The most read article on the Times website today and yesterday was this one about children who are unable to speak. A new survey from the Office of the Communication Champion and Council (otherwise known as Jean Gross) reported that many children had difficulties learning to speak, with boys generally experiencing more problems. Should we really be surprised?
The new research has been picked up by ICAN, the charity which supports speech, language and communication development in children. It does wonderful - often under-appreciated - work, flagging up issues like this one, that children are talking later. ICAN (and Jean Gross herself) also argue for more notice to be taken of speech and language issues. After all, so much in life depends on being able to talk. As Ms Gross, the government's new (and first ever) Communication Champion for Children says: "Our ability to communicate is fundamental and underpins everything else.".
Many children have problems learning to talk and of course, sometimes these aren't serious. We've all heard of late developers, who don't speak until they're four or five, but then go to achieve hugely. However, that doesn't mean we should ignore this new survey. Many children do need help - and the earlier they get it the better. What's also vital is that schools and pre-schools understand how to deal with this problem, and that parents get very involved too. Early development is not just, as Ms Gross, points out about weight targets and immunisations.
We, as parents, must do what we can to help our children to speak and communicate. That means we must talk to them, and encourage communication in so many ways. We have such a huge influence over our children, and reading, singing, just chatting away to our offspring can really help. If you are worried though, do seek help.
Below, I write about two children who did have problems. They show that speech and language issues can affect anyone, and emphasise how important it is not to ignore them.
When Liam Brown* was a baby, he was so happy that his grandmother nicknamed him “The Sunshine boy”. “He was so lovely and happy,” his mother, Stella, told me. “He was also very easy, and did all the usual things at the right times. There was nothing untoward.”
But from the age of two and a half, the easy, happy boy changed. Suddenly Stella, and her husband Peter, had a child with major behavioural problems, and they couldn’t work out why.
“It was a nightmare,” says Stella. “It began when he started playgroup and was unhappy and disruptive. He would snatch the other children’s toys and lash out at them if he couldn’t make himself understood. I can still vividly remember when I was told that he couldn’t be in the Christmas play, because he was so difficult.”
It took years to get an explicit diagnosis, but what Liam, now 11, was suffering from, was an expressive and receptive language disorder. Although he appeared to understand and could talk, he had real problems finding the right words to say, and if spoken to with too many words, was completely overwhelmed by them. He was also very unpredictable in his behaviour and had attention control delay (for example, he had the attention span of a two or three year old, when he was six).
“I read English at university and we have always been a very articulate household,” says Stella, who admits that she was really shocked. “Speech and language problems were the last thing I would have worried about. And of course, I also thought am I a classic neurotic middle class mother who’s worrying for no reason?”
But speech, language and communication disorders can strike any child.
“One of the difficulties is that people think that language comes naturally, like learning to walk,” says Kate Freeman, a specialist speech and language therapist. “Often these children are very able in other areas, but for some reason, words don’t make sense to them. They may have specific problems with muscle control or sorting out sounds, and often their parents are given the advice that they should ‘see how it goes.’ They think they’re over-anxious or don’t worry, because everyone tells them not to. But the earlier the referral the better.”
Boys are more likely than girls to have speech and language disorders, and it’s thought that there may be a genetic reason for the problem – although no one is quite sure what.
“Language is the foundation skill of life,” says Freeman. “If you can’t communicate, it will affect friendships and learning, and that continues. Our educational curriculum is delivered through talking. Not being able to do so really puts you at a disadvantage.
“The real explosion of language is between two and five. You really need to try to make the best use of the brain development at that time. After that it gets harder – it’s more like learning a foreign language.”
In the last few years, spending on services like speech and language therapy have been reined in. Many children are either not diagnosed properly, or not helped effectively. Then they not only slip through the net, labelled as difficult or unintelligent, but are affected for the rest of their lives.
“There is a common belief that children’s language has got worse,” says Freeman. “There are so many pulls on busy, modern daily life, that the structures aren’t always there to help children with their development.” Changes in society (more women working, more TV/computers, lack of extended family) have basically meant that people don’t talk as much to their children as they once did, and don’t sit down and play as much either.
And speech and communication disorders can be apparent from an early age.
“Lee started speaking at about 18 months, got to five words and didn’t progress,” says Emma Rose, his mother. “Up until then we had no worries, and we weren’t all that concerned because his level of understanding was always good. People would tell me not to worry. They’d say ‘oh he’s a boy, and he’s an only child, it’s different when there’s more of them and they talk to each other. He’s just lazy.’ But when he had his two year check, I did mention his speech.”
Because Lee had been born prematurely, he was referred to hospital for some tests. He was subsequently sent to a child development centre for an assessment, and then onto a centre run by ICAN.
“They were a life-line, “ says Emma. “He used to go to a pre-school and they noticed that he’d lashed out at a little girl through sheer frustration. He’d been playing on a bike, and got off for a second. She’d got on, she couldn’t understand him when he tried to explain that he was still using it.
“When Lee was at home, he knew he didn’t have to ask for anything. He could point or gesture, and we’d muddle through. Mind you, if it was obvious I didn’t really understand what he was trying to tell me, he’d sometimes just give up and walk off.”
When Emma was told that Lee had speech and language problems, she was devastated.
“I wondered what route life would take him if he couldn’t speak,” she says. “I worried about how he would end up, and what he would do.
“It’s also hard for you as a family and for your child because it’s not a disability you can see. If he lashed out on the street, people would just think he was a naughty boy. They wouldn’t understand.”
Lee started at the ICAN centre when he was four. Emma was astonished by the difference it made.
“It was a complete breakthrough,” says Emma. “He learnt Makaton sign language, which really helped him to communicate, and boosted his confidence, and he started learning phonics too to get the sounds out. We practised exercises at home, had toys and props to help, and made sure we talked through his play. It wasn’t easy, but it was worth it and it turned our lives around. Lee had all this intensive help, and went from a little boy who couldn’t talk to a very articulate boy.
“Even though Lee was coming up to school age when he began at the centre, they said we should speak to him like we would speak to an 18 month old, because that was where he was. We shouldn’t speak in full sentences, but just a few words, and be very clear. By the time he left, he was exactly right for his age.”
Liam's journey has not been as easy as Lee’s, but he is also transformed. He had problems throughout nursery and became increasingly upset and unhappy. Teachers would have to lock the door of the classroom, as otherwise he would run out, and his behaviour got progressively worse.
“It was a nightmare,” says Stella. “It completely dominated our lives. It was one of the most isolating times for all of us, as it was very difficult for other people to deal with, especially as he looked absolutely normal.”
Eventually someone suggested that Liam might have speech and language problems, and he began seeing a therapist. It took time, but, through independent assessments, Stella and Peter got him a statement, so that the LEA would fund help for him in school.
“We were very pro-inclusive at that time,” says Stella. “We moved him to another school, but although they wanted to help, there was a big question mark over whether he was going to be able to cope. Reluctantly we started to look at other avenues.
“It’s like a bereavement when you realise there is something wrong with your child, but when you realise that the mainstream is not going to work, and he’s going to be labelled, it’s also a very big thing to take on board. It was very difficult.”
Liam eventually went to Meath School, a special school for children with severe, complex communication and speech difficulties in Surrey. Persuading the local authority that it was the right place took 14 months and a tribunal hearing. It cost thousands of pounds (which Stella and Peter put on their mortgage).
“Something like this can either pull you apart or together,” she says. “We were united that we would do whatever it took.”
And Meath did turn Liam around. His confidence improved, and he benefited hugely not just from speech and language therapy, but also occupational therapy to help with his motor skills.
“His communication is much better, and he’s much less likely to have emotional outbursts,” says Stella. “He used to say he felt useless, that he was rubbish at everything and wanted to die. He doesn’t do that anymore. Now there’s every chance that he will get a job and live an independent life when he’s older. I doubt that would have happened otherwise.”
Janet Dunn is the head teacher at Meath. Children at the school have plans tailored just for them, and are not grouped not by age or attainment levels, but by the comprehension level of the child.
“That way you get a whole group of children at the same level,” says Dunn. “Then the child has a much better ability to access the teaching.”
Meath’s national curriculum has been specially adapted. They use pictures and symbols, signing and anything visual that will support language.
“Classrooms are about talking. If language is a child’s weakest skill area, then they fall at the first hurdle.
Children are often misdiagnosed, because people misunderstand the disability. They suspect a hearing impairment, a lazy child, or a child whose sibling who speaks for them. That all camouflages a need which makes it too long before the child is appropriately understood. There is a real lack of awareness about the impact of this impairment. We all need to understand that communication is a key skill. If parents feel that they’re not developing, they should try and find someone to help them.”
Stella says that Liam's problems completely changed their lives.
“If you’re not careful it actually takes over your life,” she adds. “You end up pouring so much energy into getting the right provision for your child. But we have met some truly amazing people, and hope that other children can be helped like Liam has been.”
*Not his real name
If you are concerned about your child’s communication development, contact your health visitor or local speech and language therapy service. For more information log onto www.ican.org.uk or call 0845 225 4071.
Parents and families can also log onto Talking Point, the UK’s most comprehensive source of
up-to-date information and resources for all aspects of children’s communication development www.talkingpoint.org.uk.
The Times Online