Developmental Language Disorder in Children and Young People with Autism
Today is Developmental Language Disorder Awareness Day and I am writing this blog post to link up with other blog posts on the same theme of Developmental Language Disorder (DLD). After you’ve read the post, please click on the links at the end to read other articles on DLD.
It is not uncommon for children and young people on the spectrum to have language difficulties. However, it can be more complex to treat and support their difficulties as they are underpinned by the core symptoms of autism, and this cannot be taken out of the equation
Difficulties Processing Language
Children and young people on the spectrum can have difficulties processing language. Mary Temple Grandin, American professor of animal science at Colorado State University and autism spokesperson, said that when she was a child she thought that adults and children spoke two different languages, as she could not process the initial consonant speech sounds when grown-ups spoke. Language development can be atypical and unusual in this population.
Impact on Attention Skills
Difficulty with executive function skills can impact considerably on understanding and using language. Children and young people can be easily distracted by what is around them and by their own thoughts and interests. Shared attention can be difficult at all ages. We can assume shared attention by a certain age, but this can be a continual area of difficulty for children and young people on the spectrum.
Shared attention is crucial for successful communication, and although we are talking about language rather than communication, I think it is hard to separate them, because language, in one form or another, is a vehicle for communication.
A Holistic Approach to Treating Language Disorders
I heard Vicky Slonims speak at Great Ormond Street Hospital earlier this year, and she said that developmental language disorder often co-occurs with other disorders and difficulties, which should be considered when we decide on interventions. One size does not fit all. We need to use a holistic approach to treating language disorders, viewing them in context rather than in isolation.
Impact on Learning Language
When a child finds it hard to focus and listen, they can miss out on information or on how to say words, word endings, speech sounds, etc. and this can impact on learning language. I have worked with many children on the spectrum who have stored words incorrectly and have persistent language difficulties, e.g. using pronouns and formulating language. This can have complex roots involving:
- Attention and listening difficulties
- Reduced monitoring skills, often due, not just to attention difficulties, but also to lack of interest and motivation, which are linked to wider difficulties, e.g. understanding communication and why we communicate, what communication partners know and don’t know and how much information we need to give them
- Reduced awareness of the audience. Children and young people on the spectrum often assume that the listener knows what they know, shares their thoughts, feelings and experiences, and this can affect their use of language.
Theory of Mind
Difficulties with theory of mind can impact significantly on learning and using language. This can be a complex area to unpick, and working on language can involve working on social understanding and thinking.
The impact of difficulties with theory of mind on language can often be seen in schools. Many schools have children and young people on the spectrum who find literacy very hard. Teachers often despair and tend to put strategies in place that work for other populations, but don’t always work for this client group. For example:
- Using Talking Tins
- Talk for Writing (Pie Corbett)
These are great resources, but the roots of this difficulty are not pure language. Communication is inextricably bound up in this and needs to be included in the intervention. Communication difficulties that you might see are:
- The child includes every single detail in their written work.
This can happen when the child cannot tell what needs to be included and what does not, so they put everything in. They might be very exact and precise, or they might focus on all the details without being able to integrate them to understand the gist of a story. As children get older, you can often unpick their difficulties by using narrative with them, which can be extremely helpful. I have learned a lot from children and young people explaining what is behind their written work. For example, I once worked with a child who said that he had so many ideas that he could not choose which to include and which not to include, the choice was so vast, that he could not write anything. Knowing this helped us to put in place appropriate support.
- The child cannot think of what to say, how to organise the information into paragraphs, what order to put things in to or how much to say.
Narrative therapy is likely to help these children, but it usually requires some adapting for this population to include difficulties with social thinking and social understanding. What the child writes might make perfect sense to them, but be hard for everyone else to understand. Narratives can seem random, a surreal train of thought that goes round the houses, but it rarely seems like that to the child or young person as they are writing with themselves as the audience. They are the author and the audience, which can affect monitoring language.
Difficulties Using Grammar
Use of grammar in children and young people who are on the spectrum can be interesting, and evidence suggests that difficulties in this area can be due to language and social communication deficits. See (https://spectrumnews.org/news/study-finds-grammar-tics-in-children-with-autism/ ). Features that I have noticed are:
- Persistent difficulties with past tense verb forms
- Difficulties with pronouns
- Repetitive use of grammatical structures in their talking
- Unusual words that sound like jargon, e.g. a child recently told me that he didn’t like it when players got crocked in football. I asked him what he meant and he gave a long technical explanation that relied on understanding the rules of football, which I don’t. I was none the wiser at the end of his explanation, and I am not convinced this is a word! Please do tell me if anyone knows what this means! Some children like the feel of saying a word, or the sound, and this can take precedence over the meaning.
Interest plays a big part in learning for children and young people on the spectrum. What can look like a vocabulary difficulty can be lack of interest in a topic. For example, a child I once worked with had an incredible vocabulary around tarantulas and other spiders (I Iearned a lot from him!), yet he had very little functional language and was just not interested in using every day words. I could write many pages on this subject, it is so interesting. It is important to pick difficulties apart but it is also essential to put the right intervention in place, which often involves taking a holistic view and acknowledging the impact of core symptoms of autism in the mix. I plan to write another post on intervention for language difficulties with this population.
Now you can read other articles on Developmental Language Disorder published today, and listen to a podcast, by following the links below:
Catherine from Wise Old Owl Speech has a brand new podcast on the change of terminology for you to listen to.
Anna from Word Steps SLT has written about helping children learn new vocabulary
Jude Philip has written a post called DLD and the older student – unraveling the knot.
Finally, please spread the word about DLD today, either by sharing this post or by sharing RADLD’s video DLD 123.