Language, however, is much more comprehensive than speech sounds, and Speech and Language Pathologists work with clients who have difficulty in many different areas of language.
The American Speech, Language and Hearing Association states, “Speech and Language Disorders are defined by difficulty in any of the three following areas – Form, content and use of language.”
Form of Language
Form refers to the rule-based aspects of language, such as the rules that define how words go together in a sentence to make it ‘correct’ or ‘grammatical’. Those kinds of rules are called ‘syntax’. A child with a syntax disorder might say something like ‘Book on table’ instead of ‘The book is on the table’.
There are also rules about how to add endings to words. For example, adding the ‘ed’ to the word ‘look’ to say ‘looked’ and make the word about something that happened in the past. A child with a disorder using endings (morphemes) might say ‘Yesterday, I look at the cow.’
Other rules refer to the sounds in language, (phonology), and how we can put those words together correctly. For example, in English, you cannot put a ‘t’ sound after a ‘b’ sound. Try saying ‘btoo’. A child with a speech-sound disorder might say ‘Is my kurn!’ instead of ‘Is my turn!’
Those are areas of ‘Form’ in which a child might have difficulty and therefore a Speech and Language disorder.
Content of Language
Content refers to the meaning of language. Usually, in terms of Speech and Language disorders, this refers to vocabulary, or the knowledge of words that a child has. A disorder might involve having a limited number of words in memory to use when trying to talk to someone or understand when someone is talking. This makes negotiating through the day quite difficult. Think about how hard it would be to go to school and try to learn science if the teacher was speaking in a language you don’t know.
Use of Language
Use refers to the social conventions of language. We also call this ‘pragmatics’. You would see a disorder in use when a child cannot follow the give-and-take of conversation or stay on the topic of conversation.
A child with a pragmatic disorder might annoy their peers by only talking about what they are interested in, like ‘trains’. Or they might interrupt their friends, or alternatively, never initiate a conversation because they don’t understand how to do so.
Speech and Language Pathologists define disorders as impairment in any one of those three areas, Form, Content and Use, or a combination of them. There is a lot of overlap among the three areas. In order to determine whether a child has a Speech or Language disorder, the Speech Language Pathologist does an assessment of a child’s performance in all of those areas. The assessment might include testing how a child says and understands sentences; adds endings to words; how they make sounds; and how well they can have a conversation.
Speech and Language Disorders, therefore, covers a very wide range of different kinds of disorders. That is why Speech and Language Pathologists work with so many different kinds of children. For example, the same therapist might work with some kids who have sound disorders, comprehension problems, limited vocabulary, and autism. Speech therapy is not just about ‘lisps’ after all!