Human Communication Just how much do we take for granted? Margaret - - PDF document

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Human Communication

Just how much do we take for granted?

Margaret Walker MBE Several months ago Peter Bateman contacted me and asked if I could talk at one of these meetings about Speech Therapy as he thought that it would be of interest. I agreed, as I used to practice as a Speech and Language Therapist. As time went on I thought I ought to broaden the topic and in this way you would understand the need for our role. However I intend to begin with a brief overview about our profession. Let’s start with a definition.

What is speech therapy?

Speech Therapy is concerned with the management of disorders of speech, language and swallowing in children and adults.

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This is the definition on the Royal College of Speech and Language Therapists’ website. It is carefully worded and does not give much information. “Management” is the key word. Perhaps after my talk you will appreciate this choice of word more because our work covers such a huge variety and complexity of communication disorders and social issues. Where do Speech and Language Therapists fit into to the Health Scene? Where do Speech and Language Therapists fit into the Health Scene?

Speech and Language Therapists are Allied Health Professionals. They work closely with Parents, Family members, Carers and

• ther professionals such as Teachers, Nurses, Occupational

Therapists and Doctors. Often they are members of specialist medical / educational teams.

We are described as Allied Health Professionals and currently there are 13,000 practising Therapists in the UK. Not a really large number to cover the current need which is estimated as being 2.5 million people in the UK with a communication disorder. Where do Speech and Language Therapists work? Speech and Language Therapists work in:

• Community Health Centres
• Hospital wards
• Occupational Therapy Departments
• Mainstream and special schools
• Children’s centres
• Day centres
• Client’s Homes

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I think this list is clear and does not need any further explanation from me, but, some of the places on the next slide may.

• Courtrooms
• Prisons
• Young Offenders institutions
• As members of specialist teams e.g. Cleft Palate,

Dementia

• Independently, in private Practice
• Courtrooms. In the last 10 years our Law Courts have seen the emergence of a

new legal professional - the Court Intermediary. Many of them are Speech Therapists, though there are some other suitably qualified and experienced professionals who have been selected to fulfil this role. It was realised that there are certain victims in Court who are only able to express themselves and understand what is said to them through unique augmentative forms of communication. This need is outside of foreign language or sign language interpretation. The Court Intermediary role is to act as the conduit between the victim, and the Judge and the Prosecuting /Defence Councils. Specific training is necessary before any professional can be considered for selection. I was on the Working Party that defined both the selection process and the training. Prisons and Young Offender’s Institutes. Many prisoners and young offenders

• ften have very poorly developed communication skills due to disruptive
• childhoods. There are a variety of reasons such as, poor parenting resulting in

inadequate stimulation, inconsistent school attendance etc. Some are also illiterate. Others may have specific communication problems e.g. hearing loss which has gone undetected. Specialist Teams need no explanation, but just a word about Independent Private

• Practice. This is on the increase due largely to economic cutbacks which have led

to a reduction in NHS provision.

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Ironically, many private Speech and Language Therapists who were forced to leave the NHS service for this reason are now being bought back with funding from different NHS, Education or Charity Budgets! After qualifying I worked in the Out-Patients departments of two General

• Hospitals. My case load was tremendously varied ranging from Cleft Palate and

ENT cases, communication disorders resulting from Strokes, Laryngectomy and

• ther forms of neurological degeneration.

I also worked in a large hospital institution for people with Learning Disability and also in a local special school and a National Autistic school. Finally towards the last twelve years of my professional career I had a unique part time position as Senior Lecturer at St Georges Hospital Medical School, London where my role was to increase the understanding of Medical Students and qualified Doctors about the needs of people with all manner of communication disabilities. I also designed the Makaton Language Programme which is extensively used all

• ver the UK and in many countries overseas with children and adults with severe

communication and learning disabilities. Now let’s take a look at the qualifications necessary in this country to practice.

Speech and Language Therapists Qualifications

All practising UK Therapists have to have membership of the Royal College of Speech and Language Therapists, (MRCSLT) the governing body in the UK. The College regulates standards, training and national policy for the profession. The basic qualification is a B.Sc Degree in Speech Sciences

• r Human Communication.

Many SALTs will also have an M.Sc or PhD in Human Communication.

I have a B.Sc and an M.Sc and was a Fellow of the College. The College was founded in 1945 with the merger of two society’s that had developed the profession that far. In 1999 it was awarded the right to use “Royal” in its title.

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Did many of you see the film “The King’s Speech about George VI and the relationship he had with his Speech Therapist, Lionel Logue? We still use many of the same principals of therapy today that he used to support the King with his stammer. However we’ve now given up rolling around on the floor with our patients!! Lionel Logue was involved in the founding of the College in 1945 and in 1948, he wrote to the King informing him about the founding of College and asking him if he would consider becoming a Patron of the College. (See copy of Lionel Logue’s letter).

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As the Monarch cannot assume such a role, King George instead arranged for his wife, Queen Elizabeth, to be the Patron of College and she continued after his early death as Queen Elizabeth the Queen Mother until her own death. The current Patron is the Countess of Wessex. Since 1945, the work of Speech Therapists has grown so much that the training has also had to expand to accommodate the needs.

B.Sc (Hons) in Speech and Language. (City University)

Four year degree Involves the theoretical study of Human Communication and the factors that influence its development and those that interfere or are acquired. Subjects studied in depth Psychology, neurology, anatomy and physiology, linguistics and phonology, related disorders of cognition, language, speech production, hearing and ENT, research and evidence based practice methods culminating in student’s research project. Practical clinical experience is also included.

Here is the current syllabus for the 4 year B.Sc in Human Communication to give you an idea of the range of subjects studied. Each year, the syllabus will also include practical clinical experience under the supervision of a qualified Speech Therapist in a variety of different environments. Let’s now look at the variety of communication disorders that we manage.

What types of Communication Disorders do SALTs treat?

Babies

• Feeding and swallowing difficulties

Children

• Mild, moderate or severe Learning Disability
• Physical disability
• Language delay
• Speech and language impairment
• Specific sound production difficulties

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Some will be present from birth, such as, Learning Disabilities, Cerebral Palsy, Autism, Cleft Palate.

• Hearing impairment
• Cleft Palate
• Stammering
• Autism and spectrum disorders
• Dyslexia
• Voice disorders
• Selective mutism

Others are acquired during our lives through illness, accident, or, injury, for example, a stroke, neurological degeneration, cancer.

Adults

• Communication, feeding or swallowing problems

and impairments following neurological impairment or degenerative conditions, such as stroke, head injury, Parkinson’s, dementia, neck and throat cancer, or, laryngectomy and

• Voice problems
• Mental Health issues
• Learning Disabilities
• Physical Disability
• Stammering
• Hearing impairment

Some can be remedied, or, the symptoms reduced, whilst others may persist and communication aids and augmentative forms of communication are provided if appropriate.

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To conclude this first part of my talk, you will remember me telling you earlier that there are about 2.5 million people in the UK with some kind of speech disorder, but there will however, also be many millions who develop normal communication without any difficulties. This is amazing as it is one of the most skilled and complicated human achievements. So let’s take a closer look at Human Communication in greater depth.

HUMAN COMMUNICATION is a two way process by which information is passed from

• ne person to another - involving a sender

and a recipient.

In order for Human Communication to be established satisfactorily, three essential criteria have to be met.

Three essential criteria to be met:

• 1. That there is some output from the

initiating person

• 2. That there is some means of

transmitting and conveying the information

• 3. That the recipient can receive,

understand and interpret the information

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There are various forms of transmission we can use.

Various means of Transmission

• 1. An oral / aural dependent one e.g. speech
• 2. A manual / visual system e.g. writing, reading,

sign language, symbols system

• 3. An oral / visual system e.g. lip-reading
• 4. A tactile system e.g. Braille, Moon, Tactile Symbols
• 5. Visual / Auditory / Technical Systems e.g.

iPhones, Texting, iPads, Computerised speech

• devices. (Prof Stephen Hawkins)

Oral = spoken or verbal Aural = related to the sense of hearing

You will notice that the output method is different in each case. What is common though is that language is at the core of them all. Several of these will be familiar to you and you will have mastered them. Being able to acquire language skills is essential as it is through language that parents, carers and educators, shape, expand and support a young child’s experiences of life through to adulthood. The manner in which daily activities and work patterns are established, friendships and lasting relationships are made and personality and individuality are expressed, all depend on the facility of language. Unfortunately, time constraints today do not allow me to discuss each of these means of transmission so I have decided to focus on Speech/Spoken Language.

Spoken Language

Speech

• A symbol system of words

Language comprising:

• Syntax - grammatical rules
• Semantics - cognitive processes that develop meaning

and understanding

• Pragmatics - rules of social interaction - language in

context Non-Verbal Communication

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It may surprise you to see that “Non-verbal Communication” is included here but it plays an essential part and I plan to explain why to you later in this talk. Now let’s take a closer look at the first item – Speech

The Production of Speech Sounds

Several processes are involved:

• 1. Articulation / Phonology
• 2. Vocalisation
• 3. Breathing
• 4. Hearing

I am going to explain each of these four components, starting with Articulation/Phonology. And, I think you will very surprised to learn about the incredible activity and synchronisation that has to happen when you converse.

Articulation / Phonology

This involves the combination and synchronisation of:

• Lip shapes and movements
• Tongue movements and positions
• The Teeth
• The Soft Palate and Uvula

The lips are important in the production of the labial sounds /p/ and /b/. The lips come together and close tightly so that the escaping air from the lungs builds up

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behind them. Then when the lips part, the sounds /p/ and /b/ are made, the only difference between the two of them is that /p/ is produced on the escape of voiceless air and /b/ on voiced air. The air is voiceless when the vocal cords are held loosely open in a relaxed manner so that the air from the lungs passes through unimpeded. When the air is voiced then they are held together so that the escaping air from the lungs causes them to vibrate. Perhaps you would like to try to make them yourselves to sense the difference. /p/ /b/. The nasal sound /m/ is made in a similar manner as /p/and /b/, except that the major amount of the escaping air passes through the nasal cavity and not the mouth, giving it a different nasal sound quality. It is voiced. The teeth are important in the production of the dental sounds /t/and /d/. The teeth close together and the tongue seals all other escape routes so that the air from the lungs is able to build up behind them. Then when they part the voiceless sound /t/ is made & the voiced sound /d/ depending on the state of the vocal cords. The nasal sound /n/ is made like /t/ and /d/ except that the majority of the escaping air passes through the nasal cavity giving it nasal quality. It is voiced. The Tongue is extremely significant in speech sound production. It is also very large comprising mainly of muscle. It is easy for us to see the front and middle of the tongue but it extends down the back of the throat into the pharynx.

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Notice the size of the tongue and relationship it has with the soft palate and the nasal cavity. The tongue is attached to the floor of the mouth by a membrane, the frenulum. It can be seen if you raise your tongue towards your nose. This was once thought to be cause of many speech sound disorders because the frenulum can extend too far towards the tongue tip in some people and restrict the tongue tip mobility. This is called Tongue tie. If this is a problem then it can be cut but it is often not the cause

• f speech sound disorders as once was thought.

The tongue is also extremely mobile and can change its shape easily. For example, the tip can be finely pointed, or, the back can be bunched up against the soft palate to create the necessary closure for the escaping air to be held under pressure, then released rapidly, to produce the sounds /c/k/ and /g/. The speech sounds /s/ and /z/ are completely dependent on the tongue for their

• production. These fricative sounds require the side edges of the tongue to seal all

the possible escape routes through the side teeth, whilst a narrow furrow is made down the centre of the tongue so that the only air that can escape, does so under friction down this central furrow and through the front teeth. The Soft Palate and Uvula are critical in closing off the nasal cavity when we swallow and during feeding to prevent regurgitation through the nose. They are also, as has already been described, important in directing the escaping air from the lungs for different speech sounds either, through the nasal cavity, or, closing the nasal cavity off, so that the air escapes through the mouth. There are as you will have realised many more speech sounds than these I have described but I hope that I have given you sufficient examples for you to realise the complexity in their production. Speech sound production is a motor act and therefore these movements are activated at various points on the Motor Cortex of the Brain.

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This rather gruesome Homunculus illustrates the positions of these activities on the Motor Cortex of the Brain. It attempts to show the relationship between the different parts of the body involved in the various movements, with the allocated area of the Motor Cortex. After taking time to study this, I think you will be surprised to see just how much space on the Motor Cortex is allocated to the speech and vocalisation. It is not known if this large space has always been there since the beginning of man, supporting the theory held by some people that humans have always had a pre-disposition to speak/communicate, or, if it has slowly enlarged as human communication skills have developed as we have evolved. The Production of Speech Sounds

Several processes are involved:

• 1. Articulation / Phonology
• 2. Vocalisation
• 3. Breathing
• 4. Hearing

Now returning to this slide again and Vocalisation and Breathing I have decided to discuss them together as they are inextricably linked.

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This time as you look again at this slide, note the position of the Larynx or as it is popularly called “the Adam’s Apple”. The top of the Larynx connects with the Pharynx and at the bottom with the Trachea or “Windpipe”. In swallowing, the Epiglottis closes over the top of the Larynx. Its size varies between men and women and generally is larger in men being related to overall body size. The Vocal Cords or Vocal Folds are positioned slightly obliquely across the

• Larynx. They are the bottom curved line of this ellipse. The top curved line shows

the False Vocal Cords or Vestibular Cords. The evolutionary function of the Vocal Cords is to prevent any foreign bodies such as food, liquid or anything else entering the air ways and the Lungs. They are secured by several ligaments, cartilages and muscles and it is these that provide the amazingly rapid movements of the vocal cords and the adjustment of their thickness, tension and length necessary for speech and vocalisation.

Vocal Cords (1)

(A) Full Abduction is when the cords are held open in heavy breathing or after for example we have been running. (B) Gentle Abduction is when we are relaxed as you might be now, sitting and listening to me. (C) Intermediate position is for a whisper. The cords are actually held under some tension and are drawn closer. Contrary to what is commonly thought, whispering requires more tension than that for normal vocalisation when

• speaking. So, if you have Laryngitis, don’t think that you will save your

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voice if you whisper because it actually puts a greater strain on them - just talk less to rest them. (D) Stage whisper- similar to (C). (E) Phonation. The vocal cords are closed together to block the air flow from the Lungs causing them to vibrate as it escapes under pressure through them. The vocal cords are pearly white in colour whereas the vestibular cords above them are red. They are about 3mm thick. In men the length is approx. 17-25 mm and in women

• approx. 12-17 mm.

The volume of the voice largely depends on the force of the breath. To produce a breath the abdominal muscles contract, causing the diaphragm to be pushed upwards and then quickly downwards, driving the air through the Larynx and Vocal Cords. The more forceful the breath, then the louder the sound. The vocal cords produce a fundamental note like a musical instrument, which is unique to each individual. If you would like to get an idea of the fundamental note or frequency of your own Larynx all you have to do is to hum for a sustained period and when it settles down

• n one continuous note then, that’s it!

We do not speak on this one frequency all the time, but use a whole range

• f other frequencies. Untrained singers can cover one and half octaves and trained

singers two and half octaves.

Vocal Cords (2)

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For the Bass voice the vocal cords come together and loosely abduct and the cords are thick and more relaxed. This gives the escaping air its distinctive tone. By contrast when you look at the Tenor voice you can see how the cords have altered so that they have shortened with the posterior part of the cords closed thus reducing the overall length. Finally, this restriction is even more obvious for the Falsetto tone of voice, where the aperture for the escaping air is so much more smaller. We also strengthen our voices by the addition of Resonance, which we describe as the quality or timbre of a voice. It occurs when there is a sympathetic vibration of other parts of the body in close proximity to the larynx e.g. the chest cavity, the larynx itself and the pharynx, throat, mouth and nasal cavity. Professional singers and singers in general, learn techniques to maximise this effect.

The Production of Speech Sounds

Several processes are involved:

• 1. Articulation / Phonology
• 2. Vocalisation
• 3. Breathing
• 4. Hearing

Referring once again to this familiar slide let’s look at the final item- Hearing.

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The Human Ear

You will notice how large the outer ear is in relation to the middle and inner ear. Sounds due to vibrations in the atmosphere produce sound waves that enter the outer ear. When they reach the Tympanic Membrane, or, Ear Drum this causes it to vibrate. Then, the first of three little bones or ossicles, in the Middle Ear, called the Malleus, picks up the vibrations and passes them on to the Incus and Stapes, which in turn increase the intensity. The vibrations are then picked up by another membrane – the vestibular window and they are conveyed through this to the Cochlea in the inner ear and then transmitted via the Auditory nerve to the Speech Area of the Brain.

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I thought it might be interesting to look at the ear from this perspective. To acquire the essential and extensive range of sounds used in speech it is vital that we have adequate hearing. If this is not possible, for example in the case,

• f a hearing loss then an appropriate from of amplification to assist the

recipient/listener is necessary e.g. a hearing aid, or, where this is not possible then perhaps a cochlea implant will be appropriate. It is important to note that not only does the listener require adequate hearing for speech, but, also the sender of the message. This is because he/she needs to be able to monitor him/herself when speaking to ensure that spoken output is correct and expresses the sender’s intended thoughts.

Speech Frequency Components

In this slide you can see the extensive range of frequencies that we need to be able to hear to process speech. Ideally we need to hear from 125 hertz to 8000 hertz at a volume of about 30dB. All the vowels sounds are at the lower end of the frequency band, whilst the voiceless sounds such a /s/ /f/ /th/ for example, are up in the high frequencies.

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Relative Intensities of Speech Sounds

This diagram shows the relative intensity levels of English speech sounds. Notice there are marked differences. The vowel sounds are understandably louder due to there being nothing to impede the air escaping from the lungs and vocal cords. So the vowels help to sustain the sound production of a word, as vowels are often positioned within a word. However it is essential that we can also hear the differences in the high frequency low intensity sounds, as these provide the distinct differences between words that are similar in composition e.g. thought and taught.

Typical HF Hearing Loss

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This is a typical audiogram of someone with a high frequency hearing loss which often occurs with ageing. I thought you might like to see some statistics that shows the current incidence of Hearing Loss in the UK.

Incidence of Deafness

1 in 6 people have a hearing loss 1 in 2 people over 60 yrs will experience a hearing loss 1 baby in 1000 in the UK will be profoundly deaf

To conclude this part of my talk on speech sound production, here are the approximate ages when the average child is expected to consistently produce the different speech sounds correctly in all positions as they occur in words. At a younger age than those given on this slide, you may hear children making some of these sounds consistently at the beginning of words, but not in the

• ther positions. Then after a while they will also begin to produce them correctly at

the end of words. It does takes longer however for them to produce them correctly in the middle of words. So these ages on this slide are the approximate ages when a child should be producing them correctly & consistently in all positions in words. Speech Sound Maturation (average child)

31/2 years b, p, m 4 years t, d, n, c/k, g 41/2 years sh, j, dg, ch 5 years f, v 51/2 years s, z, r, l, th Correct at beginning, middle and ends of words.

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The sounds such as /p/ /b/ /m/ and /c/k/ and /g/ develop from the baby’s early feeding experiences of sucking on the nipple, or, teat and from the tongue squirting the milk to the back of the throat. Then as the teeth begin to erupt the young child can be heard making and playing with the dental sounds /t/ d/ /n/ and so on.

Spoken Language

Speech

• A symbol system of words

Language comprising:

• Syntax - grammatical rules
• Semantics - cognitive processes that develop meaning

and understanding

• Pragmatics - rules of social interaction - language in

context Non-Verbal Communication

Now let’s look at Language in some detail and in particular the three major functions of – Syntax, Semantics and Pragmatics. SYNTAX/GRAMMAR As you will all realise we do not communicate with single sounds but combine them into specific sequences as meaningful words. Then we combine these words into phrases / and when we converse/ we actually produce these phrases as one continuous utterance in the same breath/ before pausing and then uttering another phrase/. Just consider how I uttered that last sentence and pause yourself where I have added the /. This is very different to writing where we leave a gap between each word. So we are really very skilled in the manner we process and understand these spoken phrases at speed. As you know, we do not live in just the present so do not speak a type of language that only describes our experiences in the present. Instead, we organise the words and concepts carrying the information we wish to convey to someone, according to particular rules which we recognise and call grammar. This allows us by using these conventional rules, to convey to the recipient whether we are speaking about something in the present, past or future and according to the specific circumstances e.g. “I could; I must; I am able” etc.

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The grammatical rules of any particular language have evolved over centuries of use by generations of people of any specific country/culture. The rules that best conveyed the information were those they retained. Most of the current 6,000 languages in the world in use today have some form of syntactic structure and there are some similarities between certain languages e.g. English and German: French and Spanish. Sign Language although a visual language and not dependent on spoken language structure, has its own distinct rules of grammar. Each generation of children have learnt these rules firstly by listening and copying their parents/carers and then during their education and life experiences they are further expanded and developed. Syntax has also been influenced by styles of communication according to Society’s use of language. Compare the grammatical rules of the language used in Chaucer’s time, with that of Jane Austen’s and, with ours today. It will be very interesting to study what the effects will be on our current syntactical language by the influence of emailing, texting, twitter/facebook etc,. after a little while. SEMANTICS Semantic function enables us to attach meaning to the words we use. A young child very early on in its development may be able to recognise and associate the name of a familiar person/object when spoken by a parent, but, semantics only comes into play when a child matures enough to be able to hold that word in Short term Memory, while he accesses the memory banks in Long Term Memory, that relate to this word. Then and only then, can the child understand the meaning of the word. Let’s look at Memory and the significant relationship between memory and

• language. In fact they are interdependent.

Memory

• Short-term memory
• Long-term memory

I think an example will help to clarify this point. I am going to use a classic example.

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Consider the concept associated with an “Orange” and the experiences that this evokes in us at different times in our lives. There is the sound of the word, the taste, smell, colour, size, shape and then there is further information we learn - that it is rich in Vitamin C and grows in countries like Spain and Israel. Different senses experience these different memories so colour, size and shape will be visual and will therefore be stored in the visual memory banks in different parts

• f the Brain. Similarly all the other experiences will be stored in the appropriate

parts of the Brain related to the specific sensory experience that was evoked at different times during our lives when we had the experience. This rather old style diagram gives an idea of the scatter of these memories across the Brain. Please note that “psychic” =memory. It is important to realise that as we develop mastery of speaking and the production

• f words with meaning, so these words are memorised and are positively used to

categorise and organise the storage of our experiences in both long and short term memory. Returning to the example of the word “Orange”, having already stored all these experiences related to it, imagine that you have a need during a discussion about fruits, to name those that are rich in Vitamin C. Then you would at an exceedingly rapid speed hold the concept “Vitamin C” in short term memory whilst rapidly scanning through your long term memory until you find the names of fruits that meet that need and “Orange” would be amongst others with similar benefit, if of course you had learnt and memorised it as being one of the fruits rich in Vitamin C.

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In these searches we use language heavily to assist in the recall and retrieval and recognition of memories. We also use what is called “Inner language” in

• reasoning. This is not the same as talking to oneself which is where we verbalise

aloud and is something quite different.

Memory

• Short-term memory
• Long-term memory

How do long and short term memories work? If we use the analogy that Long Term Memory is similar to a computer’s hard disc, then Short Term Memory is the equivalent of RAM in computer terms. Short Term Memory is not permanent. It can be easily removed. Like a computer if we do not save information held in short term memory in long term memory then it will be lost. It is known that short term memories are lost with sleep, distractions and anaesthesia. Having likened long and short term memory to a computer, we cannot extend that to the Human Brain as it is not logical like an ordinary computer, which runs through all its information in a preset mathematical order dictated by the software, but, is associative. Instead it scans all memories in the whole cerebral cortex at the same time in response to the trigger word or symbol looking for relevant data to light up.

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Spoken Language

Speech

• A symbol system of words

Language comprising:

• Syntax - grammatical rules
• Semantics - cognitive processes that develop meaning

and understanding

• Pragmatics - rules of social interaction - language in

context Non-Verbal Communication

Syntactical and semantic functions begin when a child is very young and as has already been mentioned, are learnt from the parents according to the child’s language ability and the quality of the parental stimulation. Between the ages of 5-7 years of age a child will have developed many of the syntactic and semantic functions that they will use as adults, but, it will not seem like that, because of his/her limited vocabulary and social experience.

Vital Cognitive Abilities

• 1. To form associations
• 2. To pay attention
• 3. To concentrate
• 4. To recognise significance of association
• 5. To understand the link between word and
• bject / person

The vital skills that a young child has to learn to achieve this are shown in this slide.

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Between 12-15 months of age the young child begins to form associations. In

• rder to do this he has to be able to pay attention even if only for very short bursts
• f time and to concentrate. He also needs to be able to recognise the association

and understand the link between the word and the object/person.

• 6. Ability to recall
• 7. Ability to retrieve information
• 8. Ability to categorise concepts

Gradually these cognitive processes develop further and these three additional later maturing skills are learnt.

Children’s Language Development

12 - 15 months Child produces first meaningful word for familiar object /

• person. Speech sounds very immature.

21/2 years Vocabulary for familiar objects and people growing. Begins to use 2 / 3 word phrases. 95% present tense. Speech sounds immature.

Here is a brief summary of the maturation levels for an average child’s language skills.

Page 27 of 35 3 - 4 years Using longer phrases with 3 times more verbs in past

• tense. Sometimes over-generalises grammatical rules

e.g. “goed” for “went” and “comed” for “came”. Understanding simple concepts - “in, on, under”; “full, empty”; “big, small, tiny”; “hot, cold”. Vocabulary size is approximately 100 words towards end of third year. 5 years Can understand 3 part instructions. Less dependent on

• context. Understanding of simple time markers

developing e.g. “now, later, before, after / afterwards.

Note: Understanding will be ahead of child’s expressive language until around 7 years. Then expression catches up.

We must remember that without good parental and educational stimulation these cannot easily be achieved. It is important to note, that a child’s understanding of spoken language will be ahead of his expressive language until around seven years of age. Then expressive skills catch up.

Vocabulary Size

• Average mature adult - 10,000 words
• Educated adult with

highly technical education - 100,000

Rates of Speech

• Average adult - 165 words per minute
• Fast speaker - possibly 300 words per minute

Returning once again to this familiar slide let’s take a look at Pragmatic language function which is very different from Syntax and Semantics.

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Spoken Language

Speech

• A symbol system of words

Language comprising:

• Syntax - grammatical rules
• Semantics - cognitive processes that develop meaning

and understanding

• Pragmatics - rules of social interaction - language in

context Non-Verbal Communication

Pragmatic function is concerned with the rules governing the use of language in a social context. Let me explain. When a speaker wishes to convey information to another person, then, not only does he have to produce the message according to the grammatical rules and ensure that the words he uses express his intended meaning, but, he also has to ensure that the listener, the recipient, is on the same wavelength as him. In linguistic terms we say that the recipient will need to have a “shared understanding” of the context of the sender’s message to enable him to interpret it meaningfully. I think some examples will help to make this clear:

• 1. If as a speaker I said to one of you over coffee, ” I’ve met a friend”.

What will you as the recipient make of that? Does it mean that I met as friend today, or, at some previous time? Or, could the recipient think -why is she telling me this? It would have been more helpful had I added more information and put the message into context, e.g. “I met a friend on my way here”, or, “I met a friend I have not seen for ages”, or, “I met a friend who knows you too”. Some people do not make much effort to provide a contextual framework for the recipient of the message, or, it could be difficult for them to learn how to do this. If the context is not clear then the result may lead to confusion where it is difficult for the recipient to get the “gist” of what is being said to them, or, he has to ask a series of questions to gain an understanding.

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• 2. Take another example, I might say to a friend:

“That lovely shoe shop has closed”. This would then force the friend to ask “Which shoe shop?”, “Where?”, “Why has it closed?”. It would have been more helpful had I said “Remember the lovely shoe shop in Stockbridge –it’s closed now”.

• 3. Consider something we completely take for granted but illustrates pragmatic

function again. Most parents and carers, without being told will automatically reduce the level and content of their language to an extremely simple one when talking to a very young child. They also will use more non-verbal behaviours like gestures and varying tones of voice than they would use with an older child or adult.

• 4. When we express sarcasm or scepticism we rely heavily on the recipient using

pragmatic functioning to understand our meaning and not take the actual speech we say literally. If they do not do this, then, the point we wish to make is completely lost. Consider this example: Imagine that I am the leader of a team of professionals who have been working exceedingly hard to complete a proposal to meet a deadline. When we receive the news that our proposal has been rejected, there are many things I could say like this conventional expected response – “How exceedingly disappointing for us all” or, this one requiring more pragmatic understanding, “That’s just fantastic! Now what are we expected to do?”

• 5. Finally, there are times when the speaker and the recipient are in complete

harmony and have a perfect shared understanding as this conversation will show.

Example - Conversational Language

“Sorry I’m late, the traffic...” “Dreadful, yes I know. I couldn’t cross the road at the corner where they’re building...” “Oh yes! Those builders have no idea of the trouble they’re causing with their lorries...” “Very dangerous for pedestrians and old people”.

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Interestingly they are so good at anticipating each other that they seldom complete a sentence. Pragmatic ability is not present in the very your child because he/she needs many

• pportunities to gain an understanding of it from listening to others conversing in

social contexts. Up to about the age of three and a half years of age the young child is very egocentric focussing on all that happens in his/her own world. For example a young nursery aged child may come home and start to relate something he did or that happened at the nursery, assuming that you were there and understand the context. Pragmatic functioning is often one of the difficult forms of language for people with Autism and some with severe Learning Disability to understand and develop. Where does Language functioning take place in the Brain? There is a part of the Brain that is recognised as the Speech Area. Actually it should be seen as the Speech and Language area as this is where it all happens. This is where all incoming speech is received and interpreted. This applies not just to speech but also to all the other forms of human transmission means e.g. writing, signing etc. It is also where all communication output in terms of spoken, written

• utput is planned and expressed.

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Within the Speech area shown on this diagram are two recognised areas that are significant and largely responsible for all this activity. These are Broca’s area on the left and Wernike’s area on the right side of the Brain, named after the neurologists who discovered their functions. A complex network of neurological pathways links them closely together. It is generally accepted that in most right handed people of whom there are around 85-90% currently in the UK, the Speech and Language Area is located on the left side of the Brain. However we cannot assume that language is generated on the right side of the brain in left handed people. The reasons for this are that some have mixed dominance, others are ambidextrous. The localisation of Brain function is still plastic in young children up to the very early teens, so in certain cases should a child/young teenager suffer a serious injury to one side of the Brain then there is the possibility that the other side may be able to take over some of the previous functions controlled by the damaged side and so a better recovery may be possible. With maturation into adulthood this is less likely to be possible. You may know an adult who has suffered a Stroke resulting in brain damage on the left side of their brain which has caused a serious communication problem and either a serious weakness, or, paralysis on the right side of their body effecting their right arm and leg. The reason that the opposite side of the body is affected from the damaged side of the Brain, is that the motor nerves to the limbs, cross

• ver before they exit the skull.

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There are twelve Cranial nerves, which have distinct functions and several are crucial to Speech and Language. The Vth, the Trigeminal nerve is important in providing sensation to the face and front of the tongue, The VII, the Facial nerve provides the motor nerve to the facial muscles. The VIII is the Acoustic nerve to the Ear, The IX, the Glossopharyngeal provides sensation at the back of the tongue and throat and motor control to the Soft palate and for swallowing, The X, the Vagus, which wanders, as it names suggests, all over the body, forms branches to the vocal cords, the thorax and is important in breathing. The XII, the Hypoglossal provides motor nerves to the tongue. The Blood Supply to the Brain. The Brain is more dependent on its blood supply than almost any other organ in the body. Four major arteries, two at the anterior and two at the posterior of the brain branch into networks of smaller arteries covering the entire surface and deep into the brain itself. It is worth noting that if a brain cell is deprived of blood for more that 3-4 minutes then it will die. So it is understandable that if a person’s brain suffers an insult through an injury or damage due to a stroke, accident, or the effects of a degenerating illness then the result can be catastrophic. The Speech and Language areas are often those at risk To conclude my discussion about Human Communication I thought we should summarise all the components of which it comprises.

Communicating Together

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There has to be a sender of information and a recipient, and the roles of each can be reversed. Then there is one more component that I have not so far mentioned. Motivation. This is so obvious, yet essential

Human Communication

Then there is the very significant role that Non verbal Communication plays.

Human Communication

It may surprise you to know it is hugely significant because when we speak, over 50% of our communication is non verbal.

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During this lecture I have been using many of these behaviours quite spontaneously as I have been talking to you. I will have used many different types of facial expressions some gestures and movements of my shoulders and head and small differences in my posture. Also I have used pauses and a variety of different forms of stress and tone of voice to emphasise points I wanted you to note. And my eye contact with you will have been fleeting which is characteristic of a speaker, not focussing on one particular person, but scanning you as a group, checking that I was making myself understood. Whilst on the other hand, you will have sustained a steady gaze, which is a known characteristic of the listener. Parents/Carers of young babies instinctively use a range of non verbal behaviour. They will use many more gestures as they speak to their baby and if you notice yourself when you are with young children you will find yourself spontaneously using many more gestures and a broader variety of vocal tones. Research has shown that when a young baby begins to say the first words that he/she will always accompany them with gestures and changes in body posture. So that when the baby is requesting something his body is inclined forward and when receiving information the baby sits more upright and leans back slightly. Now let’s add to this figure the most sophisticated of human behaviours that make us different from all other creatures, Language.

Human Communication

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And of course as you all know, it can be transmitted in several different ways.

Human Communication