Speech and Expressive Language Disorder - Essay Example

?Running Head: SPEECH AND EXPRESSIVE LANGUAGE DISORDER Speech and Expressive Language Disorder School Speech and Expressive Language Disorder Introduction Every child with observed developmental delay should receive assistance as early as possible. Parents whose child demonstrates a delay in speech, motor skill, receptive ability, and so on should be alarmed to observe delays and seek proper medical attention at once in order to diagnose the problem with their child. Early intervention is beneficial to avoid further problems and possibly cure the disorder or developmental delay at an early stage or before the child attends school. In the investigation conducted, a child four years of age is found to have speech and expressive language disorder. The following sections of the current paper detail the characteristics of the child, his developmental delay, and some possible interventions that may be taken to help alleviate or totally resolve the problem. I. Description of the Child and the Disability The boy who is four years of age, internationally adopted from China at three months of age, demonstrates an obvious speech disorder and expressive language delay noted at 8 and 20 months of age, respectively. Based on his records, his mother conceived him at age 30, and was not hospitalized or medicated during pregnancy. Therefore, factors such as gender, heredity, and environment (Norbury & Tomblin, 2008) may be considered as the roots of the problem. The surrogate mother of the child, who has taken care of the boy since birth, serves as the main source of information and child support. The mother is a housewife who never goes out except to do some grocery or pay bills. Although the surrogate father willingly provides support to his wife, he is the only one working for the family, is usually out, and comes home at night after office hours. Therefore, aside from the mother, the child has no one to interact with at home. Nevertheless, he is very fond of the television, and replies to people when expected. Faced with a stranger or visitor, the child behaves normally. He interacts and replies with people of all ages, although like most kids, he interacts better with other children. Whenever a visitor comes in, the boy resumes his activity, and responds to the visitor whenever asked. However, he has a very notable speech defect. He does not demonstrate other symptoms of delay except for his speech. When asked what his name is, he responds correctly, but shows inability for proper pronunciation and overall speech. In particular, he has difficulty producing the /s/ in his name and sometimes pronounces /t/ instead or deletes it in other instances. Likewise, he tends to substitute the sound of /k/ to /ch/ and so on. When at play with other kids, the boy does not talk much, but moves and does things according to expectations. At home, when asked to do a chore, he is able to obey instructions such as turning on/off the TV, looking for his toy, arranging his toys in the bin, drinking water on his own, and wearing his slippers. However, he has to be fed when eating, or else he will not be able to finish his food. His motor skills are all right. He can dance, move, go up the stairs, run, use the swing, slide, and play in the sand. However, when asked to draw or hold a pencil, he writes with palmar-supinate grasp. When asked to report what he has done, he struggles with pronunciation of words, and often times cannot be understood. Nevertheless, he tries to express himself but is a little shy with strangers. Moreover, he misses to name things at times, and points at them instead. His sentences are wrongly constructed, and even though taught the proper way, repeatedly makes wrong word order, which results in being misunderstood especially by visitors and playmates. II. Support and Resources Needed The situation of the boy calls for the services of a speech therapist. Immediate assistance may be necessary to correct the problem. Likewise, relearning of sounds and acquisition may also help to alleviate problems with pronunciation. Great effort on the part of the mother is required to teach the child how to express himself verbally. In addition, the speech therapist may help to identify other problems associated with the language delay. As observed, the child has no other notable problems except for his speech disorder. Nevertheless, the problem should be addressed immediately to help the child communicate well with others, especially now that he should be preparing for pre-school. III. Support Needed in Particular Areas of Development The child, like other kids, has needs that have to be met to address his language problem and allow him to live a normal life. The following needs must be supported to achieve the goal: A. Gross motor Fortunately, the child does not demonstrate any gross motor problem. He can run, jump, skip, go up and down the stairs, play in the swing and slides, hop, and walk in a straight line. However, he shows inability to dress up and take a bath on his own, and depends on his mother to do such things for him. B. Fine motor The child shows some problems with fine motor skills, although these are not exceptional. He can hold his eating utensils but is reluctant to eat on his own and usually relies on his mother to feed him. Also, he cannot hold pencils correctly, and grips it with his whole hand. However, he can hold toys correctly. He can shoot basketballs, play throw and catch, and sometimes play the playstation with his father. To address the problems related to fine motor skills, the child needs to be trained to do things on his own, and to understand that he needs to exert effort to learn the basic skills. C. Self-care development As mentioned previously, the child relies heavily on his mother for self-care. His mother gives him a bath, dresses him up, feeds him, brushes his teeth, ties his shoelace, and accompanies him to the toilet. As such, the child is solely dependent on his mother to do things children his age should be doing on their own. In particular, the child needs to learn to eat on his own, brush his teeth, wear his clothes especially his underwear and pants, and start tying his shoelace. The dependency of the child on his mother may be seen as a factor contributing to his speech and expressive language delay. It affects the child’s ability to take care of himself and to exert effort to speak properly. Furthermore, this inability to care for himself extends to his inability to express how he feels, whenever he is with other children. The mother reported that there were some instances when the boy did not speak up despite being hit by another child first in a party and then in a park. Therefore, the child demonstrates the need to be taught how to care for himself without the help of adults. He should understand and know what to do when his mother is not around, and he needs to deal with others. D. Cognitive The cognitive aspect of the child is not totally affected by his language delay. He can process information, follow instructions properly, and tell his stories correctly. However, he demonstrates inability to construct sentences correctly, which is still under the cognitive domain. Thus, the child needs more exposure to the proper use of sentences, and may need to receive formal instruction and outright corrections whenever he commits a mistake. E. Communication The child definitely needs more instances to communicate and practice proper pronunciation. The present environment he is in is not helping to resolve the problem. Communicating only with his mother and the television is not enough to develop his communicational skills. Because the child does not suffer from other delays (i.e., psychomotor delay), it is clear that the speech and expressive language delay may be due to his genes or environment. To help the child progress, he might need to be with other children, communicate with other elders, and to receive corrections on his speech and language errors F. Social development The child’s inability to relate well with others does not end in not quarreling or causing fights with other children. His inability to defend himself and meekness even when someone is already hurting him is not a healthy attitude. In this regard, it is obvious that the child needs more exposure to others especially children. He should gain experience to be with other children of his age in order to fill in the need at present. His current situation of spending most of his time in the house could lead him to get worse if nothing changes in the soonest time. The child’s need to interact with others to develop his linguistic skills may be addressed by sending him to a day care where he can interact with other people, bringing him to other places such as the grocery, playpark, zoo, and other places he can explore. G. Emotional development The child’s emotional aspect is quite affected by his language delay. His inability for correct speech and expression hinders him to express how he feels even in the most pressing situations. Therefore, more emotional support should be intended, which his family and social environment can provide. As observed, his mother has sheltered him fully, making it difficult for him to be independent. As such, his mother should learn to adjust and give him a little freedom to do things on his own such as eating, taking a bath, and so on. This would hopefully develop self-reliance, which he needs to survive in the social setting. Likewise, other people such as caretakers in a day care center or teachers in the pre-school can help him develop independence and self-confidence by rewarding accomplishments of simple goals and achievements. It should also be noted that when the child has tantrums, he shows signs of destructive behavior as he kicks walls and chairs. He also cries aggressively, especially when the father is not around. On this regard, further observations and examination should be conducted to relate signs of mild ADHD. IV. Relevant Instructional Strategies Children with developmental delays require the services of a field expert. In the present situation, a speech therapist may do a lot of help to improve the child’s speech and expressive language delay. Likewise, teachers in the pre-school may also work in collaboration with special education experts to help the child (Integration of Physical Education and Language). As regards the instructional strategies to be used, Murata (2000) recommends addressing minimal competencies at the beginning. Using simple, repetitive words and phrases and making the child learn by doing (Learning by Doing strategy) are some ways to improve the linguistic skills of the child. Examples of these are “go,” “jump,” “raise your hand,” and so on. Murata emphasizes that the use of these simple directional phrases can promote understanding, motor skill involvement, and challenge the mind of preschoolers. Moreover, Murata recommends demonstration of actions, giving praise, and making the children repeat instructions. This view is in line with the idea that language delay is related to motor development (Sommers, 1988; Scarborough & Dobrich, 1990). In the present case, the child’s gross motor development is not affected by his language delay because he is allowed to play in the park. However, he shows problems with his fine motor skills due to being pampered even at the age of four. As such, the interventionist should also focus on developing his fine motor skills along with his speech problem. To address the present issue that links the motor development with speech, the interventionist may use creative art activities to promote both fine motor and speech (Speech and Art Integration). The child should be given more exercises involving the use of his hand, for example, drawing, writing, coloring, painting, cutting and clay molding. The interventionist can have the child talk while doing the activities, explain what he is making, and reason out with the teacher why he produces the things he made. Through art integration, the interventionist can likewise address some social and emotional issues. For example, s/he can ask the child to draw the place he likes to go to in order to learn if the child has needs that should be addressed socially. Consequently, the interventionist should let the child explain why he wants to be in that place, and what he can see there. These conversations will help determine the thoughts of the child, and assess his cognitive skills as well. At the end of the session, the teacher should give praise to his accomplishments to motivate the child to repeat the activity or do similar activities and to promote self-confidence. Focusing on his weaknesses is very important. The phonological delay should be addressed specifically by practicing words that contain the sounds that he cannot pronounce. For instance, due to his difficulty pronouncing the final /s/ sound, the interventionist should provide pronunciation drills not just of the final /s/ but also the initial and medial /s/ sounds. Practicing the initial and medial /s/ would help in the cognition of the final /s/ sound. Teacher-modeling strategy can help improve the child’s speech in this particular area. In addition, the use of Picture Exchange Communication System (PECS) may also be valuable in improving pronunciation and functional communication (Deiner, 2009). PECS works by making the child identify what she/he wants and requesting the object from the teacher. V. Instructional Materials Relevant instructional materials will help alleviate if not solve the child’s problem of speech and expressive languge disorder. There are many intructional materials available nowadays to help promote speech and language improvement. Among these are the following: A.Signs, pictures and augmentive Devices Signs, pictures and other augmentive devices are some materials that can help promote proper speech production (Bauer, n.d.). These materials should include pictures of common and new things. The common things would assert the child’s knowledge and mastery of the items, whereas the new things will serve to introduce and increase vocabulary. Other augmentive devices such as flashcards will also help facilitate language learning and vocabulary acquisition. Picture stories are best resources to introduce new words, practice sounds, and assess emotions. B. Manipulative materials Manipulative materials such as dough, ball, puzzles, blocks and sticks will also help nurture both the speech and fine motor skills of the child. The interventionist may ask the child to create other things that the child can think of using the material such as dough, sticks and blocks/puzzles. Doing these exercises will also help promote creativity and self-esteem. Balls may be used for counting, identifying colors, and playing memory games. A collection of paired balls with different designs can be used for memory games in which the child identifies first what the color of the ball is and what shapes are drawn on it before choosing its pair. C. Songs and other interactive materials Action songs and interactive materials (videos and language games) are a fad nowadays. For the present case, songs that teach about the parts of the body, family relationship, and other values are most appropriate. In particular, the classic songs, “I Have Two Hands” and “My Toes, My Knees...” will help teach parts of the body, promote gross motor skills, and impart the value of hygiene. The interventionist can follow up the lesson with some other self-care lessons to develop self-care. The song, “A Family Fingerplay” can both teach about family and practice fine motor skills. Several computer softwares are also available for improving speech and auditory reception. The use of softwares should be decided by the speech pathologist/therapist. Softwares that promote easy word recall and simple grammar patterns should be beneficial to address the expressive language delay. In particular, softwares and activity cards from Stickids will promote cognitive, motor, and language development. D. Authentic materials and resources Authentic materials are the best materials to use for any kind of learner. These include real things found at home or in the community. For the child with speech delay, pictures will help to facilitate speech but real materials are better for easier recognition. Activities such as cooking demonstrations, role-playing, and games will challenge the child’s ability to produce the the correct words to use. In particular, role-playing activities can provide more communicational and relational instances to address expressive language issues. Likewise, authentic community resources are also helpful to make children recognize real-world features. For instance, in teaching about firemen, the interventionist can invite a fireman with his coat on to talk with the children. This is a better way to facilitate cognitive development and language ability instead just showing pictures. Conclusion Helping the child improve his speech and expressive language ability requires collaboration among language professionals, parents, and other people in the child’s environment. Similarly, choosing the right resources is important to address the needs of the child. Specifically, speech and language delay may be alleviated by providing more communicational instances in day care and community settings. Moreover, pictures, interactive materials, and authentic resources may also aid the child’s improvement. Meanwhile, fine motor skills may be improved using manipulative materials, actions songs, art projects, and demonstration lessons. Furthermore, cognitive, self-care, social, and emotional development may be enhanced by carefully choosing activities that promote word and language use, self-care activities, community concepts, and self-expression, respectively. References Bauer, S. (n.d.). Speech and language delay. Retrieved June 5, 2011 http://pediatrics.uchicago.edu/chiefs/ClinicCurriculum/documents/BauerSpeechDelay.pdf Deiner, P. (2009). Inclusive early childhood education. CA: Wadsworth. Norbury, C. & J.B. Tomblin, (2008). Understanding developmental language disorders: From theory to practice. NY: Psychology Press. Murata, N. (2000). Speech-language strategies for physical educators. The Journal of Physical Education, Recreation & Dance, 71, 36-38. Scarborough, H. & Dobrich, W. (1990). Development of children with early language delay. Journal of Speech Hearing Research, 33, 70-83. Sommers, R.K. (1988). Prediction of fine motor skills of children having language and speech disorders. Perceptual and Motor Skills, 67(1), 63-72. Read More