Adoption : Your Child's Speech and Language Development

[Guest guest]

http://www.comeunity.com/disability/speech/adoptionspeechlanguage.html

Adoption : Your Child's Speech and Language Development

Speech and Language Development in Adoption: Language is the gateway

to learning. Here's what you need to know to foster speech and

language skills of your adopted child, and to get help when you

suspect trouble.

By

" Vic has difficulty using adjectives and pronouns, and sometimes it

sounds as if he doesn't know the difference between male and female. "

" Our son, Camden, never jabbered. He would learn a few words and then

we'd hear nothing. Time would go by and we would hear a new word,

then not hear it again. It was if he were learning them, storing

them, and moving on. "

Like a child's first steps, first words are a milestone that parents

eagerly await. Typically, other words quickly follow, as the child

learns the power of speech and masters the rules of language. By age

three or four, most children are adept at expressing themselves, are

fairly understandable, and need to be reminded that someone else

might have something to say.

But some children encounter difficulty expressing themselves, calling

objects by the wrong name, or saying words that are hard to

understand. Others may be unable to make sense of what is said to

them. Speech and language skills are critical for young children as

they begin to enter the world around them. Even a mild delay in

language development may result in tantrums, interfere with learning,

sabotage social skills, and undermine self-esteem.

According to the National Institute on Deafness and Other

Communication Disorders, more than 10 percent of all preschool

children have some form of language impairment. Studies show that as

many as half the children in foster care have speech or language

delays. And, according to Dr. Jane Aronson, a pediatrician

specializing in international adoption, the majority of children who

previously lived in orphanages have speech and language delays at the

time of adoption. The good news is that, with early intervention, the

great majority of language-delayed children will be successfully

helped in their long-term language development.

Role of Early " Conversations "

One of the most important factors in language development is exposure

to meaningful speech during the first three years of life. A baby

learns the value of communication in the first few days of life, when

her cry brings food and comfort. A child soon recognizes the voice of

her parent(s) or caregivers and starts to sort out the building

blocks that compose the words of her native language. But some

children who join their families through adoption may have missed out

on this intimate back-and-forth between child and caregiver.

According to Dr. Aronson, " Children raised in institutions miss the

eye contact, constant touching, and reciprocal communication needed

for brain development at this age. "

The same is true for children who lived previously in homes with

little stimulation or language directed towards the child. Reading

and singing to children play an important role in language

development, as does holding a child for her bottle. When no one

responds to a child's babble, she learns that her voice does not

matter, and may not progress in language development.

Types of Language Delays

Although many people think of speech as a collection of words, much

more is involved in communicating with others. Some children

experience problems with the mechanics of speech. Most common are

difficulties with articulation, the correct use of the tongue, lips,

and jaw to produce the right sounds. Stuttering, lisping,

breathiness, and sudden breaks in loudness or pitch may also make a

child hard to understand.

Expressive language may also be an issue. Some children identify

objects by the wrong names, jumble the order of words in a sentence,

or have limited vocabulary. Other children may have trouble receiving

language: although their hearing is fine, they are unable to make

sense of certain words or sentences.

Even children who have language skills in their native tongue can run

into problems, says Sharon Glennen, Ph.D., associate professor of

Communications Sciences & Disorders at Towson University in land.

When faced with an abrupt change of language, internationally adopted

children typically relinquish their first language while learning

another. As a result, certain developmental and linguistic problems

may emerge. Some children will need help adjusting to new sounds,

especially if their previous learning environment was inadequate.

Others, particularly those adopted after age three, may experience

delay with the abstract thought and cognitive skills needed for

academic achievement, says Jeanne DeTemple, Ph.D., a developmental

psychologist in Concord, Massachusetts. That's because they are busy

re-acquiring language for communication purposes—a task that takes up

to three years—at a time when they would otherwise be developing

reasoning skills.

Fortunately, mild developmental language delays caused by poor

orphanage conditions often recede. In recent studies by Glennen and

Pollack of the Department of Speech Pathology & Audiology,

University of Alberta, the vast majority of preschool-aged children

from China and Eastern Europe made good progress in speech and

language within two years of adoption.

For children whose delays are more severe, speech therapy can produce

great strides. " Our sons weren't saying any words by their second

birthday, though they understood everything we said, " recalls

Seymour, the mother of twins adopted abroad as infants. " Now, after

ten months of speech therapy, we can't get them to stop talking. "

Getting Started

Before communication issues can be addressed, families must determine

whether their child is able to hear. Hearing loss, either permanent

or temporary, interferes with a child's developing ability to speak

and comprehend language. Children with ear infections often hold

fluid behind their eardrums for extended periods of time. Sounds

become muffled and indistinct. Other children may have difficulty

coordinating the muscles in their mouths. Parents, who speak with

their children daily, are the first to notice problems but may be

uncertain as to how to proceed, says Diane -Brown of the American

Speech-Language-Hearing Association (ASHA). Although some delays go

away with the passage of time, -Brown strongly advocates early

intervention.

Getting Help

In addressing speech and language concerns, many families start by

consulting their child's physician, who can help to determine if the

child is on target for his age. A child should have a hearing screen

and examination of the mouth to ensure there are not medical reasons

for limited language production. When a child's hearing is normal, it

may be reasonable to wait two to three months to see if he catches

up, says Dr. Aronson. " But if delays are dramatic, or the child's

language isn't improving, don't continue to `wait and see.' We have

to be aggressive about treatment. "

Many experts now recommend that children adopted internationally

after the age of two be evaluated in their native language within

three months of arriving home. This evaluation should include not

only words and diction, but also the structure and understanding of

spoken language. If a child is not speaking or understanding his

mother tongue, language delays will affect his ability to learn the

language of his new family. Children who have not have yet mastered

their first, native language require language intervention above and

beyond English as a Second Language (ESL).

Speech Services—Public and Private

Under the Individuals with Disabilities Education Act (IDEA), a child

suspected of speech delays is eligible for a publicly funded

evaluation. If found in need of treatment, a child may be eligible

for services through several age-based programs. Children up to three

years of age are usually treated through the Early Intervention

program in his home or in a day-care setting. In some states these

services are free; in others, fees may be based on family income.

Preschool children are typically treated in a classroom setting,

while elementary school children receive treatment from a school

professional. These programs are free, but they require an evaluation

by the school system.

For children not eligible for public services, parents should seek a

referral to a private, licensed speech-language pathologist (SLP),

preferably one who is certified by the American Speech-Language-

Hearing Association (ASHA ).

Many insurance companies cover speech therapy; however, some pay only

for delays that are shown to be medically or neurologically based,

rather than developmental in nature. In some states, adoption

subsidies may be available to assist with the expense of such

services.

Speech and language evaluations include a comprehensive medical and

developmental history, including questions about a child's language

milestones, past illnesses, birth family, and care before adoption.

The SLP should also examine the mouth to ensure that there are no

medical problems, such as tongue-tie, that interfere with sound

production. Speech and language assessments usually include phonology

(making and understanding sounds), semantics (word meaning), syntax

(word order), morphology (word forms), and pragmatics (social

language).

Following an evaluation, the speech therapist will put together a

treatment plan tailored to a child's unique needs. For children under

three years old, the programs are usually home-based. Families are

given individualized instruction for working with their child. An

older child may work with the therapist individually or as part of a

group of children. Typically, therapy involves a variety of

exercises: repeating sounds, playing naming games, or encouraging

interactive speech and dialogue. Families are often given specific

activities to continue at home to aid in ongoing language

development.

Most children enjoy speech therapy. Good speech-language pathologists

create fun activities, such as blowing through a straw or making

silly sounds. Given the linkage of language to self-esteem, it is

important to elicit cooperation in a positive manner. " Going to

speech once a week makes my daughter more willing to practice her

exercises at home, " explains Dana Moock, whose daughter was adopted

from Viet Nam. " Her speech therapist points out her strengths and

celebrates each accomplishment. "

The bottom line: most children show improvement with intervention,

whether through a home program, individualized private program, or

school-based services. Families need to work hand-in-hand with health

and school professionals to identify and address delays early, rather

than waiting to see if they subside. We cannot overestimate the value

of language to a child. He may need help, hard work, and celebrations

along the way, but the results will be something to talk about.

Read more about milestones and how to help your child's speech and

language development.

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is involved in adoptive family support activities

through both her Web site Comunity.com and Families with Children

from Viet Nam. This article was previously published in the terrific

resource, Adoptive Families Magazine.