Our speech language therapist answers questions on why your 2 or 3 year old may have speech & language and social skills difficulties. Follow up to our previous video on the same subject.
Hello and welcome! My name is Magan Chen and I’m a speech and language therapist (speech pathologist). Welcome to this video! This video is actually a follow-up to a previous video – Why your 2 or 3 year old has speech difficulty and how to help him or her. It has proven to be a very popular video. Thank you very much for your comments and discussion.
So I thought I would like to address some of the concerns that were brought up and hopefully give parents more information so that you can take further action.
You can recognise some of the terms that I use and understand what they mean, and you know enough not to get overly panicked when you don’t need to be, yet you need to know when to take additional action when required.
So I think a lot of people brought up concerns when their 2 or 3 year old or maybe even an older child is not talking and other people might bring up the possibility of autism or ASD (or Autism Spectrum Disorders). So let me start with that first because I think that’s one thing parents are usually very worried about.
First of all, what is autism? I think there are three main criteria typically for a child to be diagnosed as being on the autism spectrum.
One is speech and language difficulty. So they may be behind in terms of using speech and language to communicate with other children. They may be slower, may not use as many words, or they may restrict it in how they use their words.
They may be very good at naming letters of the alphabet, they may be very good at naming animals. They may not be so good at responding and answering questions or using language to express how they feel. So that’s speech and language difficulty.
The second area is more an area about social interaction. Now, children can interact without using speech and language when they are playing with other kids, for example they may run around, share some toys, not playing the same toys together.
They don’t really have to do that with speech. They can interact and play with other children. So when the child is having difficulty with social interaction, they may not know how to join in, or they prefer to play by themselves or are resistant to actually take turns when playing and so forth.
So the first one was speech and language difficulty, second area’s social interaction, and the third area is what is called restrictive repetitive behaviour. I’ll repeat that again, it’s restrictive repetitive behaviour or abbreviated RRB.
So as the name implies the child may have a very restricted range of play, so they have only a few rather than being interested in lots of different toys or games. They may be restricted to only a few and they may play the toy in a very repetitive way, doing something over and over again, spinning it around or banging it over and over, things like that.
So those are the three main areas. In fact the last one, RRB, or restrictive repetitive behaviour, would be one of the most defining characteristics. If a child does not have RRB and is just having difficulties or you could describe them as being socially awkward, not being very good at playing.
It could be just due to cultural and environmental factors like not having the exposure of playing with friends or it could be due to a speech and language difficulty.
What exactly are we talking about? One way to try to understand it better is to imagine that it’s literally like a child learning a foreign language. What happens when you go to foreign country and you need to learn a foreign language.
First of all, you need to know the vocabulary, for example what you call or how do you say ‘train’ in a different language, how do you ask for the bathroom in a different language and so forth.
So after you learn a few words to express the names of objects, maybe certain words and feelings, maybe you want to express more complicated ideas.
So you need to have a better grasp of the sentence structure. So maybe you need to learn phrases, you want to express idea like “Oh it’s not raining anymore” or maybe you want to ask “Do you have this in a different size” and different ideas like that.
And then if you’ve really tried this out in a foreign country, you may have had the experience that you learn a few phrases and words and then you try them out and all of a sudden somebody is speaking to you in a foreign language.
So they go on and on in Italian, Japanese or whatever language. And then you realise the other aspect of language, which is what we call receptive language, how you receive the language or understand the language which is equally important.
So very often the child doesn’t really understand the language, let’s say you ask him or her a question “Where did you see the dog?”, you’re asking about where, a location, a place, but the child may only understand “dog”, they only got the word “dog”. So what do they associate with dog?
If they understand that it was a question they may try to say something about the dog back to you. Maybe your child has only learnt that a dog goes woof-woof. But you asked “Where did you see the dog?”, instead of telling you in the playground or the garden, they may say woof-woof because that’s all they know to answer the question about the dog.
In other cases, the child may not know what to say at all. So you may get the case where you ask the child a question and they don’t respond, or they keep quiet, or sometimes they ask to repeat the question back to you not because they are being autistic, but just because they don’t understand the question. So it’s more like a speech and language difficulty.
I think the distinction is quite important, so that you know that if a child is having difficulties, is slow in picking up speech and language, it does not mean the child is autistic.
The converse is true. A child may still have a diagnosis of autism, even though he or she has speech. So he or she may be talking but maybe they’re not using it in a way to communicate what they want to do. They may repeat words just to label, like they know that this is a “tiger”, this is an “elephant”, a “lion” and so forth.
The other thing is to be aware that very often the responsiveness, sometimes even things like eye contact too, just comes with the fact that maybe a child is struggling to communicate and they may find it difficult to multitask between listening, paying attention to the question while they’re busy playing with toys. They may find it hard to multitask and respond to questions.
So again, you may find that when children with speech and language difficulties get intervention, they actually improve their speech and language skills to ask for what they want. Typically you will find that the responsiveness and the behaviour will improve as well. So that’s why I say that diagnosis is very important.
Any time you’re concerned, as I’ve brought up in the previous video, children are incredibly wired to learn speech and language. It’s different from reading for example, like we expect children to be taught how to read, but even children who have no exposure to and no opportunities for schooling are expected to pick up speech and language, like talking to their family, talking to their friends and so forth.
So when the child is having speech and language difficulties, you can see that there is a clear difference between how he or she communicate and you do want to take note, you want to see if there’s something you can do at an early stage. Speak to people, speak to the school teachers about your concerns, speak to your doctors, try to get a referral.
Like I said, I can’t really provide assessments over the video. So it’s really important for you to follow up. And sometimes it’s not even the case of getting a second opinion, you may be talking about getting a more updated opinion.
So if your child has seen a therapist some time ago, what was okay for a 1 or 2 year old may not be so okay if the child has not been really making progress in that length of time. So when the child is older, at 3 or 4, you may want to take the child for a second opinion or a more updated assessment if you find that that’s necessary.
Hopefully that answers some of your questions. I know that on the internet it’s easy to find lots of information, but sometimes it’s hard to have your questions answered. So please continue to send in your questions and join in the discussion, and hopefully I’ll try to make more videos to try to help you.
Do you like this video? Please share this video with your friends who may find it useful. Thank you very much.