Form - Content - Use

In an earlier post, I suggested that the assessments themselves are like games. I remember shortly after her 3rd birthday, we went for our first assessment - speech and hearing. On that day, I watched as the practitioner gently encouraged, cajoled, made requests, and affirmed my daughter. Nothing in her voice or body language hinted at the performance gaps. And me, the doting parent, what did I know? What I learned that day was the first of many child development concepts – language consists of content, form, and use.

“Content is the meaning of the message. It is also semantics. Form is the structural aspect that includes attaching some symbol to the meaning. The symbol can include a spoken word, picture or a sign. The form/symbol is effective as long as both the communicator and listener both agree on the meaning. Another part of form is the length and word order that includes syntax. Use is the purpose, function, or reason for the communication. It includes pragmatics and social communication.  When one of the areas is missing, a communicative attempt has been made but most likely was ineffective. If the listener and speaker are familiar, then the message may be translated.” (Taken from Speech language assessment)

She played games but didn’t follow the instructions, her eyes followed the specialist closely but in the end it was apparent, even to the doting parent that there were gaps. The specialist started with the good news (we always need the good news first – it affirms the strengths of our child). My daughter’s development was like a star. If you spread your fingers open, you’ll see the finger tips give you the height and the flesh that joins the fingers makes the low points – like a star. My daughter’s speech and language development had high points (and low points).

There were areas where she performed solidly. Then there was the other reality – in many areas, she simply could not respond. The good news was that she didn’t have an obvious hearing problem but there was clearly a problem of some kind.

The initial recommendation was to contact my local infant and toddler program for early childhood intervention services. The other recommendation seemed dorky but it made sense – get flash cards and put them around the house.  Also, she recommended that I use the flash cards or pictures to lay out the schedule. (I didn’t know then that transitioning from one activity to another was a problem….there’s so much you don’t know; and so much they can’t tell you when you get the diagnosis).

This is where I began my learning – the visual cues coupled with slow, deliberate use of the language provided stimulation. First, I got the naming words (nouns) and I put those around the house – table, chair, bed, door, sofa and things like that. Then, I got the action words - verbs - the easy ones to put up were cook, knock, wash, bathe. These I put up in the places where those action verbs were most used. The fun ones were a bit of a challenge. All of the flash cards related to outdoor activity, I put up on the wall in the basement. We’d use that exit to go out to the yard. That way, we could look at the pictures and I could talk about what we were about to do and she would see the pictures as we prepared for the activity.

I hated art and I still can’t draw, but here’s what I realized: I may not be a gifted artist with ability to draw, but my gift is the ability to turn language concepts and processes into visuals that would facilitate my daughter’s language acquisition. Many months later, I learned that speech pathologists and early childhood educators have that gift, so I could learn from them or from resources that they use.

When she started pre-school at 4, I needed to explain that she would do circle time, music, and other activities at one school and then the bus would come and take her to speech therapy. I wouldn’t be there to explain the activity while it occurred so it was important to have those pictures in her head so that when the time came to board the bus, she would remember that we’d talked about it.  Remember, she wasn’t deaf – just delayed in the acquisition of  speech.

The assessment experience also revealed that my daughter was kinesthetic – motor-oriented. That meant, if you did activities with language and movement it was easier for her to grasp meaning. Who knew?

As a student of linguistics, I understood syntax, grammar, and semantics. I knew how English had evolved from Latin to its modern day form. As a parent, all I knew was that she wasn’t speaking. Three days after her third birthday, I learned something else about language that language is not just words. It is form, use, and content and that all three elements need to be present for communication to be effective.