As a school-based speech therapist, I get asked this question a lot. Unfortunately, whether I’m talking to a worried parent or a concerned teacher, my answer is never short and simple. Many factors can affect a child’s understanding of spoken language. So it takes a little sleuthing to get to the root of the problem.
How is your child’s attention span? Kids with some types of attention-deficit hyperactivity disorder, or ADHD, can have a tough time focusing on what someone is saying. This is especially true if they’re in a noisy environment, if the message is too long or the topic is not interesting. These kids understand much more when they’re talking about high-interest topics or when they’re in a quiet setting with few distractions.
It’s helpful to get a sense of whether your child’s comprehension problems seem to be constant. Does comprehension vary from week to week, as is often seen with chronic ear infections? Is comprehension problematic even with high-interest topics?
There are a few possibilities to investigate: Auditory processing disorder, or APD, makes it hard for children to recognize different sounds in words. This happens when the brain isn’t effectively processing what the ears hear. APD symptoms can vary from person to person. It depends on the type of difficulty the auditory center of their brain is having.
APD symptoms may include things like difficulty understanding messages in noisy environments. Kids with APD may also mispronounce words. Only a trained audiologist can perform the tests necessary to diagnose APD.
There are also some communication disorders that can make it hard to understand what people say. For example, kids who have a language disorder may have difficulty expressing themselves, understanding others or both.
Does your child have trouble understanding humor or sarcasm? What about figures of speech like “hold your horses”? Kids who struggle with these things may have social communication disorder. This can make it hard to interpret nonverbal cues—such as body language or tone of voice—that affect the meaning of the message. Difficulty with social language may also be seen in kids who have high-functioning autism, ADHD and nonverbal learning disabilities.
Getting to the bottom of your child’s comprehension problems can seem like a daunting task. Just take it one step at a time. If your child is still in preschool, start by talking with your pediatrician. She can help connect you to the right resources and professionals to walk you through this process.
If your child is in school, a phone call to the classroom teacher or the school’s speech clinician will accomplish the same goal. Having the right professionals take a closer look can help identify any listening-comprehension problems. Then you can explore support based on your child’s specific needs.