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Language Processing and Comprehension Issues and Children with CAS

Chris Dollaghan, Ph.D., CCC-SLP

Language processing refers to the mental operations by which we perceive, recognize, understand and remember sounds, words, and sentences. Because it happens “inside the head,” language processing can’t be seen directly, instead, we have to test for processing problems.

It’s natural to focus on the speech production difficulties of children with CAS, but there are good reasons for parents and clinicians to take a careful look at their comprehension and processing. For one thing, speaking and understanding are tightly linked; in fact, one influential theory suggests that our knowledge of speech movements helps us perceive speech sounds. For another, children who have processing and comprehension problems often “get by” in everyday situations by using their knowledge and previous experiences to help them understand at least when they are young. But as they get older, they face more and more situations in which there are no extra clues to comprehension, and even mild processing difficulties can slow down their understanding and interfere with their performance.

Some “symptoms” of comprehension and processing problems:

  • The child may understand single words, and have an excellent vocabulary, but have difficulties in understanding phrases or sentences. Because comprehension can be so variable, others may think that the child is “just not trying” or “not paying attention.”
  • The child’s understanding will likely be better in everyday situations than in situations where there are few or no extra clues to meaning. In such situations, the child may fail to respond, may repeatedly say “Huh?”, may simply guess what has been asked, or may even repeat some or all of what was said.
  • Lengthy, complex, and abstract sentences are especially difficult for children with processing problems, especially if presented at normal or faster speaking rates.

If your child has normal hearing but you suspect a processing problem, a speech-language pathologist can assess his or her skills in single-word and sentence comprehension, as well as in phonological processing and phonological memory.

Some suggestions for parents whose children have processing problems:

  • Draw your childs attention to speech sounds in words, using rhyming and silly sound games. Point out how new sounds and words are similar to and different from sounds and words your child knows well.
  • Don’t pretend you understand when you don’t. Show your child that communication breakdowns happen to everybody, and that people have to work together to fix them. Children who are at least 5 years old can be taught to monitor their comprehension, and to know what to do when they fail to understand.

(Chris Dollaghan, Ph.D., CCC-SLP, is a professor in the Department of Communication Science and Disorders at the University of Pittsburgh, where she teaches and conducts research in pediatric speech and language disorders. She also previously served as chairperson of ASHA’s Research and Scientific Affairs Committee.)

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