Language processing difficulties are the most common type of learning disability. Youngsters with processing problems might have trouble in any of the following areas or in a combination of areas:

1. Comprehension. Language-impaired children tend to have problems understanding conversation and directions, especially when distracted in noisy rooms.

2. Hearing words correctly. A child may have trouble hearing the sounds in words (phonemic awareness), and problems with grammar and word sequencing. They may not, for example, be able to discriminate the difference between the phrases “blocking the punch” and “punching the block.”

3. Remembering verbal directions: While they may be able to process simple instructions adequately (“bring me the green ball”), difficulty sets in when the language increases in complexity. (“Put the green ball back in your room and then wash your hands; go to the kitchen and take a seat.”)

4. Expressing themselves appropriately. Even children who understand and can use words correctly may have great difficulty finding the words they want. So-called word-retrieval or word-finding problems can manifest themselves in various ways. Either a child is frightened into silence by his inability to get his meaning across, or he uses a huge number of words to make himself understood. A child explaining that he’d like his sister’s stuffed kangaroo might say, for example, “Please, uhm, could I have that furry brown animal that jumps a lot and has, uhm, that pouch thing in front?”

Language processing difficulties don’t suddenly appear in early elementary school; they are usually a continuation of specific language problems present in early childhood. Children who have difficulty with speech-sound discrimination early on may have problems reading and spelling as they reach school age.

Lisa Strick and Corinne Smith, coauthors of PARENT’S GUIDE TO LEARNING DISABILITIES, offer the following checklist to help parents determine whether their child has a language problem. It is normal for children to display a few behaviors on the list. But a persistent pattern of symptoms may indicate a language disability.

•Delays in learning to speak
•Does not modulate tone of voice appropriately; speaks in monotone or too loud
•Has problems naming objects or people
•Uses vague, imprecise language; has small vocabulary
•Speech is slow or halting; uses verbal “stalling” mechanisms (“uh, uhm, you know”)
•Uses poor grammar
•Frequently mispronounces words
•Confuses words with similar sounds (such as frustrate and fluctuate; may produce hybrids such as flustrate)
•Often uses hand gestures and body language to help convey message
•Avoids talking (especially in front of strangers, authority figures or groups)
•Insensitive to rhymes
•Little interest in books or stories
•Does not respond appropriately to questions (replies “Monday” when asked “Where do you go to school?”)
•Frequently does not understand or remember instructions

There’s no single way to assess a language processing problem, says Mona Thomas, spokesperson for the American Speech-Language-Hearing Association in Rockville, Maryland. Testing may be formal or informal and include any combination of standardized tests; direct observation of play and interaction with caregivers; reports by parents, teachers or physicians; and collection and detailed analysis of spontaneous speech samples. Several sessions as well as ongoing evaluation may be required to obtain enough information to make an accurate diagnosis.

Children diagnosed with language processing problems often benefit from speech therapy. The current thinking is that when a language delay is expected, therapy should begin as soon as possible. In some cases where a child has failed to meet other developmental milestones, the therapy may best be started even before a child begins to speak.

The American Speech-Language-Hearing Association suggests parents ask the following questions before hiring a speech therapist:

•Are you certified and licensed?
•What age groups do you work with?
•Do you work primarily with particular speech, language or hearing disorders? What are they?
•Once my child has been evaluated, is there a waiting list for treatment? If so, how long is it?
•Does my child need to be referred to your program by a particular source, such as a community agency?
•Once my child has been evaluated, will you be able to anticipate the amount of time needed to treat the problem?
•How much do you charge?
•Will my insurance pay for the evaluation, and for some or all of the treatment?

Language Processing Problems – Tips and Strategies to Adapt and Modify Materials and Instruction to Improve Language Comprehension

Accommodating the needs of students with language processing problems, receptive language disabilities, dyslexia and listening comprehension weaknesses involves:
 

* Presenting written material in brief and direct terms;
* Omitting non-essential details and double negatives; [li}Avoiding multiple choice items that require complex analysis of language should be limited. Focus instead on essential details and facts required to master the subject matter;
* Allowing extra time for students to listen to, think about, and form their own thoughts about written and spoken materials used in class;
* Allowing students to discuss assignments with each other and with teachers to get clarification; and
* Using visual models and hands-on projects when possible to allow students to gain understanding of material using their visual learning skills.

 

Accommodating Language Processing Deficits – Ways Teachers and Parents can Implement Accommodations:

* Tape lectures and lessons for playback at home during study and homework sessions;
* Have a teacher, aide, peer tutor, or other appropriate person paraphrase instructions in writing or on tape;
* Simplify words in text. Paraphrase by eliminating non-essential words and phrases, and double negatives;
* Help the child summarize what he has read and write it down in brief, easy-to-understand terms;
* Provide examples of good work, and point out features of the work that contribute to its quality. Check to ensure the student understands what characteristics distinguish good work from poor work;
* Break large reading assignments into smaller sections;
* Note the most important parts of text and instructions. Use a highlighter, and write these down in simple, concise terms;
* Create a study guide that includes key vocabulary with definitions, guiding questions, and a clear statement of learning goals for the reading or task;
* Make liberal use of visual models, pictures, videos, computer generated models, or any other means available to allow students to use their visual reasoning skills to understand materials and to express their own understanding; and
* Allow students to use visual models and projects as alternatives to written assignments or spoken presentations when possible.
* Allow students to use multisensory materials and strategies.

Philippa Greathead
Speech Language Pathologist
Speech-Language-Learning Centre
Westmead, NSW, Australia

The child or adolescent with ADHD and learning problems will often present to the Speech Language Pathologist with a range of clinical problems in language that are contributing to the learning disorder.

The types of language problems experienced by children with ADHD are varied and can cover all the modalities of language. Typically problems are seen in:

Syntax:
Disorders of syntax (oral and written grammar) are difficulties using and/or comprehending the structural components of sentences.

Semantics:
Semantic difficulties in language involve problems with word meanings and organization. School problems include difficulties comprehending written and spoken language, poor vocabulary, word-finding difficulties and difficulties using context to help with the comprehension of reading.

Pragmatics:
Pragmatics is the term used for the social use of language – i.e. the ability to use language as a means to interact with others socially or for a specific purpose (e.g. requesting information, expressing feelings, holding a conversation with people of different age levels).

Metalinguistics:
This is the ability to reflect on language objectively – to know and understand that language is a rule-bound code – e.g. humour, multimeaning in words, ambiguity, figurative language (metaphors etc), ability to segment words into syllables or phonemes (sounds).

 
Related areas of difficulty

Auditory processing:
Children with language problems often have related auditory processing difficulties – particularly in the ADHD population. Problems can be found in the areas of speed of processing, auditory memory, auditory attention, processing of auditory information, auditory analysis and auditory discrimination. Following directions or getting information from reading and listening can be a nightmare for such children.

Metacognition:
This is the ability to think about thinking in general. To know what you know and to understand what you need to know in order to learn effectively. Students with difficulties in this area cannot easily deal with the strategies involved in problem solving.

 
What makes the ADHD child with a language problem different to other children with language problems?

The child with ADHD is more likely to have language processing difficulties than a simple language delay.

There may be no early developmental history of speech and language problems – the language problems may only become apparent as the child progresses through the school system. This is particularly relevant in the clever, even gifted, student with subtle language problems and ADHD.

In particular, the ADHD child with language problems can have auditory processing difficulties such as:
 

* Short-term auditory memory weakness
* Problems following instructions
* Slow speed of processing written and spoken language
* Difficulties listening in distracting environments e.g. the classroom
* Problems in listening for information when someone is talking or reading expecting them to listen – they may miss out on details, or get the details but be unable to grasp the ‘main idea’
* Getting information from reading – reading comprehension
 
They can also have language difficulties related to their impulsivity and poor organizational skills resulting in:

* Problems with classroom discourse
* Poor writing skills
* Tangential narratives and conversations
* Word-finding problems – ‘thing, thingy, it, you know’ plus gesture
* Difficulties inferring meaning – ‘looking beyond the obvious’
* Problems with generative language
* Social language problems
 

Learning styles and ADHD

The student with ADHD is likely to have difficulties with the learning style supported by the school system – that of being a good listener, being able to sit and focus for extended periods of time and of having good reading and oral language skills.

The use of learning styles as a therapeutics and diagnostic tool gives an added dimension to the role of the Speech Language Pathologist working with school-aged children and adolescents.

Considering learning styles broadens the approaches taken in intervention and helps in the development of strategies for the general management of language-related problems.

Children with language difficulties are often unaware of their own thinking and learning processes – they have poorly developed metacognition. They either do not know that there are certain strategies that can be used to help their learning or they use the wrong strategies for their particular learning style.

Analyzing the child’s learning style can give invaluable information to help you understand how best to support the child’s learning. One method of describing that learning style is the Visual – Auditory – Kinaesthetic – Print-Orientated – Interactive (VAK POINT) model developed by Glenn Capelli.

Some common characteristics of these learning styles are:

Visual learners

* Learn best by looking, watching and observing
* Want to see how things are done
* Enjoy poster, visual overhead, colours
* Learn well from videos
* Doodle and draw
* Work well with information mapping systems (e.g. Mind Maps)
* Picture well (visualize) inside their heads

Auditory learners

* Learn well by listening and communicating with others
* Learn through rhythm and rhyme
* Learn from audiotapes
* Have good auditory discrimination for sounds and auditory attack skills for reading
* Learn languages easily

Kinaesthetic learners

* Use their hands and whole bodies to learn
* Create things, make things, pull things apart and rebuild them
* Use their feelings

Print-orientated learners

* Read to learn and for pleasure
* Have good reading comprehension
* Write well and write for pleasure

Interactive learners

* Learn well by interacting with others
* Learn from discussion and dialogue
* Group work and co-operative learning
* Have an ability to lead, follow and be flexible socially
 
Children learn by their individual learning styles. Teachers tend to teach in a way that complements their own learning style. This is one reason children may learn well with one teacher and not another.

Children with school-based learning difficulties are often deficient in one or more of these learning modalities and need to focus their learning on the area that is their greatest strength – as well as building up the weaker areas.

Typically, the child with ADHD and language problems struggles with the auditory and print-orientated styles of learning. Interestingly, some who struggle with visual learning also have language-based problems – usually related to organization, planning and overall ‘whole picture’ understanding of language-based skills

 
Strategies to help children with language processing problems

The ‘pulse style’ approach to learning
One strategy that is useful in dealing with the ADHD child with language processing problems is recommending a ‘pulse style’ approach to learning. This can be applied to any learning task and is a great way to get optimal learning happening. See Diffused learning patterns.

Classroom and parent management strategies
See Strategies for students with auditory processing difficulties.

Teaching to learn styles
If the ADHD student with a language disorder has problems with a particular style of learning e.g. auditory learning, try to work with their most successful learning style, say kinaesthetic, in order to support the weaker style.

For example, a student with weak auditory learning skills and strong kinaesthetic skills benefits from being physically involved in the learning process. If the class if doing a ‘listening type task’ it would be helpful if the ADHD child was demonstrating something or holding something rather than just ‘listening’. It is also very difficult for the poor listener to cope with comments like ‘I am only going to say this once!’ – the added anxiety this causes makes the learning even harder.

Summary
Not all students with ADHD have language problems – and the types of language problems seen in ADHD can also be seen in children without ADHD. However, problems with information processing frequently include language-related difficulties and these have to be dealt with at home, school, socially and in a learning environment.