Hidden Disability: High-Level and Metalinguistic Language Skills

Language difficulties (problems understanding or using words and sentences) are often referred to as a “hidden disability”. Children with language difficulties often look “normal” and are clearly intelligent but struggle to talk and communicate well. Some children even seem on the surface to have OK language skills but when we dig deeper they have what we call High-Level Language Difficulties. Higher Level Language skills refer to those skills that go beyond basic vocabulary, word form, and grammar skills, and are critical to academic and social success. In addition to other areas, higher-level language skills include the development of an advanced vocabulary, understanding word relationships, paraphrasing, reasoning, and developing the ability to look at things from another individual’s perspective. Metalinguistics is the ability to shift our attention from the meaning of what is said or written to how it was said or written. When a child has difficulty with higher-level language, the following are often observed:

  • Inability to understand or make connections and associations between words, sentences, or stories.
  • Poor academic performance
  • Poor social pragmatics skills
  • Difficulty with oral and written comprehension
  • Poor writing skills
  • Difficulty with understanding jokes, riddles, and humour

Four common areas of difficulty for children with higher-level language disorders are with verbal sequencing, determining cause and effect, making inferences, and understanding and using figurative language. In order to make inferences and predictions, a student must have good deductive reasoning skills and be able to look beyond what is given and fill in information that is missing. Sequencing requires that a student is able to put events in a logical order. In an academic setting, sequencing skills are critical to alphabetizing, putting events in chronological order, creating timelines, and telling or writing stories. In order to determine the cause of event of an action, a student must see the relationships between the action and the outcome. Students who find it difficult to determine causes may experience difficulties sequencing stories or in comprehending and predicting outcomes of science experiments or math problems in school. The ability to differentiate between literal and non-literal uses of language is an important part of a child’s linguistic development. As grade level reading materials begin to incorporate metaphors (e.g. “the world’s a stage”) and similes (e.g. “as brave as a lion”), difficulties in this area can negatively impact academic performance. When working with children who struggle with figurative language, it is often helpful to know that expressions that refer to tangible objects are often easier than those which only incorporate abstract ones. Speech and language therapy allows a student to practice understanding and using non-literal language. Understanding and using figurative expressions is crucial not only for academic success but for appropriate social development as well. If you think your child might have trouble with high-level language difficulties figurative language or metalinguistics then it’s a good idea to get help as soon as possible. Appropriate assessment and therapy with a registered and trained Speech-Language Pathologist can help children develop these skills. Many language-rich activities can help your child improve his or her higher-level language skills and metalinguistics and our speech therapy team can help teach you how to use these activities to help your child.

                                                               – by Rachel Tosh




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Rachel Tosh TAG clinic

Rachel Tosh
Speech Pathologist

Rachel is a Certified Practicing Speech Pathologist (CPSP) with a wide variety of clinical experience in inpatient and outpatient paediatric care in both Australia and the UK which enables her to translate theory into real life application across diverse clinical contexts. Her latest adventure, Speech Parent is changing the face of paediatric speech pathology internationally by empowering and educating parents of children with communication and feeding difficulties. She describes herself as a recovering work-a-holic (we all know she isn’t actually recovering – seriously who else sends emails at 4:30am!?). Rachel is passionate about: business leadership; literacy and feeding difficulties; educating and empowering others; and optimising therapy outcomes. Although these interests may seem diverse, the recurring theme through them all is a love for facilitating growth and development in others so they can achieve their own unique potential. Things I like: “Lamb roast, reading, helping others and creating systems that work…I may or may not enjoy these together!” Things I don’t like: “People not respecting each other and children missing out because of bad care or broken systems.” Favourite colour: “Can I have the whole rainbow?” How the TAG team describe Rachel: “Passionate”; “Hard working”; “Creative”.

“Be there for others but never leave yourself behind”    -Dodinski


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