Development in Children

Auditory Processing, Global Development Delay (GDD), Speech/Language

Over one million children in the UK have some kind of speech, language and communication needs.

Every child is different. Their needs depend on different factors, including:

  • Which areas of speech, language and communication they struggle with.
  • How severely these areas are affected.
  • What skills and strengths they have.
  • How they need to use their skills.
  • Their level of confidence and self-esteem.
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Trouble with spoken language isn’t the same as speech issues. Children with language disorders may have no problem pronouncing words, but can struggle to put together logical sentences. Here are common signs of trouble with spoken language:

  • Has a limited vocabulary compared to children the same age
  • Substitutes general words like “stuff” and “things” for more precise words
  • Has trouble learning new vocabulary words
  • Leaves out key words when talking.
  • Uses certain phrases over and over again when talking
  • Doesn’t talk much, although he understands what other people say
  • Uses short, simple sentences or speaks in phrases
  • Uses a limited variety of sentence structures when speaking
  • Has little interest in social interactions
  • Goes off-topic or monopolizes conversations
  • Doesn’t change his language for different listeners or situations
  • Has trouble understanding things that are implied and not stated directly
  • Doesn’t understand how to properly greet people or gain attention
  • Doesn’t understand riddles and sarcasm

While there are two main conditions that make it hard for children to express themselves verbally, other issues can create problems with conversation. Here are the most common causes of trouble with spoken language:

  • Expressive language disorder: This condition, also known as developmental expressive aphasia, makes it hard to put thoughts and feelings into words. Children who have it are often late to talk and don’t “catch up” on their own. They often have a limited vocabulary. They may leave out key words from sentences and mix up tenses. They are also at risk for other learning and attention issues, including dyslexia, ADHD and auditory processing disorder. It can be difficult to figure out which conditions cause which symptoms, since symptoms might overlap; ADHD and auditory processing disorder, for instance, may cause expressive language difficulties.
  • Mixed receptive-expressive language disorder: Children with mixed receptive-expressive language disorder may show some of the symptoms of expressive language disorder, as well as difficulty with understanding what others say (receptive language). They may have trouble putting their thoughts into words. They often have difficulty understanding verbal directions or longer sentences. They may have trouble understanding basic vocabulary and may not understand stories that are read to them. They’re at risk for reading comprehension difficulties too.
  • Social communication disorder (SCD): This is a newly defined condition that has gone by other names in the past. They include pragmatic language impairment and semantic pragmatic disorder. SCD makes it hard for children to make appropriate conversation. They may interrupt often and speak too much or too little. They may also say things that seem rude because they have trouble understanding the rules of social interaction.
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Global Developmental Delay is the general term used to describe a condition that occurs during the developmental period of a child between birth and 18 years. It is usually defined by the child being diagnosed with having a lower intellectual functioning than what is perceived as ‘normal’. It is usually accompanied by having significant limitations in communication. It is said to affect about 1-3% of the population.

Babies and children usually learn important skills such as sitting up, rolling over, crawling, walking, babbling (making basic speech sounds), talking and becoming toilet trained as they grow up. These skills are known as developmental milestones and happen in a predictable order and usually at a fairly predictable age. While all children reach these stages at different times, a child with GDD may not reach one or more of these milestones until much later than expected.

A child may be described as having global developmental delay if they have not reached two or more milestones in all areas of development (called developmental domains).

These areas are:

  • motor skills - either gross motor skills like sitting up or rolling over and fine motor skills, for example picking up small objects
  • speech and language - which also includes babbling, imitating speech and identifying sounds, as well as understanding what other people are trying to communicate to them (auditory processing)
  • cognitive skills - the ability to learn new things, process information, organise their thoughts and remember things
  • social and emotional skills - interacting with others and development of personal traits and feelings, as well as starting to understanding and respond to the needs and feelings of others.
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Auditory Processing Disorder is a hearing or listening problem caused by the brain not processing sounds in the normal way.

It can affect a child’s ability to:

  • pinpoint where a sound is coming from
  • tell which sound comes before another
  • distinguish similar sounds from one another – such as "seventy" and "seventeen"
  • understand speech – particularly if there's background noise, more than one person speaking, the person is speaking quickly, or the sound quality is poor
  • remember instructions you've been told
  • enjoy music

Children with the problem may also have difficulty responding to sounds, understanding things they're told, concentrating, and expressing themselves with speech. Their reading and spelling may also be affected.

Many people find the condition becomes less of an issue over time as they develop the skills to deal with it. Children may need extra help and support at school but they can be just as successful as their classmates.

Auditory processing disorder affects people of all ages. Many cases start in childhood, although it sometimes can develop in adults.

Children with auditory processing disorder may have noticeable problems from a very young age, although sometimes the symptoms might not be obvious or only become apparent later when they start school, college, university or a new job.

It's not clear exactly how many people have auditory processing disorderbut it's thought up to 1 in every 20 children may have it to some degree.

Exactly what causes auditory processing disorder isn't fully understood. Sometimes a possible underlying factor is identified but not always.

In children, the condition may occur after a persistent hearing problem at a young age, such as glue ear, which has since passed but has had a permanent effect on how the brain processes sound. It may also be caused by a genetic defect, as some cases seem to run in families.

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