Excerpt taken from:
Handbook of
SPEECH-LANGUAGE
PATHOLOGY
AND
AUDIOLOGY
Norman J. Lass. Ph.D.
Professor
Department of Speech, Pathology and Audiology
West Virginia University
Morgantown, West 'Virginia
Leija
V. McReynolds, Ph.D.
Professor
Department of Hearing and Speech
University of Kansas Medical Center
Kansas City, Kansas
Jerry L Northern, Ph.D.
Professor
Department of Otolaryngology
Head, Audiology Division. University Hospital
University of Colorado Health Sciences Center
Denver, Colorado
David E. Yoder. Ph.D.
Book Title:
Professor and Chair
Department of Medical Allied Health Professors
University of North Carolina School of Medicine
Chapel Hill, North Carolina
1988
CB Decker Inc • Toronto • Philadelphia
•
Language Disorders
22
Chapter Title:
Language Delay
in the Child
Anne van Kleeck, Ph.D.
Alice Richardson, Ph.D.
THE ROLE OF LANGUAGE
IN DEVELOPMENT
In the section on theories of language acquisition,
we discussed various ways in which social factors,
cognition, and innate endowments might affect
language development. In this section, we wish to
consider the opposite side of the coin -- how language
affects other domains of development. Specifically,
we will consider the role of language in developing
and maintaining social relationships, developing self. concept, and achieving academic success. These are
areas in which language delayed children might
experience problems secondary to their language
problems. At times, work in these areas constitutes
goals of therapy. At other times, such problems might
be avoided altogether by direct work on facilitating
language development.
The issue of how language affects other aspects of
development is often alluded to in the literature that
discusses the various functions of language. Indeed,
a look at some of the major taxonomies of language
functions reveals that the three categories listed
previously are often addressed in thi-e'e lists. Halliday,
for example, considers the following functions of
language:" (1) instrumental: to get things done; (2)
regulatory: to regulate the behaviour of others; (3)
interactional: interaction between self and others; (4)
imaginative: to create reality; (5) personal: expression
of identity, of self; (6) heuristic: to explore the
environment and to learn; and (7) representational: to
express propositions (convey information).
The first three functions listed obviously relate to
the role of language in developing and maintaining
social relationships. We suggest that the imaginative
function would be included here as well, because of
its importance in the development of peer
relationships. Halliday's personal function
corresponds to our "development of self-concept"
category, and he argues that language plays an
essential role in the development of personality. The
heuristic function, or using language to learn, is one of
the ways in which language impacts upon academic
success.
Unlike Halliday and many others, we have
chosen not to list functions of language in this
section, but rather to focus on the role of language in
other domains of development. The reason for this is
that most people tend to think of communicative
functions only when they think of the functions of
language. As Halliday notes,
We tend to underestimate both the total extent and the
functional diversity of the part played by language in the life
of the child. His interaction with others, which begins at
birth, is gradually given form by language, through the
process whereby at a very early age language already begins
to mediate In every aspect of his experience. It is not only as
tthe child comes to act on and to learn about his environment
that language comes in, it is there from the start in his
achievements of intimacy and in the expression of his
individuality.
u
Furthermore, focusing on the role of language in
other domains of development provides, we believe.
a better conceptual framework for guiding assessment
anti intervention by emphasizing the rationale for
Language Delay in the Child 675
doing so than does a list of language functions. It
somehow seems less urgent and compelling if we say a
child completely lacks the "personal" function of
language than if we say a child is experiencing severe
self-esteem problems due to her or his language delay.
Development and Maintenance
of Social Relationships
From birth, communicative ability influences and
shapes social relationships. In this section, we consider
the impact of a language delay on parent-child and
peer interaction. We have chosen their particular
social relationships because the former has been
extensively studied with language delayed children and
because the latter has been studied with normal
children, but is all too rarely considered in our work
with language delayed children.
Parent-Child Interaction
A body of literature now exists that documents the
impact of impaired communicative ability upon
parent-child, particularly mother-child, interaction
from birth onward. Elicitors of parental responses in
infancy include the communicative behaviours of
crying, smiling and laughter, looking, and nondistressed vocalizations. A growing body of literature
documents that numerous populations of infants who
are at high risk for later communication disorders i.e.g.,
Down's syndrome, developmentally disabled, brain
damaged, malnourished, blind and high risk; exhibit
communicative behaviours in infancy that are more
difficult to detect than in normal infants." For
example, cries may be of lower intensity, sustained for
shorter periods of time, less differentiated, and
arrhythmical, making them less apparent to parents.
The probable effect of a less "readable" infant on
the parent-infant interaction has been discussed by
Dunst," Goldberg'? and Hari.r. According to
Goldberg, the chain of events is as follows: "When the
infant is unpredictable and difficult to read, decisions
(on the parents' part) require a longer time, are
difficult to make, and are less likely to be
appropriate."" The interaction leaves both parties
feeling ineffective -- the infant because she or he
cannot predictably influence the environment and the
parent because he or she cannot figure out an
appropriate response. Eventually these feelings of
helplessness and inefficacy make both parties less
likely to initiate or respond to communicative bids.
The decreased motivation to communicate leads to less
opportunity for the infant to practice communicative
skills and hence leads to a further lowering of skill level
and of self-concept as a communicator.
As children with communicative impairments
mature, parent-child interaction continues to be
characterized by withdrawal. This is, significantly less
overall interaction occurs between parents and their
Language Delay in the Child 676
language delayed children than between parents and
normally developing children. The interaction that
does take place between parents and their language
delayed children is often characterized as controlling
and intrusive, containing (1) attempts to elicit rather
than respond to behaviour, (2) a preponderance of
parent initiated interactions, and (3) a large amount
of parental directiveness. These patterns of
interaction have been documented in numerous
studies of children with language delay, mental
retardation, and hearing impairments and their
mothers. It seems that mothers attempt to
compensate for the child's passivity by attempting to
get the child to respond more and by initiating more
themselves.
The high frequency of directives in maternal
speech to these children may have a different
explanation. Parents are highly motivated to socialize
their babies successfully, that is, to get them to act in
socially acceptable ways. As well, babies learn a lot
by simply observing socially appropriate behaviour.
But much behaviour seems to be taught by overt
direction -- the child hears a lot of "Do this" and
"Don't do that." Indeed, many research studies have
documented the directive nature of early adult-child
interaction. Most infants become increasingly selfregulatory, and mothers of normally developing
children correspondingly decease the amount of
directiveness in the language that they address to
their children. However, self-regulation is mediated
primarily through language. Children who may not
adequately develop the ability to self-regulate because
they have language deficits, may be more regulated by
their parents in a compensatory fashion.
The previous discussion clearly indicates that the
basic interaction patterns of the extremely important
mother-child relationship can fall into a negative cycle
early on with communicatively impaired children,
thereby leading to a decreased desire to communicate
on the part of both participants. Without
intervention, this cycle develops into a continued low
frequency of interaction for the children who most
desperately need practice and success with
communication. When interaction does occur,
parents may be controlling and intrusive,
unknowingly reinforcing the communicative passivity
they are working so hard to draw the children out of.
The parent-child interaction lens is evidently a
critical one for viewing the language impaired child,
and clinicians need to address the parent-child
interaction in their intervention efforts. It is the
foundation, the crucial platform, on which the success
of all other intervention goals depends. The earlier
we can intervene, the less entrenched a negative
interaction pattern will be, and the easier it will be to
successfully teach alternate interaction patterns.
Assessing parent-child interaction at an intra
system level can be accomplished by coding both
parent and child behaviours in a spontaneous
language sample or by an observational checklist such
as the "Home Observation for Measurement of the
Environment" by Caldwell and Bradley."
In coding a spontaneous language sample, the
clinician might first of all indicate the range and
frequency of communicative intentions used by the
parent. This indication would highlight an excessive
use of directives and questions, both considered
controlling interaction devices. In addition, on a
discourse level, the clinician could code the parent's
type and frequency of responsiveness to any
communicative attempts on the child's part, either
verbal or nonverbal. This encoding would reveal how
often and in what ways the adult follows the child's
lead, consequently providing the child with a sense of
the power of communication to affect the
environment.
Once the pattern of parent-child interaction is
determined, the clinician must examine that
interaction in relation to the child's language
development and life needs. When the interaction is
facilatory for language growth and the parents' own
personal needs have been assessed, the parents' role in
the overall intervention program should be considered.
Many parents can play an active and important role in
building their child's language skills. This role may
range from carrying out home assignments to
implementing a full program with direction from the
interventionist. Assuming a maximally supportive
environment, to in effect train the parents to be the
language facilitators is often more efficacious,
especially for very young children. Certainly they
spend much more time with their children than the
therapist and have many more opportunities to
facilitate language in natural contexts.
When assessment indicates a less than ideal parentchild interaction and the parent is a viable candidate
for becoming involved in intervention, (see "Why
Parent Programs Fail" by Nygard and Adair"),
improving the parent-child interaction becomes a most
appropriate goal for intervention. This goal is
especially appropriate for infants and preschoolers who
spend a great deal of time interacting with one or both
parents.
If parents' behaviours are targeted, an essential first
step involves a careful and convincing explanation that
their current interaction patterns are a completely
natural adaptation to interacting with a
communicatively handicapped child. Although a
natural adaptation, clinicians need to explain that it
may not be the best for facilitating language
development- Because these children are already
experiencing difficulty learning language, clinicians
want to provide the maximal environmental support
possible. The point that must be made manifestly
dear is that the parents are not to blame for the child's
language problems (except in the rare instances when
this may indeed be the case). We often explain to
parents that we have to work long and hard in
training clinicians to repress the same natural
reaction to "taking over" for the child who has
difficulty communicating.
'The HOWE manual is available from the Center for Child
Development and education, University of Arloansas, Little Rock,
Arkansas 72204
Language Delay in the Child 677
Some structured parent training programs such as
the Hanen program. "It Takes Two to Talk," focus
on the parent-child interaction." This particular
program trains parents to systematically (1) observe
the child's attempts to communicate. (2) follow the
child's lead, (3) respond so that the child learns, (4)
keep the conversation going, and (5) prompt for
better turns. Although the Hanan program was
designed for the parents of prelinguistic and very
early-language-level children, the same principles can
guide intervention in the parent-child relationship
regardless of the child's level of communicative
ability.
Peer Interactions
From another point on the age continuum, the
social problems of older children with language
disorders and learning disabilities provide further
evidence of the detrimental effect a language delay
can have on development In a review of the
communication skills and peer relations of learning
disabled adolescents, Donahue and Bryan describe
the kinds of social interaction difficulties older
language impaired children may encounter." Included
are problems with making and keeping friends,
interacting cooperatively with others in the classroom,
fitting into cliques, and learning the slang that is
currently popular. These problems may persist into
adulthood; Blalock found that 50 percent of the
adults she studied with residual language and learning
disabilities had few friends, made inappropriate social
comments, or showed inappropriate use of personal
space. 96
There are several reasons why children with
delayed language development may have peer
interaction problems. First, some children with
language delays also have problems in social
perception. They have difficulty perceiving and
interpreting the non-verbal cues of social
communication, such as facial expression, intonation,
social space, and gesture.' Second, language delayed
children sometimes also have motor problems that
may interfere with their mastery of social activities
such as sports and learning dance steps. A third and
major reason language delayed children may have
peer interaction problems relates specifically to the
language impairment_ Gottman and Parker identified
several conversational processes that are highly
related to children hitting it. off with each other in the
first steps of friendship building." In order of
importance, these processes are communication
clarity and connectedness (especially the provision of
clarification following a request). the successful
exchange of information, exploration of interpersonal
similarities and differences, the establishment of joint
play activities, the amicable resolution of conflicts,
and disclosure of private thoughts and information.
Language delayed children may have considerable
difficulty with many of these communicative
exchange processes. In addition, numerous other
communication problems of language delayed children
can influence their peer relationships: they frequently
have difficulty understanding verbal humour; they
have trouble learning ritual insults; they take teasing
very literally; they are slow to master slang; their
problems understanding rapid speech and following
topic shifts may make it hard to keep up with
conversations; they may have problems learning the
rules of games, especially word games; they may not
know the rules for when and how to initiate and
terminate conversations; or they may be excluded
because they "sound different." And fourth, language
delayed children may develop poor peer interaction
skills because they have more limited opportunities to
learn them. Children who are socially and
linguistically less mature than their age mates may
become social isolates, thereby further decreasing their
opportunities to learn appropriate peer interaction
skills. Educational settings can contribute to this
problem as well. Children who are served in special
education classrooms may have little opportunity to
learn appropriate peer interaction skills from normal
peers.
Awareness of the probabilities of peer interaction
problems among children with delayed language
development alerts clinicians to the need to assess peer
interaction as a subsystem of the social domain.
Clinicians have several techniques available for such as
assessment at an intrasystem level. These include
observing the frequency and type of social interaction
the child engages in within the classroom, on the
playground, and in small group situations; interviewing
parents and teachers about the child's activities,
including friendships, groups the child participates in,
and special interests; and sociograms of the
relationship dynamics in groups. At an intrasystem
interactions level, the clinician can pay particular
attention to the role language plays in each of these
situations. If the child is found to be at risk for peer
interaction problems, several methods of intervention
are available. First, the child's environment can be
structured so that more opportunities arise for
successful social interaction. These opportunities may
include having a parent arrange small playgroups,
finding a few potential friends and arranging for more
frequent contact with them, mainstreaming the child
to increase opportunities to learn social behaviour from
normal peers, and having the teacher arrange peer
tutoring opportunities. Helping the child develop
special interests in which she or he can excel is useful
for boosting the child's self-concept and can also afford
opportunities to interact with peers who have similar
interests. Teachers can be encouraged to reinforce
cooperative group performance on tasks, rather than
rewarding individual competition." For children who
do not interact successfully with normal peers,
opportunities can be arranged for the child to interact
with younger normal children, who may be more
comparable in language age and social maturity to the
language delayed child.
A second approach to intervention for language
delayed children with peer interaction problems
Language Delay in the Child 678
involves direct teaching of social interaction skills.
The techniques used for direct teaching include using
films for modelling prosocial behaviour,' applying
programs for social training (such as magic circle" or
personal effectiveness training') and training specific
social communication skills.' Researchers at the
University of Kansas are developing a strategies
training approach for use with learning disabled
adolescents.' Students are taught specific strategies
for resisting peer pressure, giving positive and negative
feedback, negotiating, and personal problem solving.
Development of Self-Concept
Two aspects of self-concept were distinguished by
William James -- the social self and the private self.
The social self consists of the many social roles we
play, which expand and change throughout
development. The toddler soon adds to the roles of
child, daughter, and sibling those Orplaymate, pupil
and so forth. The private self is one's inner essence -those thoughts, feelings, intentions, and memories of
a unique set of experiences that are hidden from the
purview of others. Although anthropologists such as
Rosaldo have recently suggested that this dichotomy
may be culturally shaped and not a universal
characteristic of human beings everywhere, '02 it i s a
helpful framework for considering the self-concept of
the language delayed child. On the one hand, one
needs to consider how well a child has absorbed the
role attributes and relationships that are required in
various social contexts. This consideration requires a
social view of the child in myriad social contexts. On
the other hand, one should be attuned to the inner
emotional world of the child.
The self-esteem of language and learning disabled
children often becomes a glaring clinical problem by
the time the children reach adolescence." We would
hope that a conscious consideration of the role of
language in the development of self-concept would
alert clinicians to pay attention to this dimension of
the child's development from the earliest stages of
intervention and to intervene when problems are
evidenced.
In order to consider the impact of a language delay
upon a child's developing self-concept, consideration
of the process of development is helpful. In the
following, we will consider two possible avenues of
development of self-concept -- the "looking glass self"
and learning social roles -- and how a language delay
might interfere in both of these processes.
Thz Looking Glass Self
Mead stresses the impact of the child's experiences
with others on her or his developing self concept:'
-
He discusses the looking glass self" wherein
children's developing understanding of their own
identity represents a reflection of how others see and
respond to them. Mead distinguished between the "I"
-- the personality -- and the "me" -- which is built on
attitudes of others. We tend to agree with the
anthropologist Rosaldo, who recently suggested that
undoubtedly both aspects are socially created, not just
the "public" self.' Indeed, in the following discussion,
we consider how others' opinions might shape the
innermost emotional landscape of the • language
delayed child.
We might extend Mead's "looking glass" metaphor
and consider factors that might cause others to give the
language delayed child a poor reflection of himself, an
image eventually internalized to form the child's own
poor "self-image." First of all, from Mead's perspective
the development of the self-concept is inextricably
bound to social interaction. As such, the issues
discussed earlier in the section on the development of
social relationships point out potential problems in the
development of self-concept as well. The parent who
cannot "read" the infant and who eventually feels
helpless because of this inability probably initially
reflects any number of negative emotions back onto
the child, such as frustration and anger. Later, the
parent protects himself from these less than
satisfactory interactions by simply avoiding them
altogether. Meanwhile, the child is internalizing these
negative feelings in the initial formation of his selfconcept. The lack of interaction that ensues may also
have a disintegrative effect on the emotional health of
the child (e.g., Bowlby and Spitz both have studied the
extremely deleterious effects of extreme social
deprivation on all aspects of infant development' 0 '. 105 ).
In addition to the day to day frustrations of
interacting with a child who is difficult to interact
with, the parents' emotional "reflections" may stem
from the broader impact of dealing with the extreme
disappointment of having a handicapped child at all.
An emotionally healthy adjustment to such
disappointment often requires months, or even years,
of moving through the grieving process, with its stages
of denial, anger, guilt, and depression that may precede
acceptance of the handicap. These emotions are
undoubtedly also "reflected" back onto the child. In
addition, siblings may naturally become jealous of the
special attention given to the handicapped child,
leading to yet another source of negative reflections on
the "looking glass" that serves as the basis of the child's
self-concept.
Negative reflections are not restricted to family
members alone. The "different" child is also exposed
to the reflections of a society at large in which
attitudes toward handicaps may be manifested in
ridicule, scorn, revulsion, pity, overprotection, and so
forth. One mother we worked with relayed a heartrending story of the appalled reaction of a woman in a
neighbouring car at a red light to the behaviour of her
autistic son. The mother felt so humiliated by the
other woman's reaction that she followed her for
blocks to give her a card she carried for just such
occasions. It said, "Please excuse my child's unusual
behaviour. He is autistic. For more information on
autism, call " (here she provided the
phone number of the state society for autistic citizens).
Language Delay in the Child 679
The notion of the "looking glass self" reminds the
clinician doing the initial inter- and intrasystem
analyses to look closely at the child's emotional selfconcept, at the reflections of self she or he is receiving
from significant others, and at the needs of those
others as well. We must sensitize ourselves to the
many ways in which the child might allow us glimpses
of the state of her or his own inner emotional world
that has developed as a result of many of these
experiences. Children sometimes provide such
glimpses by fleeting comments they make. More
often, we are able to discern their feelings by reading
the sometimes subtle and sometimes poignantly
direct symbols manifested in their play, drawings and
fantasy stories.
Interviewing the parents and siblings and
examining parent-child and sibling-child interactions
aid the clinician in identifying the child's mirrors in
the immediate environment In addition, the
clinician might specifically assess the parents' feelings
and attitudes about having a handicapped child as
well as their resources for coping with these problems.
Too often clinicians react to parents' expressions of
guilt, anger, fear, denial, or depression without
understanding the functions these feelings serve in
helping the parents cope with having a handicapped
child. Moses has provided helpful explanations of the
functions of these feelings and suggestions for how
clinicians might deal with them productively rather
than reactively?'
At the developmental level, Greenspan's work
provides a framework for discerning the normal
emotional concerns of children at different
developmental stages." This framework provides a
backdrop to use in determining whether a language
delayed child is having emotional problems above and
beyond the normal unconscious struggles toward
growth.
When self-concept problems are suspected or
identified through analysis of the "looking glass self,"
clinical intervention aimed at either preventing or
remediating the language delayed child's poor selfconcept might include a number of approaches.
These include (1) improving the parent-child
interaction, (2) connecting the parents with resources
(such as counselling, support groups, and financial
assistance) for coping with the added stress of having
a handicapped child, (3) helping parents through the
grieving process, and (4) being alert to signals from
the handicapped child regarding her or his inner
emotional world. In addition, involving siblings in
the intervention process can serve to abate the natural
and potentially destructive rivalries that often attend
having a handicapped sibling.
Learning Social Roles
Much of our identity is defined by the various
social roles we play. During development, a child
learns the norms or prescriptions for behaviour
associated with various roles. Language is related to
this process in several ways. First, at the most global
level, a child's mastery of the language of her or his
community is a prerequisite to full participation in that
society. Second, language is the principal avenue for
conveying attitudes and social beliefs to the child.
Third, knowing the language of cultural subgroups is
essential to a sense of belonging to those groups. '°8
Language delayed children are clearly at a
disadvantage in learning the variety of social roles that
provide access to social groups and to society in
general. Because these children have less skill with
language, they are deprived of the most important
channel for learning about social roles. This
undoubtedly leads to an experiential deficit, since the
language delayed child does not learn the many roles
that the normal child can pick up incidentally by
observing others converse in various roles. In addition,
normal children often practice roles such as mother,
father, doctor, or teacher by role playing them in their
dramatic play. We have already mentioned that some
language delayed children appear to have deficits in
their ability to engage in such symbolic play. Here
again, the language delayed child, because of a lack of
skill, would be deprived of practice in learning social
roles.
For older children, being a member of the
childhood culture in part requires the rather advanced
linguistic skills involved in playground chants, jump
rope rhymes, handclap songs, punning, ritualized
insults, and secret languages. These types of language
play are transmitted by children to children. Bernstein
notes that such play with language makes the child
"sensitive to roles and status and also to the customary
relationships connecting and legitimizing the social
positions within his peer group."' Regarding secret
languages specifically, Sherzer notes that "a common
function of play languages is concealment and a
corresponding delineation of social groups and
subgroups. n° Not surprisingly, these various forms of
language play are beyond the capacity of many
language disordered children. They are unable to use
such language skills to reinforce group solidarity and
achieve access to important aspects of the childhood
culture.
The preceding discussion offers some guidelines for
the assessment of a child's knowledge of social roles at
an intrasystem analysis level. One may want to
observe the child interacting in a variety of social roles
— as a daughter or son, student, playmate, sibling, and
so forth -- in an attempt to determine the child's role
attribute knowledge. If the child engages in role play
during dramatic play, one is provided with yet another
window into such competencies. For the older child,
one would need to assess the ability to engage in
language play.
At an interaction level, the notion of social roles
suggests that the interventionist consider potential
language goals for their usefulness in the various social
roles the child must function in. In addition, children
may need to be taught to recognize the different social
roles of others and to adjust their language accordingly.
As was discussed when we addressed peer interaction,
Language Delay in the Child 680
particular types of language required for some roles
might need to be taught directly. Many language
delayed children must be taught to understand and
enjoy jokes, slang and the rituals of their peer groups.
Social role learning also raises the issue of who is the
best agent to teach different social roles. Peers may
be the best agents for teaching play group roles;
parents may be best for son or daughter roles;
teachers may be best for student roles. Often
clinicians want to engage others in the child's
intervention to increase carryover effects. However,
many times clinicians ask others to play a clinician
role. The social role learning perspective suggests that
these others may be more naturally equipped to teach
the language related to roles they already engage in
with the child. The most successful clinician may be
the one who can convey critical information about
how the child learns and what language the child
needs to learn for particular roles and may also be the
one who can guide others to assist in the teaching.
nature of print (i.e., that it corresponds to oral
language and hence meaningful ideas), (2) the multiple
functions of print (for entertainment, communicating,
self-expression, acquiring information, carrying out
daily affairs, practicing religion), (3) many conventions
of print (e.g., front to back of book, left to right on line
of print, top to bottom on page), and (4) how to take
meaning from books (i.e., answer questions about their
content in a school-like fashion).
Researchers in this area all suggest that these kinds
of knowledge facilitate a smooth transition into
learning how to actually read. van Kleeck and Schuele
posit that, in addition to focusing on oral language
skills, intervention with preschool language delayed
children should be aimed toward developing such
literacy knowledge."' In a second article, these authors
offer numerous concrete suggestions for both
assessment and intervention aimed at these skill
areas. 118
Metalinguirtic Skills
Academic Success
In the preschool years, children's dual task of both
learning language and deriving meaning in social
contexts is bolstered by the fact that the language
they hear is usually embedded in concrete, daily life
experiences. The nonlinguistic context and numerous
nonverbal devices provide cues to meaning. As the
child enters school, there are increasing demands to
derive meaning from the linguistic code alone in both
reading and following classroom discussions. In our
culture, language is the primary medium of formal
education. It is not surprising then that language
delayed children are at risk for academic failure.
Language plays a crucial role in nearly all the
academic tasks children encounter. Many kinds of
language skills interact to influence classroom success,
including (1) literacy knowledge, (2) metalinguistic
skills, (3) comprehension monitoring." (4) classroom
pragmatic and discourse skills."'" (5) the role of
language in concept formation,". (6) the role of
language in reasoning (7) using language to plan.
(8) strategies for learning and study skills, and (9)
language necessary for specific academic content
areas." Entire books have been written about many
of these areas. We shall briefly discuss only the rust
two areas listed and refer readers to the references
listed after each of the other areas for comprehensive
coverage of the issues involved.
Metalinguistic refers to language awareness. These
skills are manifested when a child is able to consciously
focus on the linguistic code as an object in its own
right. This ability underlies numerous skills," not the
least of which numerous researchers believe is learning
to decode print in early reading acquisition. In
addition, learning secret languages and many other
forms of language play discussed earlier require a
conscious focus on the linguistic code. Many
classroom language arts skills -- such as defining words,
forming synonyms and antonyms, and rhyming -- are
clearly metalinguistic in nature.
Many language delayed children experience
difficulty with various metalinguistic skills.'' Here
again, as with literacy knowledge, intervention can
begin in the preschool year. van Kleeck and Schuele
discuss the normal development of numerous early
emerging metalinguistic skills believed to be important
to early reading and provide assessment and
intervention suggestions in a subsequent article.' 119
SUMMARY
In this chapter, we have reviewed the theories and
models upon which much current language
intervention practice is based. We have suggested that
the variety of available theoretic perspectives provide
a set of lenses through which the clinician might view
In rrcent years. anthropologists who have become
interested in literacy as a cultural phenomenon have
documented the vast knowledge about literacy that
individual children who present with the symptom of
language delay. There are two final considerations we
must address before leaving the clinician to use these
lenses to explore language delayed children's individual
differences.
The first consideration involves the problem of
fragmentation. There is a danger in the artificiality of
children acquire before they ever learn to actually
viewing the child as a series of separate systems.
Literary Knowledge
decode print van Kleeck and Schuele summarize the
domains of literacy knowledge possessed by
preschoolers that are indicated in this research."'
Some of these areas of knowledge include (1) the
Damico has discussed the strong reliance on
fragmentation in language assessment and the fallacy
of breaking "the elements of language apart and trying
to test them with little or no attention to the way
Language Delay in the Child 681
those elements interact in the larger context of
communication."' Neither language nor children
function this way; both are complex. synergistic
systems in which the whole is significantly different
from the sum of the parts. Unfortunately, as Schacter
et al have pointed out, interventionists have tended to
take either a fragmented view and attempted to "fix"
one part of the system or a whole child view and
attempted to provide general stimulation.'Neither
approach is successful in meeting all of the individual
needs of language delayed children.
We would suggest that the nature of the problem
lies not so much in the initial fragmentation, but in
the failure to put the parts back together again. The
complexity of language and its social, cognitive, and
physical bases requires the careful scrutiny of its parts
if the clinician hopes to examine the child's strengths
and weaknesses in sufficient depth to understand
them. What speech-language pathology has spent
less time doing is examining the inter and intrasystem
interactions in order to understind the reciprocal
relationships among the specific language problems,
the contexts in which they occur, the other systems
involved, and the whole child. We hope that more
careful attention to levels four and five in our
intervention planning model will remedy many of our
former oversights.
The final consideration is the potential theoretic
incompatibility that can arise from clinicians viewing
children through lenses of different and possibly
conflicting theoretic perspective. One type of
problem that may arise is a mismatch between
assumptions about language and actual intervention
practices. For example: Rice has discussed the
mismatch between the premises of most language
intervention that the problem resides within the child,
that the focus of treatment should be on discrete
skills, that language skills can be hierarchically
organized) and the premises of the communication
competence model, which takes into account the
complex interactions among language, cultural
expectations, and the context of communication.'
Another type of problem springs from the clinician's
lack of awareness of and commitment to her or his
own theoretic assumptions. In order to adapt to the
individual needs of language delayed children, the
clinician may switch assumptions with each child. As
Johnston quips, "If this is Elmer, I must provide
reinforcing consequent events."'
The necessity to draw form numerous theoretic
perspectives in assessing and planning for the
language delayed child should be obvious by this
point. None of the theoretic orientations we have
reviewed is comprehensive enough to yield an
adequately broad view of the whole child. Few
models account for the heterogeneity we find among
children with delayed language. And no one
perspective addresses all of the levels that need to be
considered in intervention planning, even within the
primary domain it focuses on. So how can the
interventionist integrate many simultaneously held
beliefs into one theoretically consistent perspective
for dealing with children's individual differences? We
agree with Johnston that the solution lies in taking
theory seriously and in making explicit one's basic
beliefs!' The clinician who is sensitive to individual
differences expects children to differ in the etiology
and pathogenesis of the language difficulties, in the
effects of context and the environment, in the
interactions that occur within and among systems, in
the goals selected for intervention, and in the optimal
intervention agents and procedures. However, despite
vieing the child through many different lenses, it is
unlikely that the clinician can switch basic beliefs on
the following questions without considerable
soulsearching:
1. What is the nature of language?
2. What is language intervention?
3. What makes children's language behaviour change?
The clinician must make explicit her or his answers to
these questions and then must test the assessment and
intervention practices selected to be sure that they are
compatible with these basic assumptions.
Acknowledgement. We wish to thank Dana Kovarsky
for her help in compiling the information in Tables 227 to 22-11.
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