More About Speech, Language and Communication
Speech Difficulties
This is the term used for children who have difficulty with articulating letter sounds such as ‘s’, ‘p’, ‘th’ and combining them to make words. Some children may also find it hard to make sense of the speech sounds used in words or sentences. For example, they may confuse ‘bell’ and ‘ball’ in a sentence such as ‘Show me the bell’.
Speech difficulties are the most common type of SLCN. In most cases they can be resolved quite readily. However, there are some mostly quite rare forms of speech difficulty that are likely to require intensive specialist help. These are often described as Speech (Sound) Disorders and they include:
- Childhood Apraxia of Speech (A speech disorder that affects the ability to plan and coordinate the movements of the mouth and voice for speech)
- Inconsistent Speech (or Phonological) Disorder: (Atypical error patterns with inconsistent word production)
- Consistent Phonological Disorder (Typical error patterns that persist)
- Dysarthria also known as Worster-Drought Syndrome (Difficulty with speech due to a weakness of the speech muscles. This type of speech disorder is characteristic of children with Cerebral Palsy).
- Auditory Processing Disorder (APD) (A difficulty with making sense of speech)
Language Difficulties
The term language is used to describe the ability to use and understand words and sentences – and the way that children acquire this skill.
Typically, children generally start saying their first words around the age of one and soon enough are chatting away. Some ‘late talkers’ might lag behind, but if they understand what you say to them, they generally catch up by the time they start school.
Language difficulties that persist are called Developmental Language Disorder (DLD). Children with DLD have problems with language development that continue into school age and beyond. This has a significant impact on social interactions and/or educational progress. DLD may affect Expressive Language (speaking), Receptive Language (understanding what other people say) or both to a greater or lesser degree.
This link shows a diagram that illustrates how DLD and SLCN relate to each other. https://www.afasic.org.uk/wp-content/uploads/2024/05/Afasic-Flowchart.jpg
Social Communication Difficulties
This term is used for children who find it hard to speak and respond appropriately in context to what other people say. Typically, younger children might ignore something you say, and then, later on, start repeating it over and over again. Children with social communication difficulties are often mistakenly thought to have a behavioural problem.
This type of language and communication difficulty is also seen in autistic children and help from professionals with the relevant expertise is essential. Research has found that children with Social Communication Disorder (the term for an ongoing difficulty) tend to grow up to do much better academically than children with language disorders.
Other terms you may come across include:
- Social Pragmatic Communication Disorder (SPCD)
- Pragmatic Language Impairment – ‘Pragmatic’ is a term used by speech and language therapists for the way language is used in a social context.
Please see the following two articles for further information:
N.B. Some children may have a very specific form of speech or language disorder. Others may have a combination of various types of SLCN.
Diagnosis – Points to note
Diagnosing the various types of SLCN can be tricky. There are no clear markers, such as a blood test, that can tell you what is wrong. Professionals largely rely on their own expertise and how the child presents on the particular day and time that they see them. For this reason, it is essential that you tell them as much as possible about what your child can and cannot do, under what circumstances, and when you noticed what. It is advisable to make notes so that you don’t forget anything crucial.
Even so, it is not unusual for children’s diagnosis to change depending how their speech, language and communication skills develop over time. For this reason, parents should be aware that a diagnosis only ever reflects a moment in time, and you may, in due course, notice that the original diagnosis no longer seems accurate. Parents should, however, be careful about jumping to conclusions about the ‘right’ diagnosis. Some types of SLCN are particularly rare and statistically unlikely to be your child’s diagnosis.
N.B. The Afasic Helpline has lots of experience of discussing concerns about diagnosis and can help to talk through your current situation.
Some forms of SLCN can co-exist with, or lead to, other diagnoses. For example, Dyspraxia (a difficulty with fine or gross motor skills, motor planning and coordination) often co-exists with SLCN and Dyslexia (a difficulty with reading, writing and spelling) frequently results from a former or ongoing difficulty with speech and language.
N.B. The point is that these difficulties do not cause SLCN, but coincide with them, unlike say, autism, certain genetic conditions and hearing impairments.
