Universidad ISEP

Intervention in Pragmatic Language Difficulties

Pragmatics is understood as the study of the principles that regulate the use of language in communication, that is, the conditions that determine both the use of a specific utterance by a specific speaker in a specific communicative situation, and its interpretation by the recipient.

What is pragmatic language difficulty?

When we talk about pragmatic language difficulty, we refer to the problems individuals have in the use of language for communicative purposes. In classrooms, it is observed that many children do not speak, meaning they find it difficult to use language as a tool to interact with others and to formulate questions, requests, and clarifications about the content taught in class. Usually, children with pragmatic difficulties also present problems in other language components, especially in the morphosyntactic one. In any case, the interest lies in establishing if there is any type of relationship between language difficulty in general and pragmatic difficulty in particular (Acosta and Moreno, 2001).

Real example of educational speech therapy intervention

Let’s look at an example of intervention, with the participation of a speech therapist with training in educational speech therapy.

Pablo is a school-aged child in the second cycle of basic education, 5 years and six months old, who presents certain difficulties in using language as a tool to access various curricular demands, a situation that worsens when he has to perform cooperative activities, where a poor use of language is observed and, furthermore, he avoids interaction with other children.

On the other hand, he also presents difficulties in understanding multiple sentences. His linguistic production is also limited, as he presents a scarce vocabulary and a predominance of incomplete sentences and non-verbal interventions, as well as sentences with grammatical errors in which the use of self-corrections or reformulations is evident.

Regarding the linguistic structures used, there is a predominance of simple and dependent sentences, but more difficulties with coordinated multiple sentences. In conversations, he appears as an unassertive child with his peers, and sometimes takes turns inappropriately. When he is asked to initiate a topic, he does so, but finds it difficult to maintain it, and when it is started by his peers, he finds it very hard to get involved. All of this is more evident when he is asked to converse about things or events that are not present, whereas when the conversation is organized around an object or activity, the child participates more, takes the initiative, and maintains the topic. His responses are simple (yes, no) or he simply does not respond. The absence of the referent puts Pablo in a difficult conversational situation, for example, when asked to describe his favorite food or what he would do if he encountered a lion in the garden? (Acosta y Moreno, 2001).

What to do in case of pragmatic language difficulties?

Therefore, the intervention program was based on:

a) Ensuring he maintains the topic within a sequence of questions and answers.

b) Improving his ability to describe and explain events in the absence of the referent.

c) Increasing his vocabulary.

d) Trying to make his linguistic production more elaborate and explicit (Acosta y Moreno, 2001).

The contents of the intervention program designed to work with the patient included: conversational discourse through the use of decontextualized topics or with the absence of the referent, lexical conceptual naming, and multiple sentences (Acosta y Moreno, 2001).

The child was attended individually by an educational speech therapist for two days a week. In one of the 30-minute sessions, Pablo’s mother participated. Work was also done in the classroom alongside Pablo’s teacher, taking as reference the curricular contents of the second cycle of early childhood education, making use of story reading, narratives, vocabulary games, and basic concepts (Acosta y Moreno, 2001).

The teacher and mother were made aware of the importance of adjusting their input in shared communication dyads, as this would improve their ability to maintain the topic appropriately in a question-and-answer sequence situation. For example, they were taught to formulate good questions where the child had to decide, for example, for a snack, “Do you want a ham or cheese sandwich?”, or those that create interest and expectation: “What’s next?”, “What if an alien appears?” On the other hand, they were advised to avoid questions that stop communication, such as “What is that?”, or those that contain the answer: “You want an apple, right?” (Acosta y Moreno, 2001).

Conversational improvement in children with pragmatic learning difficulties

For the improvement of conversational discourse on past and future topics, different scripts were used, such as: “The plane trip”, “The visit to the doctor”, “Going shopping at the supermarket”, using the appropriate materials for each situation. Working with the scripts allowed the achievement of objectives of lexical naming and conceptualization. For example, from “going shopping at the supermarket”, cards were developed to name a wide vocabulary which then allowed the introduction of operations such as classification, inclusion, exclusion, search for similarities and differences, etc. (Acosta y Moreno, 2001)

The mother was suggested to facilitate the child’s performance of certain household tasks, such as helping him prepare a snack, for which he had to make a list of everything needed. Collaborative work was done with the teacher to plan each didactic unit, from which the basic vocabulary was extracted to be used in the speech therapy room. This allowed Pablo to acquire a broader vocabulary and the opportunity to generalize it to real communication and learning situations within the classroom. Multiple sentences were facilitated by emphasizing an interactive communication style, which materialized in the management of expansions, extensions, and incorporations in interactions (Acosta y Moreno, 2001)

Results of speech therapy intervention

Regarding the results obtained, the child achieved greater participation in interaction situations, while also taking more initiative. His contribution to the conversation has been notable, being able to use turns to speak in situations without the presence of the referent. The most remarkable thing is that through the continuous use of communicative strategies integrated into participatory, interactive, and conversational situations, a triple objective was achieved: a greater development of pragmatic skills in Pablo, greater progress in lexical and morphosyntactic structuring aspects, and a change in the communicative and linguistic style of the mother and the teacher (Acosta y Moreno, 2001).

The intervention of the educational speech therapist must include people from the child’s close circle, as they will be an active part of the treatment. ISEP, with its Master’s in Educational Speech Therapy, trains its students in the need to integrate parents and educators into the intervention to achieve greater effectiveness, as seen in Pablo’s case.

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