Speech, language and ND

Comprehension and verbal use of language may develop later in neurodivergent individuals than their typical peers. This can vary hugely from one individual to the next. However, even if a child does not use verbal language, they may be able to understand it.

Instead of learning single words and building them up into phrases/sentences, some individuals learn language in whole chunks instead; they may repeat full phrases or sentences (known as echolalia) rather than using single words.

This may be repeated from those around them, or from books/TV/songs. This can be described as gestalt language processing, a different, natural variation in learning language.

The way individuals learn, remember and use words/vocabulary can differ in neurodivergent individuals. Some individuals may pick up new vocabulary very quickly and use very advanced and technical language from a young age. This can seem very formal and stand out in some children, for their age.

Neurodivergent individuals may make up their own new words or use them in unusual ways.
However, some individuals’ may find it challenging to learn and use new words, particularly as they get older and words and language become more complicated.

Grammar in phrases, such as ‘ing’, ‘ed’, ‘is/are’ and ‘she/her/hers’ can be mixed up or mis-understood by some neurodivergent individuals. The order and structure of words in sentences can also get mixed up, e.g. ‘the girl fed the cat’ can come out as ‘the cat fed the girl’. This can lead to communication being easily mis-understood.

The information included in a story/narrative, e.g. what you did at the weekend, what happened between you and a friend, and the order that the information is given in will affect the way the person you are talking to understands and pictures what you are telling them.

The information given, the detail of this information, and the order of the information, can be different in neurodivergent individuals’ language. Specific parts of the story may be heavily focused on or missed out and the information can be given in different orders. This can lead to stories that are shared being mis-understood between different people.

Individual speech sounds can sometimes be used differently in different words, e.g. ‘umbrella’ said as ‘umbwella’, or ‘stretch’ said as ‘stwets’. Sometimes these speech sound differences can affect how well individuals are understood and can impact their confidence in speaking. Some individuals may use other communication strategies to help others understand them, e.g. gestures, pictures, signs (e.g. Makaton) or actions.

Differences in speech sound production can occur for lots of different reasons, including natural variations in brain and muscle development. While having speech sound differences may make it challenging to be understood, it is something that can be accommodated for and supported. It is not something to feel bad about or feel ashamed of.

Repeating some sounds, e.g. b, b, b, b, but, sssssssnake, or words, such as, may may may may maybe,  can be described as dysfluency, stammering, or stuttering in speech. These differences can affect how well a person is understood, how much other people give them time to get their message out, or how confident an individual is to express themselves verbally.

Dysfluency in speech can happen for a lot of reasons, including a natural variation in brain development. It is not something to be ashamed of or to be made to feel bad about.

Different tones and qualities in a person’s voice is what makes all of our voices unique to us and there is no ‘right’ or ‘wrong’ tone of voice. However, some individual’s voices can become strained, weak or hoarse and feel physically uncomfortable. This can be called dysphonia. This can make it challenging to communicate verbally with others and can sometimes indicate a medical condition. If this is the case, it is best to speak to your GP for further advice.

Non-literal language such as ‘give me a hand’, ‘wait a second’ and ‘keep an eye on it’, and jokes, can be understood very literally and can be challenging for neurodivergent individuals to understand easily.

Some individuals may use no, or very little verbal words, described as non-speaking. They may still express themselves verbally though, e.g. verbalising, laughing, sighing and moaning. When someone is non-speaking, this does not mean that they cannot understand language – this can vary greatly between individuals.

Some individuals are able to speak verbally in some situations, e.g. at home, but not in others, e.g. school. This can be part of an anxiety situational/selective mutism, which physically stops them from talking in certain situations.

• “Don’t just tell me, show me!” – back up all verbal information with visual information, e.g. visual pictures, objects, actions, colour coding and diagrams to help with understanding and remembering.
• Colour coding and using visual symbols can also help with understanding and remembering verbal information.

• Slow down. Give the child/young person extra time to understand what you’ve said and for them to think about what they want to say.
• Try not to interrupt them or finish their sentence for them.

• Make sure they are ready to listen and process the information before giving instructions, information or asking questions.
• Call their name to gain their attention or gently touch/tap them to let them know you would like to give them information. Wait for them to pay attention before giving any information.

• Lots of repetition of information, e.g. instructions, information, questions and new words.
• Lots of repetition will help the child/young person to understand, process and remember the information.

• Use language that they will be able to understand. Think about the level of language and vocabulary they use and try to match that.
• Support any more complicated language with visual information, e.g. pictures, photos, diagrams.
• Avoid non-literal language, e.g. ‘give me a hand’, ‘it’s raining cats and dogs’. If you do, check that they understand this and/or explain it to them clearly.

• Verbally explain and physically demonstrate new or complicated words.
• Use visual pictures, photos and diagrams to explain the new/complicated word.Use lots of repetition – they are likely to need to hear the word more times to remember and use it.
• Visual information and physical actions can help to understand, learn and remember new words.

• If a child/young person gets their words and sentences muddled up, acknowledge what they have said and say it back to them with the correct grammar and word order e.g. “her catched ball” – “yes, she caught the ball”.
• Do not over-correct or tell them they are wrong; this can impact confidence and self-esteem

• Give instructions in the order you want them doing, e.g. first, put your English book away. Then get your art book and coloured pencils out, instead of ‘before you get your art book and pencils out, put your English book away’.
• Physically demonstrate the instruction where possible. Draw it out, write it down, or place objects out in the order.
  Use specific language e.g. “please put your book bags in the box” instead of “please put them in there”.

• If a child/young person says a word/sound differently, acknowledge what they have said and model it back correctly, e.g. “the bwue ball”, ‘ah yes, the blue ball”. Do not over correct the individual, especially in front of others as this can negatively impact their confidence to speak.
• If the child is able and motivated to work on their speech sounds, do this in a safe, quiet place, one-to-one under the guidance of a Speech and Language Therapist.