Karen Levin, Ph.D Speech Therapist, Johannesburg

Communication is a lifetime process. 

 

Communication development begins in utero: Babies in the womb can hear, and can differentiate between sounds. At birth, babies are pre-wired to do all kinds of things that comprise early communication including pay attention to voices, discriminate sounds, listen, look at and focus on faces, and  respond to sound. Within the first six weeks, babies smile at others, and respond when spoken to in some way. We talk to babies as if they are communicating.

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In the first year of life, babies learn to do things that are necessary for later speaking and language use. This is like crawling before walking. They explore toys and the environment (which will later be the topic of their talk); they scream, cry and yell, moan, smile and goo (and so they learn to demand, ask, protest, insist, plead, convince, engage.... these behaviours teach them the functions of language which they will use later); they use gesture and vocalisations (to learn to become specific so we know exactly what they are talking about);  and they make noises and babble  (and so learn to make speech sounds).

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If babies do not communicate, or if their parents are not able to interpret the babies signals as being of communicative value, speech-language therapists have the skills to intervene and to help - right from the earliest stages.

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Once they have this early background and have learned these early skills, in the early part of the second year of life toddlers say their first words. They learn to put words together and make little sentences. They learn that they can control their worlds with speech and language, and learn by using speech and language. Their speech and language connects them to others.

 

If babies or toddlers do not so any of this, speech-language therapists can faciliate their development, starting under 12-months of age.  We do not have to wait until the baby is talking - we can start before they start to talk. We have ample evidence that the earlier we begin to intervene with a child who has a communication delay or impairment, the better the outcomes.

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In the third year of life, their speech becomes more refined and becomes intelligible to everyone. They make errors but these speech errors are "cute" and do not affect intelligibility. They use many, many words and their grammar develops so much that they can use the words they know to convey a lot of meaning. They can now communicate with a wider circle of people.

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By three years of age, young children have a wide vocabulary, can make their needs known, and are ready for nursery school. 

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And so it begins: they learn the language needed for school (listening to instructions; following stories; learning about topics), and they learn to use their language to interact with others. They learn social rules, and the beginnings of the art of conversation.

 

By age 6 or 7, children enter formal schooling, where they need to be able to express themselves, interact with others, and move their conversational language skills a notch higher: now they have to learn the language of school including topics,  questions, and comprehensions. Their sounds go up another notch: now their speech system is intact, and the rules that they know are put on paper in the form of letters (which we call 'graphemes'). They use auditory memory, closure skills, and their ability to analyse the sounds of their language to learn to read, spell and write.

 

Children progress through school, from childhood through adolescence, learning the language of academics, but also the art of conversation. They learn to make and maintain relationships and communicate with friends and others. They learn how to talk to teachers, friends, strangers. They learn to argue and debate. Many learn a second or third language. They learn that their social skills depend to a large extent on their language, and they use language to connect to others.

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Although scholastic skills lie outside of the scope of practice of speech-language therapists (e.g. we do not teach spelling, reading, or class work), we are involved in working with the perceptual processes underlying these skills, as well as the language that is required to get through school and learn. For example, we may assist with the understanding of questions in mathematics; with using language to understand text and so on.

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We work with adolescents on their language of academics, but also assist when their use of language is not developing sufficiently for social purposes, or for them to enter the post-school world.

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By young adulthood, we expect people to have sufficient speech and language to enter post-school education and/or the workforce.

 

Adults are at risk of communication impairments. There are all kinds of medical illnesses that are associated with a loss of the ability to speak, and others that lead to a loss in the ability to understand and/or use language. In addition, there are all kinds of aspects of communication that deteriorate with age.

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Speech-language therapy for adults addresses all kinds of communication impairments, and we assist our clients wherever possible to re-enter the work world, and assist with their communication in their social worlds. We also work with adults who have lived with lifelong communication impairments.