S: Speech and Language Disorders

MODULE S: UNDERSTANDING SPEECH AND LANGUAGE DISORDERS

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In Module C and Module F of the Inclusion Toolbox, we explained that effective communication with the family and the Scout is essential for accommodating any special need or disability.  For those with speech and language challenges, the family of the Scout is likely your best guide for information to help their child.  If you have not read the section on Joining Conferences in Module F, be sure to do that.

Speech and language challenges are invisible disabilities.  As with many other disabilities, Scouts with speech or language challenges may behave differently from others. They may avoid situations that requiring speaking, to avoid drawing attention to their disabilities. They may also pretend to understand conversations and instructions they did not fully understand.  A leader may have to make an extra effort to maintain a positive unit culture to encourage Scouts to communicate using their preferred method. A leader will also need to monitor the reactions of other Scouts to prevent bullying and teasing. This is discussed more fully in the Corrective Action section in Module F. Additionally, adults working with scouts with social communication issues need to be aware that when a Scout communicates in a way that appears disrespectful, lazy, or disinterested, this may be a feature of the disability rather than his or her personality.

The overarching goal of supporting a Scout with a speech or language disability is to help the Scout understand and be understood rather than try to reduce the differences in how the Scout sounds compared to others.

WHAT IS SPEECH? [1]

“Speech” and “language” are different, and a person can struggle with either or both of them.  Speech is how we say sounds and words. Speech includes three aspects:

  • Articulation, which is how we make sounds by moving the mouth, lips, and tongue. For example, we need to be able to say the “r” sound to say “rabbit” instead of “wabbit.”
  • Voice, which is how we use breath and our vocal folds (commonly called vocal cords) to make sounds. Our voice can be loud or soft, pitched high or low, or hoarse or smooth. We can hurt our voice by talking too much, yelling, or coughing a lot.
  • Fluency, which is the rhythm of our speech. We sometimes repeat sounds or pause while talking. People who do this a lot may be described as stuttering.

ARTICULATION

Articulation is how we produce speech sounds. Scouts with articulation delays or disorders will have speech that sounds different than other youth their same age. They may have difficulty producing one or many sounds correctly. Some of the differences could even resemble a foreign accent.

A Scout with an articulation disorder may be very difficult to understand. They may also use hands or body language to make themselves understood.  They may get frustrated because they can’t be understood, and misbehave as a means of communicating.  This is more common when they are very young.

When communicating with a Scout who has trouble producing the speech sounds correctly, remember:

  • The Scout may have typical cognitive skills and hearing and no difficulty understanding you.
  • You do not need to change how fast or loud you talk.
  • The Scout may (or may not be) embarrassed about how he or she speaks.

Tips for working with Scouts with articulation disorders:

  • Ask Scouts to repeat/rephrase/write or act out what they are trying to say. Do not act like you understand if you don’t. It’s very important that you respect and honor the Scouts’ attempts to communicate, as well as their wishes and needs.
  • Ask the family of the Scout for tips about how to communicate with and understand their child. Many people can be more easily understood if you know which sounds they substitute for others.
  • Don’t correct the child’s speech.
  • Allow Scouts with articulation disorders to choose how they want to communicate, perhaps by writing down answers instead of presenting information orally.

STUTTERING OR DYSFLUENCY

Fluency is the rhythm or smoothness of our speech. Scouts with dysfluent speech, or who stutter, struggle to get words out. They often repeat sounds or words, and appear to physically struggle to move to the next sound or word. They often substitute other words for words that they tend to stutter on. As a result, their word choice or vocabulary may seem different from others their age. Dysfluencies tend to get more severe when the person is under stress or pressure. People who stutter may be as smart as anyone else, but may be embarrassed by their stuttering. It is important to realize that they do not usually have other language or developmental issues.

Tips for working with Scouts with dysfluency or stuttering:

  • If such a Scout volunteers to speak in front of a group, encourage him or her, but do not put anyone on the spot.
  • When possible and if needed, allow Scouts to present material in alternative ways like written work, posters, pictures, photos, or videos.
  • If a verbal presentation is necessary, allow time for preparation and practice beforehand.
  • Do not finish words for the Scout. Patiently wait for him or her to finish expressing the thought.
  • Do not tell the Scout to slow down or “relax”.   It is better to set a relaxed mood in the first place.

VOICE DISORDERS

Voice is the way we produce sounds. Most Scouts with voice disorders will have hoarse or whispery voices. Some Scouts may have other voice disorders that cause their voices to be very quiet and difficult to hear. Since voice disorders can be caused by underlying medical conditions or by overuse/misuse of the voice, it is good to ask the family of the Scout what accommodations are made at home or school to assist the Scout, and do likewise.

Tips for working with a Scout with a voice disorder, in addition to tips recommended by the family:

  • Allow the Scout to present information in other forms – written, drawing, pictures, photos or posters.
  • Conduct conversations in quiet places, so you can hear the Scout.
  • Provide a microphone and sound system if the Scout wants to present to a larger group.

WHAT IS LANGUAGE?

Language refers to the words we use and how we use them to share ideas and get what we want. Language includes:

  • Word meanings – Some words have more than one meaning. For example, a “star” can be a bright object in the sky or someone famous.
  • Modifying words to make new words – For example, we can say “friend”, “friendly”, or “unfriendly” and mean something different each time.
  • Putting words together to express ideas – For example, in English we say, “Peg walked to the new store” instead of “Peg walk store new.”
  • Adapting messages to the situation – For example, if someone is standing on your foot, you might be more polite at first and say, “Would you mind moving your foot?” But, if the person does not move soon, you may shout, “Get off my foot!”

EXPRESSIVE LANGUAGE

Expressive Language is the way we use words and sentences to express ourselves. Scouts with expressive language delays or disorders have difficulty using the intended words and building sentences to express themselves. Their vocabulary is sometimes less varied than other Scouts their age. They may struggle to get their point across. Some children with expressive language delays or disorders also struggle with written expression as well[2]. Scouts with expressive language disorders may or may not also have receptive language disorders (discussed next).

Tips for working with Scouts with expressive language delays or disorders:

  • Accept shorter answers (both written and spoken) than you would otherwise expect.
  • Allow Scouts to report or present information in a variety of ways[3]. Allow them to use posters, pictures, drama, oral or written presentations. Allow them to use a variety of presentation methods in the way that allows them to express themselves the best.
  • Allow extra time to prepare and practice before presentations.
  • A Scout with an expressive language delay or disorder may shut down and stop talking when they get frustrated. Allow the Scout time to regroup and then ask how you can help. See Module F for a discussion on self-removal to manage stressful situations.

RECEPTIVE LANGUAGE

Receptive language is how we understand the language we hear.  When the brain connects the sound of a word to the wrong word or concept, you get confused. Scouts with receptive language delays or disorders may have difficulty following oral presentations, conversations and directions.  The effect is similar to a hearing reduction, but the underlying struggle is different.  Scouts with receptive language delays or disorders may appear to be listening but do not understand what is said. Others may act out because they are frustrated that they cannot understand what is asked of them or what is being said in a conversation.

Tips for working with Scouts with receptive language delays or disorders:

  • Check for understanding. After giving the Scout instructions or discussing important information, check for understanding by asking him or her to repeat back the instructions or the information.  If he or she needs clarification, explain again in a different way but don’t talk down to the Scout.
  • Break down instructions into small bites of information. Give the Scout one step at a time. Once they finish one direction, give them the next step.
  • Pair the Scout with a buddy who can also hear the same instructions and repeat them back.
  • Teach with a variety of methods. Show illustrations (pictures or photos), use video, draw things out, write things out, or physically demonstrate in addition to verbal instruction.

SOCIAL COMMUNICATION[4]

The ability to use speech and language for social interaction is very important.  This adds another layer to language beyond words and sentences.  There are many subtle “rules” in every culture about what you can say in different situations and to different people.  In speech and language circles, this is often called “pragmatic language”. These rules vary from one culture to another.  Here are some of the major skills for social communication:

  • Using language for different functions/reasons: these include greetings, sharing information, requesting, demanding information or action, thanking, or acknowledging other people
  • Adapting your communication to the listener. For example,
    • talking to someone older than you differently than you would to someone younger
    • treating someone you don’t know well more formally than a friend
    • respecting the position or authority of another person
    • distinguishing between formal and informal situations
  • Following sequences for conversation and storytelling. For example:
    • Beginning with a greeting
    • Signaling the topic at the beginning
    • Taking turns while talking
    • Letting others talk
    • Staying on topic
    • Ending with a farewell
  • Using gestures and body language.  For example:
    • Standing at the right distance from other people
    • Showing interest/disinterest through posture and eye contact
    • Using facial expressions to add meaning and context to the words

All children need time and experience to learn unstated social rules. Social communication issues vary from day to day and will change over the years as a Scout matures.  A scout with a social communication struggle may have a hard time being accepted socially into the group. Adult leaders may misunderstand Scouts with social communication issues. The Scout may come across as disrespectful, disinterested in others, bossy, demanding, or odd; when that is not his or her intent.

Tips for working with Scouts with social communication delays or disorders:

  • Understand that they may appear “rude” or disinterested when in one on one or group situations when they are not intending to look that way.
  • Include these Scouts in discussions with a personal, targeted invitation to contribute. Do not assume that they will chime in like other Scouts do.
  • Facilitate communication between the Scout and the other Scouts in the group. The Scout with social communication differences may not immediately or spontaneously communicate with peers and will often be left out of groups.
  • Check for understanding with the Scout since they may not understand the gestures or nonverbal communication that accompanied the instructions.
  • Be very careful in your use of sarcasm, similes, metaphors and idioms when speaking with the Scout. Discourage sarcasm by other Scouts. These types of communication are very often misunderstood by someone with social communication differences.

SCOUTS THAT DO NOT SPEAK

Some Scouts are not able to use verbal speech and language to communicate[5]. Some others find themselves unable to speak in certain situations[6]. A Scout that does not speak may or may not have a hearing problem. The Scout may or may not have difficulty understanding what you are saying. These Scouts may be able to say some words but they do not use enough spoken words or sentences to express themselves fully. They may use other means of communication. These include gestures, sign language, facial expressions and specialized tablets or computers with special software that allow them to speak through the device. These specialized devices are called AAC (Augmentative and Alternative Communication) devices[7]. Some families call them talkers, speech devices, communication devices, or VODs (voice output devices).  The Scout unit does not need to provide this equipment but should make use of the technology the Scout already has available.  Using AAC, these Scouts are communicating using words but not with their natural voice. It is good to ask the family of the Scout what accommodations are made at home or school to assist the Scout and do likewise.

Tips for working with a Scout who does not speak, in addition to tips recommended by the family:

  • Allow the Scout to present information in other forms – written, drawing, pictures, photos or posters.
  • Use a small whiteboard to communicate in the outdoors or other locations where electronics are not practical.
  • Be very patient with the Scout when he or she is communicating. It takes much longer to communicate via gestures or a communication device than with spoken words.
  • If a Scout is using a communication device, talk with the family about the need to add any Scouting vocabulary to the device. For example: Scoutmaster, merit badge, camporee, names of knots, or types of camping equipment.

[1] https://www.asha.org/public/speech/development/speech-and-language/

[2] Though this effect is a little different, there is a discussion of Dysgraphia in Module Q, with learning disorders.

[3] Module E discusses how to make accommodations for advancement requirements that are typically done in written or verbal form.

[4] Atypical social communication is a relatively common feature of autism spectrum disorders but not the only feature.  Autism is discussed in Module L.  However, don’t assume that a child with a social language challenge is on the autism spectrum.

[5] Speech and language professionals usually refer to these youth as “nonverbal” or “nonoral”.

[6] The formal name for this condition is “selective mutism”.

[7] There is additional information above alternative communication technology in Module N which addresses hearing difficulties.