As Speech and Language Therapists we often refer to comprehension, all we mean by that is what the child understands of what is being said to them but also visual cues in their environment, social interactions and non verbal communication.
There is a difference between listening and understanding and children often get told they are not listening when perhaps they haven’t understood what is being said to them. This can then be frustrating for both sides.
When we talk, there are inevitably clues around us that help the child understand what is being said. This is the way babies learn language; you point at the object and say its name. Then they can make the association between the item and the spoken word. So, if you are about to leave the house, point to your shoes, and say “Can you put your shoes on please” – how many words do you need to understand to follow the instruction correctly? There were 6 words in the sentence; do you need to understand all of them? The answer is 0. You do not need to understand any of the words to have a good chance of following the instruction correctly. You are following an everyday routine, you always put shoes on before going out of the door, and you pointed to the object. All the information to understand the instruction was in the environment.
To really assess a child’s understanding of language, we have to remove these clues. By doing this you can determine which words and how many the child is understanding. So when you think about the instructions you give, you also have to think about the objects around you.
There are many skills needed to be able to follow verbal instructions:
- Focus their attention and listen to the person talking
- Understand the meaning of the words being used
- Understanding the intention and expectations of who is talking
- Understand concept words which may determine the order that the instruction has to be performed in.
- Remember all parts of the instruction
- Predict what will happen next as a result of following what the person has said.
How do we know what level of language to use with our children?
When we think about the complexity of what a child understands we think of it in 2 ways:
- The type of language that is being used. (Blanks levels)
- How complex the utterance is. (Key-words/Information Carrying words)
Blanks levels of questions
When we think of the type of language we often refer to Blanks level of questioning to guide us with what the child is able to follow, there are 4 levels starting with level 1 being the easiest and most concrete and 4 requiring the child to make predictions and think about abstract concepts.
- Matching perception – ‘look at it’ – talking about objects that are present. Understanding of these questions develops at approximately 3 years of age.
- Selective analysis of perception – ‘talk about it’ – talking about less obvious features of stimuli (objects, pictures etc.). Understanding of these questions develops at approximately 4 years of age.
- Reordering perception- ‘think about it’ – talking about looking at objects in a variety of ways. Understanding of these questions develops at approximately 4.5 years of age.
- Reasoning about perception – ‘reasoning’ – talking about what causes things to happen and make predictions about future events based upon past experiences. Understanding of these questions begins to emerge at around 5 years of age and is continuing to develop at 6 years of age.
Key Words/Information Carrying Words
When we think about how complex the instruction is we refer to this as ‘key word level’. Key words are the important pieces of information in a sentence. Key words are also known as ‘Information Carrying Words’. When thinking about how many ICW’s are in an utterance we need to consider the environment and what choices there are for the child to choose from. To make instructions easier, take about any distractions in the environment or change your language to break it down into smaller steps.
For example:
‘The big blue box has a chocolate biscuit in’ – This sentence has 6 key words in it as it tells us which box, what is in it and where the thing is. However, if there was only one box on the table it becomes a much easier sentence to understand as there are no boxes to choose between so you don’t need to understand that the box is big and blue.
If we think about the instructions we often give our children they can get quite long and complicated and if a child has troubles with their comprehension it can be hard for them to retain all the information and follow the instructions.
E.g. ‘it’s dinner time, tidy up your toys and then wash your hands before coming to the table’ This is a 7 key word level instruction.
As a rough guide a child’s age is the number of key words they can typically follow in an instruction up to 4/5 key word level.
Children who have trouble following longer instructions may have difficulty with their auditory memory. This means that they may struggle to keep hold of all the information in their head as they work through the instruction. If we think about ourselves, how often do we forget something at the supermarket if we haven’t written a list, or in my case left the list at home! There’s only so many items we can remember at any one time and so we use strategies, such as writing lists, to help us retain all the information.
How can we support a child with their understanding of spoken instructions?
- Call their name or touch their shoulders to gain their attention before giving the instruction
- Ensure you are talking in a quiet distraction free environment if possible
- Ensure you are using words and concepts that they understand
- Break the instruction down into individual steps (think about the key words you are using)
- Help them to predict what is going to happen by including it in the utterance, e.g. ‘we’re going to the park, get your coat’
- Use gesture and point to things in the environment to help with their understanding
What games can we play to support our child’s understanding?
- Shopping games/posting games – any game where the child has to remember more than one thing will help their auditory memory skills and have a knock on effect on their ability to understand longer more complex instructions
- Books/I spy style games – Use these to Work on their understanding of different question types (blanks level of questions). Pause on a page in a story and think about the different types of questions you can ask (what/who are the easier ones where they are required to answer with something that is in the picture to why/how style questions which require the child to use more abstract thoughts and inferencing)
- Barrier style games – Games we may remember from our child, such as ‘Battle-ships’ are great for this, alternatively you can use colouring sheets. Where the person listening, can not see the picture that the ‘talker’ is describing and you need to see if you have identical images at the end.
