Children’s Academy for Neurodevelopment & Learning

SPEECH AND LANGUAGE

 By Toni Hager

Most of us take speech for granted.  But it only takes one case of laryngitis to recall to our consciousness how total our reliance on speech is. This article will address the components of language and speech and some of the many related neurological dysorganization. 

             Historically the primary problem is the overwhelming tendency among educators, therapists, and caregivers to treat symptoms, when what is needed is a neurodevelopmental approach.  A neurodevelopmental approach involves identifying the developmental and neurological factors involved in each area where ‘symptoms’ imply delay or inappropriate function, and then determine how we can intervene and make a significant impact on the issues that created the problem in the first place.

 Speech and language

           The term speech and language are often used interchangeably, but they need to be separated if we are to understand the components involved in helping an individual to verbally articulate his or her thoughts with good enunciation.  Important lines of distinction tend to get blurred in this discussion, because of issues pertaining to word articulation.  To be “articulate” means to be able to speak effectively, which would place the word squarely on the language side of the ledger.  But, we use the word “articulation” to refer to the ability to enunciate, to pronounce a sound, a phoneme, a word or a sentence clearly.  This is an issue of speech and language.  We want our children to speak with good articulation and to be articulate… we want both good speech and language. For the purpose of this article let’s define speech as the neuro-motor function of pronouncing words clearly. Language will be defined as the neurodevelopmental ability to use words, and to combine words so as to communicate. 

Many children have both speech and
language problems while others have
only speech problems.

Language

 The basis for language function is auditory function. We must first have good hearing and processing of sound.

 Auditory function and hearing

            We should first look at “normal” development of auditory function.  The auditory nerve, which is the 8^th Cranial nerve, is the most primitive nerve in the body; the first nerve to develop in the fetus.  The nerve and the stimulation of this nerve are very critical to the entire development of the child.  The brain begins to learn how to process sounds in utero.  The child is not born with the ability to process a full range of tones well, as a matter of fact, many people never learn to process a full range of tones well.  The human ear can process tones throughout a huge range, from 20HZ to 20,000 HZ.  The brain must learn to process these tones, particularly the tones that are within the language range.

Auditory Tonal Processing

           A child generally learns how to process the tones in their native language during the first two years of life; some tone are unique to specific languages and absent in others.  A good example of tonal processing is when learning to speak a different language.  If the individual has not learned to hear those tones they will not be able to articulate those tones causing extreme difficulty speaking the new language.

             Many children do have difficulty processing tones.  If the quality of auditory input is disrupted or interfered with auditory tonal processing development will be delayed or permanently impaired, unless there is specific and effective therapeutic intervention.   

            You ask how can auditory input be disrupted or interfered with?  Ear infections and/or fluid against the eardrum are the two main culprits. The child who experiences either or both of these situations isn’t giving the brain consistent auditory input. This may halt or slow receptive (understanding) language.  Distort sounds. Hamper understanding of spoken language. Unable to hear speech clearly; therefore, expressive (spoken language) is distorted… a child will pronounce words the WAYS their brain heard them.

If your child’s language is delayed or if there is some question about their hearing I highly recommend having their hearing checked.  Tests are either subjective or objective.  Subjective tests include the audiogram in which the child is asked to respond in some manner to tones.  Objective tests include the auditory evoked response which measures the brain’s response to specific tones.  These tests can generally be relied upon to identify significant global hearing loss, BUT they do not attempt to test more than a few sound frequencies.  Many tonal processing deficits escape detection.  For example, the inability of a native Japanese speaker to hear an “R” will not show up on such testing.  In these tests, typically about 8 frequencies are tested across the 20,000 frequencies that we should be able to hear.  This is at best a ver partial measure of auditory tonal processing. 

          Auditory tonal processing problems are very common, matter of fact most of society have auditory tonal processing problems to some degree.  The majority of children in special education classes with most ‘labels’ have this problem. 

Physical problems due to repeated
ear infections or fluid:

•  Stuffy & congested

• Mouth breather

• Insufficient way to breathe

• Lungs don’t receive ample oxygen

• Tongue thicken & lips weaken

• Weakens the immune system

• Sinuses become flatten which changes facial structure

• Phonation and/or resonation problems develop

• Applies pressure on the inner ear which affect the development of the vestibular & balance system.  Vestibular function directs ocular muscles

 I strongly suggest working closely with very regular visits to a ENT (a physician specializing in treating the Ears, Nose, and Throat) who will also check the status and condition of the tonsils, adenoids, and sinuses. 

For more information on ear infections read “Ear Infections Impact Learning” and “Behaviors Hidden Problems: food sensitivities” on this site.

       All of us, children and adults, are bombarded every day by noises and sounds that have a deleterious effect on our brain and well being. Whether in the classroom, office or living room, our ears and brain constantly have to work hard to "tune out" these sounds in order to focus in on family, studies, or the task at hand. For sensitive children and adults, environmental noise pollution can be a constant source of stress.

      Many of my clients are experiencing good results with the “Concentration” CD.  It retrains the brain to hear the different ranges of sounds PLUS “filters” all the extra white noise enabling the child to clearly hear, concentrate, and learn.  This series is all many children need.

      For those with more involved tonality issues I recommend and use “The Listening Program”.  This is an in-home, cost efficient program.

AUDITORY SEQUENTIAL PROCESSING

     The brain must be able to process the information (stimulus) it receives.  Processing is how the brain understands, categorizes, interprets, and does something with its information.  This is called ‘auditory sequential processing’ or short-term memory.  This is the ability to take in bits or pieces of auditory input and to process it in a sequence.  Initially, each phoneme (sound) is a bit (ie: an infant learns to first say “ma”, “ba”) then he/she learns to recognize a group of sounds together (toddler using a familiar word).   Eventually a familiar couplet or phrase is also recognized and processed as a single bit of information.  As the child develops the ability to sequence more and more bits, his/her language ability grows. The sequence grows from an initial sound, to an approximation, to a word, to a couplet, to a 3-4 word phrase, to a sentence and then a string of sentences.  

      Normal, sequential processing (digit span) occurs at a rate of one bit per year of development until the age of seven. A seven year old or adult should be able to hold together seven (+/- 2) individual bits of information.  Our perception is that anyone over the age of seven with a digit span of less than seven has a deficiency in auditory sequential processing. 

      Sequential processing is vital to normal function.  For example, if you are over age seven but process say, at a 4 or 5 then basically your brain is processing as that of a 4 or 5 yr old child.

 Auditory sequential processing impacts

• behavior (know right from wrong, tantrums, actions, understanding consequences, attitudes, abilities),

• decision making (wearing appropriate clothes for the weather,  choices, actions, logic, reasoning)

•  learning  (Your 12 or 15 or 18 yr old isn’t learning to read or do higher level math, yet has a digit span of 4 or 5… do you know any other 4 -5 yr olds reading (well) or able to do higher level math?  Neither does your child.)

Other problem areas due to sequential processing

•  Trouble with phonics,

•  Unable to follow directions

•  Easily distracted

• Needs things repeated

• Just didn’t hear you

•  Speaking & writing skills

    Auditory sequential processing determines the ability to process language, to think, to think conceptually, and to express oneself in words.

     Auditory sequential memory
can be improved!

For non-verbal or child under five—

      Generally, we use digits… they are abstract, harder to remember and you can’t make a cute word to remember it.  But for the non-verbal or young child we use directions and “touch ___”. 

      First, tell the child we are going to play a fun game.  I will ask you to do something and I want you to do it, ready?!  Keep it short (half a mins. to a full min at first then build to 3 mins.) and very positive and reinforcing.  In a monotone voice, with a one-second pause give a direction. Initially, start with one direction.  This is an auditory exercise do not give ANY visual cues!   Say… “touch nose”.  Child should immediately touch their nose.  If not, take their hand and touch their nose.  Do four different ones.  If they immediately follow your direction increase to two directions “touch knees, arm”.  Again, they must respond immediately; if not do the direction using their hand on them.  Keep increasing… 3 to 4 to 5 and so on. Other directions: blow kiss, turn around, give hug, wave bye, etc.  Note-Each digit is a developmental year.  Going from a 1 to a 2 or 3 to a 4 means the brain is learning to hold together that many bits of information; and,  with many children usually takes a full year to accomplish. Sometimes as the child is moving to next level they may follow 21/2 directions.  They may touch the first two parts but pause while ‘thinking’ of the third.  This normal and major progress!! Don’t get discouraged… hang in there they will get there.  Remember auditory sequential memory is one piece of neurodevelopment organization.  If the child has other inefficiencies progress will be slower.

Follow the directions above except use numerals. Start with 3 (4,7,2) they immediately repeat it. Do a couple more of 3’s then move up to 4 (0,4,2,8) again they immediately repeat.  Keep going.  We want to reach seven to have average processing but I know kids who can do 9 and 12!!  The higher the processing the easier the learning ability!! Same note as above. Sometimes they repeat the right numeral but in wrong order.   They are developmentally moving up to the next level!  Repeat the same sequence but emphasize that third (or whatever) digit.

      Doing this activity two to four times a day for 1-3 mins will help “light years” in speech and language development.  It’s fun… you can do it in the car, while walking or doing dishes, any place.

     The quality and quantity of specific auditory input, which the child receives, determines the development of auditory sequential processing.  This is sound in a clear tones and words.  This can be good classical music using a wide range of instruments, sounds of nature, animals or the environment (laugher, sirens, plane over head, etc.).  Speak in a clear voice and just talk to the child.  Listening to you speak will teach the child how to pronounce the words but inputs vocabulary.. Do not use “baby talk”.  Have an environment free of extraneous auditory input—noise that isn’t needed. Model language by having face to face articulation.  Let them watch how you place and move you lips, tongue and use your voice. 

      There is a direct correlation between language development, cognitive development, academic development and auditory sequential processing. 

To summarize language development
we find there are five components:

1. The physical health of the child

2. Tonal processing

3. Auditory sequential processing

4. Opportunity to receive quality auditory input

5. The NEED to speak to be understood

      Human’s have the ability and need to speak, that’s one of the thing’s which make us human. The general practice with children who have speech & language problems is to teach them sign language. Teaching a child sign language should be the last resort not the first. A child in “infant stimulation” programs and special education classes immediately start teaching a child to sign.  Here’s the problem.  Signing is visual; therefore, a child learning to sign watches the persons hands instead of mouth.  They are concentrating so hard on watching the hands they don’t hear the spoken words which attributes to low sequential processing.  Then the teacher or therapist emphasizes signing not spoken language causing the child to ‘not bother’ trying to use language.  In many cases, the child becomes “non-verbal” and everyone assumes the child is incapable of language. 

       Some argue without signing the child has no means of communication.  This is true; however, he/she will make an attempt.  You expect your “normal” child to attempt to talk and sometimes demand it by with holding the item until they make an attempt.  Many times the frustration of getting the word out provides the opportunity to practice and make an attempt.  Many children start speaking when they get frustrated enough at mom not giving them what they want. So, why is it that because a child has been “labeled” Down’s Syndrome, Autism, or Learning Disabled they aren’t expected to use language?  In many cases, the “labeled” child’s opportunity and expectations are low… they shouldn’t be.  

Neuro-motor problems

      The brain must know where every little piece of the body is in space (up, down, sideways) and it must know where every little piece of the body is, this is called ‘proprioception’.  If for whatever reason the brain doesn’t know that its body has a tongue, lips, voice box or some other part required for language…. It can’t make that piece move.  For example, many children with articulation problems don’t use their palate, tongue or lips properly.  The brain doesn’t know they’re there..  Specific activities to stimulate all of the speech parts can, in most cases, eliminate the problem and the child will gain the ability to speak.

       I hope this article has shed some light on possible neurological ‘root causes’ causing your child’s speech and language problems.  When addressed Neurologically and given the opportunity and stimulation needed to build tonal processing, sequential memory, proprioception speech and language is a reality for most children.