Sensory Processing Disorders

A person with a sensory processing disorder may be unable to respond “appropriately” to ordinary experiences. This disorder makes it difficult to integrate information from the five senses (sight, hearing, touch, smell, and taste), in addition to the sense of movement (vestibular system), and/or the awareness of the body’s position in space (proprioception).

Sensory processing is the procedure in which we take in messages from our bodies and our surroundings.


When sensory processing is typical, we interpret these messages and organize purposeful responses. Individuals with a sensory processing disorder have difficulty interpreting these sensory messages.

Individuals with a sensory processing disorder may sense information normally, but the information is perceived abnormally and may cause discomfort, pain, or confusion.

A person with a sensory processing disorder finds it difficult to process and act upon information received through the senses, which creates challenges in performing activities of daily living.

An individual with a sensory processing disorder may exhibit the following characteristics:

  • Hypersensitivity
  • Hyposensitivity
  • Difficulty self-regulating (experience an activity level that is unusually high or unusually low)
  • Decreased proprioceptive awareness (difficulty knowing where one’s body is in space)
  • Easily distracted
  • Physical clumsiness
  • Apparent carelessness
  • Impulsivity
  • Difficulty making transitions from one situation to another
  • Poor self concept
  • Lacking in self-control
  • Social and/or emotional problems
  • Inability to self-soothe
  • Delays in speech, language, motor skills, and/or academic achievement

What causes sensory processing disorders?

There is no known direct cause of sensory processing disorders; however, a discrepancy in the sensory integration process is the root of this disorder. The mid-brain and brainstem regions of the central nervous system are early centers in the processing pathway for sensory integration.

Prenatal/birth complications and environmental factors, as well as other disorders, such as autism spectrum disorder, may increase the risk of a sensory processing deficit/disorder.

Sensory Processing and Speech

Individuals with sensory processing disorders often have speech and language impairments.

Speech and language development requires several foundational processes including the integration of auditory and visual stimuli, motor planning, and proprioceptive knowledge of the body in space.

Difficulties in these and other areas of sensory processing can negatively affect speech and language development.

Treatment for Sensory Processing Disorders

Sensory processing disorders may be assessed and diagnosed by occupational therapists, neurologists, and/or developmental pediatricians.

Treatment for sensory processing disorders is usually provided by occupational therapists. Treatment focuses on integrating a variety of senses including sight, sound, smell, touch (tactile sense), proprioceptive sense, and vestibular senses.

Goals for sensory integration therapy are unique to each child and vary greatly depending on the child’s specific difficulties and challenges.

Areas of treatment may address:

  • Gross motor skills
  • Fine motor skills
  • Motor planning
  • Postural control
  • Coordination
  • Balance
  • Strength

Ashley DiGregorio MA CF SLP TSSLD


Dealing with Defiance

When working with children who exhibit defiant behaviors, it can be hard to sustain an environment conducive for learning. Some children exhibit defiance to seek attention and express frustration towards the level of work that is expected of them, while others may be experiencing a behavioral disorder.

The first step in managing negative behaviors in therapy may be to shift gears. Many behaviors demonstrated by children (i.e., self-stimulatory, attention-seeking, aggression) are triggered by stimuli in their surrounding environment.

The treating SLP must consider the framework of each session and the goals being targeted. Some children with oppositional traits benefit from a patient-centered approach, in which the patient guides the structure of the session (maintaining a sense of control) while goals are integrated into productive, yet achievable tasks.

Other children may exhibit success with visual schedules, positive reinforcement (verbal/tangible), and work-to-earn systems. It is important to tailor incentive to each individual in order to yield the most success.

Tips for Dealing with Defiance in Therapy:

  • Respond without anger.
  • Speak calmly and matter-of-factly to a defiant child. Defiant children will not respond well to sarcasm, lectures, or complex directions.
  • Avoid open-ended questions (unless you are willing to accept any answer).
  • Avoid a power struggle; children with defiance often seek power and control. Offering limited choices let’s the child feel in control and allows them to hold onto their sense of significance and dignity but teaches them expectations.
  • Avoid negotiating in the moment; decide on a consequence and remain firm in this decision. Negotiation gives the child more control and gives them the message that they can avoid redirection by resisting.
  • Be strong in your follow through; defiant children will work to “wear adults down and win.”
  • Do not take a child’s behavior personally.
  • Be as neutral and objective as possible (in both verbal and non verbal expression).
  • Keep setting limits with children and follow through by giving them consequences/holding them accountable for their actions.
  • Defiant children need to feel that despite difficulties, you will still care about them, recognize their successes, and actively include them in the learning environment.
  • All children, including those who frustrate you, have positive attributes. Make a point to learn about their interests and channel their talents in ways that foster their sense of significance.
  • All children, especially those who struggle with defiance, need to hear when they are doing well and where they are improving.
  • Make a point of noticing a child’s successes, such as following directions, transitioning smoothly, or doing anything ordinary that might invite resistance.
  • Avoid suggesting that pleasing you is what’s most important; steer clear of phrases such as “I like..”, “I want…”, or “I appreciate” when reinforcing positive behavior.

A child who is sensitive to being told what to do may feel manipulated by “I” statements.

  • Teach defiant children how to disagree respectfully; when teaching children appropriate ways to disagree make it clear that in the moment they still need to follow directions and rules. Let them know that later they can discuss what they feel was unfair and what should be changed. Teaching phrases such as “I feel that…”, and “I suggest…” can go a long way.
  • When a child is being defiant make sure they are (1) safe and (2) give them time to cool down.
  • Avoid doing things that may heighten a child’s level of stress and trigger more resistance.
  • Do not try to reason or make en emotional appeal to “win” the child over.
  • Slow down; waiting a few seconds before you say/do anything lets the child regain their ability to cooperate and also lets you assess the situation calmly and objectively.
  • After an episode of defiance, reflect on what preceded it. Eventually you will begin to recognize the situations that set off the child’s defiance, such as unexpected schedule changes or tasks that are too challenging.
  • Look for signs of frustration and discomfort such as opening and closing fists, body tension, and avoiding eye contact. Often times we may overlook red flags and consequently push children further into a defiant episode.
  • Intervene early; respond as soon as you can with respectful reminders or redirections. Following redirection do not expect immediate compliance. Children often need space literally and emotionally. Taking a step back will lessen the sense that you are controlling them.
  • A reward system can give children incentive to be compliant. Behavior contracts may also allow children to earn privileges through compliance (i.e., 15 extra minutes of iPad at home when session goes well).
  • Consistent discipline across settings is essential in reducing defiance.

Ward off attention-seeking negative behavior by giving children a daily dose of positive attention. A few minutes of positive attention can be enough for defiant children to feel satisfied.

Sometimes after cycling through teaching techniques and therapy approaches, children still exhibit reluctance to participate in sessions. This may be indicative of a clinical behavioral disorder.

What is Oppositional Defiance Disorder (ODD)?

Oppositional Defiance Disorder (ODD) is a childhood behavioral problem characterized by constant disobedience and hostility. The characteristics of ODD usually appear in school-aged children and include:

  • Child is easily annoyed or angered
  • Child has frequent temper tantrums
  • Child argues frequently with adults, particularly their parents
  • Child refuses to obey rules
  • Child appears to deliberately annoy or aggravate others
  • Child has low self-esteem
  • Child has a low frustration threshold
  • Child seeks to blame others for any misconduct

Some children with traits of ODD may experience:

  • Poor social interactions
  • Difficulties complying with rules and expectations
  • Anger/Frustration
  • Difficulty taking responsibility for their own actions

Management Strategies for School and Home:

  • Parent counseling by a licensed psychologist helps parents to better manage and interact with their child. This may include learning behavioral techniques that reinforce good behavior and discourage bad behavior.
  • Functional family therapy teaches family members how to problem solve and communicate more effectively with one another to decrease defiance and hostility in the home.
  • Consistency of care is essential. For effectiveness of intervention, all people involved in the care of the child need to be consistent in the way they behave and manage the child. This includes teachers, grandparents, parents, siblings, babysitters, etc.

Speech-Language Therapy to Support the Child with ODD:

  • A thorough speech and language assessment may help families understand how a child is processing, understanding, learning, and using language and communication.
  • Communication strategies may provide families with strategies and techniques to increase and enhance communication with their child.
  • Daily activities can be targeted to help children with ODD understand the environment, routines, and importance of language.
  • Developing language can help younger children to understand and use language more spontaneously and appropriately.
  • Working on conversation and pragmatic language skills can help children with social communication (i.e., turn-taking, appropriate use of language across settings). An SLP can help children learn when and how to use language.
  • Concept skills can enhance a child’s ability to develop abstract concepts, such as time (this can decrease frustration and confusion in regards to change and consistency in routine).
  • Visuals can be used to help children express their needs, wants, and thoughts, as well as organize and plan a routine for the day.
  • Speech goals may enhance verbal and non-verbal communication, including gestures/signs, speech, and written language.
  • Communicating with educators and family members to discuss the nature of the difficulties and ways to help the child will help ensure a cohesive plan for generalization of skills.

What does a diagnosis of Oppositional Defiance Disorder (ODD) really mean for a child?

A diagnosis can help to identify:

  • Other co-morbid disorders
  • Medication that might be appropriate
  • Therapies that might help the child
  • Course of intervention/projected outcome

According to the DSM-V, diagnoses are used to label a set of symptoms that are being experienced by a child. A licensed psychologist can provide a comprehensive evaluation to determine the nature and severity of a child’s deficits, as well as the presence of a behavioral disorder.

Ashley DiGregorio M.A. CF-SLP, TSSLD

The Importance of Reading for Early Language Development and Expressive Speech

Family-ReadingExposing children to early developing speech sounds is a great way to encourage a child to pronounce those sounds correctly.

  • Before a child can even read, parents can introduce “story time” to children.
  • Research suggests that children with greater language exposure, and families who read to them, often experience richer language skills.
  • Auditory bombardment also increases a child’s ability to hear incorrect sounds in their own speech.
  • Providing a good speech model by over-emphasizing the target sounds can help increase a child’s spontaneous and correct production of those sounds.
  • Integrating books into therapy sessions and at home is a great way to make a fun activity a learning task.

It is easy to embed goals in reading and may be enriching for children on so many levels. Some goals that may be targeted include:

  • “WH” Questions
  • Predictions (early inferencing skills)
  • Object naming/labeling (increases a child’s lexical repertoire)
  • Letter/sound recognition


Some great books by phoneme (in developmentally-appropriate order) include:

  • /b/
    Brown Bear, Brown Bear, What Do You See? by Bill Martin and Eric Carle
    The Baby BeeBee Bird by Diane Redfield Massie
    Chicka, Chicka Boom Boom by Bill Martin, Jr. and John Archambault The Wheels on the Bus by Paul D. Zelinsky
    How Many Bugs in a Box by David A. Carter
  • /p/
    It’s Pumpkin Time by Zoe Hall
    A Pair of Socks by Stuart J. Murphy
    Pizza Pat by Rita Goldman Gelman Purple Sock, Pink Sock by Jonathan Allen Sheep in a Jeep by Nancy Shaw
    Ten Apples Up On Top! By Dr. Seuss
  • /m/
    City Mouse-Country Mouse by John Wallner
    Five Little Monkeys Jumping on the Bed by Eileen Christelow Goodnight Moon by Margaret Wise Brown
    If You Give a Moose a Muffin by Laura Joffe Numeroff
    Mouse Mess by Linnea Asplind Riley
    The Gum on the Drum by Barbara Gregorich
  • /d/
    The Doorbell Rang by Pat Hutchins
    Barnyard Dance! by Sandra Boynton
    My Dad by Anthony Brown
    No, David! by David Shannon
    Five Little Monkeys Jumping on the Bed by Eileen Christelow
  • /t/
    In the Tall, Tall Grass by Denise Fleming Tails by Matthew Van Fleet
    Teeny Tiny by Jill Bennett and Tomie dePaola The Fat Cat Sat on a Mat by Nurit Karlin Where’s Spot? by Eric Hill
  • /v/
    The Very Hungry Caterpillar by Eric Carle
    Does a Kangaroo Have a Mother Too? by Eric Carle Mama, Do You Love Me? by Barbara Joosse
    I Love You, Stinky Face by Lisa McCourt
  • /f/
    Fall Leaves Fall! By Zoe Hall
    The Foot Book by Dr. Seuss
    Fuzzy Yellow Ducks by Matthew Van Fleet
    Touch and Feel Farm by Dorling Kindersley Publishing The Dog Who Cried Woof by Bob Barkly
  • /g/
    Go, Dog, Go! by P.D. Eastman
    Good Night, Gorilla by Peggy Rathmann My Gum is Gone by Richard Yurcheshen The Three Pigs by David Wiesner
    Big Pig on a Dig by Jenny Tyler
  • /k/
    Counting on Calico by Phyllis Limbacher Tildes Cows Can’t Fly by David Milgrim
    From Head to Toe by Eric Carle
    Kiss the Cow by Phyllis Root
    Two Cool Cows by Toby Speed
    Five Little Ducks by Penny Ives
  • /h/
    Clap Your Hands by Lorinda Bryan Cauley
    Happy Hiding Hippos by Bobette McCarthy
    A House is a House for Me by Mary Ann Hoberman Polar Bear, Polar Bear, What Do You Hear? By Eric Carle
  • /n/
    Know Your Noses by June A. English
    The Mitten by Jan Brett
    No, David! by David Shannon
    Two Eyes, A Nose, and a Mouth by Roberta Grobel Intrater Nine Men Chase a hen by Barbara Gregorich
  • /z/
    Going to the Zoo by Tom Paxton
    If I Ran the Zoo by Dr. Seuss
    Zip, Whiz, Zoom! by Stephanie Calmenson
    Whose Nose? by Jeannette Rowe
    Two Eyes, a Nose, and a Mouth by Roberta Grobel Intrater
  • /s/
    Can You See What I See? by Walter Wick
    Silly Sally by Audrey Wood
    Sid and Sam by Nola Buck
    If You Give a Mouse a Cookie by Laura Joffe Numeroff Town Mouse Country Mouse by Jan Brett
  • “sh”
    Sheep in a Shop by Nancy Shaw Sheep on a Ship by Nancy Shaw
    I Love My Shadow by Hans Wilhelm Splish, Splash! by Sarah Weeks
  • /l/
    5 Little Lady Bugs by Karyn Henley
    Big, Small, Little Red Ball by Emma Dodd Look Book by Tana Hoban
    Leo the Late Bloomer by Robert Kraus Smile Lily by Candace Fleming
  • /r/
    The Little Mouse, the Red Ripe Strawberry, and the Big Hungry Bear by Audrey Wood
    Roling Rose by James Stevenson
    Rosie’s Roses by Pamela Duncan Edwards
    Harriet’s Horrible Hair Day by Dawn Lesley Stewart
    Mary Wore Her Red Dress and Henry Wore His Green Sneakers by Merle Peek
    Stars! Stars! Stars! By Bob Barner
    The Very Hungry Caterpillar by Eric Carle
  • /s/ Blends
    The Itsy Bitsy Spider by Iza Trapani
    Sledding by Elizabeth Winthrop
    White Snow, Bright Snow by Alvin Tresselt
    Stop that Pickle! by Peter Armour
    Snake Supper by Alan Durant and Ant Parker
    Caps for Sale by Esphyr Slobodkina
    “There are Rocks in My Socks!” Said the Ox to the Fox by Patricia Thomas
    Fox in Socks by Dr. Seuss
  • /l/ Blends
    Cows Can’t Fly by David Milgrim
    I Love Planes! by Philemon Sturges Slip! Slide! Skate! by Gail Herman Flip-Flops by Nancy Cote
    Sledding by Elizabeth Winthrop
  • /r/ Blends
    Big Frank’s Fire Truck by Leslie McGuire
    A Crack in the Track by W. Rev Audry and Jane Gerver Five Green and Speckled Frogs by Priscilla Burris Little Green Truck by Ken Wilson-Max
    Froggy Gets Dressed by Jonathan London
  • /dg/ or “j” as in “jump”
    The Giant Jam Sandwich by John Vernon Lord
    Jump, Frog, Jump! by Robert Kalan
    Making Plum Jam by John Warren Stewig and Karen O’Malley The Animal Hedge by Paul Fleischman
  • “ch”
    Ah-Choo! by Margery Cuyler
    Chicka Chicka Boom Boom by Bill Martin, Jr. and John Archambault Say Cheese, Please! by Leslie McGuirk
    Itchy, Itchy Chicken Pox by Grace MacCarone
  • “th”
    The Little Engine That Could by Watty Piper Oh, the Thinks You Can Think! by Dr. Seuss One, Two, Three! by Sandra Boynton Cousin Ruth’s Tooth by Amy MacDonald Mouths and Teeth by Elizabeth Miles
  • /w/ and “y”
    Big Wheels by Anne Rockwell
    I Went Walking by Sue Williams
    The Wheels on the Bus by Paul O. Zelinski Yo! Yes? by Chris Raschka

Ashley DiGregorio MA CF SLP TSSLD

Down Syndrome

Down syndrome, also known as Trisomy 21, is caused by an extra whole number chromosome 21, resulting in 47, rather than the normal 46 chromosomes. According to the Centers for Disease Control and Prevention, approximately one in every 700 babies in the United States is born with Down syndrome, making Down syndrome the most common chromosomal  condition. About 6,000 babies with Down syndrome are born in the United States each year. The cause of the extra chromosome is unknown. Maternal age is the only factor that has been linked to an increased chance of having a baby with Down syndrome.  However, due to higher birth rates in younger women, 80% of children with Down syndrome are born to women under 35 years of age. There is no definitive scientific research that indicates that Down syndrome is caused by environmental factors or the parents’ activities before or during pregnancy.

Physical characteristics include generalized hypotonia, a flat facial profile, small ears, nose, and chin, and brachycephaly (flattened back of the head). Other physical characteristics include mid-face dysplasia (malformation of the mid-face), shortened oral and pharyngeal structures, a narrow and high arched palate, a relatively large and fissured tongue that tends to protrude, a short neck with excess skin on the back of it, hyperflexible joints, cardiac malformations (in approximately 40% of cases), and short fingers. Vision problems are also commonly presented by children with Down Syndrome, including the following: strabismus (cross-eyed), near- or farsightedness, and an increased risk of cataracts.

Communication problems include conductive loss in many cases and sensorineural loss in some. There may be language delays and disorders, especially deficient syntactic and morphological features accompanied by relatively better vocabulary skills. Hypernasality and nasal emission, breathier voice, and articulation disorders may also be present. Along with the treatment of an ENT, speech therapy will also be beneficial in improving communication deficits for children diagnosed with Down Syndrome.

Some children with Down Syndrome demonstrate no significant health problems, others may experience multiple co-occuring medical conditions. For example, almost half of all children born with Down Syndrome have a congenital heart defect. Children with Down syndrome are at an increased risk of developing pulmonary hypertension, a serious condition that can lead to irreversible damage to the lungs.




Gabrielle Cormace MS CF SLP


Gavin, M. L. (2015, September). Down Syndrome. Retrieved from KidsHealth :

Roseberry-McKibbin, C., & Hegde, M. (2016). An Advanced Review of Speech-Language Pathology. Austin, TX: Pro-ed.

National Down Syndrome Society. (n.d.). What Is Down Syndrome? . Retrieved from National Down Syndrome Society:

Cleft Lip & Cleft Palate

A cleft is an opening in a normally closed structure. Cleft lip, therefore, is an opening in the lip, usually the upper lip. Lower lip clefting is very rare. Clefts of the lips alone are very rare; they are usually associated with cleft of the palate. Cleft of the palate are often not associated with cleft lips, however. Cleft lips are often unilateral than bilateral, and they occur more frequently on the left side than on the right side. Rare bilateral lip clefts have an even greater tendency to coexist with palatal cleft than unilateral left lip clefts do. Cleft lips alone rarely result in speech disorders and are less frequently associated with other genetic anomalies than palatal clefts. Clefting is a congenital disorder, meaning it is present from birth. Congenital disorders may or may not be inherited.

Palatal clefts are various congenital malformations resulting in an opening in the hard palate, the soft palate or both. These malformations are due to disruptions of the embryonic growth processes, resulting in a failure to fuse structures that are normally fused. Cleft palates may be a part of a genetic syndrome with other anomalies. It is now belived that clefting of the lip and palate is etiologically different from clefting of the palate only. Generally, males tend to exhibit a higher frequency and greater severity of cleft lip (with or without cleft palate) than females, who tend to exhibit higher frequency of palatal clefts (without the cleft lip).

  1. Etiology:
    1. Genetic abnormalities
      1. Autosomal dominiant ingeretance in some syndromes (e.g., Apert syndrome, Stickler syndrome, Van der Woude syndrome, Waardenburg syndrome, and Treacher-Collins syndrome)
      2. Recessive genetic ingeritance in some syndromes (e.g., orofacial-digital syndrome)
      3. X-linked ingeritance in some syndromes (e.g., oto-palatal-digital syndrome)
      4. Chromosomal abnormalities (e.g., Trisomy 13)
    2. Environmental teratogenic factors
      1. Fetal alcohol syndrome
      2. Illegal drug use
      3. Side effects of some prescription drugs (e.g., anticonvulsant drugs or thalidomide, a sedative)
      4. Rubella
    3. Mechanical factors
      1. Intrauterine crowding
      2. Twinning
      3. Uterine tumor
      4. Amniotic ruptures

Communication disorders associated with clefts include hearing loss (e.g., middle ear infections and hearing loss), speech sound disorders (e.g., difficulty with unvoiced sounds, difficulty with sibilants /s, z/, difficulty with fricatives, affricates and plosives, and sound substitutions), language disorders (e.g., expressive language delays) and laryngeal and phonatory disorders (e.g., vocal nodules, hypertrophy and edema of the vocal folds, hoarseness, reduced vocal intensity, hypernasality, hyponasality, denasality, or combination). Children who are born with cleft lip and/or palate will most often require intervention, specifically speech-language therapy to address deficits within resonance, voice and/or expressive speech skills.


Gabrielle Cormace MS CF-SLP

Resource: Roseberry-McKibbin, C., & Hegde, M. (2016). An Advanced Review of Speech-Language Pathology. Austin, TX: Pro-ed.


Specific Language Impairment (SLI)

Children with SLI manifest an impairment specific to language. This impairment is not secondary to other developmental disabilities. Children with SLI have no known etiology or associated condition, such as sensorimotor problems, intellectual disability, or significant neurological impairments. Some children with SLI have cognitive deficiencies, although their general intelligence may be within the normal range. The sequence of language development in children with SLI is the same as that of typically developing children. However, problems may be seen with various components of language. Children with SLI display varied profiles. Some have great difficulty in syntax but relatively normal pragmatic performance and moderate difficulty with semantic skills, for example. Children with SLI present as widely varied and diverse group.

Children with SLI often have articulatory and phonological difficulties and/or speech sound disorders. They may have poor speech intelligibility and may exhibit phonological processes longer than typically developing children.

Learning abstract or figurative words is often hard for children with SLI. They frequently use concrete, not abstract, words to express themselves. For example, a child with SLI might say, “I’m mad,” instead of “I feel frustrated with this situation.”  The majority of children with SLI have marked morphological problems including the following:

  1. Perceptual problems. Children do not perceive morphological features as well as they do other features because those features are produced with less stress and lower intensity.
  2. Syntactic problems. The syntactic complexity involved in sentence comprehension and production may have a negative effect on morphology.
  3. Regular and irregular plural morphemes
  4. Possessive morphemes
  5. Present progressive –ing
  6. Third-person singular (e.g., “He plays ball”)
  7. Articles (a, an, the)
  8. Auxiliary and copula verbs (e.g., the auxiliary is in “She is running”; the copula is in “She is smart”)
  9. Comparatives and superlatives (e.g., -er in smaller and –est in smallest)
  10. Children with SLI may also show confusion with the following structures:
    1. Singular and plural forms of words
    2. Plural and singular forms of auxiliary and copula verbs (are, is)
    3. Subject case marking (him, he; her, she)
    4. Regular and irregular forms of plural and past tense morphemes

Children with SLI may have difficulty with the following aspects of pragmatic language skills, also known as the social use of language:

  1. Topic initiation
  2. Turn taking
  3. Topic maintenance
  4. Appropriate conversational repair strategies (e.g., asking, “What do you mean?” when a speaker’s utterances are not understood or changing one’s own productions when a listener fails to understand”
  5. Discourse and narrative skills
  6. Staying relevant during conversation

Young children with SLI are at risk for later problems with reading and writing. If a child demonstrates any of the aforementioned difficulties, they may present with a specific language impairment (SLI) and speech-language therapy may be warranted.



Roseberry-McKibbin, C., & Hegde, M. (2016). An Advanced Review of Speech-Language Pathology. Austin, TX: Pro-ed.

Gabrielle Cormace MS CF-SLP

4 Components of Language

Linguistics is the study of language, its structure, and the rules that govern its structure. Linguists, specialists in linguistics, have traditionally analyzed language in terms of several subfields of study. Speech-language pathologists study these subfields of language and are specially trained to assess and treat language and its subfields. These include morphology, syntax, semantics, pragmatics and phonology.

Morphology is the study of word structure. It describes how words are formed out of more basic elements of language called morphemes. A morpheme is the smallest meaningful unit of a language. Morphemes are considered minimal because if they were subdivided any further, they would become meaningless. Each morpheme is different from the others because each singles a distinct meaning. Morphemes are used to form words. Base, root or free morphemes are word that have meaning, cannot be broken-down into smaller parts, and can have other morphemes added to them. Examples of free morphemes are ocean, establish, book, color, connect, and hinge. These words mean something, can stand by themselves, and cannot be broken down into smaller units. These words can also have other morphemes added to the. Bound or grammatical morphemes, which cannot convey meaning by themselves, must be joined with free morphemes in order to have meaning. In the following examples, the free morphemes are underlined; the bound morphemes are in capital letters: oceanS, establishMENT, bookED, colorFUL, DISconnect. Common bound or grammatical morphemes include the following: -ing (the present progressive), -s (the regular plural; e.g., cats), -s (the possessive inflection; e.g., man’s), and –ed (the regular past tense; e.g., washed). Morphemes are a means of modifying word structures to change meaning. The morphology of a given language describes the rules of such modifications.

Syntax and morphology are concerned with two major categories of language structure. Morphology is the study of word structure syntax is the study of sentence structure. The basic meaning of the word syntax is “to join,” “to put together.” In the study of language, syntax involves the following:

  1. The arrangement of words to form meaningful sentences
  2. The word order and overall structure of a sentence

A collection of rules that specify the ways and order in which words may be combined to form sentences in a particular language. As they mature in syntactic development, children begin to use compound and complex sentences, which can be defined as follows:

  1. Compound sentence: two or more independent clauses joined by a common and a conjunction or by a semicolon. There are no subordinate clauses in a compounded sentence. A clause contains a subject and a predicate. An independent or main clause has a subject and a predicate and can stand alone (e.g., “The policeman held up the sign, and the cars stopped.”)
  2. Complex sentence: contains one independent clause and one or more dependent or subordinate clauses. A dependent or subordinate clause has a subject and predicate but cannot stand alone. (e.g., “I will drive my car to Reno if I have enough gas.”)

Syntax rules differ by language. Speakers of a language do not produce structures with random and meaningless word order. If they do, speech and language therapy may be warranted. For example, an English speaker could say, “He said he was going to come but didn’t.” Due to syntactic rules, a speaker could not say, “He’s going to was said he didn’t but come.” Languages have different syntactic structures. In English, the basic syntactic structure is subject + verb + object. This structure, usually called the “kernel sentence”, can also be called the phrase structure or base structure.

Semantics is the study of meaning in language. The semantic component is the meaning conveyed by words, phrases and sentences. Semantics includes a person’s vocabulary or lexicon. Vocabulary development depends heavily upon environmental exposure, as well as the individual capacity each child brings to the learning situation. Important aspects of vocabulary development include knowledge of the following: antonyms, or opposites, synonyms, multiple meanings of words, humor/riddles, figurative language (including metaphors, idioms, proverbs), deictic words, or words whose referents change depending on who is speaking (e.g., this here, that, come, go).


  1. Semantic categories are used to sort words. Examples of a few of these categories are recurrence, rejection, and causality. A child using recurrence might say, “More milk”.
  2. Word knowledge involves a person’s autobiographical and experiential memory and understanding of particular events. For example, a child might be able to discuss an aquarium because he has been to several and has been exposed to marine life.
  3. Word knowledge is primarily verbal and contains word and symbol definitions. For example, a child might be able to name the planets in the solar system because she has learned them in kindergarten.
  4. Another important semantic aspect of language development is developing the ability to categorize words. For example, children must learn that tiger, cat, dog, pig and horse fall into the category of animals.

Pragmatics is the study of rules that govern the use of language in social situations. In pragmatics, one focuses on use of language in social context. Pragmatics places greater emphasis on functions, or uses of language, than on structure. Functions of language include:

  1. Labeling/naming
  2. Protesting
  3. Commenting
    1. Important functions of utterances include the following:
      1. Providing listeners with adequate information without redundancy
      2. Making a sequence of statements coherent and logical
      3. Taking turns with other speakers
      4. Maintaining a topic
      5. Repairing communication breakdowns

      Language context involves where the utterance takes place, to whom the utterance is directed and what and who are present at the time. Pragmatic skills also involve the appropriate knowledge and use of discourse. Discourse refers to how utterances are related to one another it has to do with the connected flow of language. Discourse can involve a monologue, a dialogue, or even conversational exchange. When people talk to one another they are engaging in discourse. Pragmatic skills are important social skills for social, academic and vocational success.

      References:Roseberry-McKibbin, C., & Hegde, M. (2016). An Advanced Review of Speech-Language Pathology. Austin, TX: Pro-ed.


      Gabrielle Cormace MS CF SLP

      HELLO in eight different languages