Speech Therapy -> Receptive Language

Receptive Language

Receptive language is the ability to understand and comprehend spoken language that you hear or read.

Minor focus areas

Skilled interventions

  • Altered Auditory Input

    Altered Auditory Input is a language intervention technique that alters the parameters of rate, prosody, and pattern of pausing to improve language input for patients with language processing difficulties.

    Method: SLP alters the speed of presentation, pattern of pausing, and prosody.

    Slowed rate: “Touch..the..big..ball”
    Slow rate plus altered pausing: “Touch……the..big……ball” or “Touch..the……..big..ball”.

    Once the patient processes the concepts then the AAI technique is gradually phased out (McKinnis & Thompson, 1999).

  • Declarative Language (Receptive)

    Declarative language is an ideal communication style for neurodivergent children. It is the opposite of imperative language. Whereas imperative language (such as commands and questions) requires a response from the child, declarative language (such as comments) does not. An example of an imperative statement would be “clean up” and an example of a declarative statement would be “it looks like everyone is starting to clean up.” Imperative language can lead to anxiety and dysregulation in children (often seen in a fight/flight/freeze response). Declarative language allows children the opportunity to engage critical thinking, problem solving, and perspective taking. For example, when saying “it looks like everyone is cleaning up,” you are indirectly cueing the child to check in with their environment and determine what they should do next. If you say “clean up,” you are simply telling the child what to do, but not why they might want to do it. Linda K. Murphy MS, CCC-SLP developed declarative language and more information can be found in her book, The Declarative Language Handbook.

  • Emergent Literacy Intervention

    Emergent Literacy Intervention is an approach to language and reading that focuses attention of the patient to orthographic features of written language and the phonologic features of oral language. Method: Sessions include 2 components

    1. Name writing: Session starts with child “signing in” by tracing the letters in their name. SLP provides assistance and has the child name the letters as they write them.
    2. Alphabet recitation: Provide child with cards depicting the alphabet letters and corresponding pictures and lead them through 2 to 3 alphabet recitations. Have the child point to the letters while they are singing/reciting the alphabet.
    3. Phonological awareness games: Perform tasks with the alphabet cards such as pointing to the letter that are in their names. Complete phonological awareness tasks focusing on rhyme detection, rhyme production, sentence or syllable segmentation, or initial sound identification. Example: Provide patient with picture card depicting a common object (hat, bat, car) and then ask them to indicate whether their cards rhymed with a target picture shown (cat) (Justice, et al, 2003).

  • Focused Stimulation

    Focused Stimulation: This is a hybrid intervention approach which combines methods from both child-centered and clinician-directed interventions. The interactions are set to provide a high density of models of the target forms in meaningful communicative contexts.

    Procedures of focused stimulation include:

    Modeling the targets:
    Example of modeling the target of “will” while mixing up some juice:
    Child: We need some water.
    SLP: Will you get some?
    Child: Yea.
    SLP: You will? Good. Then I will get the glasses.

    Recasts: These can be simply correcting the error;
    Example:
    Child: Him too big.
    SLP: Yeah, he is too big.
    Recasts can also change the basic modality of the utterances.
    Example:
    Child: “This too hard”
    SLP: “Is it too hard?” or “It isn’t too hard”.
    Recasts can be very informative because they use a variety of ways in which a structure can be used.

    Buildups:
    Example:
    Child: I drawed a picture. It pretty.
    SLP: Yeah, you drew a pretty picture.
    Child: Me get another cookie. Me hungry.
    SLP: Oh, you’re going to get another cookie because you’re hungry.

    Breakdowns:
    Example:
    Child: I need book, not boot.
    SLP: Oh, the book. Not the boot. Ok, I’ll get the book.
    Child: No. I get it.
    SLP: No, I will. I will get it.

    Eliciting attempts at the targets: False assertions to encourage the child to produce sentences that require the use of a target.
    Example:
    Activity: Puzzle, target: use of can’t.
    SLP: That can go there (knowing that the piece does not fit).
    Child: No it not.
    SLP: Yes, it can.
    Child: No.
    SLP: Yeah, you’re right. That piece can’t go there.
    Feigned misunderstandings where SLP intentionally misinterprets an utterance that the child uses.
    Example: target is “I”.
    Child: “Me want it.”
    SLP: (pointing to another person (pretend doll or parent)) “She wants it?”
    Child: No, me want it
    Adult: No, I do (pointing to herself).

    Forced-choice questions:
    Example:
    Child: “I get it.”
    SLP: "You already got it or you will get it now?”
    Target: Complex sentences:
    Child: I like that.
    SLP: Why do you like swimming?
    Child: Cool me off.
    SLP: Oh, you like swimming because the water cools you off.

    (Cleave & Fey, 1997; Fey, 1986; Girolametto, et al, 1996).

  • Imitative Modeling

    Imitative modeling technique is a modeling approach that presents the patient with a series of modeled utterances that are very similar in grammatical structure, but quite different in semantic content. For example: the boy is running; the girl is playing; the dog is barking. Imitative modeling’s emphasis on similarity in grammatical structure allows the patient to extract the underlying grammatical rule from the series of utterances (is +ing) instead of mimicking (the boy is running; the girl is running; the dog is running). As a result; the child is able to internalize and retain the abstract rule of language, thus facilitating its application to novel context and situations (Courtright, & Courtright, 1979).

  • Indirect Language Stimulation (ILS)

    This is a child-centered approach where the SLP arranges activities so that opportunities for the patient to provide target responses occur as a natural part of play interactions.

    ILS techniques include:

    Self Talk – SLP describes his/her own activities when interacting with a patient.

    Parallel Talk – SLP describes/comments on child’s actions during play tasks. Often this will elicit an imitation or a verbalization from the child that can then be expanded and/or extended.

    Reversed imitation – SLP imitates what the child says and there is substantial probability that the child will imitate the imitation. The more the child says, the more the opportunities exist for practice of phonological, lexical, and syntactic forms and the more opportunities there are for feedback.

    Expansion – Process of expanding a child’s incomplete or telegraphic statements into grammatically complete productions. Process of extracting the meaning of a child’s utterance and putting it into a more complex form. Expand the utterance by using adult grammar and do not add new information.

    Example: Child puts a toy dog in a dollhouse and says “doggy house” SLP expands this by saying “The doggy is in the house.”

    Extension – Process of putting a child’s utterance in a broader context, extending the meaning of the phrase. Therapist uses adult grammar, but takes it to the next level by adding new information.

    Example: Child says “doggy house” SLP says “He went inside” or “yes, he got cold”.

    Recasting – SLP expands a patient’s utterance into a different type of utterance or repeats incorrect responses back to a patient, with the error corrected.

    Example: Child says “doggy house” SLP recasts it as a question, “Is the doggy in the house?” or a negative sentence (used as a playful denial of the child’s utterances), “The doggy is not in the house?”. Recast has shown to be highly effective in teaching grammatical forms to children with specific language impairment.

    Buildups and breakdowns – SLP expands the child’s utterance to a fully grammatical form then breaks it down into several phrase-sized pieces in a series of sequential utterances that overlap in content.

    Example: Child says “doggy house” SLP responds, “Yes, the doggy is in the house. The house. He’s in the house. In the house. The doggy is in the house. The doggy. The doggy’s in the house.”

  • Literacy-based Intervention

    Literacy-based intervention is a language intervention program that engages the patient in literature-based activities featuring an implicit focus on oral and written language through shared storybook reading.

    Method: SLP and patient share storybook reading and story retelling activity. Different genres (rhyming, narrative) and formats (lift-the-flap, big books) can be used. The SLP uses strategies to promote the patient’s active involvement and verbal involvement.

    1. Predication: After the book is introduced the SLP asks the patient what they think might happen in the story; during the reading stop and ask/give the patient opportunities to predict or discuss narrative events.
    2. Dialogic strategies: ask open-ended questions, responding to patient’s interests, and give praise/feedback.
    3. After the reading of the story the SLP leads the patient through a retelling activity such as reenacting the story or drawing and discussing pictures representing key story events (Justice, et al, 2003, Kaderavek & Justice, 2002).

  • Narrative Skills Development

    This intervention focuses on developing storytelling and comprehension skills. Activities include creating story maps, sequencing events, and discussing story elements like characters and settings to improve narrative abilities.

  • Phonological Awareness Strategy

    Phonological Awareness Strategy is a technique addressing phonological awareness, which is defined as: The explicit knowledge of, awareness of, or sensitivity to the phonological structure of language; skills used to think about, compare, and manipulate sounds in words. Rhyming and phoneme awareness activities are used in therapy sessions. Phoneme awareness activities include: initial sound identification, generating initial sounds, and identify initial and final sounds (Stanovich, 1988, Snow, Burns, & Griffen, 1998, Van Kleeck, et al 1998, Wing, 1990).

  • Whole Language Approach to Language Intervention

    Whole Language Approach to Language Intervention takes the philosophy of Whole Language and applies it to the development of treatment strategies. Whole language strategies integrate all aspects of language into personally meaningful activities to facilitate learning in oral and written language.

    Method: Create a therapy environment where there are opportunities for language to develop along the general to specific; familiar to unfamiliar continuums, there must be repeatable context and experiences. Theme building makes use of recurring ideas and events that are common to the theme, and allows for multiple formats (art, pictures, play, literature, writing, drawing, storytelling, dance, snacks, and discussion) Theme building allows for transactional and expressive language functions to be expressed. By maintaining the same theme across activities and the child has the time and the opportunity to refine his/her understanding to include very specific knowledge. This meaning embedded process results in great language development (Westby, 1990, Norris & Damico, 1990).

Reference links

  • Red Flags For Speech-Language Impairment In Bilingual Children 1
    leader.pubs.asha.org     Author: Scott Prath On ASHA Wire - Red Flags for Speech-Language Impairment in Bilingual Children Differentiate disability from disorder by understanding common developmental milestones.
  • Bilingual (English/Spanish) Language Milestones From Bilinguistics 2
    bilinguistics.com     Author: Bilinguistics - PDF of language milestones for bilingual (English/Spanish) children
  • Multilingual, Multicultural, Bilingual Resource Link For SLPs 1
    www.asha.org     Author: ASHA - Link includes ASHA resources and information related to evaluation and treatment of clients from linguistically and culturally diverse backgrounds. Link includes ASHA resources to: Accent Modification Bilingual Service Delivery Collaborating With Interpreters, Transliterators, and Translators Cultural Competence Voice and Communication Services for Transgender and Gender Diverse Populations Dynamic Assessment Micro Course Cultural Competence Self Assessment Phonemic Inventories and Cultural and Linguistic Information Across Languages Collaboration With Interpreters: Securing Positive Outcomes Practical Assessment and Treatment Strategies for English Language Learners with Language Impairments Serving Clients From Diverse Backgrounds: Speech-Language Difference vs. Disorder Langu Continuing the Dialogue on Dialect: Positive Steps Toward Less Biased Assessments of Children Who Speak African American Englishage and Identity--Shifting Away from a Deficit Perspective on African American English Información en español
  • Bilingual Service Delivery 1
    www.asha.org     Author: ASHA - Information and resources regarding bilingual service delivery by SLPs (from ASHA)
  • Effects of Parents' Mealtime Conversation Techniques For Preschool Children With Hearing Loss Who Use Listening and Spoken Language 2
    pubs.asha.org     Author: Elaine R. Smolen, Ye Wang, Maria C. Hartman, and Young-Sun Lee - Parents of preschoolers with hearing loss may benefit from specific coaching to elicit language and introduce new vocabulary during home routines. These techniques may help develop their children's receptive language.
  • Bilingual Language Development Video 1
    www.youtube.com     Author: Kathy Kohnert - YouTube Video on Bilingual Language Development by Kathy Kohnert
  • Language Difference vs Language Disorder: Assessing English Learners 1
    digitalcommons.odu.edu     Author: Carol Westby and Kimberly Murphy - Video available Language Difference vs Language Disorder: Assessing English Learners Carol Westby, Bilingual and Multicultural Services, Albuquerque, NM Kimberly Murphy (Host), Old Dominion UniversityFollow Document Type Presentation Publication Date 5-20-2020 Abstract To a large extent, determining whether an English learner has a language/learning disability is a process of elimination. There are no tests that can definitely tell us whether the student has a language/learning disability. Inappropriately identifying an EL student as having a language/learning disability can result in stigmatization or reduced access to academic content, but waiting too long to identify a student who truly has a language/learning disability can be the beginning or the extension of a cycle of communicative, academic, and/or social failure. Assessment of EL learners requires collaboration between classroom teachers and speech/language pathologists. This session will cover (1) factors that complicate the assessment of English learners; (2) multi-tiered systems of support (MTSS) and performance-based assessment; (3) process assessments, and (4) dynamic narrative assessment. Comments This professional development webinar was presented by Dr. Carol Westby for speech-language pathologists in Virginia. It was funded by the Virginia Department of Education and hosted by Dr. Kimberly Murphy, Old Dominion University.
  • Milestone Moments 1
    www.cdc.gov     Author: Centers For Disease Control and Prevention - These developmental milestones show what most children (75% or more) can do by each age. Subject matter experts selected these milestones based on available data and expert consensus.
  • Increasing Adolescents’ Depth of Understanding of Cross-Curriculum Words: An Intervention Study 2
    onlinelibrary.wiley.com     Author: Sarah Spencer, Judy Clegg, Hilary Lowe, and Joy Stackhouse - Cross-curriculum words are not consistently understood by adolescents at risk of low educational attainment within a low socio-economic context. A 10-week intervention programme resulted in some increases to the depth of knowledge of targeted cross-curriculum words. https://www.theinformedslp.com/review/vocabulary-intervention-for-at-risk-adolescents
  • Efficacy of Auditory-Verbal Therapy In Children With Hearing Impairment: A Systematic Review From 1993 to 2015 2
    www.sciencedirect.com     Author: Ramesh Kaipa and Michelle L. Danser - This systematic review investigates the effects of auditory-verbal therapy (AVT) on receptive and expressive language development, auditory and speech perception, and "mainstreaming" in children, 2-months-old to 17-years-old, with hearing loss.
  • Learning Two Languages: Bilingualism 1
    www.asha.org     Author: ASHA - Information and resources for SLPs and parents of bilingual children
  • Receptive Language (understanding Words and Language) 1
    childdevelopment.com.au     Author: Kid Sense Child Development - What is receptive language (understanding words and language)? Receptive language is the ability to understand words and language. It involves gaining information and meaning from routine (e.g. we have finished our breakfast so next it is time to get dressed), visual information within the environment (e.g. mum holding her keys means that we are going to get the car, a green light means go), sounds and words (e.g. a siren means a fire engine is coming down the street, the word ball means a round bouncy thing we play with), concepts such as size, shape, colours and time, grammar (e.g. regular plurals: cat/s, regular past tense: fetch/ed) and written information (e.g. signs in the environment like "no climbing", written stories).
  • Receptive Language Vs. Expressive Language 1
    napacenter.org     Author: NAPA Center - Put simply, receptive language generally refers to listening while expressive language refers to talking. But there's more to it, as we share in this blog!
  • Should Adolescents Go Back to the Basics?: A Review of Teaching Word Reading Skills to Middle and High School Students 2
    apps.asha.org     Author: Laurice M. Joseph and Rebecca Schisler - This review investigates the effects of word reading interventions (e.g., phonic analysis, sight word reading, oral reading fluency) on reading achievement outcomes in middle and high school students (grades 6 through 12) with mixed conditions (e.g., learning disabilities, intellectual disabilities, emotional/behavioral disabilities).
  • Your Child’s Early Development is a Journey 1
    www.cdc.gov     Author: Centers For Disease Control and Prevention - Skills such as taking the first step, smiling for the first time, and waving “bye-bye” are called developmental milestones. Children reach milestones in how they play, learn, speak, act, and move. Click on the age of your child to see the milestones:
  • Evaluation of Bilingual Children- Considerations 1
    leader.pubs.asha.org     Author: Alejandro E. Brice and Roanne G. Brice - An overview of considerations when evaluating bilingual (Spanish/English) children
  • Bilingual (Spanish/English) Evaluation Resources 1
    bilinguistics.com     Author: Bilinguistics - Dozens of speech, language, fluency, and other evaluation resources for bilingual evaluations
  • Bilingual (English/Spanish) Therapy Materials By Bilinguistics 1
    bilinguistics.com     Author: Bilinguistics - Downloads and resources for providing bilingual therapy (Spanish/English)

Activity List(s)

Visual Schedule Cards

Related Disorder(s)

  • Receptive Language Disorder - A child with receptive language disorder has difficulties with understanding what is said to them. The symptoms vary between children but, generally, problems with language comprehension begin before the age of three years. Children need to understand spoken language before they can use language to express themselves.
  • Childhood apraxia of speech - Childhood apraxia of speech (CAS) is a disorder that involves difficulty in making speech sounds voluntarily and stringing these sounds together in the correct order to make words. A person with childhood apraxia of speech is not intellectually impaired. Speech pathologists assess, diagnose and support people with CAS.
  • Speech sound disorders - Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segments—including phonotactic rules governing permissible speech sound sequences in a language.
  • Motor Speech Disorders - Dysarthria can be related to neurological damage, however it can be related to many other causes. Dysarthria is a motor speech disorder above all. A dysarthria diagnoses can come from a weakened Parkinson’s patient, a anatomy damaged TBI patient, a stroke patient with cranial nerve and strength deficits, etc).

Assessments

Goal Bank

  • In six month's time, the child will be able to communicate on purpose for a variety of reasons, such as asking for something, sharing his interest, or showing something via a variety of spoken words, consistent gestures, and/or picture symbols visual supports (e.g., picture cards), demonstrating the ability to engage in two- to three-turn conversations with familiar adults and peers in 100% of opportunities. 1
  • Toby will display pre-literacy skills (identifying letters, words, book titles, etc.) across a 2 month treatment period. 1

Therapists

Therapists who selected this major focus area as their top area of expertise.