Words left unspoken – study reveals hidden suffering of children with language difficulties

The study is the first scientific examination of quality of life for children with speech and language difficulties (SaLD). It was carried out by the University of Portsmouth as part of a £200 K Researcher Development Fellowship Award from the Department of Health.

It is estimated that one in ten children in the UK (up to 1.5 million) have speech and language difficulties. Until now, treatment for these children has typically focused on developing their speech and vocabulary. No-one has previously explored how to improve their day-to-day lives and until now, no-one has thought to ask the children themselves.

Chris Markham, Senior Research Fellow at the University of Portsmouth, designed a picture card game to discover what aspects of their lives the children felt were important. He used the game with a group of 30 children aged between six and nineteen to encourage them to talk about how they felt.

Key themes which emerged were poor self-esteem, loneliness and frustration about being unable to communicate effectively. Doing well and fitting in at school was important and family support was crucial to the children’s well-being. Friendships were vital.

He said: “The game was pivotal to getting the children to open up about their feelings and to gain an understanding of how they rated aspects of their lives and how they were affected by their condition.”

He has used the results to develop a new assessment for speech and language therapists (SLTs) to use with children. This has been well-received from industry professionals.

Kate Symes is manager of the Speech and Language Therapy Team for the Isle of Wight Education Service. She said it was a vital new approach and something that has been overlooked in the past.

One SLT said that she has already changed the way she works as a result of trialling the assessment on one of the children she is working with.

When working as a speech and language therapist on the Isle of Wight, Markham had seen that working on children’s social skills and confidence made a huge difference to their lives but there was no system in place to measure progress.

Parents who took part in the focus groups said that improvements to their child’s confidence and social skills were what mattered most.

Markham said: “Effective oral language skills are the building blocks on which subsequent literacy and numeracy development is based, so success in life depends upon good communication skills,” he said.

“As children we use these skills at school to make friends and to learn and as adults, communication is the key to forming relationships, getting a job and interacting with those around us. Issues facing children with SaLD become worse as the child gets older because expectations of them become higher and there is less tolerance of the condition by their peers.”

Research indicates that therapy which encourages social interaction and behavioural development has a positive impact on language development.

Existing research indicates that poor self esteem and social difficulties increase over time and can lead to behavioural problems. Markham says that it is no coincidence that high levels of speech, language and communication difficulties are found among the young offender population.

Studies show that at least ten per cent of young offenders had significant problems with speech, language and communication, while fifty percent of prisoners have literacy difficulties compared with seventeen per cent of the general population. Some prisons already employ speech and language therapists in recognition of the problem.

This latest study indicates that tackling the problem at source and smoothing the transition from childhood to adulthood would go a long way to preventing problems when the children leave their teens.

Markham is confident that the study will help speech and language therapists target those areas to better help the children they treat.

He concludes: “The study demonstrates the importance of involving children in the assessment and the therapeutic decision-making process, alongside the value of a much more holistic pattern of care than simply focussing on their speech and language.”