To conclude this series of articles dedicated to TEL We want to go a little further and detail the specific areas of intervention that we can take into account in children with SLI symptoms., always taking into account the specific difficulties defined in the different types that exist in this disorder:
Once we have attended to these 4 basic requirements For language, we delve into the work of intervention by areas of action. We leave you with some ideas for you to put into practice!
A. PHONOLOGICAL LEVEL
At this level we find 3 clear objectives of problems to be treated:
1. Alterations in phoneme discrimination: Generally, exercises focus on both discriminating similar phonemes and identifying the order of phonemes within words. Exercises such as:
- Differentiate between words that are the same or that differ only in one phoneme (eye/bear, elbow/elbow, choir/elbow, etc.).
- Following commands that contain problematic phonemes.
- Point to objects.
- Use different gestures depending on the phoneme presented.
- Respond to words based on phoneme discrimination.
2. Deficits in phoneme production: It is recommended to improve the pronunciation of phonemes the child has already acquired, while also teaching those he or she has not yet produced. Some appropriate exercises would be:
- Direct manipulation of the articulation organs.
- Biofeedback devices.
- Imitation of phonemes and words.
- Reading syllables, words, phrases and texts.
- Name of cards that contain drawings or actions.
- Phonetic lotuses.
- Phonetic bingos.
- Games with phonemes.
- Popular songs and poems.
- Role-playing in which appropriate roles are played.
- Scripts.
- Physical guide to the vocal organs.
- Use of joint modifiers (depressors, balls, etc.).
- Imitation of the speech therapist.
- Speech Viewers
3. Problems at the syllabic level: Children with SLI often also have difficulty discriminating the syllables that make up words, a difficulty that affects both syllable production and comprehension. To address this issue, activities such as:
- Discriminate the duration of words (more or fewer syllables).
- Discriminate the variations in the tone of voice in different syllables.
- Identify the number of syllables that make up the words (start by marking the syllables with voice beats that gradually fade away).
- Imitation of syllables.
- Repeat a word, omitting a syllable.
- Add syllables to words.
- Imitation.
B. LEXICAL-PRAGMATIC LEVEL
Children with SLI have a smaller vocabulary than children with normal language development and have limitations at the semantic level, hence it is common for the speech therapist to intervene on these aspects focusing on 2 objectives:
- Increase vocabulary both at a comprehensive and productive level. For this purpose, some appropriate exercises could be:
- Imagine stories about general and specific topics.
- Imitation.
- Games of similarities and differences.
- Synonym and antonym games.
- Evocation tasks.
- Take objects out of a bag and describe them.
- Detect mistakes made when reading a story.
- I spy game.
- Respond to orders.
- Point to pictures when saying their name.
- Recall missing words in a series.
- Recognize the object that corresponds to a given description.
- Improve lexical relationships between vocabulary words In addition to improving vocabulary, it's necessary to work on building thematic and hierarchical relationships, rather than simply accumulating words. Suitable exercises could include the following:
- Vocabulary questions (what is it, why, what for)
- Games of similarities and differences.
- Analogies.
- Direct questions (tell me things a bird or a plane can do? What animals can fly? Where can you find bread?)
- Choose two words at random and try to match them.
- Polysemy exercises.
- Invent riddles
C. MORPHOSYNTACTIC LEVEL OF LANGUAGE
The most frequently encountered difficulties in children with SLI, within the dimension of morphology and syntax, have to do with the following aspects:
- Use of syntactic and grammatical elements where activities are used to work on those elements with which the child has problems (plurals, pronouns, verbs, prepositions, futures, etc.).
- Make sentences from one or two given words.
- Tell the content of a sheet with drawings.
- Correct errors or omissions.
- Correct the phrases that a doll says.
- Sort words.
- Construct sentences that contain the problematic elements.
- Joining parts of statements.
- Create imaginary stories and tales.
- Children's songs.
- Imitation.
- Role-playing.
- Scripts.
2. Sentence structure for which it will be necessary to take into account the child's age and the evolutionary sequence of language acquisition, to design exercises that allow for single words to two-word combinations of the most common types (agent-action, action-object, agent-object, etc.) and then to first sentences. These exercises could involve:
- Imitation.
- Sorting comics.
- Recognize correct sentences.
- Complete sentences.
- Correct jumbled sentences.
- Description of events.
- Invention of stories.
- Role-playing.
- Scripts.
3. Sentence comprehension To work on this area, exercises such as:
- Tracking individual orders. For example, “take a pencil”, “give me the eraser”, “draw a house” or “paint a tree pink”.
- Tracking complex orders. For example, “take a pencil and jump”, “give me the eraser with a star on it”, “draw a house with a green roof” or “in front of the house, draw a pink tree that is shorter than the house”.
- Produce similar sentences.
D. PRAGMATIC LEVEL OF LANGUAGE
Sometimes, children with SLI have difficulty participating in the communication that occurs in their environments, they fail to initiate conversational exchanges, and they are unable to regularly use language as a tool to meet their diverse needs. In this sense, speech therapy intervention at the pragmatic level usually emphasizes two different but complementary aspects:
- Development of intentionality: The goal would be to facilitate the child's conscious and intentional initiation of language exchange. Some relevant exercises would include:
- Describe what is done while performing an activity.
- Describe story boards.
- Songs.
- Drawing and telling stories.
- Complete unfinished drawings and make up stories with them.
- Role-playing.
- Using scripts.
- Stories in which missing information is needed for the child to fill in. For example, the story "Pablo left his bedroom window open while he slept at night. He couldn't go to school the next day" is told, and questions are asked such as, "What's wrong with him? Is it winter or summer? What would his mother say?"
- Development of the speech: Through activities such as:
- Share personal experiences.
- Describe events that have occurred or are occurring.
- Talk about familiar topics.
- Tell stories that involve feelings.
- Talking on the phone imaginarily with other people.
- Games of similarities and differences.
- Role-playing.
- Using scripts.
- Stories in which missing information is needed for the child to fill in. For example, the story "Pablo left his bedroom window open while he slept at night. He couldn't go to school the next day" is told, and questions are asked such as, "What's wrong with him? Is it winter or summer? What would his mother say?"
We hope you find ideas, games, activities, and above all, that it helps you analyze your child's developmental stage and needs so that you can understand the complex and methodical approach of the professionals around you, learn from them, work together, and little by little, together, you'll be able to see your children take off!
Cristina Oroz Bajo