Identifying Language Disorders in Young Children: Looking Past Second Language Issues

Working in multilingual environment such as Hong Kong can make it difficult for Educational Psychologist’s or other professionals to diagnose language disorders. Many children will show difficulties understanding language (receptive) and using language (expressive) during early childhood. Language difficulties are most apparent during pre-school and early school years and can persist into adult life. When a child has difficulty understanding and using language it may have a negative effect his or her social, emotional and academic development. The problems associated with understanding and using language are often categorised as language delay or language disorders. A child with a specific developmental delay in expressive and/or receptive language skills has a difficulty which is not associated with learning disabilities (UK terminology) or mental handicap (North American terminology) autism or sensory disorders such as deafness. In other words, the child’s development in other areas such as motor, social, non-verbal cognitive, self-help and academic areas is at or near age appropriate levels. However, children with specific language disorder may show difficulties in socialisation, behaviour, attention/concentration and acquisition of academic skills. Impairment in acquisition of basic literacy skills (reading and writing) is sometimes associated with language disorders.

There are a variety of possible causes for language disorders/delays, but the exact cause may be unknown. In many cases there may be a family history of similar difficulties. An overview of stages of language development which the majority of children reach by a specified age is included in at the end of this article. If your child has not reached these milestones there is cause for concern and assessment by relevant professionals such as Audiologists, Physicians, Psychologists and Speech Language Therapists is recommended. Parents may sometimes have the following thoughts or comments with regard to a child with apparent language delay:
l “That’s just his baby talk. I’m sure he will outgrow it”

l “Everyone in our family was a late talker. My child will talk when the time is right. He has been spoilt by his grandparents and sisters and often doesn’t have to use speech to communicate as everything is done for him”.

l “He has been exposed to many languages, so how can he be expected to have really good skills in only one”

Many parents have similar thoughts or comments. Usually there is concern about a child’s speech and language skills if there is no use of language by age 1 year, or if speech is not clear, or if speech or language is markedly different from that of other children of the same age.

Some children demonstrate difficulty producing speech sounds (articulation) along with language difficulties or their language is appropriate but their articulation is in need of development. Speech articulation requires the correct pronunciation of sounds to form words. It is not uncommon for young children to have difficulty producing specific speech sounds. Specific sound development is often related to the child’s chronological age and may not be a problem. If your child is difficult to understand or you are concerned about his or her speech development again an assessment by the relevant professionals mentioned above is recommended. Articulation problems and delayed language development can occur simultaneously.
Language Development Overview

Age Language Skill

1-2 months Cooing, Gurgling, smiling in response to stimulation. Startles and looks in response to loud sound.

3-6 months Babbling appears. Gurgles and laughs, calls out for attention. Turns toward speaker or ringing bell.

6-9 months Babbles double syllables: Mama, Dada. Imitates some consonants and inflection. Looks at objects and pictures when named.

9-11 months Babbles more extensively. Imitates sound sequences (echolalia). Preverbal communication gestures appear: Points, waves bye-bye, shakes head no, play peek-a-boo and pat-a-cake. Reaches to be lifted up. Reaches for an object. Understands and responds to his own name. Understands the word “no”.

12-18 months First true words appear (10-18 months): 3-20 word vocabulary. Words may not be clear. Word type is often noun. Frequently occurring first words are Mama, Dada, cookie, bye-bye, no. Uses jargon (syllables strung together into well-inflected ‘sentences’). Babbling and echolalia diminish. Highly communicative via gestures, words, and vocal play. Communications to request, protest, comment, greet, call, and show off. Follows simple instructions. Points to two or more objects. Identifies one to two body parts.

18-24 months Two-to three-word phrases appear usually when the child has acquired approximately 20 single words. Examples of typically appearing early phrases are More milk, Dada, bye-bye, Doggie all gone. Names five pictures by 24 months. Says own name. Negation (no bottle), possession (Mommy chair), and verbal turn-taking are used. Questions are indicated by inflection and intonation. Approximately 200 word vocabulary. Likes to listen to stories.

2-2 1/2 years Uses three-word phrases such as My big truck or See Daddy car. Uses at least two pronouns, -ing verbs, plurals, articles a, and early prepositions (in and on). Uses 400 words by age 2 1/2. Beginning to use descriptive language. Answering what and where questions. Listen to 5-10 minute story. Follows two related commands.

2 1/2 – 3years Asks basic questions. Uses pronouns I, me, you and mine with he, she and it emerging. Possessive s, is, and regular past tense is used. Not is emerging. Answers who, why and where questions by age three. Points to 10 use-objects (Show me the one that you eat with). Comprehends size (big and little) and 3 prepositions (in, on, under). Uses 500 words.

3 1/2 years Uses most parts of speech in short, correct sentences, combining four to five words. For example, he’s going to open this or I jumped over the sprinkler. Asking who, whose, why, and how-many questions and using and. Third-person singular and irregular plurals are emerging. Understands command involving two objects or two actions. Uses polite forms. Maintains topic over several conversational turns.

4years More conversational; fewer grammatical errors. Uses many four-to seven-word sentences. Asks how when, why questions. Uses conditionals and because. Can sequence a simple story with events but lacking character and theme. Complies with commands involving three actions. Able to complete simple verbal analogies such as a daddy is big, a baby is…(3 1/2 – 4 years).

5years Average sentence is 5-8 words. Asks word meanings. Defines words. Tells long stories. Use will for future (4 1/2 – 5). Grammar sounds like that of rest of the family. Using figurative language.

Note: Individual Variability exists. Ages are approximate.