Banter Speech & Language

Sydney speech pathologists helping adults and children speak for themselves.

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Is your child struggling to read? Here’s what works

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On reflection, I’m incredibly lucky.

Both my parents were teachers. Growing up, my house was full of chatter, stories and books. My early state school education in regional Victoria was long on “old school” phonics and short on fads.

I learned to read without much trouble. I discovered many of the things I’m still passionate about in life – dinosaurs, planets, social justice, travel, speech and language, consumer rights, history, current affairs, philosophy, and bad science fiction – because I could read. Reading lets me learn new skills, explore the world, entertain myself and my kids, connect with friends and colleagues, and of course, earn my living as a speech pathologist and lawyer.

Children and adults who struggle to read miss out on many of the opportunities good readers take for granted. Helping people to learn to read is important work – far too important to waste time, energy and money on false ideas and programs that don’t work.

In this article, we summarise some of the key evidence-based principles to help children (and adults) to read. We also include links to peer-reviewed evidence, leading researchers’ websites, and some evidence-based literacy programs and resources.

12 principles I apply

A. Learning to read is a right, not a privilege 

1. Reading is a human right, and affects your health, work opportunities and life-participation.

  • The General Assembly of the United Nations is convinced that: “[L]iteracy is crucial to the acquisition of every child, youth and adult, of essential life skills that enable them to address the challenges they may face in life, and represents an essential step in basic education, which is an indispensable means for effective participation in the societies and economies of the 21st century.” (GA Resolution 56/116.)
  • Low literacy may impair health, affecting the patient-doctor communication dynamics, and leading to substandard medical care. It is associated with poor understanding of written or spoken medical advice, adverse health outcomes, and negative effects on the health of the population (e.g. AHRQ Report, see below).
  • Early reading difficulties are related to children’s ability to develop positive social skills (e.g. Bennett et al., 2003).
  • Academic problems, like poor reading, often foster behavioural problems, which frequently result in disciplinary practices that remove the student from school (Christle et al., 2005).
  • Low levels of literacy affect educational attainment and labour force participation (ABS, 2009).

2. Learning to read opens doors; poor reading ability closes them. Literacy creates opportunities for lifelong learning and training, a good job, housing stability and improved health across your life (Gakidou et al., 2010). (Not being able to read has big negative effects on school achievement, job opportunities, mental health and participation in society.) Arguably, reading is more important than ever, with most jobs in the West now requiring literacy (e.g. Murnane, 2004), and with access to the Internet, social media platforms and even texting friends requiring a degree of literacy to participate socially (e.g. Durkin et al., 2011).

B. Reading instruction should be based on independent, peer-reviewed evidence (not ideology), and should take the client’s socio-economic background and oral language skills into account

3. Reading is “biologically unnatural“. Humans have only been reading since about 3000BC (Fischer, 2001). Unlike speaking, you have to learn to do it (e.g. Gough & Hillinger, 1980). That’s why literacy is still not universal (e.g. Gough, 1996). While it’s true some kids find reading easy to learn, others need a lot of help.

4. Reading instruction should be based on the “Five Big Ideas” (aka the “Big Five”). Independent, peer-reviewed scientific research evidence reviews (cited below) say that, to learn to read, you need to be taught these “Big Five”:

  • Phonemic awareness (also known as phonological awareness): knowledge about the sound structure of the language and the ability to manipulate the sound making up that structure (Rayner, Foorman, Perfetti, Pesetsky, and Seidenberg, 2001).
  • Phonics: see below.
  • Vocabulary: it’s been estimated that, to cope with the curriculum, a Year 2 child needs to understand 300-400 words; a Year 3-4 child needs to understand 3,000-4,000 words; and a Year 5 student needs 10,000! (Hempenstall, 2005).
  • Comprehension skills.
  • Reading fluency.

5. As one of the Big Five, direct synthetic phonics instruction is essential. In the USA, Australia and the UK, independent evidence reviews affirmed the need for systematic, direct and explicit phonics instruction so that children master the essential alphabetic code-breaking skills required for foundational reading proficiency. (The importance of teaching teachers to do this was recognised by the New South Wales Board of Studies in 2015 – New South Wales Board of Studies, Teaching and Educational Standards. (2015).)

The best phonics to teach children is “synthetic phonics“. Synthetic doesn’t mean “fake”, here; it means “synthesising” (or blending) the sounds (phonemes) together to read words. You can read an excellent explanation of “synthetic phonics” by some of my favourite literacy researchers here.

6. It’s a myth that you can’t use phonics to read English words. In fact, according to Hanna et al., (1996):

  • 50% of English words are directly decodable with synthetic phonics;
  • 36% have only one “breach” of the sound-letter link (usually a vowel);
  • 10% can be spelt properly if morphology and word histories/roots are taken into account; and
  • only 4% are truly irregular.

7. Oral language skills (talking and understanding) and reading skills are linked; oral language and reading skills are mutually beneficial. Improvements in spoken language skills improve reading skills, and vice versa. Oral language and reading skills piggy back on each other during the school years (Snow, 2016). If one is impaired or delayed, the other suffers. For example, children with speech-language language disorders (diagnosed or not) are at a high risk of having reading problems.

Similarly, children with reading problems may have problems learning new words and higher level language skills, which then affect their oral language development. (This, by the way, is why I screen oral language and phonological awareness in addition to decoding and reading comprehension when assessing a school-aged child with reading problems.)

8. Kids learn to read on an uneven playing field. Socio-economically disadvantaged children are at greater risk of language and reading difficulties than children from higher socio-economic backgrounds. Even though oral language development is biologically natural, it’s vulnerable to environmental factors. For example, the foundations of early language development (and the emergence of emotional security) both depend on a high dose of quality carer engagement. By the age of 4 years, on average, children of high income, professional parents may have heard 30 million more words than some children from a socio-economically disadvantaged background (e.g. Hart & Risely, 1995).

Different children have very different levels of exposure to language and books when the turn up for their first day at school. Unsurprisingly, this has knock-on effects for readiness to learn to read (see the discussion about the Matthew Effect below).

C. Evidence-based reading instruction for young struggling school-aged children is urgent: the critical 3-year window to teach children to read well

9. The 3-year learning-to-read “window”. In the first three years at school, the focus is on helping children learn to read. This is when good evidence-based reading instruction is most important. Your child’s access to good reading instruction in this period is important for all children, and vital for children from low-socioeconomic backgrounds and children struggling to read.

10. The “fourth grade slump”. Starting in the fourth year of school, the focus of the curriculum switches away from learning to read. Instead, children are expected to “read to learn”. For good readers, this is no problem. For poor readers, this is where the real trouble begins:

  • By the fourth year of school (year 3), a child’s performance relative to his/her peers becomes fairly fixed (Spira et al., 2005);
  • your child’s reading level by the start of the third grade is a good predictor of:
    • later academic achievement; and
    • later mental and social health; and
  • the “Matthew Effect” kicks into high gear.

11. The Matthew Effect. With reading (as with money), the rich get richer, and the poor get poorer. Good readers read more, learn more word meanings and then improve their reading skills. Children who are poor readers read less, and don’t learn new words as quickly, which further slows their growth in reading ability (Stanovich, 1986). As school progresses, the gap between good and poor readers grows and grows and grows.

That’s not to say that older kids and adults can’t learn to read. It’s just that it’s harder. As with language difficulties generally, the earlier you get help, the better. But it’s never too late!

D. Too many children and adults can’t read properly

12. Literacy levels are a big problem in Australia:

  • In 2011, a quarter of Australian Year 4 children are below the expected standard in reading; and 7% performed “extremely poorly” (ACER, 2012).
  • In 2009, 43.7% of adults were at or below Level 2 in their reading skills on a 5 point scale (ABS, 2009).
  • In 2011, the Industry Skills Council of Australia  found that millions of Australians have insufficient language, literacy and numeracy (“LLN”) skills to benefit from training or to participate effectively at work (ISCA, 2011).

The human, social and economic costs of low literacy are enormous.

E. So what gets in the way?

A controversial question!  Here are some candidates:

  • Professional divides: An unhelpful divide exists between the knowledge bases and expertise of teachers, speech pathologists and education psychologists. Teachers are educators, whereas psychologists and speech pathologists are health professionals. Reading failure is of course both an education and health problem. But the lack of coordination between different professionals doesn’t help clients with reading problems or their families. When I work with a school-aged child, my first port of call is the parents. My second port of call (with parents’ consent) is to teachers and any health professionals who’ve worked or are working with the child. The more we can coordinate our care and approach, prioritising the client’s interests and goals, the better things tend to go.
  • Ideological squabbling. If you’ve got a day or two to waste surfing the Internet and getting confused at all the navel gazing and self-interest, Google “Reading Wars”. In short, the “war” was fought between supporters of:
    • a phonics- and phonemic awareness-based approach to reading instruction, focused on letter-sound links and blending sounds to read words; and
    • so-called Whole-Language theories, based on post-modern theories of child development, teaching children to read words from “cues”, like context and pictures in predictable texts.

Although it was hoped that the independent reviews in the USA, UK and Australia (cited below) resolved the “reading wars” in favour of phonics and the rest of the Big Five, there are still programs influenced by Whole Language philosophies used today, including the much-maligned “Reading Recovery” program (which you can read about here). In any case, the key casualties of the war were and continue to be children failing to learn to read.

  • Inadequate training in the Big Five (and the “Peter Effect”). You can only give what you have; and you can only teach what you know. If you haven’t been taught properly how to teach reading using evidence-based teaching methods, you will have great difficulty teaching school children to read – especially struggling students. Unfortunately, some teachers, speech pathologists and psychologists haven’t been trained in how to teach reading using the evidence, especially if their University lecturers subscribed to the Whole Language ideology. Any education or health professional engaged in helping people to read should have training in how to teach the Big Five.
  • Commercial programs unsupported by independent evidence, glossy products and fads. Unfortunately, there is a big market for children and adults with poor literacy in Australia and elsewhere. Lots of reading programs seek to “exploit” this market, and some of them have no evidence to support their effectiveness. Of course, it’s hard for parents (and even some teachers) to know which ones are evidence-based. Fortunately, there are independent research groups that publish evidence summaries to assist. In our clinic, for example, we only use evidence-based programs based on the Big Five.

Whatever the reasons, we should all strive to read and apply the best quality, independent evidence to better support school-aged children, young adults, and adults with reading problems.

Related articles:

Principal source: Snow, P.C. (2016). Elizabeth Usher Memorial Lecture: Language is literacy is language – Positioning speech-language pathology in education policy, practice, paradigms and polemics. International Journal of Speech-Language Pathology, 18:3, 216-228. (This article should be mandatory reading for any teacher, speech pathologist or education psychologist working in literacy.)

Further reading

Reading as a human right that affects your health:

US AHRQ’s Evidence Report No. 87, Literacy and Health Outcomes (summary) 

Evidence for what works, including evidence supporting the Big Five:

Rose, J. (2006). The [UK] Independent Review of the Teaching of Early Reading (aka “The Rose Report”)

Evidence that too many children and adults in Australia are poor readers:

Thomson, Sue; Hillman, Kylie; Wernert, Nicole; Schmid, Marina; Buckley, Sarah; Munene, Ann (2012). Monitoring Australian year 4 student achievement internationally: TIMSS and PIRLS 2011. Melbourne: Australian Council for Educational Research (ACER).
Australian Bureau of Statistics (2009). Adult Literacy.

Industry Skills Council of Australia (2011). No More Excuses.

The role of speech pathologists in the development of literacy:

Speech Pathology Australia. (2011). Position Statement: Literacy.

On the shoulders of experts: evidence-based literacy researchers, organisations and blogs I follow: 

If you are interested in the science of reading and evidence-based reading programs and resources, here are some of the key experts, organisations and literacy/language blogs I follow closely (in no particular order):

Toe By Toe

Image: http://tinyurl.com/z3rgm3u

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

My child is learning two languages: what do I need to know about bilingual development?

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More than half of my clients are growing up in homes where English is not the first or only language. I think it’s a great thing. Bilingualism is a tremendous asset living on this increasingly connected planet. We need more of it in Australia.

But there’s a catch: with bilingualism comes a whole host of worries and concerns about what is best for a child’s language development.

All families I work with want the best for their kids. But there is so much conflicting information out there about bilingual language development. Some of it is based on old ideas. Others are myths that are not supported by the evidence. This makes it hard for parents to make informed decisions about important issues for toddlers and pre-school children.

At least once a week, I’m asked for my views on questions like these:

  • Will my child get confused between the two languages?
  • Should one parent should speak the “home” language, and the other parent speak English?
  • Should parents speak to their child in English, even if they are not fluent themselves?
  • Should parents send their child to an English-speaking pre-school or daycare centre before school?

So here’s what the peer-reviewed research evidence says:

1. Parents should speak their native language with their children

  • As noted above, bilingualism is an asset – not a liability.
  • Many parents want to maintain their cultural heritage. Language is an important part of that heritage.
  • For parents who cannot speak English fluently, speaking broken English to a child may do more harm than good. It is much better for the child to hear a language being spoken fluently, especially in the early years.
  • Children from homes in which the first language was in addition to English show stronger cognitive outcomes than children from immigrant homes in which only English was spoken (Winsler et al., 2014).
  • There is some evidence that higher order language comprehension and literacy skills transfer from one language to another. For example, children who are good at reading in one language tend also to be good at reading in English (Oller et al., 2002, although it’s worth noting that the languages studied in this study were both European).
  • There is some evidence that interventions to help a child read in their first language can have positive effects on the child’s reading in English (Goldenberg et al., 2011).
  • There is evidence that immigrant families who can speak their parents’ native language have better family relationships and stronger ethnic identities that those who cannot, and that good family relationships and strong ethnic identity are positively related to other outcomes including academic achievement (e.g. Oh & Fuligni, 2010, Tseng & Fuligni, 2000).

2. There is no “one-size fits all” approach to raising bilingual children

Home differs in:

  • the balance of languages;
  • the number of speakers who use each language;
  • the proportion of each language that comes from native speakers;
  • how much adults talk and read to children;
  • the number and age of the children in the household; and
  • the complexity of language used.

Bilingual children who attend school tend to use their first language at home and English at school and outside the home. Young bilingual children with siblings at school are likely to have more advanced English and weaker native language skills than children the same age without older siblings. Childcare arrangements are another source of variability in language development.

In short, bilingual children are extremely varied in their levels and profiles of dual language skills.

3. Speaking two languages at home does not confuse children. Children can learn two languages at the same time

  • Back in the 1990s, people thought that speaking two languages to your children would confuse them. We now know that’s wrong.
  • Infants are good at distinguishing languages. If they hear two languages at home, they develop two separate systems for speech sounds, words and word meanings, and grammar. Of course, the languages influence each other. But kids don’t get confused (e.g. Byers-Heinlein et al., 2010; Werker, 2012, Lin & Johnson, 2010).

4. Languages do not need to be kept separate for children to learn them

  • I often hear people say that one-parent should speak the home language and the other should speak English. There is no evidence to support this idea.
  • Studies show that the degree of mixing languages is not related to the children’s skills in their home language or English (e.g. Place et al., 2011, Hoff et al., 2011).
  • There is no evidence that mixing languages at home stops children from realising they are hearing two languages or acquiring them. However, there is some limited evidence to suggest that parents should try to avoid mixing up the languages within individual sentences/utterances when talking with 18-month olds (Byers-Heinlein, 2013).

5. Learning two languages takes longer than learning one

This seems obvious. But there were some small, early studies that suggested that bilingual children acquire two languages at the same rate monolingual children acquire one. (e.g. Pearson et al., 1993). This view may have contributed to the over-diagnosis of language learning impairment in bilingual children.

We now know that bilingual children lag slightly behind monolingual children of the same age in their vocabulary and grammatical development when measured in each language separately (e.g. Bialystock & Feng, 2011, Gathercole & Thomas, 2009, Marchman et al., 2010, Vag et al., 2009).

We also know that bilingual children’s phonological (speech sound) skills and narrative skills are closer to monolingual levels than their vocabulary and grammar (Oller et al., 2007; and Paradis & Kirova, 2014). This is why I always test narrative ability and screen speech sounds when assessing bilingual children for possible language learning impairments.

Compared to monolingual children, it’s more common for bilingual children’s receptive language abilities (understanding of language) to be significantly stronger than their expressive language skills (Ribot, 2014).

6. It can take a long time for bilingual children to “catch up”

In grammar, if bilingual children are exposed to continued, consistent and quality exposure to two languages spoken fluently, they tend to catch up to monolingual children by the age of 10 years (Gathercole & Thomas, 2007).

Even adult bilinguals tend to have smaller vocabularies in each of their languages than monolinguals, although there are obviously exceptions. The size of the vocabulary gap diminishes with age (Hoff et al., 2014).

7. Bilingual children often score within the normal range on language tests in their “dominant language”

Diminished exposure to a language affects language acquisition. Two-year olds with a balanced input of two languages lag significantly behind monolinguals in each language. Children’s skills in each language are significantly related to the proportion of their input that is in that language (Hoff et al., 2012; Pearson et al., 1997).

There is some evidence that even 80% exposure to one language is not sufficient to reach the level of a typically developing monolingual child (DeAnda et al., in press). However, although learning two languages takes longer than acquiring one, it does not take twice as long.

8. Bilingual children can have different strengths in each language

For example, bilingual children:

  • may know words to do with things at home in their first language;
  • may know words to do with things for school in English; and
  • may have equal comprehension in each language, but better expressive language skills in one language – hence the commonly seen receptive-expressive gap in young bilingual children (e.g. Gibson, et al., 2012).

9. The quality and quantity of bilingual children’s input in each language influences their rate of language development in each language

  • Children develop language more rapidly in the language they hear more (e.g. Hoff et al., 2012).
  • As children’s relative levels of exposure change, language skill levels change as well. For example, young children who start going to a high quality English-speaking childcare centre, tend to improve their English skills, although the quality of the input is just as, if not more, important than the quantity (e.g. Grüter et al., 2014).
  • In theory, the use of a varied vocabulary, complex and varied syntax and child-centred speech in a language should be positive predictors of a child’s growth in that language. Evidence suggests that exposure to a language in interactive book-reading with fluent speakers supports language growth, but passively watching TV in a language isn’t as helpful (e.g. Rowe et al., 2012; and Patterson et al., 2004).
  • Hearing a language from several different speakers is more supportive of language development than the same number of hours of language exposure from a few speakers (Place et al., 2011), though we’re not sure why.
  • Interestingly, even in families where the parents are fluent in English, there is evidence that when parents talk with their child in their native language, they use a more diverse vocabulary than when they talk to their children in their second language (Hof et al., 2013).
  • Exposure to English outside of the home through friends and organised activities and also through media is a significant predictor of language growth in English (Pardis, 2011).

Bottom line

Giving bilingual parents practical advice about their child’s language development is difficult. Parents face real challenges for which there are often no easy solutions.

Acquisition of a heritage language is a legitimate goal and has many benefits for the child, the family and society as a whole. Acquisition of strong English skills by school entry is also an important goal, which is hard to attain if the parents don’t speak fluent English themselves.

In countries like Australia, where English is the dominant language, we know that poor English skills at school entry places a child at increased risk for school failure (e.g. Han, 2012). The weight of data to date suggests that young bilingual children who will attend an English-speaking school in the future should:

  • speak with their parents in a language or languages in which their parents are fluent (rather than broken English); and
  • if possible, be exposed to English outside the home, preferably spoken fluently by native speakers, in the toddler and pre-school years.

An optimal environment for English language development is exposure-rich, grammatically varied English of the sort spoken by educated, native English speakers. As a society, we are a long way from being able to offer this to bilingual children from all cultural and economic backgrounds. But that’s what we should shoot for. Interactive technology may make this easier to achieve. But nothing is as good as face-to-face human interaction which, after all, is the basis of language development.

Related articles:

Principal source: Hoff, E., & Core, C. (2015). What Clinicians Need to Know about Bilingual Development.  Seminars in Speech and Language, 36(2), 89-99.

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Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

Let’s cut to the chase: when should I seek help from a speech pathologist for my child?

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Speech pathologists help people with communication problems. But many of us are not very good at explaining what we do in Plain English:

  • We use too many long, pointless words.
  • We call ourselves different things in different countries.
  • We can’t agree on what to call some communication impairments.

And we’re not alone. Psychologists, doctors and psychiatrists use different words and phrases to talk about communication issues. It’s not always clear whether we’re all talking about the same thing.

This is a big problem: it’s confusing to people and families who need help.

There’s an urgent need for speech pathologists to give people better information about common communication impairments. In this article, we answer some questions about speech pathology and common communication problems.

We want to help you understand what we do and how we can help.

1. Are speech pathologists, speech therapists and speech-language pathologists the same thing?

Yes.

2. What do speech pathologists do?

Most speech pathologists help people with communication impairments. Some of us also help people with swallowing and feeding impairments.** An impairment is a disability.

3. What does “communication impairment” mean?

To survive and to take part in society, we need information: facts and knowledge. One way we get and pass on information is by communicating with others. Communication means sending information to, and receiving information from, others.

Some people have problems sending and/or receiving information. We call these problems communication impairments.

4. What are the most common communication impairments?

Developmental language disorders and speech sound disorders. They affect about 5-8% of pre-school children. If untreated, they can lead to lots of problems including with behaviour and social interaction, reading and writing, school and work success, and mental health.

(a) Are language and speech the same thing?

No.

One way we communicate with other people is through language. Language is understanding and using words and sentences to receive and to send information. We can do this by speaking and listening, reading and writing, or by sign-language. Language includes:

Speech means using our voices to make words and sentences. Speech involves both language skills and motor skills (using nerves, muscles and body parts to make speech sounds). For example, to say “banana” we need to coordinate our breath, vocal chords, lips, soft palate, jaw, tongue and teeth to articulate the three “beats” – ba-na-na – in a way that others can understand.

You can have good language skills, but impaired speech skills. For example, you might be able to write or sign fluently, but not be able to speak clearly.

(b) Developmental language disorders

These are problems understanding and/or using language to communicate with others.

Confusingly, speech pathologists and others can’t agree on a single name to call it. Different people in different places use different terms, e.g.

  • language delay;
  • language disorder;
  • specific language impairment;
  • language learning impairment; and
  • developmental dysphasia (or aphasia).

All these names have their pros and cons. In line with recent academic and professional efforts to reach agreement, we prefer the term “developmental language disorders”.

(c) Speech sound disorders

These are problems saying speech sounds correctly and being understood. If strangers can’t understand your child’s speech, they might have a speech sound disorder.

Speech sound disorders include:

  • not being able to say some sounds. You can read more about when children are expected to be able to say different consonants here;
  • developmental and unusual error patterns called “phonological processes”. You can read more about 10 common error patterns here; and
  • articulation problems, like lisps. You can read more about lisps here and here.

5. When should you see a speech pathologist about your child’s speech-language development?

When any of the following is true:

6. How do speech pathologists assess communication impairments?

Speech pathologists should get their information from more than one place to make sure they understand the scope of the problem and its effects:

Speech pathologists should look at two things when they assess people with language or speech problems:

  • the skills that are impaired; and
  • the effect of the person’s communication impairments on their participation in the real world.

These are different things. For some people, a minor impairment (e.g. a lisp) can have a big impact on their quality of life. For others, even a severe communication impairment may not cause many problems.

7. What communication skills do speech pathologists assess?

Often, speech-language assessments are done in stages. We look for the big issues first, then zero in on specific problems.

8. Can children have both developmental language disorders and speech sound disorders?

Yes. We know that:

  • around 15% of 3 year olds have a speech sound issues; and
  • 50-75% of these children also have a developmental language disorder.

You can read more about this here.

9. What if my child speaks more than one language?

Speaking more than one language:

  • does not cause language learning impairments; and
  • is an advantage for many children.

At 30 months of age, children who have at least 60% exposure to English will usually have similar language skills to a native English speaker. Children need around 5-7 years exposure to a language to be fluent in it.

A true language impairment will affect all languages a child speaks.

You can read more about language impairments and children who speak more than one language here.

10. Can children with language disorders also have other issues?

Yes. Developmental language disorders and speech disorders frequently happen at the same time as other difficulties, including problems with:

In these cases, it can be a good idea for your child to be assessed by other relevant professionals as well as a speech pathologist, e.g.

  • a paediatrician for a developmental assessment;
  • an audiologist for hearing and auditory processing assessments;
  • an occupational therapist for sensory, gross and fine motor assessments; and
  • a psychologist for a cognitive or reading assessment.

Some children with developmental language disorders and speech sound disorders also have developmental disorders or life-long disabilities, e.g. some children with:

  • moderate-severe profound hearing loss (although this typically only affects oral language – not signing or speech – if the child is exposed to signing early in life);
  • intellectual disabilities;
  • Down Syndrome;
  • Klinefelter Syndrome; or
  • Autism Spectrum Disorder.

11. My child might be stuttering. Where can I find information about evidence-based treatments?

Stuttering is fairly common, and often starts between the ages of 2 and 3 years. There are some great treatments available for pre-schoolers. Stuttering gets harder to treat with age.

You can read more about stuttering and other fluency disorders here. We don’t think there is any link between developmental language disorders and stuttering. However, we know that 30-40% of children who stutter also have a speech sound disorder.

12. My child has voice problems. Should I be concerned?

Voice disorders are probably not picked up as often as they should be and can have a big impact on a child’s quality of life.

You can read more about voice disorders here.

Bottom line

Speech-language communication impairments:

  • are the most common of childhood disabilities;
  • are often not picked up early enough; and
  • can have serious effects on a child’s social, school and later work goals, participation and achievements.

Speech pathologists (myself included) need to do a better job telling the public about common childhood communication impairments. We need to:

  • agree on our terms;
  • cut out the jargon and speak in Plain English; and
  • give families:
    • quality information based on the latest research evidence; and
    •  practical guidance on when, where and how to seek help.

If you have any concerns about your child’s communication skills, please contact your local speech pathologist for a chat.

Principal sources:

  1. Bishop, D.V..M., Snowling, M.J., Thompson, P., & Greenhalgh, T. (2016). CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children. PLOS One, 11(7). Full text can be accessed here.
  2. Prelock, P.A., Hutchins, T., Glascoe, F.P. (2008). Speech-Language Impairment: How to identify the Most Common and Least Diagnosed Disability of Childhood. Medscape Journal of Medicine, 10(6), 136.

** People use many of the same nerves, muscles and body parts for both speech and swallowing. But they use them in very different ways. At Banter, we focus on speech and language and do not treat feeding or swallowing disorders. For people with swallowing or feeding needs, we are always more than happy to refer them on to speech pathologists with this expertise.

Image: http://tinyurl.com/zbtpfav

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

FAQ: 10 common speech error patterns seen in children of 3-5 years of age – and when you should be concerned

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Speech is a wonderfully complex skill, and children need lots of practice to learn how to do it.  As with any motor skill, children make plenty of mistakes as they learn to speak clearly.

In English, we hear several common patterns of error in children’s speech as they grow up.  Here are 10 common types of error pattern, and the approximate age by which we expect them to be “fixed” (gone) in typically developing children:

1. Assimilation: 

Lala wants the lellow kuk. (Lara wants the yellow truck.)

It’s human nature to do as little work as possible, and our tongues, lips and other “articulators” can be just as lazy as the rest of us! Often one sound in a word will affect one or more other sounds in the word.  This is called assimilation (or consonant harmony). Sometimes, the first sound in a word will change later sounds, e.g. if the child said “beb” for “bed”.  This is called progressive assimilation.  Other times, later sounds in a word affect earlier sounds, e.g. if a child says “lellow” for “yellow”.  This is called regressive assimilation.

When to consider seeking help: if assimilation is still a feature of your child’s speech at the age of 2½-3 years of age.

2. Reduplication: 

The taitai needs wawa. (The tiger needs water.)

When children repeat a syllable twice, rather than pronouncing both syllables of the word, they can sound a bit like babies babbling (e.g. mama, dada).  When we hear it in 3-5 year olds, we call this error pattern reduplication.  It almost always happens when the child repeats the stressed syllable twice, at the expense of the weak syllable, e.g. as in tiger and water above.

When to consider seeking help: if your child is 2½-3 years old or older and reduplicating syllables more than occasionally.

3.  Voicing: 

I fount a pek for the bram. (I found a peg for the pram.)

The sentence above makes no sense whatsoever.  But it allows me to illustrate voicing errors.  In English, we produce some of our sounds with our vocal chords apart.  These are called unvoiced sounds, which include sounds like p, t, k, s and sh.  For other sounds, we bring our vocal chords together to “turn on” our voices.  These are called voiced sounds and include b, d, g, z and n.  It takes a lot of control to turn your voice on and off during speech, and it’s not unusual for some children to make errors like not voicing sounds when they should (e.g. pek instead of peg) or voicing sounds when they shouldn’t (e.g. bram instead of pram).

Age at which you should you consider therapy: 3 years (or younger if your child is being teased for it).

4. Final consonant deletion: 

Gi me my du ma ba. (Give me my duck mat back.)

Young children often omit the final consonants in their words.  This is called (appropriately enough) final consonant deletion.  It can have a big impact on how easy your child is for others to understand – could you understand the example sentence above without the translation?

When to consider seeking help: if your child is regularly omitting final consonants in words at the age of 3 years, 3 months.

5. Fronting: 

Sorn tan’t find any eds to teep.  (Sean can’t find any eggs to keep.)

This type of error is called fronting.  It occurs when sounds normally produced with the tongue positioned at the back of the mouth (e.g. k, g and sh) are instead produced with the tongue positioned towards the front of the mouth (e.g. like t, d, and s).

Age at which you should you consider therapy: 3½-4 years of age (or younger if your child is hard for others to understand or being teased for it).

6. Stopping: 

Da ban crac into dit debra. (The van crashed into this zebra.)

This ghoulish sentence illustrates stopping.  In English, many speech sounds can be stretched out and held continuously until you run out of breath.  Sounds like s, z, f, v and th, are good examples.  Other speech sounds can’t be held continuously, e.g. p, b, t, d, k and g, which are all examples of “plosives”.  It’s common for young children to substitute plosives for continuous sounds.  We call this “stopping” because the children are “stopping” the sounds, e.g. turning the “this” with its nice continuous “th” and “s” sound into “dit”.

Age at which you should you consider therapy:

  • 3 years of age for “f” or “s” (or younger if your child is being teased for it);
  • 3½ years of age for “v” or “z” (or younger if your child is being teased for it);
  • 4½ years of age for “sh”, “j” or “ch” (or younger if your child is being teased for it); and
  • 5-7 years of age for “th” (as in “thin”) and “th” (as in “the”) (or younger if your child is being teased for it).

7. Weak syllable deletion: 

The efant needs a brela. (The elephant needs an umbrella.)

When we speak, we don’t emphasise each of our syllables equally. For example, in the word “telephone”, we usually place the stress on the “te” and “phone”, leaving the “le” syllable in the middle un-stressed and weak.  In “umbrella”, we stress the “bre”, leaving the “um” unstressed and weak.  I’ll spare you a lecture about Trochaic and Iambic stress patterns in English.  Why I mention stress patterns is that it’s common for young children to omit weak syllables.  We call this weak syllable deletion.

Age at which you should you consider therapy: 4 years (or younger if your child is being teased for it).

8. Cluster Reduction: 

There’s a ‘cary ‘pider in my room! (There’s a scary spider in my room!)

Many words in English contain combinations or “clusters” of consonants, e.g. squawk, crab or flower.  It’s common for young children to omit one or more of the consonants in a cluster (so called cluster reduction), and there are some clever rules of thumb speech pathologists use to help us predict which ones.

Age at which you should you consider therapy: 4-5 years (or younger if your child is hard for others to understand or is being teased for it).

9. Deaffrication: 

I broke my wash on the frids door. (I broke my watch on the fridge door.)

This one has a fancy name – deaffrication.  Let me explain: in English, “ch” and “j” are actually made up of two sounds each.  Ch = t + sh.  J = d + zh (as in measure or vision).  Affricate comes to us via German from the same Latin root as friction, meaning “rub together”.  Because they are made by rubbing together two sounds, ch and j are called affricates.  It’s common for children to drop one of the two sounds (i.e. to de-affricate them), e.g. the “t” in watch.

Age at which you should you consider therapy: 5 years of age (or younger if your child is being teased for it).

10. Gliding: 

The wabbit woves wed wibbons. (The rabbit loves red ribbons.)

We call this error pattern gliding.  It’s most common with r and l.  Two year olds who glide are often praised for their cuteness. Gliding is not so adorable when you’re seven.

Age at which you should you consider therapy: 5-6 years of age (or younger if your child is being teased for it).

Other considerations

In reality, young children – especially 2 and 3 year olds – often make many of these errors in the same sentence, e.g. “dec a tary fwigt’n pider in my woo”. This can make it very difficult for adults who don’t know a child well to understand what he or she is trying to communicate.

The above suggested ages for considering seeking help are, of course, only guides.  You are the expert on your child and you should always feel free to discuss your child’s speech development with a speech pathologist.

As a general rule, if:

  • your child’s speech is noticeably less developed or easy to understand than that of his or her peers;
  • your child shows signs of anxiety or frustration about his or her speech;
  • your child is self-conscious about his or her speech, or is being teased or bullied;
  • your child’s childcare, pre-school or school teachers flag concerns about your child’s speech;
  • you simply want to check that there’s nothing to worry about; or
  • your child’s speech features any of these error patterns at 5 years of age,

we recommend you contact a speech pathologist to discuss your concerns.

Principal sources: Dodd, Hua, Crosbie, Holm & Ozanne (2002); Grunwell (1987); McLeod (1996); Bowen (1998).

Related articles:

Image: http://tinyurl.com/neoc5by

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

5 ways for teachers to help children who stutter – tips from people who stutter themselves

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Last week I attended a public forum co-hosted by the Australian Speak Easy Association and the Australian Stuttering Research Centre of the University of Sydney.  The focus was on how to help school-age children who stutter in the classroom.

The event was moderated by Associate Professor Ross Menzies, a clinical psychologist who has been doing some great research on studying the complex relationship between anxiety and stuttering.  It also featured talks from speech pathologists from the University of Sydney and the Stuttering Unit of the Bankstown Health Service.

But, for me, the highlight was hearing several adults who stutter recount some of their experiences at school.  Not everyone who stutters had difficulties at school – there were some examples of people who had wonderful teachers and peers supporting them at school.  But there were some harrowing stories, too, for example about:

  • being teased and bullied by other students;
  • feelings of dread while waiting for their turn to read aloud to the class or to answer a teacher’s questions;
  • worrying about whether teachers and the other children thought they were “slow” because of their stuttering;
  • deciding to “go mute”, call in sick, or otherwise avoiding situations like presentations requiring speech; and
  • leaving school as soon as possible to “escape”.

Teachers and others who work with children who stutter at school often ask what they can do to help.  And because we still don’t know exactly what causes stuttering, there is still no “professional” consensus.

So here are 5 tips from the real experts – people who stuttered at school and were brave enough to share their stories:

1. Don’t think a student is less intelligent because they stutter.  There is no link between intelligence and stuttering.

2. Give the student time to speak and maintain eye contact while they are talking to you.  No-one likes to be interrupted or have others finish their sentences or look away mid-sentence.

3. Although anxiety doesn’t cause stuttering, it can make it worse.  For some children who stutter, it can be really hard to read aloud in class, to answer questions when put on the spot, or to give a class presentation.  Have a private conversation with the child and ask him or her whether there is anything you can do to make it easier.  If a child is anxious about stuttering in front of the whole class, for example, you might:

  • allow the child to give their news or a presentation to a smaller group or just to you; or
  • ask the child to read aloud in unison with someone else.

4. Don’t give unsolicited advice to “take a deep breath” or to “calm down”.  This kind of advice – which is usually given with the best of intentions – can increase anxiety and make the stuttering worse.

5. Don’t pretend the stuttering isn’t there.  Make sure the student is getting appropriate help. Evidence-based treatments are available, but stuttering gets harder to treat with age, with early treatment strongly recommended for school-aged children.

A student might already be in treatment.  If so, ask the parents whether you can speak with the child’s speech pathologist for further advice specific to the child and to coordinate care.  If not, recommend to the parents that they get in touch with a speech pathologist as a matter of priority.

More resources for teachers

Since playing a person who stutters (or “stammers” as they say in the United Kingdom) in A Fish Called Wanda – and as the son of a man who stuttered and never talked about it – Michael Palin has been a fantastic public advocate for people who stutter for many years.  His centre has published some terrific resources about stuttering for teachers, including this video (which could be used in class to educate children about stuttering):

and this fact sheet, which contains a number of suggestions consistent with the tips above.

Also:

Related articles:

Image: http://tinyurl.com/qgkedp8

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

Beyond school readiness: 7 signs that your kindergarten, year 1 or year 2 child may have a language delay

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There are some fantastic school readiness checklists and speech-language programs out there to help you help your child develop the language skills necessary for his or her first day at big school.  But what signs of language delay should you look out for after your child has started school?

Of course – disclaimer alert! – children don’t develop in exactly the same way according to a pre-programmed formula (if only!). But here are 7 fairly straightforward things you can listen out for that signal there might be an issue worth looking into:

  • Your child doesn’t use correct plurals for common nouns.  He/she says dog for dogs, bus for buses, mans for men, childs for children, and sheeps for sheep. Don’t worry about fish/es – a controversial topic at the best of times!
  • Your child doesn’t have a good handle on the past tense of common irregular verbs, e.g. if he/she says words like “goed” and “holded” and “broked” and “flied” and “falled”.  Although this is a common stage of language development called “overgeneralisation” – the subject of a separate article here – most children have “went”, “held” and “broke”, and “flew” and “fell” down by school.
  • Your child can’t rhyme words, count syllables, identify words that begin with the same sound or link sounds to letters of the alphabet.  This may indicate a problem with phonological awareness, which is strongly related to later reading development.
  • Your child can’t give or follow two-step instructions, e.g. “Put on your shoes after you pack your lunchbox”.  This may indicate your child is not processing sentences with complex syntax or applying rules of thumb, like watching what others do or doing things in the order they’re said.  Of course, it may also indicate your child is ignoring you and testing your patience/limits (something that happens to me with increasing frequency!).
  • Your child can’t sort common words by opposites or category.  For example, knowing black/white, big/small, up/down, over/under, heavy/light are related words; or that chickens, horses, cows, goats, sheep and ducks are all farm animals, while cars, motorbikes, jets, boats and trains are all forms of transport.
  • Your child can’t sit and listen quietly to others.  There are a number of possible explanations for this, including possible attention issues or simply – dare I say it? – old-fashioned naughtiness.  But it may also signal that your child has problems understanding what others are saying, causing frustration to both listener and speaker.
  • Your child can’t re-tell a simple story coherently.  As your child goes up the grades at school, he/she will be required to work with what some academic folk call “text types of the narrative genre”, and what almost everyone else calls “stories”.  This one is easy to check – simply read your child an age-appropriate bedtime story, then ask him/her to tell it back to you.  Does the story make sense?  Did your child cover the start, middle, high point and end?  Did your child identify the main and supporting characters?  Did he/she speak in full, grammatically correct sentences with lots of description and appropriate emotion in his/her voice?

If you spot one or more of these potential issues – DON’T PANIC!  It doesn’t necessarily mean your child has a language delay. If there is an issue, there’s a good chance your child’s teacher has spotted it and is working on it with specialist teachers at the school.  But if you are worried – particularly if your child ticks more than 3 boxes above, or you have a family history of language problems – don’t hesitate to contact a qualified speech-language pathologist who can assess each of the above language skills (and more) with a comprehensive diagnostic assessment.

Image: http://www.flickr.com/photos/britishlibrary/11130516894/
Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).