Abstract
Although textbooks on language development abound, those written for a more general readership tend to treat language impairments in separate chapters, if at all. This publication meets the specific needs of speech and language therapy students by integrating language impairment and language development throughout the text. Although entitled an introduction, the text will be of use to student clinicians throughout their course and to qualified clinicians as they develop their paediatric practice, as well as to those in related areas.
The stated aims of the book are to help readers understand how the language of children with language impairment is different to that of typically developing children, and to understand what prevents these children from acquiring language within the usual time-frame. A loosely chronological structure is followed, but each chapter focuses on one foremost aspect, thus integrating a thematic approach covering each area of language in turn. To achieve their aims, the authors adopt a problem-based approach, presenting a series of mainly clinical scenarios as a basis for discussion. After presentation of the problem, a separate box entitled ‘learning issues’ unpacks the key questions which arise. Problem solving is a core skill for clinicians, and this approach is invaluable for students, modelling how to identify the issues. From the outset, readers are presented with knowledge and theories in an applied context, rather than being required to make the leap of application alone.
The first chapter, ‘Overview’, explores the linguistic environment in which children acquire language, and provides a brief introduction to each of the main conditions giving rise to speech, language and communication needs. There is useful consideration of the linguistic community as the background to clinical decision-making, covering both bilingual acquisition and variation in dialect or accent. The wide variation in typical development is discussed together with potential causes. Cognitive processing capacities are briefly considered but more weight is given to external factors through discussion of child-directed speech and social background. This sets the tone for future chapters where a social-interactionist perspective tends to predominate, alongside the emphasis on analysis of the child’s language in order to accurately identify features of impairment.
In Chapter 2, ‘The first year of life’, case studies covering autism, Down syndrome and hearing impairment lead to discussion of speech production and perception, and of how social and cognitive development relate to language acquisition. Clinical application is embedded using the Rosetti Infant-Toddler Language Scales (Rosetti, 1990) and an adaptation of the Hanen ‘how and why’ chart (Weitzman & Greenberg, 2002), which enables analysis of early communicative forms and functions. Chapter 3, ‘Sounds’, provides a more in-depth consideration of phonological development, notably including an explanation of vowel systems in typically developing children and some of the forms which vowel impairments take.
‘Words’, Chapter 4, focuses on lexical acquisition mainly in the age group 12–36 months. The discussion provides an excellent example of how the authors make no assumptions of prior knowledge: common and proper nouns are defined, there is detailed explanation using a concrete example of how perceptual features combine to form a prototypical category item, leading to the proposition that semantic categories have fuzzy boundaries. This serves as the basis for discussion of mapping and over/under-extension. As elsewhere in the book, worked examples illustrate the use of clinical assessments. In this chapter the inclusion of the Irish-English Communicative Development Inventory (O’Toole & Fletcher, 2010) underlines bilingual acquisition as a normal state of affairs, a refreshing approach conveyed throughout the text.
The link between semantics and morpho-syntax is made at the end of Chapter 4, through an exploration of verb learning and argument structure. This provides a transition into Chapter 5, ‘Combining words’. The problem-based approach here is the same, but now the reader is guided through the process of transcribing and independently analysing a language sample using software transcription systems and automatized analysis measures, followed by LARSP (Language Assessment Remediation and Screening Procedure) profiling (Crystal, Fletcher, & Garman, 1989) and use of the accompanying reference database (Klee & Gavin, 2010). The chapter provides a convincing demonstration of the value of this approach in clinical work, using analysis to reach clinical decisions in three areas: development of tense, interrogatives and complex sentences. Practising clinicians too will find the level of detail in these sections a useful and nuanced reference.
Chapter 6 goes ‘Beyond the sentence’, where analysis of conversational and narrative data offers an exceptionally clear guide to the complexities of developmental pragmatics, demonstrating the impact of semantic, syntactic or phonological difficulties on communicative competence. The authors also describe clinical tools and assessments to facilitate analysis of pragmatics which deserve to become more widely known. This chapter, like others, concentrates on development up to the age of five, which is a pity. However, the authors acknowledge that language acquisition is not complete at that age and give brief information about further development at relevant points throughout the book.
Fletcher and O’Toole have written a detailed, research-infused introduction to both language development and language impairment, which is nonetheless accessible and grounded in evidence-based clinical practice. Throughout the book there are clearly marked links to websites prompting further exploration. Each chapter ends with scenarios for additional study or discussion, and for tutors, the publisher’s website includes recommended readings and resources to support student work on these problems, making it an excellent resource for all involved with teaching and learning in this area.