Today I’m going to focus on comprehension (understanding). This is a big area, but I’m going to try and give you an overview of the sorts of areas your child’s speech and language therapist might look at and therefore comment on in their report.
What a child understands can depend upon the setting. For example, there might be a difference between what they can understand in a real-life situation and what they can understand in a more formal setting. Also, there may be a difference between what they can understand 1:1 and what they can understand in a group situation. The speech and language therapist will probably look at the differences between these. In particular they will try to find out what your child can understand when all of the context clues are taken away. For example, your child might understand “Put your coat and boots on” when you are standing by the door looking at the rain and pointing to her coat. But does she understand the same instruction in the middle of the afternoon, when she doesn’t know you’re going out anywhere? Many children will find the first one easier. This is a good start, because often in real life there are clues you can pick up from what’s going on around you. However, children do need to be able to do the second kind of understanding as well, especially as they start going to nursery or school. If they need context all the time, they are likely to find it hard to talk about anything outside of what’s going on right now. Your child’s report may talk about his understanding “with visual clues” or “without visual clues” and it is this difference that they are talking about.
The vocabulary involved can make a difference to how well your child understands. Some children understand a wide range of different words, and others find it hard to remember what new words mean. Many children will find concrete nouns (words for people and things) the easiest words to remember to begin with, and will have more difficulty with verbs (doing words) and particularly concept words, such as big, empty, different, hot. These words are more abstract and therefore it can be more difficult for a child to understand them.
The length of the instruction can also make a difference. With a young child, your SLT might talk about ICWs (information carrying words) or key words. These refer to the amount of information the child needs to understand in order to follow an instruction correctly. This is quite a complicated idea and we’ll come back to it another day, but it relates to what I said about context.
Memory can also affect how well a child understands instructions. They may only remember the last part of what was said, or find it hard to remember the order the instructions came in. The structure of the sentence also makes a difference. For example, an instruction such as “close your eyes and count to 3” is easier to understand than “before you count to 3, close your eyes”, because you have to understand the function of before in the sentence and that actually the second half of the sentence has to be done first.
The therapist may specifically talk about your child’s understanding of questions. The question words (who, what, where, when, why, which, how) all sound very similar and they are notoriously difficult for children with language problems to understand. Some questions are easier than others (“what” questions are easier than “why” questions for example). This is another topic we’ll return to another day.
With older children, SLTs also talk about “higher level comprehension”. This really just refers to the more complex aspects of language. The therapist may look at whether your child understands links between words (semantics), whether they understand that words can have more than one meaning (for example, “orange” can be a fruit and a colour) and whether they understand things that are not directly stated. (For example, in the sentence “Barney barked loudly and walked over to his bone”, does the child understand that Barney is a dog, even though it wasn’t said directly?). This skill is known as inferencing and it can trip up a lot of children with language difficulties! Higher level comprehension also includes understanding of idioms (for example, does the child understand that “do you see?” does not always refer to being able to physically see something; it is sometimes used to mean, “do you understand?” as well?).
As you can tell, the area of comprehension of language is a huge one, and there are so many things within it. Hopefully this has given you a bit of an introduction to some of the terms speech and language therapists use and what they mean. If you are a parent reading this, and there are any aspects here that you’d like us to talk more about, do let us know – we’d love to hear from you!