Functional Communication, A Desired Outcome for Children with DLD
We communicate to be included with others and to learn. This happens so easily most of the time. We don’t stop to think about just how important good communication is to functioning in everyday life.
Children with Developmental Language Disorder (DLD) lack the basic language skills required to be good communicators. Their weak language skills interfere with communication and success in social and academic interactions. They might find it difficult to share a story with a friend or to answer a teacher’s question in the classroom. We call this functional communication, or sometimes communicative participation, and it can be challenging for those with DLD.
To illustrate this, here is a quick story. A speech-language pathologist works with a 4-year-old boy with DLD to help him form grammatically complete sentences, for example, saying “he is going home” instead of “him go home”. By speaking in sentences like other children his age, the boy will be able to communicate more effectively with family and friends. He will have better functional communication. One day the boy’s mother (with tears in her eyes) told the speech-language pathologist that he was invited to his friend’s birthday party! Together, they recognized two important outcomes from the work they had been doing. The boy’s spoken language skills improved and he was being included by his friends!
It is important to consider how DLD impacts a child’s functional communication and to find ways to help. Speech-language pathologists include measures of functional communication as part of their evaluation of DLD and intervention. Some of the tools used to measure functional communication are the: Focus on the Outcomes of Communication Under Six, Functional Communication Profile, Intelligibility in Context Scale, and National Outcome Measures System.
Ultimately, increasing a child’s ability to participate in everyday social and educational activities is an important— perhaps the most important—outcome of language intervention. Parents are an important source of information about a child’s functional communication needs. Discuss your child’s functional communication goals with your speech-language pathologist and how progress on those goals will be measured.
ReferencesAmerican Speech-Language-Hearing Association. (2001; 2016a). Scope of Practice in Speech-Language Pathology. Retrieved from www.asha.org/policy.
American Speech-Language-Hearing Association. (2003). National Outcomes Measurement System (NOMS): K–12 speech-language pathology user’s guide. Rockville, MD: Author.
Bishop, D. V. M., Snowling, M. J., Thompson, P.A., Greenhalgh, T., and the, C.-c. (2017). Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. Journal of Child Psychology Psychiatry, 58, 1068–1080.
Cunningham, B., Washington, K. N., Binns, A., Rolfe, K., Robertson, B., & Rosenbaum, P. (2016). Current methods of evaluating speech-language outcomes for pre-schoolers with communication disorders: A scoping review using the ICF-CY. Journal of Speech, Language, and Hearing Research,60, 447–464.
Eadie, T., Yorkston, K., Klasner, E., Dudgeon, B., Deitz, J., Baylor, C., & Amtmann, D. (2006). Measuring communicative participation: A review of self-report instruments in speech-language pathology. American Journal of Speech-Language Pathology, 15, 307–320.
Kleiman, L. I. (2003). Functional Communication Profile—Revised. Austin, TX: LinguiSystems.
McLeod, S., Harrison, L. J., & McCormack, J. (2012c). The Intelligibility in Context Scale: Validity and reliability of a subjective rating measure. Journal of Speech, Language, and
Hearing Research, 55(2), 648–655.
McLeod, S., & Threats, T. (2008). The ICF-CY and children with communication disabilities. International Journal of Speech-Language Pathology, 10(1), 92–109.
Redmond, S.M. (2011). Peer victimization among students with specific language impairment, attention deficit hyperactivity disorder, and typical development.
Language, Speech, and Hearing Services in Schools, 42, 520–535.
Rice. M. L. (1993). “Don’t talk to him; he’s weird”. A social consequences account of language and social interactions. In S.F. Warren & J. Reichle (Series Eds.) A.P. Kaiser, & D.B. Gray (Eds.), Communication and language intervention series: Vol 2. Enhancing children’s communication. Research foundations for intervention (pp. 139-158). Baltimore, MD: H. Brookes Publishing.
Thomas-Stonell, N. L., Oddson, B., Robertson, B., & Rosenbaum, P. L. (2010). Development of the FOCUS (FOCUS on the Outcomes of Communication Under Six), a communication outcome measure for preschool children. Developmental Medicine and Child Neurology, 52, 47–53.
Thomas-Stonell, N., Washington, K., Oddson, B., Robertson, B., & Rosenbaum, P. (2013). Measuring communicative participation using the FOCUS.
Child: Care, Health, and Development, 39(4), 474–480.
Washington, K. (2007). Using the ICF within speech-language pathology: Application to developmental language impairment. International Journal of Speech-Language Pathology, 9(3),242–255.
Washington, K., Thomas-Stonell, N., McLeod, S., & Warr-Leeper, G. (2015). Outcomes and predictors in preschoolers with speech-language and/or developmental mobility impairments. Child Language Teaching and Therapy, 31(2), 141–157.
Washington, K., Thomas-Stonell, N., Oddson, B., McLeod, S., Warr-Leeper, G., & Rosenbaum, P. (2013). Construct validity of the FOCUS (Focus on the Outcomes of Communication Under Six): A functional communication outcome measure for preschool children. Child: Care, Health, and Development, 39(4), 481–489.
Yorkston, K., Baylor, C., Dietz, J., Dudgeon, B., Eadie, T., Miller, R., & Amtmann, D. (2008)
Developing a scale of communicative participation: A cognitive interviewing study. Disability and Rehabilitation, 30, 425–433.