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By Taylor Bardell, MClSc/PhD Combined Candidate, School of Communication Sciences and Disorders, The University of Western Ontario and Lisa Archibald, PhD, Associate Professor, School of Communication Sciences & Disorders and Department of Psychology, The University of Western Ontario 

“Oral language is the child’s first, most important, and most frequently used structured medium of communication. It is the primary means through which each individual child will be enabled to structure, to evaluate, to describe and to control his/her experience. In addition, and most significantly, oral language is the primary mediator of culture, the way in which children locate themselves in the world, and define themselves with it and within it."

(Cregan, 1998, as cited in Shiel et al., 2012) 

Introduction  

Oral language skills are involved in virtually every aspect of a child’s school day. From socializing with peers at drop-off, to understanding instructions from educators and participating in classroom activities, oral language skills are at the centre of every interaction and profoundly impact success in school (Foorman et al., 2015; Ladd et al., 2012; Rubin et al., 2012)  

It is not surprising then, that children with a persistent problem learning language known as Developmental Language Disorder (DLD)are at an increased risk of poorer academic and social performance (Catts et al., 2002; Conti-Ramsden et al., 2013; Cross et al., 2019; Mok et al., 2014)Frequently, these children go undiagnosed and thus don’t receive the specialized assistance that would help them succeed (Hendricks et al., 2019; Prelock et al., 2008)This occurs in spite of the fact that approximately 2 children in every classroom of 30 have DLD, making it 5 times more common than autism spectrum disorder and 50 times more common than hearing impairment (Norbury et al., 2016). Children with DLD are also 6 times more likely to have reading disabilities and 4 times more likely to have math disabilities than other children (Adlof & Hogan, 2018; Catts et al., 2002; Komesidou & Hogan, 2019). Weak language skills can be challenging to recognize, so many children with DLD are instead identified with a learning disability or attentional disorder due to poor performance in school (Archibald, 2019). It is plausible, then, that many children with a learning disability could have an underlying language disorder hampering their learning. Educators are uniquely capable of making an enormous difference for these children. Knowing the signs of DLDmaking small adjustments to their teaching styles, and advocating for awareness of the disorder are just some of the ways educators can help children with DLD succeed.  

What are oral language skills?

Before helping children who struggle with oral language skills, it is first necessary to understand what these skills are and the impact they have on a child’s academic success. The term “Oral language” is often used in reference to vocabularybut it actually encompasses five main areas: phonology, morphology, semantics, syntax, and pragmatics 

PHONOLOGY refers to the system of sounds within a particular language. Establishing a phonological system begins in infancy, when children learn to listen to speech and gain the ability to distinguish syllables, words, and phrases. As they grow, children start to gain an understanding of other aspects of phonological awareness, such as blending, segmenting, and manipulating sounds, rhyme and alliteration. Fostering a child’s phonological awareness can have a tremendous impact on later academic success. Research has shown that early phonological awareness is related both to reading (Deacon & Kirby, 2004) and writing ability (Mackenzie & Hemmings, 2014) 

MORPHOLOGY refers to morphemes, the smallest units of meaning in language, and how they are combined to form words. For example, the word ‘cups’ has 2 morphemes: <cup> refers to a vessel for holding liquid, and <s> denotes the plural form. Morphological awareness refers to a child’s awareness and ability to manipulate these small units of meaning (Carlisle, 1995), and it begins to develop as early as the preschool years. Morphological awareness is also related to children’s reading success, and should, therefore, be targeted alongside phonological awareness in interventions for early literacy (Deacon & Kirby, 2004)  

SEMANTICS refers to the meaning of words and phrasesincluding vocabulary knowledge. Vocabulary knowledge can be broken down into two distinct categories: spoken vocabulary, which includes words used informally in conversation, and academic vocabulary, which refers to words used in academic talk or text. Just like phonological and morphological awareness, academic vocabulary is another significant contributor to reading ability (Nation & Snowling, 2004; Snow, 1983)There is also a strong relationship between spoken vocabulary and social development. Children with greater spoken vocabulary abilities have been shown to have greater success interacting socially with their peers (Mashburn et al., 2009; Sparapani et al., 2018)  

SYNTAX, sometimes simply referred to as grammar, is the set of rules that dictate the ways in which words and phrases can be combined into sentences and paragraphs. It is essential to use correct syntax in order to communicate messages that are meaningful and easy to understand. From an early agesyntax influences the way in which children communicate spoken language. As they age, the importance of syntax extends to written language as well. In fact, syntax has been shown to be a predictor of writing success, which in turn impacts success in higher education and employment later in life (Daffern et al., 2017; National Commission on Writing, 2004) 

PRAGMATICS refers to the social use of language. This includes a variety of social norms regarding how to participate in communication including how to take turns in a conversation, interact in a group, maintain personal space, and use appropriate behaviour with different communication partners or in different settings. Not only do children who struggle with pragmatic skills have difficulty interacting with peers and forming social relationships, but many also have underdeveloped early literacy skills due to difficulty participating in classroom activities (McClelland et al., 2006) 

For the majority of children, oral language develops during the first few years of life with little effort. Precursors for the five language skills outlined above are apparent early in infancy and develop in concert as a child ages, becoming increasingly complex (Honig, 2007). Oral language is an integration of all of these skills, and thus educators can focus on targeting oral language as a whole, rather than focusing on each skill separately. Consider word learning; a word is not fully known until a child learns the sounds (phonology), meaningful parts of the word (morphology), how the word fits in a sentence (syntax), what the word means (semantics), and how to use it to communicate (pragmatics). By providing rich language experiences, models, and explicit instruction, an educator can support all aspects of language development. 

Who might struggle with oral language skills?

Difficulty with language skills is a component of many learning-related disorders. As a result, children with language-based learning difficulties may be identified with several different terms, including learning disabilities. A variety of factors influence how children’s learning challenges are identified, but one historical problem has been a lack of consensus in the term used to describe children with a language-based learning difficulty relating to understanding and using spoken and written language (Newhall, 2012). In 2017, however, an international consensus agreed on the use of the term Developmental Language Disorder (DLD) to describe children with a persistent language problem with a significant impact on school learning or social functioning and not associated with a biomedical condition accounting for the language disorder (Bishop et al., 2017). In cases where a language disorder is associated with a well-characterized developmental condition, such as autism or fetal alcohol syndrome, Bishop et al. recommended the term Language Disorder associated with {that condition}.  

Approximately 7-9% of children show significant enough impairment in the ability to understand and produce spoken language to meet criteria for DLD (Norbury et al., 2016)This is about 2 children in every classroom, making DLD 5 times more common than autism spectrum disorder and 50 times more common than hearing impairment (McGregor, 2019)DLD can co-occur with other neurodevelopmental disorders (for example: ADHD). It has no known cause, and is likely a result of multiple biological, genetic, and environmental factors. (Bishop et al., 2017).  

Effects of oral language impairment on school

Having impaired oral language skills can impact learning in all subject areas and thus have an enormous effect on school success.   

Given the relationship between oral and written language skills, it is unsurprising that children with impaired oral language skills struggle in subjects such as Language Arts and early literacy activities. Research has shown that children with DLD are 6 times more likely to have reading disabilities such as dyslexia than other children (Adlof & Hogan, 2018; Catts et al., 2002)This doesn’t mean that only performance in literacy-focused subjects is impacted by a child’s DLD. Almost all activities and evaluations in school require the ability to read and write effectively (Komesidou & Hogan, 2019)For example, second grade Science unit may be focused on learning about the life cycle of a butterfly. The unit may include some language goals like increasing vocabulary related to life cycles, but the main focus is not language or literacy skills. Still, all instructions for activities are given orally and/or in written format by the teacher. Participation in activities may involve group work with peerswhich requires quite sophisticated communication skills. Answering questions is also likely done either orally or in written form. Clearly, language and literacy are involved in every aspect of the unit.  

It would be very challenging to come up with an example of an activity or evaluation in school in any subject that does not involve language or literacy in some capacity. Even math has been shown to be challenging for those with DLD. Although they may have success with numerical calculations (Cross et al. 2019), children with DLD are 4 times more likely to have math disabilities (Komesidou & Hogan, 2019)As an educator, it is important to recognize the impact that such a disorder will have in all subjects – not just those traditionally thought of as language-focused.  

What can educators do to help children who struggle with oral language skills?

It is clear that children who struggle with oral language skills need additional support in order to be successful in school. So what can educators do to help?  

1. Look for signs of DLD in children in your class and consult with a speech-language pathologist if you have any concerns

“All too often, people mistake un-identified DLD as laziness or lack of attention. In reality, people with DLD are working hard to meet complex language demands.”

(Archibald, 2019).  

DLD can be very difficult to recognize due to the wide variety of ways that it presents in children. Although every child with DLD struggles with oral language skills, one child may find phonology particularly difficult, while another struggles more with pragmatics. Additionally, a child will not “grow out” of DLD; it is a lifelong condition. However, the way it looks and develops across a lifespan can change.  

The language errors observed in children with DLD are very similar to those considered developmentally appropriate in other children, which also makes DLD difficult to recognize. With DLD, however, these errors will be more frequent, and be part of a child’s talking for longer than expected. Still, it can be difficult to discern if a certain pattern of errors is simply part of language development, or if a diagnosis of DLD is warranted 

Finally, there are no physical characteristics of DLD. You cannot look at a child and discern whether or not they have DLD. It may not even be apparent in everyday communication that a child has DLD, because these situations are familiar to the child and they’ve had lots of practice communicating in these instances. DLD may only become apparent when communication tasks become more demanding (Archibald, 2019) 

Although the diagnosis of DLD can only be done by an expert like a speech-language pathologist, anyone who is aware of the signs can begin the path to getting that child the help they need. Aside from primary caregivers, educators spend the most time with a child each day. If throughout the many interactions with a child, an educator is able to identify these signs, they should reach out to the school speech-language pathologist who can assist them in investigating further.  

A diagnosis of DLD is not usually given until the preschool years, but signs of DLD can be present even earlier (Rudolph & Leonard, 2016). Teachers should look for the following signs of DLD in children of all ages and grade-levels.  

Signs of DLD (adapted from Bishop et al., 2017)  

A child:  

  • May not talk as much as other children  
  • May use immature language  
  • May struggle to think of certain words (word-finding difficulties) 
  • May have difficulty with words that have more than one meaning  
  • May not understand or remember what is being said to them  
  • May have difficulty categorizing and manipulating sounds. For example, a child may be unable to identify the three phonemes in the word ‘dog’, or recognize that ‘dog’ and ‘Dad’ begin with the same phoneme
  • May provide too much or too little information to a conversation 
  • May be insensitive to social cues 
  • May be over-literal and have difficulty understanding figurative language 
  • May have difficulty telling a story that makes sense to listeners. For example, ideas in the story may appear disconnected and hard to follow  
  • May have difficulty remembering sequences of sounds or words over short term (verbal short-term memory difficulties) 

2. Make small adjustments to your teaching that better support students with language impairments

Seemingly small changes in the way that teachers communicate and present information in their classrooms can have huge impacts for children with DLD. Some easy to implement changes can be represented by the acronym S.M.A.R.T (adapted from Mentrasti, 2019 

SMART acronym for students struggling with oral language skills

SLOW DOWN: Slowing down your rate of speech can help provide children with DLD more time to process what you are saying. If you speak too quickly, these children are more likely to miss important information.  

(E)MPHASIZE: Emphasizing key points in your message will help cue children with DLD to the most critical words in your instructions.  

ADD VISUALSAdding visual cues in the form of gestures or pictures can provide children with DLD hints to help them understand your messages.  

REPEAT INSTRUCTIONS: Repeating instructions two or three times has been shown to be highly beneficial for children with DLD.  

TIME TO RESPOND: Children with DLD often need extra time not only to process messages, but also to craft a response. Providing more time to give an answer can allow them to better formulate and deliver an answer.  

Additional ways that educators can support children with impaired oral language skills include:

(Cross et al., 2019; Crosskey & Vance, 2011; Dickinson et al., 2014; Dockrell et al., 2010; Ebbels et al., 2019; Hagen et al., 2017; Matheson & Hutchison, 2014; Saxton et al., 2005) 

  • Introduce and highlight key vocabulary, especially new and complex words. For example, when you begin a new unit you could start a chart of ‘New Words’ and post the chart in an easily visible spot in the classroom. Each word could also have a picture or image that accompanies it. Throughout the unit, encourage children to use these new words frequently, and provide numerous models of how to use the word yourself 
  • Encourage oral participation. Provide opportunities for your student to use the new words they’re learning, and discuss their ideas. Find what works best for your student such as talking to you, talking to a peer or small group, or talking to the whole class. Strategies to help the child be prepared for participation can be knowing the question in advance and practicing a response or adding a response after several other students have taken a turn. Providing a picture to look at while taking a turn can also be a helpful cue to remind children what topic you’re discussing at that time.   
  • Restate key points. Not only is it important to emphasize and explain key points, but it is also important to restate these points in different ways to provide children with as many cues for understanding as possible.  
  • Provide opportunities for students to signal they have not understood somethingIt is crucial to nurture a classroom environment where students feel comfortable asking questions and letting them know when they are not understanding something. A non-verbal gesture of some kind could be developed with students to indicate that they need a concept to be explained again or reframed 
  • Provide multimodal learning and assessment opportunities. Lessons involving multimodal opportunities through verbal instructions, written words, pictures, diagrams, videos, and hands-on activities with concrete objects allow for all children to participatelearn, and be evaluated regardless of their language abilities.
  • Provide scaffolding as much as possibleIf a written or verbal response is required for an activity and a child is struggling, try to think of different ways you can provide scaffolding to support the child in completing the task. Options could include providing a scribe for the student, helping the student organize their ideas in a graphic organizer, or allowing the child to complete drawings to supplement their ideas. 
  • Collaboratwith your student’s speech-language pathologist! If a student in your class is already working with a speech-language pathologist (SLP)a lot can be achieved by working together. SLPs can help the child better access the curriculum in the classroom. For example, if you are working on a new unit that includes difficult vocabulary, the speech-language pathologist could incorporate this new vocabulary into their intervention sessions. Furthermore, the speech-language pathologist could provide tips on how to help the child be more successful during social interactions, which could make classroom activities run more smoothly. 
  • Consider ways of reducing the cognitive load. Distractions can make focusing on challenging language demands even more difficult for children with DLD. Ensure that background noise is reduced as much as possible and that the seating arrangement minimizes distractions during challenging tasks.  

 3. Help increase awareness of DLD   

“(DLD) is one of the most poorly recognized and understood disorders of childhood despite its prevalence.”

(Norbury, 2017)  

Despite it being more common than many widely known childhood conditions such as autism spectrum disorder and ADHD, awareness of DLD remains alarmingly low (Bishop et al., 2012; Dockrell et al., 2019). If people are not aware of DLD, they will not be able to recognize the signs of the disorder, and children will continue to go undiagnosed and unassisted (Hendricks et al., 2019; Prelock et al., 2008). With the proper assistance, many children with DLD go on to have good quality of life outcomes  (Hobson & Bird, 2019; Johnson et al., 2010). Advocacy campaigns have the potential to increase public awareness of little-known disorders like DLD, and hopefully increase lobbying efforts for additional support for these children (Bishop et al., 2012). Two campaigns, in particular, have received an abundance of support from clinicians, researchers, and educators both nationally and internationally: Raising Awareness for Developmental Language Disorder (RADLD; https://radld.org) and DLD and Me (https://dldandme.org). By getting involved in campaigns such as these, educators can help increase public awareness of DLD, which can lead to better support for these children and their families.   

Tipsheet - How can educators support students struggling with oral language skills

Click here to download an educator tip sheet that summarizes the signs of DLD and some of the ways in which educators can support students who struggle with oral language skills. 

For more information about supporting children with DLD, please refer to the following resources: 

Supporting Developmental Language Disorders in the Classroom - Youtube Video:

https://www.youtube.com/watch?v=PKegRlHFqH4  

Raising Awareness for Development Language Disorder (RADLD) Campaign: https://radld.org  

DLD and Me: https://dldandme.org  

 About the Authors: 

Taylor Bardell is a graduate student in the combined MClSc/Ph.D. program in Speech-Language Pathology at the University of Western Ontario. She is supervised by Dr. Lisa Archibald. Her research focuses on using practice-based research to examine and evaluate language intervention programs in schools. She graduated from Queen's University with a BSc in Psychology. 

Lisa Archibald is an Associate Professor in the School of Communication Sciences and Disorders at the University of Western Ontario, Canada. Lisa studies links between memory and language processes in individuals with communication disorders. In particular, she is interested in working memory and language learning deficits in children. Recently, she has focused on SLP-educator school-based collaborations, and has been part of an international team of researchers and stakeholders considering terminology and profile for children with and unexplained, persistent language disorder now known as developmental language disorder (DLD). 

Lisa is a member of the international organizing committee for Raising Awareness of Developmental Language Disorder (RADLD.org) and a founding member of DLDandMe.org. Prior to her research career, Lisa worked as a clinical Speech-Language Pathologist (SLP) for over 15 years providing services to children and adults, in schools, hospitals, and other facilities. 

You can follow Lisa on twitter at @larchiba6. 

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