links where we think this would be useful
Hanen / Learning language and loving it
Use of visuals – timetables, now and next boards, pictures and symbols etc.
Communication boards / Talking Mats
Music and art based approaches
We’d love to hear your thoughts. Are you experiencing more children with lower levels of language? What strategies do you find most effective?
[1] https://www.eif.org.uk/report/language-as-a-child-wellbeing-indicator#:~:text=The%20UK%20prevalence%20rate%20for,cycle%20of%20disadvantage%20and%20poverty.