Language & Literacy Intervention Tips: Metalinguistics, Visualization, Memory Strategies
Children and adolescents can learn strategies to improve their language & literacy skills. They can make gains in academic and linguistic abilities when they practice their strategies during speech/language therapy sessions, the classroom, and at home. Speech/language pathologists, teachers, and parents can guide them through applying metalinguistic, visualization, and memory strategies to succeed across school curriculum areas such as language arts, science, social studies, and math.
Metalinguistics is an individual’s ability to actively think about, talk about, and analyze language. These skills are essential for higher-order language or critical thinking. This is an essential component in language learning and involves someone thinking about oral and written language. Children who have good metalinguistic awareness have a solid understanding of phonological awareness, morphological awareness, syntactic awareness, semantic awareness, and pragmatic language or social skills.
For instance, students with excellent phonological awareness are good at identifying and manipulating speech sounds in words, a meta-awareness skill. Children with excellent language or metalinguistic skills can actively think about their learning and new language or academic concepts. These individuals have a good understanding of word structure, sentence structure, vocabulary, and social language use. They are strong thinkers and readers who can make inferences, predictions, draw conclusions, understand multiple meanings, and comprehend non-literal or figurative language. They are able to think about science concepts, social studies topics, and learn and explain math concepts. They are able to answer verbal reasoning questions and math word problems. Effective language comprehension skills are the foundation for academic success in all subjects or classes.
To visualize means to create a mental image, or to imagine. Visualization strategies help a reader develop a mental image of what is being described in a story or text. The artwork in picture books can be used with children of all ages, not just younger children, to help them see how words and images connect. With visualization, the first step is to explain to the child what visualization means and that by picturing what the text describes will help them remember what they read. It is like making a movie in their head about what they read or about information that is read aloud.
A pre-story task can be conducted where the child is asked to examine a scene in the story they are reading. Then the scene is removed, and the child is asked to visualize it on their own. Finally, the clinician reads a sentence to the child and describes what she “sees.” The clinician then chooses sections from the text and asks the student to practice visualizing and discussing what they see. These visualization techniques are designed to help students make references so that it is easier for them to recall and understand information.
The visualization technique provides an opportunity for children and adolescents to use mental imagery by making a picture in their mind of a vocabulary word or information they are learning at school. Visualization is an excellent language strategy to build comprehension and oral language skills. During speech/language therapy, the speech/language pathologist can ask students several probing questions to help them describe familiar or personal objects with key attributes. Children can practice describing tier 1 vocabulary or objects that are not directly in front of them (e.g., food, item at house, a pet, a piece of jewelry, etc.). Once children can accurately describe familiar or personal objects, they learn to create mental images of simple sentences, paragraphs, and eventually the whole text to improve their listening and reading comprehension skills.
The speech language pathologist can guide a child or adolescent, to process language visually, express what they visualize, orally define vocabulary, and answer literal and inferential questions from information read aloud or presented in text.
Additionally, there are various memory strategies that may be utilized in speech/language therapy, the classroom, and at home to build essential skills. These include:
1. Mnemonics and Acronyms:
A mnemonic is a learning method that involves using a phrase or pattern of letters to remember information. Using an acronym or abbreviation from the initial letters of words can improve memory. Let children create their own mnemonics to assist them in memorizing important curriculum facts, the elements of a process, list, definition, etc.
2. Visual Lists:
Write down an agenda throughout speech therapy next to your workspace. Children will visualize and recall the items that must be done in the therapy session. Children can practice remembering key items from a grocery list when with their family.
3. Games and Puzzles:
Use games such as checkers or chess as a preferred activity to strategize with each child. Puzzles are a great exercise for the brain to build cognitive or thinking skills.
4. Categorizing and Making Connections:
Let children create a hierarchy and classification of categories to enhance archiving and memory skills. They can learn key language arts, science, social studies, and math vocabulary by organizing and listing words according to topics or categories.
5. Drawing and/or Tracing:
Another activity can be performed by allowing children to draw or trace new vocabulary actions and objects to help visualize and ingrain the word within their minds.
6. Color Coordination:
Children can use different color highlighters, colored pencils or markers to emphasize key vocabulary or color-coordinate study guides/class notes.
This is a simple and important strategy, repetition. It can significantly improve memory and performance for a child. Mental repetition is crucial.
Children can utilize different modalities to transfer information from short term to long term memory. For example, when studying for a test, they can say the information from a study guide aloud, rewrite notes, use highlighters, draw diagrams, or move their body (e.g. clap hands, jumping jacks) to practice vocabulary or math facts such as multiplication tables.
Language & Literacy Connection: Phonology, Morphology, Syntax, and Orthography
Effective language and literacy skills are the foundation for successful communication, academic, and life skills. Therefore, it is important to understand the connection between phonology, morphology, syntax, and orthography. Children and adolescents with excellent linguistic skills readily learn various tasks in these language domains. However, those with language disorders, learning disability, and dyslexia will struggle immensely with these areas.
Phonology is the study of phonemes or sounds and their patterns. This is a pre-requisite skill to develop literacy skills. It is part of language form. Children with language and reading disorders need direct instruction in this area. Those who struggle immensely with reading decoding do not have a solid understanding of phonology, phonological awareness, and phonemic awareness. It is imperative that speech/language pathologists, reading teachers, and literacy specialists provide remediation in this area for children and adolescents who struggle with understanding and completing phoneme tasks.
Reading decoding and encoding (orthography or spelling) begins with the simplest and smallest units of language (e.g. phoneme) and progresses to increasingly larger and more complex structures. As learners progress in their understand of sound to symbol correspondences (e.g. phoneme to grapheme), word patterns, and language structure, then intervention shifts more to advanced word analysis (morphology) and sentence structure/conventions (syntax).
Morphology is the study of word structure that includes root words, prefixes, and suffixes. Children and adolescents with morphological disorder have a spoken and/or written language disorder in the area of word structure. They do not have adequate morphological awareness or an understanding of how words can be broken down into smaller units of meanings including the root words, prefixes, and suffixes. Children and adolescents who demonstrate morphological errors that are not due to language or dialectical differences have a language impairment in the area of morphology.
Syntax is the sentence structure. Language has a rules of word order and word combinations to form phrases and sentences. Solid syntactic skills require an understanding of correct word order and language organization of simple, compound, and complex sentence forms. Children with language impairment, reading disorder, and writing disorder often have difficulty with syntax. They may have difficulty spontaneously communicating sentences in a clear and cohesive manner. In these instances, their verbal or written message may not be understood by their communication partner or the reader.
A syntactic disorder is a spoken and/or written language disorder that occurs when children or adults have difficulty sequencing words, thoughts, and information in order. When toddlers learn to speak, they may use incorrect syntax or word order. As children get older and enter school, the complexity of their sentences increases. Students, even in early grades, begin to understand the importance of word order and how it affects the meaning of a phrase, sentence, or passage. Children and adolescents who exhibit syntactic errors that are not due to linguistic/dialectical differences have a language impairment with sentence structure.
Children and adolescents with morphological and syntactic deficits have difficulty learning and using the rules that govern word formation (morphemes) and phrase/sentence formation (syntax). At the word level, these children may not correctly use plural forms or verb tenses. At the phrase or sentence level, children with syntactic deficits might use incorrect word order, leave out words, or use a limited number of complex sentences. For example, a child may omit prepositional clauses which decreases one’s use of complex sentences. It is important to target prepositions with one-step instructions such as stating, “Put the ball under the box.” In addition, locative prepositions can be targeted by presenting a descriptive photograph with many items, asking the child, “What is under the ___?”
Speech/language pathologists should provide direct instruction using structured and functional tasks. They can serve as a verbal model for correct grammatical usage. Then they can provide children and adolescents practice opportunities with root words, prefixes, suffixes, and verb tenses. During speech/language therapy sessions, students will need both oral and written language practice to master this essential skill. Similarly, they need practice formulating simple, compound, and complex sentences in both structured language activities and conversation. SLPs can provide picture description tasks for children to practice producing oral and written sentence with various syntactic structures. Fiction and non-fiction text can be used as exemplars for correct sentence structures. When planning intervention, it is important to keep in mind dialectical variations and provide language therapy for the word and sentence structures that are truly disordered rather than due to linguistic difference.
Additionally, general and special education teachers should directly teach alphabetic principle. This means that students should learn that there are predictable relationships between sounds and letters. Words are comprised of letters that each have a distinct sound. Consonant blends such as /th/, /sh/, and /ch/ are diagraphs that represent one sound. It is important for teachers to understand that a grapheme is an individual letter or sequence of written symbols (e.g. c – a – t). A grapheme is also multi-letter or consonant blends that represent one sound or phoneme (e.g. /th/, /sh/, and /ch/). Speech-language pathologists can help reinforce alphabetic principle as needed during speech/language therapy sessions with children who struggle with reading and writing. Children with language and literacy disorders can practice writing simple sentences through dictation. Teachers may use high frequency words (e.g. Fry or Dolch word lists) for sentence dictation practice. Speech/language pathologist may assist children and adolescents with written expression during functional tasks such as writing a letter to a parent, describing a personal narrative, or retelling a story with key story grammar elements. They can help guide them with organizing their ideas in a cohesive manner at the basic paragraph level or 3-5 paragraphs over time. Teachers address this in the general education and special education classrooms and also focus on conventions such as capitalization and punctuation.
There is a definite connection between phonology, morphology, syntax, and orthography. With a comprehensive assessment and intervention, children and adolescents with language, reading, and writing disorders can make noticeable gains in these areas. Speech/language pathologists and educators can collaborate to maximize student achievement with language, reading, writing, and spelling. This will contribute to an increase in functional and academic skills.
Early Identification of Language Disorders and Language-Based Learning Disabilities
It is imperative that children with language disorders and language-based learning disabilities are identified at an early age. Speech/language pathologists are skilled at identifying receptive and expressive language disorders across the lifespan. Children can start receiving speech/language therapy as a toddler if their comprehension and oral language skills are not age-appropriate. Services can continue through the preschool and school aged years as needed to build essential communication, language, and literacy skills. Speech/language pathologists participate in special education eligibility meetings in the public school setting with school psychologists, special education teachers, and general education teachers and assist in the identification of children with learning disabilities. Language-based learning disabilities negatively impact a child’s understanding and use of spoken and written language. Dyslexia is a neurologically based disorder and a type of language-based learning disability, but the specific language and literacy difficulties are not due to cognitive or intellectual impairment. Early identification is necessary to mitigate consequences that may result from a lack of screening, diagnosis, and effective intervention for language disorders and language-based learning disabilities.
Children with language impairment have a history of speech/language delay, speech sound disorder, oral language difficulties, and/or language processing challenges that persist during school years. Speech/language pathologists and educators can play an important role in recognizing the signs of dyslexia specifically.
Recently, legislation has changed in the U.S., and the public school system is now required to provide universal screening for dyslexia and related language and literacy intervention in the Multi-Tiered System of Supports (MTSS).It should be noted that there was always a system in place to identify children with language and reading disorders via the previous Response to Intervention (RTI) process. However, the new legislation calls for an immediate overhaul and strategic focus on enhanced evidence-based dyslexia screening and intervention. In Georgia, the Department of Education has a three-year Dyslexia Pilot Program (2020-2023) in pilot districts throughout the state. In 2024-2025, there will be an official statewide dyslexia screening mandate.
Many important factors contribute to dyslexia including heredity and phonological processing deficit. Learning disabilities including dyslexia often run in families and are a lifelong learning difference. Research confirms that children with inadequate phonological awareness, phonological memory, phonological retrieval, and phonological production may occur in approximately 50 % of children with dyslexia (Pennington et al. 2012). Another study confirmed 48 % of children with phonological awareness deficits also had dyslexia and then 73% if the participants also had language and rapid automized naming deficits (Catts et al. 2017). Other factors may operate with dyslexia as well such as language impairments, attentional deficits, executive functioning difficulties, visual problems, and trauma/stress.
To mitigate dyslexia in the family and school environments, it is wise to build a growth mindset, task-focused behavior, adaptive coping strategies, as well as family, teacher and peer support. In the school setting, children and adolescents with language based learning disabilities are taught learning strategies, receive classroom accomodations and supports so that their brain can effectively process and retain curriculum content.
Sometimes, reading becomes an aversive activity for a young child with dyslexia. In addition, with a negative mindset, children may believe that they are not smart enough to read which diminishes the child from practicing reading. It is important for any child to feel confident in themselves while recognizing their strengths and areas of need. Children, adolescents, speech language pathologists, educators, and parents can find ways to increase opportunities for successful experiences at school, home, and in the community. It is equally important for children and adolescents to learn from challenging situations so they can learn perseverance. Coping strategies may include having higher self-confidence which stems from one’s environment, self-determination, positive aspirations, and hope that one can succeed academically and with everyday life skills.
As speech language pathologists, it is our responsibility to support children by understanding their thoughts regarding their struggles in language and reading, while assessing their critical needs across all literacy domains of listening, speaking, reading, and writing. It is important for families to seek out literacy professionals who have the training to effectively assess and provide skilled speech, language, literacy, and dyslexia therapy/instruction. Contact Building Successful Lives Speech & Language Services if you require further consultation or evaluation for a child or adolescent.
T. Anderson, M.S., Ed.S., CCC-SLP
Speech Language Pathologist, Education Specialist, Author, Consultant
Dr. Hugh Catts
Professor and Director of the School of Communication Science and Disorders
Florida State University
Word Finding Difficulties & Associated Strategies for Children with Language Disorders
Word finding difficulties occur when a person knows and understands a particular word, but has difficulty retrieving it and using it in his or her verbal communication.
Children might retrieve a word that sounds similar to the one they want, or they might say nonsense words or neologisms. In school, children with a word finding problem may have difficulty expressing their knowledge. They may appear not to know the answers when asked questions that need retrieval of specific facts. This may correlate with their memory function or in extreme cases neurodegenerative conditions.
For instance, children may have difficulty remembering a character or people’s names, locations, dates, or other specific facts from curriculum content or age level conversational topics. Their conversation may be brief or include word repetitions, substitutions, empty words, time fillers, and delays.
A child with an acquired brain injury will also have severe problems with finding the right word.
Children with developmental language disorder (DLD) and adults with language disorders are frequently found to have word retrieval difficulties.
Some strategies that children of all ages can use include the following:
- Practice reading – Use books that contain rhymes for younger children. This will help target similar words and differentiate the meaning of similar words for the children through visuals and written words. Providing a rhyming word may help children recall other target words for verbal communication.
- Associations – Start with a tier 1 word and the child must provide a word that is associated with that word. E.g. hamburger-fries-ketchup or plane – car – motorbike – bicycle etc. Ask the child to explain the reason for the association to further increase his or her semantic processing skills.
- Antonyms – Use a series of pictures and instead of naming the picture, get the child to quickly name an opposite. You may time the child and encourage him or her to improve his or her speed of vocabulary recall.
- Synonyms – Build synonym word lists with your child. This can be done in a little book. Encourage your child to draw a picture to represent each word. When doing home language practice sentences orally and/or in writing, refer to the synonym book to encourage expansion and use of new vocabulary. Have your child practice vocabulary/word relationships games online or through apps.
- Categorizations – Use pictures or objects and get the child to sort them into the correct tier 1 vocabulary category or group. Cutting up pictures from grocery store advertisements or magazines can work well. Kids can practice naming items when given the category name (e.g. breakfast foods, desserts, drinks).
- Riddles – Playing riddle games that require children to describe the features or attributes (e.g. category, function/verb, size, location, adjective) of words. Parents or SLPs may also tell children different noun attributes and then have them name the target vocabulary word. This will help build the child’s ability to store and retrieve new vocabulary effectively.
- Phonemic Cues- Giving the beginning sound of the word often helps to retrieve the word. This is an excellent strategy when working on building recall and verbal expression of tier 1 and tier 2 vocabulary.
- Sentence Context – Children learn best when key vocabulary is presented in sentence or paragraph context. When a parent or speech/language pathologist provides children with a cloze or fill in the blank sentence, this language strategy often prompts them to retrieve or recall the correct word. If it is not a frequently occurring word in their spoken vocabulary, children can use context clues to figure out the meaning of the unknown word.
Speech/language pathologists and parents may provide children in grades 3rd-6th this activity below to practice language categorization and organization. This can assist children with improving their vocabulary recall in various semantic (word) categories or groups. Click here for direct access.
Characteristics of Dyslexia and Areas of Impact for Children with Speech, Language, & Literacy Disorders
Dyslexia is a language-based learning disability that is characterized by deficits in understanding and using the phonological system for literacy. Students with dyslexia usually experience difficulties with other speech and language skills such as spelling, writing, and pronouncing words. Dyslexia affects individuals throughout their lives; however, its impact can change at different stages in a person’s life. It is referred to as a learning disability because dyslexia impacts the way a person’s brain processes information and subsequently can make it very difficult for a student to succeed academically in the typical instructional environment. In its more severe forms, it will qualify a student for special education, special accommodations, or extra support services.
About 15%-20 % of people have characteristics of dyslexia in the United States (United States Department of Health and Services).
People with dyslexia may exhibit challenges with:
- Learning to speak
- Learning letters and their sounds
- Reading decoding and fluency
- Organizing written and spoken language
- Memorizing number facts
- Reading quickly enough to comprehend
- Persisting with and comprehending longer reading assignments
- Learning a foreign language
- Correctly doing math operations
How is dyslexia treated?
Educators and speech/language pathologists must first recognize the characteristics of dyslexia and provide language/literacy screenings. Then skilled intervention should be provided in the Multi-Tiered System of Supports (MTSS) and subsequently from the Special Education program as deemed necessary in the public school system. MTSS helps educators provide academic interventions and strategies for students struggling with various skills. Schools can implement academic accommodations and modifications in the classroom to help students with dyslexia succeed. For example, a student with dyslexia can be given extra time to complete tasks, help with taking notes, and work assignments that are modified appropriately. Educators can read aloud test questions and answer choices or allow students with dyslexia to use alternative means of assessment. There are private schools and speech/language pathologists that specialize in providing dyslexia assessment and intervention.
Early intervention that specifically targets phonology, sound-symbol association, semantics, morphology, and syntax can significantly influence the language and literacy skills for children with dyslexia. By practicing structured language and reading strategies from an early age, dyslexia characteristics may be reduced or hardly recognizable. Older students can benefit by reading texts with an audiobook simultaneously. In addition, as professionals, it is important provide empathy and guidance for individuals with dyslexia.
As speech language pathologists, we can use the Orton Gillingham Approach when aiding a child with dyslexia. Using various speech techniques in cuing, the Orton Gillingham Approach includes multisensory, phonetic, sequential, repetitive, incremental, cumulative, individualized, and explicit strategies to help children with dyslexia. It is also important to note that using principles of structured literacy instruction is an excellent method to remediate language-based learning disability, reading disorders, and/or dyslexia. The five key elements in structured literacy are phonemic awareness, phonics, fluency, vocabulary, and comprehension.
Keep in mind that there are other multisensory reading approaches or programs to successfully remediate language-based learning disability, reading disorders, and/or dyslexia including Wilson Reading System, Barton Reading & Spelling System, and S.P.I.R.E. Reading Program. However, the structured literacy approach is the most effective multisensory approach for children who experience significant and unusual difficulty learning to read and spell printed words.
Research indicates that the majority of children learn to read best with direct and systematic language and literacy instruction in the key structured literacy areas of phonology, sound-symbol association, syllables, morphology, syntax, and semantics.
Dyslexia may impact various areas in the human system:
- Visual and/or Auditory
- Phonological Processing
Each child should be treated individually. For every area, each child experiences dyslexia differently. One may have co-occurring impacted areas, while some children may experience one or two areas of impact.
Visual symptoms may include an interrupted style of learning in pictures, diagrams, demonstrations, displays, handouts, films, etc. Auditory symptoms may include difficulty with the transfer of information through listening to verbal speech and discriminating/identifying letters and their corresponding sounds.
Phonological processing deficits include challenges with the sound structure of spoken words. Children will demonstrate difficulty distinguishing various sounds. It is a core deficit in processing the sounds of a language. For example, it may include the difficulty of pronouncing words, remembering names, identifying words or rhymes, segmenting sounds, blending sounds, and manipulating sounds essential for effective reading and spelling.
Spatial/sequencing symptoms can include a disruption in various senses that may combine in different ways such as orientation and/or sequencing.
Temporal symptoms involve uncontrollable emotions, language, and certain aspects of visual perception as well as orientation and/or sequencing.
Language symptoms include deficits in both spoken (expressive and receptive) and written language as well as how we process language.
Children with dyslexia and co-occurring ADHD and/or executive functioning disorder often demonstrate challenges with organizational tasks. Specifically, some children may experience difficulty with oral expression, handwriting, writing cohesive information, and/or completing everyday academic tasks with multiple steps. They need language scaffolding, visualization strategies, and metalinguistic strategies to break down large functional and curriculum tasks at school and home so they can complete them. They need practical strategies to improve their focus during the school day in order to listen attentively and learn curriculum content. Additionally, parents may seek guidance from a pediatrician, school psychologist, or neuropsychologist, regarding the possibility of medication management for ADHD symptoms.
Other co-occurring characteristics with dyslexia may include:
- Working memory weakness
- Processing speed weakness
- Social/emotional challenges
- Motivation difficulties
- Math difficulties
- Low self-esteem
Children with dyslexia are in every classroom in public and private schools. Therefore, it is imperative that they receive speech/language/literacy screenings, comprehensive evaluations, speech/language therapy, and special education services as deemed appropriate by trained professionals. If you have further questions, contact Building Successful Lives Speech & Language Services to inquire about consultative and direct speech/language/literacy services.
Building Language Skills: Pragmatics in School Aged Children & Adolescents
Communication is essential for everyday interactions. Individuals share information, ask questions, and develop connections with others at school, work, home, and in the community. Relationships and friendships are vital for a meaningful life. Therefore, it is important to build one’s pragmatic or social use of language. By enhancing these skills, children and teens will be able to form connections with other people from friendships to professional endeavors. Children and teenagers with language impairment, learning disability, and/or autism oftentimes do not have the linguistic skills necessary for effective communication. This may lead to social anxiety, limited social interactions, or difficulties in pragmatics. Socialization is important for one’s future career. For instance, with good pragmatics, a person can ace a job interview or conduct a thorough meeting with ease. A speech language pathologist can guide a child and adolescent to develop social language skills such as turn taking, initiating communication, maintaining topic of conversation, asking questions, processing emotions, displaying gestures, greeting people, talking to people appropriately across settings, etc.
Pragmatic Language Skills in Conversation Involves:
1. Social Greetings
When greeting a person, we use language differently than stating a demand. For example, someone greets a person by saying, “Hello, how are you?” A demand may look like this: “Take out the garbage, please.”
Make sure your child understands these conversational cues. Using a script can help your child understand the different uses in language.
2. Adjusting language based on the social situation or person in the conversation
If children are speaking with their friends, they typically may have their own language with them. However, it is important to teach children and teenagers to have respect when speaking with adults – using a different tone, higher vocabulary, politeness, etc.
If someone is visibly upset, it is important for the child or teenager to process emotions for any person. Perhaps, the child can ask the person, “What’s wrong?” or “What happened?” to their friends, family, and co-workers.
Practice this step with your child by using social stories to help your child to develop good functional communication skills and respect. In addition, friendly jokes and non-literal language can be introduced to your child to develop a better understanding of language.
3.Following the pragmatic rules of conversation
It is important for a child to practice his or her listening skills when engaging with others in a conversation. This means that a child cannot dominate or interrupt the conversation with his or her sole interests. In addition, practicing eye contact and kind facial expressions will help the child listen to one’s conversation. Also, it is important for the child to contribute to a conversation as well while staying on topic using relevant vocabulary. Practice these skills with your child by playing a game with turn taking or introducing new people to your child, so that he or she can develop his or her conversational skills. Remember, make your child feel safe that he or she can ask questions.
Clinicians may show videos of hypothetical age level social scenarios in conversations. Then, they can strategically provide intervention breaking down key pragmatic language elements. Next, speech/language pathologists and parents may role play conversations with children to build essential pragmatic language skills.
For speech/language pathologists, it is important to distinguish between Social (Pragmatic) Communication Disorder and Pragmatic Language deficits. This differential diagnosis may be difficult because many behaviors and symptoms overlap between Autism Spectrum Disorder and Social Communication Disorder. Did you know that Social Communication Disorder is a new diagnosis in the DSM-5? Individuals who have significant problems with verbal and nonverbal communication for social purposes that are not autistic or have low cognitive ability may have SCD. Characteristics must be present in early childhood and often contributes to difficulties with social relationships, academic achievement, or occupational performance. SCD can occur alongside other developmental issues such as language impairment, learning disability, speech sound disorder, and attention-deficit hyperactivity disorder. Speech language pathologists may review the details from APA here to adequately differentiate between Social Communication Disorder and Autism Spectrum Disorder (ASD):
Speech language pathologists often refer to the term Pragmatic Language Disorder in the school and private practice settings. This is a key language impairment for autistic children and adolescents. These individuals have difficulty with understanding the perspective of others, asking relevant questions, participating effectively in conversation with preferred and nonpreferred topics, and the three main areas outlined above.
Additionally, it is important to consider cultural differences with social use of language such as eye contact, initiating communication, and maintaining conversations. After considering sociocultural factors, clinicians may confirm that a disorder exists when pragmatic impairment occurs that are atypical for individuals from a similar linguistic and cultural background. It is always important to confirm language disorder vs. language difference.
Building Language Skills: Critical Thinking & Reasoning Skills in School Age Children & Adolescents
Many children and adolescents with language disorders have difficulty thinking critically and applying reasoning skills, which can make it difficult for them to make the right decisions. Linguistic skills are necessary for analytical thinking or adequate expressive language skills needed for higher-order language tasks. This requires comprehension of vocabulary, an ability to process language, background knowledge, and effective reasoning skills.
To answer more advanced language processing questions such as problem solving, comparisons/contrasts, cause and effect, reasoning, predictions, and verbal expressions of opinions and reasoning, visual supports can help aid a child with a language disorder to understand these skills with the use of prompts. Each child is different, and the skills that are most important for success in any field are the foundational skills.
Critical thinking is a fundamental skill for both language and literacy success. The following activities can influence a child’s thinking towards a deeper analysis of a literary piece:
- Compare and contrast
- Explain why things happen
- Evaluate ideas and form opinions
- Understand the perspectives of others
- Predict/infer what will happen in the future
- Think of creative solutions
- Understanding higher vocabulary
- Story sequencing
- Asking evaluative “wh” questions (what, when, where, and why)
For younger children with language disorders, it is important to use picture books to visualize what is occurring in the story. In addition, the speech language pathologist can look at their ability to comprehend the words, infer the message, and then use their language to navigate the situation. Ideally, the speech language pathologist can apply these strategies with middle and high school children with informational text at varied levels of difficulty and reading lexile levels. Additionally, it is important for the speech language pathologist to guide children and adolescents to work on metalinguistic awareness in speech/language therapy sessions. They need to develop language beyond concrete meanings.
If you are concerned with your child’s verbal reasoning skills, you should consult a speech language pathologist who has expertise in developing verbal reasoning skills. However, even if you are not concerned, practice verbal reasoning skills at home to build higher linguistic abilities. This will help your child improve their ability to understand their environment and use their language effectively in a variety of academic and social situations.
Speech language pathologists may use the Critical Thinking Progress Monitoring Tool to assess key areas including: inferences, problem & solution, cause & effect, compare & contrast, predictions, opinions & reasons. Access the digital download today.
Building Language Skills: Strategies for Compound and Complex Sentences
Language is comprised of sounds, words, phrases, and sentences. At all levels, language tends to be rule-based. Phonology refers to the rules of the sound system and the rules of sound combination. Morphology refers to the structure and construction of words. Morphology skills require an understanding and use of the appropriate structure of a word, such as word roots, prefixes, and affixes (called morphemes). Strong knowledge of grammatical morphemes, such as use of –ing for a present progressive verb, /s/ to indicate a plural form, and correct use of verb tense, is necessary to have well developed morphology skills. The content or semantics is the meaning behind the morphemes and words within a sentence – the literal meaning. How we convey semantics in our everyday speech and language is known as our pragmatic language such as conversational turns or the attitude of the speaker.
Syntax refers to the rules of word order and word combinations to form phrases and sentences. Solid syntactic skills require an understanding of the use of correct word order and organization in phrases and sentences with the ability to use increasingly complex sentences as language develops. This phenomenon can be difficult for a child with disabilities.
Children with morphology and syntactic deficits have trouble learning and using the rules that govern word formation (morphemes) and phrase/sentence formation (syntax). At the word level, these children may not correctly use plural forms or verb tenses. At the phrase or sentence level, children with syntactic deficits might use incorrect word order, leave out words, or use a limited number of complex sentences. For example, a child may omit prepositional clauses which decreases one’s use of complex sentences. It is important to target prepositions with one-step instructions such as stating, “Put the ball under the box.” In addition, locative prepositions can be targeted by presenting a descriptive photograph with many items, asking the child, “What is under the ___?”
Children with disorders of motor speech control are likely to have cooccurring difficulties with morphology related to impaired speech control. For example, a child with a motor speech disorder may not be able to produce /s/ and /z/. This limits the child in producing plural words. Disorganized and/or immature language in phrases and sentences is also seen frequently in children with motor speech disorders. Words may be omitted, or sentences simplified due to difficulty with speech production. Facial and tongue exercises can relieve the difficulty of speech production.
By introducing various sentence structures one at a time, it will be easier for the child to understand sentence structures. Begin with simple sentences, focusing on the subject and verb. A subject and verb together is the purest form of a sentence. Once the child understands this sentence structure, it is important to introduce adjectives. Children should be able to identify descriptive language words by pointing to objects and pictures, then they can learn to verbally express adjectives. Next, children can learn to construct various sentence structures (e.g. Article + Noun+ Verb + Adjective, Article + Adjective + Noun + Verb). There will be a variety of other simple sentence forms for children to learn to communicate. Once they have added a variety of expressive sentences consistently into their communication repertoire, a speech-language pathologist can introduce compound sentences to children with language disorders. Explain that a compound sentence has at least two simple sentences or independent clauses that can stand on its own. Phrases or dependent clauses are not included in compound sentences.
Then, introduce the mnemonic acronym FANBOYS: for, and, nor, but, or, yet, and so. These words mark the beginning of a phrase; they are also known as coordinating conjunctions because the words join two simple sentences. A speech-language pathologist can provide children with a verbal and written model of compound sentences (e.g. I went to the museum and I saw the dinosaur exhibit). Children can practice identifying compound sentences in children’s literature, rearranging provided words to construct sentences, and expressing compound sentences when provided with target coordinating conjunctions. Many children in elementary and even middle school need direct instruction during language therapy to master this linguistic skill.
Prepositions also indicate the beginning of a dependent phrase. During speech/language therapy practice, children can highlight prepositions and coordinating conjunctions in a dependent phrase to differentiate independent and dependent clauses. Once the child understands the difference between a dependent and independent clause, explain that a complex sentence contains one dependent clause (e.g. phrase) and one independent clause (e.g. simple sentence). A complex sentence often begins with a subordinating conjunction. The speech language pathologist can describe the mnemonic acronym AAAWWUUBBIS: after, although, as, when, while, until, unless, because, before, if, since to learn these types of conjunctions.
Compound-complex sentences are sentences with at least two independent clauses and at least one dependent clause. A compound-complex sentence combines both compound sentences and complex sentences together. An activity during speech/language therapy with middle school students, can be to highlight the dependent clauses, while underlining each independent clause. Remember each clause always needs an agreeing subject and a verb!
Many children and adolescents will benefit from learning the parts of speech that are essential for sentence construction. A speech-language pathologist may provide a quick vocabulary check to evaluate what parts of speech terms a student may already know. It is a good idea to provide a brief assessment that contains a word bank. Then, you should provide direct instruction to elementary and middle school students with examples containing the parts of speech. They can practice identifying the words in children’s literature and structured syntax activities. Additionally, picture description tasks are ideal activities for children to practice building compound and complex sentences. Here are a few language building resources to improve the syntax skills of children with receptive and expressive language disorders:
English/Language Arts Vocabulary Progress Monitoring
Parts of Speech Graphic Organizer
Guess What? Types of Sentences, Parts of Sentences, & Parts of Speech
No Glamour Sentence Structure
Guess What? Prefixes & Suffixes
Speech/Language Therapy Curriculum Assessments
Parent Tips to Build Functional Communication Skills for Preschool & School Aged Children
All behavior is communication. Functional communication is the first step towards gaining the most basic communication skills with your child in preschool. When a child expresses basic wants and needs, such as “I want” or “I need this,” they are expressing functional communication. Eventually, these words expand throughout the following years of development with simple sentences. Preschool children typically communicate on a simple sentence level using a variety of nouns, verbs, spatial concepts (e.g. in, on, under, next to), and qualitative concepts (e.g. adjectives). However, children with speech and language delays may produce words and sentences much later than expected for their age.
To work on functional language, a speech language pathologist can verbally model receptive and expressive language skills through play-based activities, everyday routines, and structured language tasks. The speech language pathologist can then coach parents on how to expand or lengthen a child’s speech utterances by adding vocabulary or more complex syntax or sentence structures. Additionally, the speech language pathologist can demonstrate to parents how to use language recasts or modify a child’s speech utterance by changing the type of sentence or voice. For example, if a child says a declarative statement, the parent can recast or change it into an interrogative or question sentence.
Here are a few play-based toys that parents may use to facilitate language growth with preschool children:
5. Sensory Toys
Here are a few selections from Lakeshore Learning. Click here
For nonverbal or minimally verbal children, parents also desire tips to attain the best possible results for building communication skills. With collaboration from the speech language pathologist, a parent may use the following to facilitate an increase in functional communication:
Sign Language: Nonverbal children can use simple signs to communicate wants and needs. This does not interfere with language acquisition.
Body Language and Gestures: Pointing is an early indicator of communication for children. Facial expressions also indicate communication whether it be through joy or sadness. For example, if you notice that your child is happy, you may state the following: “I notice that you are happy because you are playing with the toy.”
Picture Exchange Communication System (PECS): PECS allows a child to communicate through pictures of what he or she wants.
Low Tech or High Tech Communication AAC: A low tech AAC does not have voice output but can still assist a child in communication. It is an alternative/augmentative communication (AAC) device with pictures in which the child can point towards his or her wants or needs. High Tech Communication AAC device has voice output that may be recorded by the parent or speech language pathologist with core and other functional vocabulary.
As a parent, once you are aware of the optimal communication method of your child, depending on the level of the severity of your child’s communication skills, you can begin to choose new words to teach. Explaining new vocabulary words carefully in sentence examples can help your child understand the new words. You must model the new words and repeat the words many, many times. It may take some time for your child to understand the new word. Children in preschool and elementary school aged children must hear new words many times to learn the new vocabulary.
In addition to learning new words, try to expand the sentences of your child’s speech production. For example, ask questions pertaining to the subject of conversation. Use who, what, when, where, and how. Expand each sentence. You will be amazed with your child’s results and knowledge.
Description is vital for both preschool and elementary school children. Whenever you are going to a new place, describe the environment. Talk about the day’s activities or about your regular workday in the evening. In addition, talk about the books that you read together.
Reading is the most important element towards your child’s success. By improving one’s receptive language, your child’s understanding of language will flourish when reading with your child daily. Reading will also build your child’s vocabulary and help your child to utilize “context clues” to discover new words.
To further educate your child, take a look at these books for National Caribbean Heritage Month to learn more about the culture of the Caribbean Islands!
If you have any questions or comments, feel free to leave a message on the website.
Women’s History Language & Literacy Books
Women’s History Month originally began in California as Women’s History Week. The first week was celebrated in 1978 and purposefully coincided with March 8th or International Women’s Day that is sponsored by the United Nations. Each year, The National Women’s History Alliance selects a theme for the month. Since we are still in an ongoing pandemic, the organizers selected “Women Providing Healing, Promoting Hope” as the 2022 theme to honor frontline workers, women who work in the service professions, and women from diverse cultures who provide both healing and hope in their communities. You can learn more about that organization here.
This month is celebrated each March since the U.S. Congress passed Women’s History Month as a Public Law in 1987. Numerous women throughout the decades have committed their lives to service in various areas. Often times their contributions are overlooked and not celebrated as they should. You can learn more about the month on history.com.
Children and adolescents need to increase their understanding of non-fiction text. Consistent use of informational text is essential to remediating language impairment. They must be provided guided practice opportunities to increase linguistic skills using engaging and higher level content. Therefore, Women’s History Month is an ideal theme to use meaningfully during speech/language therapy sessions. I recommend the following six books to use with students with communication disorders, language disorders and learning disabilities.
Herstory 50 Women and Girls Who Shook Up the World by Katherine Halligan
This book is a new addition to my speech/language library this year. Children and adolescents will have an opportunity to learn interesting facts about a wide variety of women. The illustrations depicted in the text are bold and vivid. You can select women that relate to the 2022 theme of providing healing and read aloud information about Florence Nightingale, the founder of modern nursing, to children with language disorders. She was born in Florence, Italy and then her family moved back to England. From a young age, she had a desire to become a nurse and provide vital assistance to others. She worked in a London hospital, cared for soldiers during war time, and even started the Florence Nightingale Training School for nurses in 1860. She was the inspiration behind the creation of the International Red Cross, a humanitarian organization that exists in over 192 countries today. Mary Seacole is another historic woman that made a significant contribution to society. She was born in Kingston, Jamaica and was a nurse, writer, and war hero. She learned many of her nursing skills from her mother who was a traditional healer and cared for injured soldiers in a boarding house. She traveled to various countries in the Caribbean, Central America, and England. She was instrumental in ending the cholera epidemic in Jamaica and a yellow fever outbreak. During the Crimean War, she went to England and treated soldiers where she earned the name “Mother Seacole.” These are two of many women that were positive contributors to our global society that are highlighted in this excellent book.
Speech/Language Targets: Language Memory- verbally communicate 3-5 facts, Vocabulary- define tier 2 vocabulary
The Power of Her Pen, The Story of Groundbreaking Journalist Ethel L. Payne by Lesa Cline-Ransome
This book is about Black journalist Ethel Payne who documented events as they unfolded during the civil rights era and beyond. She was a national television and radio commentator. Ethel was the first Black woman to join the White House Press. She traveled overseas and reported in various international affairs during war time and diplomacy negotiations. She was known for asking challenging questions that many did not want to pose and was given the title “First Lady of the Black Press.” This book is appropriate to read aloud to children in 4th-grade through middle school level. It is written at a fifth grade reading level with a lexile of 1010. Lexiles are a measure of text complexity. You can learn more about that here.
Speech/Language Targets: Listening Comprehension- answer literal wh and how questions, Language Memory- verbally communicate 3-5 facts, Vocabulary- define tier 2 vocabulary using sentence/paragraph context
Malala’s Magic Pencil by Malala Yousazai
This is a timely book about young activist, Malala Yousazai, who desires for children to find their voice and use it to create a better world. She is a strong advocate for education for girls and helping those in need. Malala lived in Pakistan where girls were not allowed to seek higher education. She spoke out against oppressive practices. She currently resides in Birmingham, England. Malala later was awarded a Nobel Peace Prize for her dedication as a female education and humanitarian advocate. What if we had the magic to find solutions to life’s most pressing global issues? What if we can truly make a difference? This book is deliberately written from her perspective. Did you know that there are over 130 million girls who do not attend school? Malala Yousazai’s organization, Malala Fund, has the mission of enabling girls to learn and lead.
Speech/Language Targets: Listening Comprehension- answer literal and critical thinking questions, Language Memory- verbally communicate 3-5 facts, Vocabulary- define tier 2 vocabulary from sentence and paragraph context
Elizabeth Leads the Way, Elizabeth Cady Stanton and the Right to Vote by Tanya Lee Stone
This biography is about the life of Elizabeth Cady Stanton. It has a 3rd grade lexile level (700 L), but can be read aloud in speech/language therapy to children in 2nd-5th grade. As a young girl, she often heard that boys were able to do more things than girls. She lived during a time when girls and women did not have equal rights. Her father was a judge and she learned that women could not even own property and even if their husbands died, they would lose the property and land where they lived. Elizabeth wanted to change these unfair laws and she desired for women to have the right to vote. I like the author’s note that is provided at the back of the book that provides additional facts about Elizabeth’s life. Did you know that she ran for congress in 1866? She was the creator of the National Woman Suffrage Association with Susan B. Anthony. She served as the president of the organization for 21 years. In 1920, 18 years after she died, women finally were legally provided the right to vote with the Nineteenth Amendment to the U.S. Constitution.
Speech/Language Targets: Listening Comprehension- answer literal and critical thinking questions, Language Memory- verbally communicate 3-5 facts, Vocabulary- define tier 2 vocabulary
Women in Science, 50 Fearless Pioneers Who Changed the World by Rachel Ignotofsky
This is another wonderful recommendation that has valuable non-fiction passages. Speech language pathologists can read aloud the passages to children and adolescents with communication disorders, language disorders, and learning disabilities. I think this book is ideal for children in 4th-8th grade. They will learn about phenomenal women in the scientific community who made contributions in research, medicine, science, technology, and engineering. Some of the women included in this book include Rosalind Franklin, a scientist who discovered DNA, Katherine Johnson, a mathematician who calculated the trajectory of the Apollo 11 space shuttle to the moon, and Ada Lovelace, a computer engineer. The majority of the information in this book will be new knowledge for most students.
Speech/Language Targets: Listening Comprehension- answer literal and critical thinking questions, Language Memory- verbally communicate 3-5 facts
Little Dreamers Visionary Women Around the World by Vashti Harrison
This is an excellent book by Caribbean American author, Vashti Harrison. I added this book to my speech/language therapy library last year. The author purposefully selected amazing women from around the world from different cultures and wrote brief biographies with accompanying illustrations. Children and adolescents can learn about Marie Curie, Physicist and Chemist, who was awarded the Nobel Prize in Chemistry and for contributions in medicine. Did you know that she invented a portable X-ray machine that was used during World War I? They can learn about Katherine Dunham, choreographer and anthropologist. She studied how the roots of African culture spread around the world and the contributions of dance from the African diaspora. She founded the Dunham School of Dance and Theatre in the U.S. She combined African and Caribbean movements with modern and ballet dance forms. Katherine is known as the Matriarch of Black Dance and the Dunham Technique is still taught today. There are over 50 women featured in this book so that you can easily differentiate instruction based on the content presented and students’ interest. I often provide children choices of influential women to learn about during speech/language sessions.
Speech/Language Targets: Listening Comprehension- answer literal and critical thinking questions, Language Memory- verbally communicate 3-5 facts
Have you used these books in speech/language therapy? What are your favorites?
Tamara Anderson, M.S., Ed.S., CCC-SLP
Speech Language Pathologist
Diversity & Equity Advocate