Do not be frustrated by children's learning difficulties.
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Developmental Language Delay
Language develops from the babbling of a few months' babies to discourse of five to six year old kids. However, Pervasive Developmental Disorders, Autism, Down's Syndrome, Cerebral Palsy, Global Developmental Delay, Lack of Language Stimulation or some unknown reasons may lead to different degrees of language delays or disorders in some children. We should find out the reason(s) at one hand, AND move on to find ways and really take action to help our kids as soon as possible on the other hand. All kids should be learning language to meet their learning, social and communication needs as they grow.
Autism
Autism is a developmental disorder which appear in some children before three years of age. Professionals around the world are continually studying the causes of the disorder, but have not yet come into a concrete conclusion. It is known that children with autism have different degree of delay or disorder in cognition, language, social communication, sensation and behavior, which lead to learning difficulties. Lack of initiative, weak communicative intention, nonverbal, weak in keeping eye contact with people, unable to follow verbal commands, easily irritated by environmental factors such as sound and touch, or crying, yelling and unreasonably bad temper etc. are some of the symptoms that are found in this group of children.
For therapy, there are now various treatment approaches originated from US and Europe, but those that are widely recognized and adapted by special educators include Visual Strategies, TEACCH, Individualized Educational Plans(IEP), Speech Therapy(ST), Occupational Therapy(OT), Behavior Management etc. The roles of Speech Therapists are mainly on promoting children's language comprehension, language expression and communication. In addition, the progress is more drastic with active participation of parents usually.
Down's Syndrome
Down's Syndrome is a congenital disorder, in which children are born with three copies of chromosome 21. Mental retardation, slanting eyes, broad short skull, broad hands and short fingers are some of the clinical features. In addition, children with Down's Syndrome may have heart defects, esophageal atresia and increased incidence of acute lymphocytic leukemia.
Children with Down's Syndrome usually have language problems due to their delayed cognitive abilities. They have difficulties in both language comprehension and expression, articulation errors and horse voice. Fortunately, speech therapy is effective for these children because they have better social communicative abilities, like the use gestures to express, and they are generally willing to imitate speech.
Articulation Delay or Disorder
Articulation is the abilities of oral organs to produce sounds, or a bit like pronunciation. For the Cantonese-speaking population, generally two-year-old children can correctly produce all Cantonese vowels, diphthongs, / b / and / m / sounds, and / s / sound is correctly produced by most children at the age of around four. Children with articulation delay may substitute sounds, and produce “go” as / dou /, “star” as / da /, “mommy” as / babi /, “like” as / aik / etc. For the English-speaking population, 3-year-old kids can master / p, b, m, w, h / and all vowels; 4 years / d, t, n, g, k, f, y /; 5 years / r, l, s, ch, sh, z /; 6 years / j, v, th, zh /.
Parents should contact family doctor and request for referral to speech therapists immediately in case of worries on children's articulation problems.
Fluency Disorder
Fluency Disorder is also called Stuttering or Stammering, children may repeat or prolong part or whole part of a sentence. E.g. “I I I wanna play play toys.” “Wh Wh Wh Wh Where is is it?” In addition, children may blink eyes excessively, hold fists tightly, or show nervous facial expressions. Children's speech may be "normally dysfluent”from age 2 to 5. Parents should consult Speech Therapists when there are worries of their children's fluency of speech.
Dysphagia/ Swallowing Disorder
Swallowing ability of babies develop as early as 11 weeks of gestation. Suckling is reflexive at 0-3 months, lip closure is more active at 4-6 months, sucking/ swallowing/ breathing abilities are more coordinated at 7-9 months, and become mature at 10-12 month. Chewing is vertical and diagonal at 10-12 month, and becomes rotary at 12-24 months.
Children with swallowing disorders have delayed or inefficient laryngeal elevation, excessive coughing after eating and drinking, weak or uncoordinated sucking and swallowing, drooling, gaggling, and easily choking etc.
For therapy, Speech Therapists would improve eating environment, position, food type and consistencies, and feeding methods, together with oral-motor exercises. For cases with severe swallowing disabilities, Speech Therapists may consider non-oral intake methods (such as PEG, NG tube) to ensure safe swallowing and to reduce frequency of pneumonia that is fatal. For worries of children's eating and swallowing abilities, parents should consult ENT doctors and Speech Therapists. It is wise to seek for professional diagnosis and treatment in HOSPITALS immediately.
Voice Disorder
Voice is produced by the vibrating actions of the two vocal folds at our larynx. When we speak, we breathe in and then breath out, voice is produced as airstreams passes through the two vibrating vocal folds as we breathe out. In addition, different sounds and speech are produced when our oral structures (jaw, lips, tongue) move differently.
When children have difficulties in using appropriate loudness(too loud/ too soft), pitch (too high/ too low) and quality (too hoarse/ too nasal) to speak, it is probable that they have voice disorder. Common problems include hoarse voice, using too high the pitch, or abnormal pitch change etc. Parents should consult Ear, Nose & Throat Doctor and Speech Therapists when necessary.
Hearing Difficulties
Generally, people can detect sound with intensity as low as 10 decibels(dB). Daily conversation is at about 60dB, and sound of electric drill at about 110 dB. Children who cannot detect faint sound or who can only hear very loud speech may have hearing difficulties, and should be referred to Audiologists to receive hearing tests as soon as possible. Audiologists and Speech Therapists may then recommend ways to improve children's hearing and speech abilities.
Oral Motor Difficulties
Both speech and feeing involve muscles of our jaw, lips, tongue and cheek. Sometimes, children’s difficulties in expressive speech and articulation are due to weaker oral musculature strength, mobility and control. With oral motor exercises, children can control their own jaw, lips and tongue easier, and they can then imitate adults’ mouth shapes and speech sounds with greater success. Feeding skills can also be improved with oral-motor training. (Please refer to Sara Rosenfeld Johnson’s Oral-Placement Therapy).
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