Review of Studies on Children Language Disorder
INTRODUCTION
Language is a very important thing for everyone in
this world. To do everything, it used by everyone to stimulate their proposes
in their life. There are many people have perfect language with a perfect of
organs in their body. While, some of them are not really lucky for having a
normal thing such that. Some people experience a language disorder in their
communication, especially for children. What is actually language disorder or
language communication? (Eric, 2001) stated that Children with communication
disorders have deficits in their ability to exchange information with others. A
communication disorder may occur in the realm of language, speech and/or
hearing. Language difficulties include spoken language, reading and/or writing
difficulties. Speech encompasses such areas as articulation and phonology (the
ability to speak clearly and be intelligible), fluency (stuttering), and voice.
Hearing difficulties may also encompass speech problems (e.g., articulation or
voice) and/or language problems. Hearing impairments include deafness and
hearing loss, which can result from a conductive loss, a sensorineural loss, a
mixed loss, or a central hearing loss.
Another kind of language disorder
that the writer found from one of popular journal in American Journal (2004)
which titled Narrative Skills in Children with Selective Mutism: An Exploratory
Study which is done by the researchers (Mclnnes, Fung, Manassis, Fiksenbaum,
and Tannock) in the Hospital for sick Children, Toronto, Ontario, Canada. These
researchers try to analyse Selective Mutism (SM) that happen to children and
try to compare it with children with Social Phobia (SP) using Narrative Skills.
The Journal states several definitions about the definition of Selective
Mutism. First definition is a rare and complex disorder associated with anxiety
symptoms and speech-language deficits; however the nature of these language deficits
has not been studied systematically. Second definition is a rare and perplexing
disorder in which the child does not speak in specific social situations (e.g.,
school, public places) despite speaking normally in others (e.g., home). The
cardinal symptom of SM is the child’s persistent failure to speak in selected
situations that cannot be attributed to serious primary communication deficits,
pervasive developmental disorder, or lack of language ability required for the
situation. The ethology of SM is not well understood; however, two key factors
have been consistently associated with the disorder: (a) anxiety, especially
social anxiety, and (b) language deficits associated with developmental delays.
(Mclnness, Alison;Fung, Daniel;Manassis, Katharina;Fiksenbaum, Lisa;Tannock,
Rosemary, 2004:pg. 304). For the Narrative Skills they use as a tool to state
which one more dangerous is. The result showed that SM is more dangerous than
SP.
From the statements above, the writer believe that
this research in journal with that title will be very interesting to be
discussed and it will very useful for everyone especially parents and teachers,
they will be more carefully when they know such this language disorder that
usually happen to the children because SM is also very important to be erased
from our children’s world. As usually people said that children’s era is for
having happy moments and experience many beautiful experiences in their life of
their growing.
DISCUSSION
This review discuses about the journal article under
the title Narrative Skills in Children
with Selective Mutism: An Exploratory Study. It was published by American Journal of Speech-Language
Pathology on November 2004. The specification of this journal article is volume
13, issue 4 and taken from ProQuest page
304. The researchers of this journal article are Alison Mclnnes, Daniel Fung,
Katharina Manassis, Lisa Fiksenbaum and Rosemary Tannaock from The Hospital for
Sick Children, Toronto, Ontario, Canada.
This study explains more about the selective mutism as
a rare and complex disorder associated with anxiety symptoms and speech
language deficit. In addition, such kind of anxiety disorders are the most
pervasive class of mental disorders, with a 12 months prevalence in the
community of about 18% (Stein &Stein, 2008). In disciplinary, a novel
assessed the anxiety and nonverbal cognitive, receptive language and expressive
narrative abilities by using 7 children with Selective Mutism (SM) and 7
children with social phobia (SP). In this study, SM children have shorter
narrative than children with SP. Besides, they shows the normal nonverbal
cognitive and receptive language abilities. Therefore, based on this study,
hopefully it can be useful for the language clinicians.
This journal article includes in the kinds of research
report. It has method, measures, and assessment procedure and data analysis. Each
of these parts has the specific explanation and steps in doing this narrative
skills in selective mutism. In the following paragraph will be explained in
detail about every part in which support this research report.
Method
The method of
this research uses 14 participants of sample containing 7 children with
Selective Mutism (SM) and 7 children with Social Phobia (SP). The children who
are categorised as SM are recruited from larger clinical sample of children in
the current study. Further, SP children are participant in a study of anxiety,
language cognitive skills and achievement then they are from a large
metropolitan children’s hospital in which as the outpatient of anxiety
disorder. The criteria of these children is in between 7 and 14 years old. In
addition, the participants has attended cognitive and receptive language tests
in the assessment protocol with normal score. They should not have other
co-occurring psychiatric diagnosis for example they don’t have trouble and
disabilities in speech language or learning and depression. In detail, the
participants with SM consist of 4 children with current SM diagnosis and 3
children with long standing SM diagnosis but they are in resolving symptoms. Furthermore,
SM and SP participants are in equivalent number of boys and girls with the
pattern X2 (n = 14) =
0.27, p > 5. They are not
differentiated based on their age, performance IQ, or receptive language skill.
The further method of this research is doing a
semi-structured interview administrated by child psychiatrist who is Daniel
Fung. This process includes their parent in responding on a computerized
structured diagnostic interview based on Diagnostic
and Statistical Manual of Mental Disorder (DSM IV). In doing their
participant of this research, the children are not taking medication for their
anxiety or depression at the time. They are not differentiated also in age,
nonverbal cognitive skills or receptive language ability in comparing
expressive narrative abilities in children while it as the rationale for using
a subset of the larger SM sample in the present investigation. In the fact, the
several children with SM from the larger sample are known as younger than the
youngest child with SP. It indicates the evidence of speech language deficits
with them. Moreover, it is as the factor in which would have precluded
interpretation of any differences found. It happens because there is
potentially confounding comparison of narrative skills between the group. That
is the older children in SP group would presumably have had better developed
language skills rather than the oldest children in SM group.
Measure
The measure of this research report are includes three
aspects in doing narrative skills in selective mutism. The first is about
anxiety and selective mutism measure. In this part, the anxiety rating of
participants are obtained from the child participants, their parents and their
teachers using standardized symptom-rating scale. Then, it provides the parent
and teacher ratings of the child’s behaviour at home and school. This study
also provides the behaviour of children’s typical speaking with familiar and non-familiar
partner. It has already developed as the standardized instrument survey for
participant in this research.
The second measure is standardized cognitive and
language measures. In this part, it contains of nonverbal cognitive and
receptive language abilities that are assessed using a protocol of standardized
tests that don’t require verbal responses. Then, for nonverbal cognitive
ability test uses performance subtests from the Wechsler Intelligence Scale for
Children as the way to assess the participants. In addition, it also uses
nonverbal test of working memory ability. Furthermore, language measures
includes both direct assessments of receptive language and parent ratings of
speech language skills.
The third measure is expressive language measure. This
part of measuring participants uses the Strong Narrative Assessment Procedure
(SNAP) as the narrative sample. The participants will retell the stories that
are presented in audiotape with including wordless picture book as the
non-standardized task. The process of measurement contains of reporting with
similar complexity, length, number of scenes and number of characters. In the
end of this measure, there is listening comprehension after retelling stories
and it includes with questions regarding facts and inferences.
Assessment
Procedure
The assessment procedure of narrative skills in
selective mutism test has one session in assessing the children with the
parents. They are assessed in one team which comprises a psychiatrist, a
psychometric and speech language pathologist. The location of testing is in
hospital clinic laboratory in 3, 5 - 4 hours by including test and promote optimal
motivation and performance. The rundown of this test contains three parts. The
first part of this assessment, before having appointment, the parents were sent
a copy of one of the audiotape frog stories and book, a blank audiotape and a
description of the elicitation procedure from SNAP. It is completed by
instructions to audiotape their child’s retelling of the story. Then, they
should answer the comprehension questions at home and bring the tape to the
hospital for their clinic appointment. In the second part of assessment, the
children complete the standardized language and cognitive test while the
psychiatrist interview the parents. The test of the children is separately with
the speech language pathologist and psychometrist. The third part of this
assessment, the narrative answer and answer to the comprehension questions was
then obtained from each participant in the clinic room with the parent as
listener. Furthermore, this assessment using two settings that is used to
assess children actually as the helping to ensure that elicitation condition
are consistent across settings.
Data
Analysis
In this narrative analysis, the researchers provide by using length,
linguistic complexity and inclusion of grammar element in the way children
share their audio type narrative. In analysing the length, the researcher will
count the C-units (communication unit that is proportion scores indicate
occurrence of each story element in each retell relative to total occurrences
of that element in the complete story). Then, for linguistic complexity is determined
by calculating the number of words per C-unit and counting the total number of
subordinate clauses in each sample to determine the proportion of subordinate
clauses produces by C-unit. The last is about story grammar analysis is carried
out according to the SNAP which involves determining the number of occurrences
of each type of story element expressed in the child’s retell (as the table
below). Therefore, the data analysis of this research is used this kind of
categories
Result
The result of this study shows that the
multidisciplinary assessment protocol that have relatively with clinical
contact to SM and SP. Then, it shows that SM’s children had fewer kinds of
clause and syntactic skill, and lower left brain development than SP’s
children. For retelling, SM’s children had fewer settings, initiating events,
and internal responses than SP’s children. Further result is in the table
below.
FURTHER STUDIES
There are many kinds children had Selective Mutism
(SM) in every place in this world. They should be help and get adequate care
because when they is not, they will have many problem when they mingle with the
society. Such as having excessive fear when in a foreign environment, difficult
to communicate with forager, feeling themselves in danger situation, etc. In
other hand, SM children must have more concern than children that have Social
Phobia (SP) because SM children like the final impact of the SP children. It is
known by the researcher that SP children easier to adaptation with the foreign
environment than SM children. Like when SP come together with someone that they
believe, they will more feel safe and comfortable. However, SM children is too
difficult to do it. They that environment will do something dangerous to them.
It is the fact that makes the distinction between SP and SM children very
necessary to be discussed.
This journal have many aspects that not or less
including in this research to support the accuracy of data and fact that have
been described. When we look at the number of subjects, which were study only
14 children, each of SM and SP are seven children. It is too difficult to say
that this invention can serve as a guideline for further research, because the
source data is too few. From external factor that SM children had or get, it is
not include in this research. For example, like the age, background life,
family history of disease, having trauma for each children. It is so possible, when the research use new
method and/or new object that are compared will give new point of view. To sum
up, the researcher suggest to further research to include that point to be
taken as consideration and make this research as the one of all option to
deeper research about Selective Mutism.
ISSUES ON CHILDREN LANGUAGE DISORDER
From our discussion section in the class, we are as
the presenters got some questions from the audiences.
1. The first question is delivered by our friend Sara
Mustofa Shokshok who comes from Libya. The question is that “Is selective
mutism acquired or development disorder?”
2. The second question is delivered by our friend Dony Cahyono
who comes from Tuban. The question is that “What is your opinion about the
children that got an accident then they experience trauma till they cannot say
anything because their trauma. Can they be called as children with SM? If yes,
how to cure them?”
3. The last question is delivered by Fitri Dewi Wulandari
who is actually from another class of Psycholinguistics’ class. The question is
that “How to identify the children with SM? When do they not speak to others?
And what will happen if they don’t get a good treatment?”
For
the more explanation and discussion, we will explain clearly below.
The first question is asking about kind of SM in
language disorder. To answer this question, firstly, we have to have a look to
the reasons or factors or something else that still related to the background
of this SM that can make this disorder happen to the children. As (Mclnness,
Alison;Fung, Daniel;Manassis, Katharina;Fiksenbaum, Lisa;Tannock, Rosemary,
2004) stated in their research that the ethology of SM is not well understood
and the diagnosis of this disorder is usually made on school entry or during
the preschool years and requires symptoms to have been present for at least 1
month (not including the 1st; month after school entry) to a degree that
impairs the child’s social functioning outside the home. So, the answer is the
children acquire this SM when they get extra protection from their family which
is automatically build it to their children.
The second question is about children that cannot say
anything because of trauma which is caused by accident. Well the answer is it
is not kind of SM because in SM case the children are not experiencing any
accident in their life. It includes in Aphasia case because Aphasia happen
because of an accident. As (Indah, 2017) stated that Aphasia is caused by brain
injury, as may occur during a traumatic accident or when the brain is deprived
of oxygen during a stroke. It can also be caused by brain tumors, such as
Alzheimer's disease, or infections, such as encephalitis. Aphasia may be
temporary or permanent. Aphasia does not include speech difficulties caused by
loss of muscle control (Llussa`, 2010).
Last, for the third question, it is about how to
identify this disorder, when they do not speak to others, and what will happen
if they do not get a good treatment for solving their disorder. To identify
this disorder, of course we as people who are close with the children with SM
for example, should be very smart to understand with our children’s condition
in many situations. When suddenly our children become much selected to
communicate with people in their surrounding or they suddenly become silence
children in their age and look different, very different in communication case,
it may be one of SM symptoms. Hence, try to ask them or ask them to be friendly
with their friends and also with people in their surroundings. In some cases,
their silences are usually happening in their new situations the just know, for
example in social public, their new school, their new home town, etc. all of
new situations they have just experienced in their life. The researchers in the
journal we have analysed stated that clinically, children with SM present as a
heterogeneous group, often showing co-occurring delays in cognitive,
speech-language, and/or motor development, reported in both large clinical
samples and in case studies (Cleator & Hand, 2000; Kolvin & Fundudis,
1981; Kristensen, 2000: Steinhausen & Juzi, 1996). Therefore, if they do
not get a good treatment for solving the disorder, the consequences are
actually relative. It may be something very dangerous for the development of
our children or on the contrary because sometimes some of them can solve by
themselves when they are growing up. Usually, for the children in this kind,
they have special characteristics. But, sometimes also not truly luck for some
of them who cannot solve it by themselves. That’s why, to be more careful of responding
this kind of disorder, better for us to be a good family for our children and
all of children who experienced it in the world.
CONCLUSION
Language is the main tool when we live in the
community, but some of us is not have lucky like us. Some of them had perfect
body, but they do not have complete nerves or body system. Another one, they
get bad incident that makes them lose limbs, even loss of other body abilities,
especially loss of language skills. However, they also not only get internal
factor to lose their language skill. Some of them also get external factor,
like Social Phobia and Selective Mutism. They have similarity, the language
disorder while in a foreign environment. It will be impact to their future,
they cannot be like normal children who can enjoy happiness in their childhood
and are likely to be alienated from society.
Therefore, the researcher using this subject being the
base data. The method used is giving task and order to 14 children, seven of SM
patients and other seven children is SP patients. Furthermore, the task given
is to work on the question with and without the person that they trust. The
order given is to retell the stories that they heard, read, and/or saw in their
own way. The key points that examined are in term of their answers and mental,
to the task section. While the matter of order, the main point is the demands
of the story, grammar, and content that they retell. All section done with and
without mentoring from someone who they trust.
Finally, researcher found various facts.
Starting from different mentoring results in doing all the tests until the
psychological side of the child when doing all those things. The fact that a
child with SM is more to need of healing than a child with SP, because of the
tendency of those who feel more threatened by their existence. Moreover, the
researcher also suggested to the future research to have more subject, method,
and other factors. So that research will become more complex and can be used as
the main reference in finding ways to handle children with Selective Mutism.
REFERENCES
Hall,
B.J., Oyer, H.J. & Haas, W.H. (2001). Speech, language, and hearing
disorders: A guide for the teacher (3rd Ed.). Needham Heights, MA: Allyn &
Bacon.
Indah
R. N. & Abdurrahman, 2008, Psikolinguistik: konsep & isu umum, Malang:
UIN Press
Indah
R. N, 2011, Gangguan Berbahasa Kajian Pengantar, Malang: UIN Press
McInnes,
A., Fung, D., Manassis, K., Fiksenbaum, L., & Tannock, R. (2004). Narrative
Skills in Children with Selective Mutism: An Exploratory Study. American Journal of Speech-Language
Pathology, 13 (4), 304. Retrieved from ProQuest.
Stein,
M. & Stein, D. (2008). Social Anxiety Disorder. The Lancet: Biological Science Database, 371, 1115. Retrieved from
ProQuest.
APPENDIX
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