There are many areas of communication and they are all important. Imagine a young boy with Autism, who is able to speak fluently, with all the correct sounds and sentence structures; he even understands very well what he hears and reads. Yet he struggles with understanding and using social conventions, is perceived as rude or odd by others, has trouble making friends, and is bullied at school. Now imagine a woman in her 80s who has had a stroke, affecting her ability to speak. She is unable to use speech to communicate, yet she understands perfectly what others say to her and is able to read and write. A young woman, a teacher, has had many days off work this year because her voice keeps cutting out, and she has been diagnosed with vocal nodules.
These examples don’t even cover the range of stories I hear each day in my clinic!
Communication is complex. Communication is hearing, attending to what is seen or heard, thinking (AKA cognitive skills), understanding (AKA receptive language), expressing (AKA expressive language), using correct speech sounds and using good social skills. In addition, from preschool onwards, communication also involves a range of skills around literacy: sound awareness (AKA phonemic awareness, or awareness of sounds in words), print awareness, reading and spelling.
The processes involved in speaking
When you think about speaking, imagine all the processes involved:
You conceive the idea. Your brain thinks about what to communicate and makes decisions about it.
Messages are sent from the brain to the muscles involved in speech production. The messages contain information about what words you will speak, in what order (making a sentence), how loud you will say it, with what tone of voice, what sounds will be produced (and how to make each sound) and what facial expression or body language will accompany it.
As you breathe air out of your lungs, your vocal cords inside your voice box move. This movement affects the passage of air out of the lung and you produce voice.
After the air moves through the voice box, your throat, mouth and nose also impact on the sound waves. Tiny movements of the soft palate, jaw, tongue and lips help to shape the sound waves into sounds which the listener will be able to recognise and understand.
As you do this, your body may also be involved by making certain movements, such as nodding your head, pointing or moving in some other way to help convey your message.
This can all occur within a fraction of a second! Isn’t it amazing!
Communication is a little different for people who communicate without speech (eg. via sign language). However brain imaging shows us that many of the same areas of the brain are involved in the planning and message-sending, when compared with people who use speech to communicate.
Areas of Communication
Let’s look at all the different areas of communication and the problems we can encounter in each area:
Language is the ability to understand and use words and sentences to communicate.
Receptive Language – this refers to the ability to understand what others say to us.
Expressive Language – this refers to the ability to use words and sentences to express ourselves. When we talk about “use” of language, we are usually honing in on the expressive side of language, rather than the receptive side.
Within receptive and expressive language we have the ability to:
Understand and use words – referred to as “vocabulary”
Understand and use grammar – eg. tense, plurals, word order and sentence structure
There are a number of skills which children develop in the lead-up to learning to read and write. This includes:
Awareness of sounds in words – eg. rhyme, syllables, first and last sounds. This is also known as “Phonological awareness” (or sound awareness) and has been shown to influence early literacy skills greatly.
Ability to manipulate sounds in words – eg. swap sounds around
Print awareness – eg. identifying what is a letter, word and sentence.
2. Written expression includes spelling and the use of correct grammar and vocabulary to express ourselves through writing.
Reading is influenced by the age of the person and their educational level. Reading includes the ability to match letters with sounds, read words, sentences and passages fluently and understand what is read.
Fluency refers to the smoothness or flow of sounds, words and sentences as we speak. The most commonly-known problem with fluency is stuttering (AKA stammering). Stuttering is when a person repeats or prolongs sounds, words or phrases, interrupting the flow of their speech. Cluttering is another disorder of fluency.
Voice refers to the use of the lungs and vocal cords (in the larynx, or voice box) to communicate. Voice is produced when air is forced out of the lungs and through the voice box. The vocal cords come together and vibrate, producing voice. Problems with voice include hoarseness, vocal nodules and muscle tension dysphonia.
Speech (AKA articulation) refers to the sounds we use when we speak. When children are learning to talk, their speech system is immature and they may be very difficult to understand. As they grow and develop, their speech sounds become more adult-like and we begin to understand more of what they say. People who have more than 1 language may have speech that is difficult for us to understand – here we perceive that they have an accent. The most common speech problems are developmental phonological disorders (AKA delayed speech), apraxia (AKA dyspraxia) and dysarthria.
Social skills refer to the ability to use language appropriately in different ways, in different places and contexts, with different people. Social skills includes being able to:
use body language, facial expression and tone of voice appropriately
get someone’s attention appropriately
give the right amount of information – not too much and not too little
perceive, understand and use humour
change communication styles to suit different contexts
and so much more!
People who have troubles with social skills may be those who have a traumatic brain injury, dementia or Autism.
I hope that this article helps you to appreciate how complex communication is!
Let’s look at all areas!
Because communication is so complex, there are different areas of communication that we can fall down with. It is common to have a problem with one area while having no problem with another area of communication. I sometimes hear: “My child doesn’t need a Speech Pathologist! He’s so chatty!” Some children will do really well in some areas, while needing help in other areas. Don’t ignore the areas of struggle just because your child excels in one or more other areas of communication.
When looking at the communication milestones, to see if your child is progressing well, remember to look at all areas of communication for their age – speech, language, social skills and literacy skills (depending on age).
Speech versus language
Do you find the difference between speech and language disorders confusing? You are not alone! However, I hope you can appreciate that a speech disorder affects someone’s ability to use speech sounds to communicate; a language disorder may affect their ability to understand what others say, and to use the right words and word and sentence structures to communicate with others. Of course, speech and language disorders often go together, meaning that someone may have both disorders.
Where to get help
If you are concerned about your communication or the communication of your loved one, look for a qualified Speech Pathologist. In children, getting in early with a Speech Pathology assessment will give them the best chance of success.