What is communication

Attention & Listening

From birth, babies are aware of the sounds around them and begin to attach meaning to different sounds. As a child becomes older, they recognize sounds (speech sounds) as speech and develop an understanding of words they hear. These listening skills are very important for learning and social development. Children need to be able to listen and attend to incoming communication in order to develop their speech and language skills as well as develop friendships with peers.

Some children may experience difficulties with listening due to hearing difficulties, language delays, difficulty processing information or difficulty focusing on one thing at a time.

Children with attention & Listening Difficulties may have the following characteristics:
–    Appear to not be listening
–    Frequently interrupt or talk when they should be listening
–    Appear confused or do not know what to do when instructions are given
–    Easily distracted
–    Can not tell you what has just been said/what has been spoken about

Receptive Language

Receptive Language is the comprehension of language. It is the listening and understanding what is communicated. It can also refer to reading comprehension. Receptive language includes the understanding of both figurative and literal language. It also includes being able to follow instructions.

Children with a receptive language problem have difficulties in understanding spoken and, sometimes, written language. Some signs that may indicate receptive language difficulties are:
•    Difficulty following instructions
•    May seem like they are ‘zoning’ out when language becomes too complex
•    Constantly asking for repetition or appearing not to be listening
•    Often appearing confused when language is more complex or when having to follow multi-step instructions
•    Constantly imitating words or phrases (echolalia)

Expressive Language

Expressive Language is the use of language. It is the ability to put words and sentences together, both orally and in writing, to express thoughts. It is about conveying meaning and messages to others, while labeling objects, actions and events, and using various grammatical structures.

Children with an expressive language difficulty struggle to use spoken and, sometimes, written, language. Some signs that may indicate expressive language difficulties are:
•    Having a difficulty naming objects and actions
•    Having a difficulty linking together words into sentences or using sentences that are considered shorter and less complex than what is                 expected for a specific age
•    Using “jargon” (made up words)
•    Using sentences that are incorrectly structured and/or not fluid (the words are in the incorrect order, and there may be frequent stops and           starts)
•    Having difficulties finding the right word when describing something
•    Having difficulty retelling a story


Phonology can be described as an aspect of language that deals with rules for the structure and sequencing of speech sounds.

Phonological awareness refers to an individual’s awareness of the phonological structure, or sound structure, of spoken words. It involves the detection and manipulation of sounds at varying levels e.g. syllabification, rhyming, alliteration etc.
Phonological Awareness is an important ability for literacy skills.

Some signs that indicate phonological awareness difficulties are:
•    Struggling to clap out syllables
•    Unable to blend or segment sounds
•    Finding it difficulty to manipulate sounds in words or within a sound cluster

A Phonological Speech Disorder is when a child has numerous phoneme errors that can usually be grouped into categories or patterns. For example, all speech sounds made at the back of the mouth (such as ‘k’ ‘g’) are made at the front of the mouth (‘t’, ‘d’). The speech errors are usually not linked to oral motor difficulties and/or normal development.

An articulation Disorder/Difficulty is when a child has problems making sounds. The sounds can be substituted, omitted, added or changed. For example ‘car’ may become ‘tar’. Young children often make speech errors, e.g. many young children sound like they are making a “w” sound for an “r” sound (e.g., “wabbit” for “rabbit”) or may leave sounds out of words, such as “nana” for “banana.” The child may have an articulation disorder if these errors continue past the expected age.

Social interaction and pragmatic skills

Social and pragmatic skills are defined as the skills that facilitate interaction and communication with others in a social context. It is related to the skills people use to communicate, using both verbal and non-verbal language, through the use of gestures and body language, while observing the rules for social communication.

Some signs that may indicate social and pragmatic difficulties are:

•    Difficulties using appropriate eye contact and/or non-verbal turn-taking
•    Difficulties maintaining and/or changing the topic of conversation, including introducing topics and taking conversational turns
•    Difficulties initiating and or maintaining social interactions
•    Difficulty interpreting non-verbal language such as facial expressions and body language
•    Tendency to have a literal understanding of language

Who do we see?
We see children who have a wide range of communication difficulties, such as:
•    Attention & Listening difficulties, including auditory processing difficulties
•    Receptive (understanding) difficulties
•    Expressive (talking) difficulties
•    Speech delay/ disorder, including articulation difficulties
•    Verbal/oral dyspraxia (planning and oro-motor difficulties)
•    Social communication difficulties
•    Dysfluency (Stammer)

These difficulties can occur in isolation or as part of an existing diagnosis (e.g. autism, cognitive impairment, Down syndrome, cleft palate, etc.).