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Children on the autism spectrum can be nonverbal or partially verbal for many reasons. In my career, the main two have been processing problems versus expressive language problems. In the beginning families and professionals often cannot tell which is the problem or even what the difference is. Today we are going to go over what each one is, how they present in daily life and a brief overview of the therapies that I’ve found work for each.
The first time I witnessed a nonverbal child expressing advanced concepts through a letter board or typing I was shocked. How could this child, who was unable to control their body, be able to express their thoughts and desires in complete sentences on paper? Experts said something must be wrong or they must be being influenced. However, now that same child is typing and writing independently. Still not speaking, but producing five-paragraph essays for school.
I thought it was magic. I tried the same process on other students with no success. Was the first time a fluke? Did I do it wrong the second time?
No. Those students just had different issues. I didn’t yet understand the difference between processing and expressive language problems.
The therapies they wound up needing were completely different.
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This is all in my disclaimers, but I’m going to say it again here. I am not a diagnostician. I am speaking from my experience as a SEIT. Please be aware none of what follows should be considered a firm diagnosis for processing versus expressive language problems. This post is meant to educate you, and help you establish what therapies you should seek.
How Our Brains Handle Language
To understand processing versus expressive language problems first we need to talk about the brain.
According to my memory of my linguistics course of neurology and linguistics, our brains have two places where they handle langage.
There are two areas of the brain where we process language, Brocca’s Area and Wernicke’s Area.
First the language hits Broca’s area which is in charge of processing speech and articulation. People with damage in Broca’s area (Broca’s Aphasia) speak grammatically incorrect, but are able to convey what they mean, suggesting Broca’s Area is where we form what we want to say.
Wernicke’s area is in charge of determining meaning. If someone has damage to Wernicke’s area they process fluent speech that means nothing, but is grammatically incorrect. Without Wernicke’s area they are unable to form meaningful expressions.
After language hits Broca’s and Wernicke’s area, a person forms how they want to respond to what they heard (aka how they want to answer.) This information then goes to their motor cortex, which plans how to move their lips and tongue, or the rest of their body if they want to respond using something more than language.
In nonverbal children on the spectrum this process gets interrupted somehow. How you respond depends on where the disruption is occurring.
For more information, and to double check my interpretation click here.
(Also to all the people who said I’d never use those linguistics classes as a special ed teacher, IN YOUR FACE!)
Processing Problems
Processing language is when you not only hear people speaking, but are unable to register the words in your head and connect them to meaning.
This is also called Auditory Processing Disorder, and it makes it difficult to distinguish not only individual words from another, but also someone’s voice from background noise.
If your students have processing problems they can hear you, but cannot understand the individual words and connect them to meaning.
They know you are talking, and might even be trying to listen. But they have no idea what you are saying.
Since they aren’t able to process speech, their expressive language, aka ability to talk, is affected. Children learn to talk through exposure to language. Since their exposure is limited by neurology, it doesn’t develop the way it should.
The disruption in production is occurring in Wernicke’s or Broca’s Area. Someone a lot smarter than me might be able to tell you which.
Signs of Processing Problems
- The child can read large parts of text aloud without language problems (if they can read)
- The Student can write but it sounds similar to how they speak (if they can write)
- They might say “yeah” or “yes” a lot without demonstrating understanding
- Child can say words or sentences but disjointedly, often with incorrect grammar.
- Sensitive to sounds
- Picking one word of what you said and latching onto it.
- Child is in full control of their motor skills besides speech
Please note this is not a complete or comprehensive list. This is just based on what I’ve seen and experienced with my own students.
Expressive Language Problems
Again, calling on those totally useful linguistics classes, expressive language is basically being able to express your thoughts. It’s talking.
A child with expressive language problems understands everything that is going on around them, but they cannot tell you their thoughts on it.
There is no problem in Wernicke’s or Brocca’s area for these kiddos. It’s in the motor cortex.
Students with expressive language problems might have a hard time planning out movements and controlling their bodies, a syndrome known as Body Betrayal.
However just because their motor cortex is failing them, it doesn’t mean they don’t understand language. It might seem like they’re off in their own world, but frequently these students are taking everything in all around them, including what the adults in their life say, so watch what you talk about in front of them!
Signs of Expressive Language Problems
- Child is prone to wild uncontrollable movements
- At times, the child attends to speech very intently, and might mutter one or two words on topic at random
- Child speaks with a limited vocabulary or not at all
- If child can use an alternate communication device, they might express ideas beyond their verbal capacity
Please note this is not a complete or comprehensive list. This is just based on what I’ve seen and experienced with my own students.
Therapies
The therapies needed for Processing versus Expressive language Problems are completely different, even contradictory at times.
For kids with processing problems, you want to focus on getting the language to go in and getting them to understand it.
With each you do what to work on retraining and strengthening the brain, but how you go about it will be very different.
I have found writing short stories with five sentences, presenting them with each sentence one at a time and having them read it three times, helps strengthen the weaker areas of their brain and understand written speech better.
As students with Auditory processing problems get to know you better, and know your voice, cadence, and how you talk, they get better at understanding you. One student, who I have known for years understands almost everything I say. However, when he meets a new adult, he gets maybe one or two words.
Make sure to talk slower to these students, enunciate and use as few words as possible, especially when you’re first starting out. You don’t want to be too cognitively demanding.
For kids with expressive language problems, the first thing you have to do is strengthen their motor cortex. It needs to get used to controlling the body to improve their ability to talk, write, or type.
If these kids cannot control their bodies, they’ll never be able to control their lips, tongue, or fingers.
Have them complete simple exercises with their body to strengthen the neural connections in their motor cortex. I started by just putting a line of painter’s tape down the middle of a kid’s room and having him walk the line, heel to toe, slowly and purposefully.
With each you do what to work on retraining and strengthening the brain, but how you go about it will be very different.
My Infinite Wisdom
What if they have both?
While I personally have never encountered a child with both, I’m assuming it’s beyond possible.
My instinct would be to focus on the motor cortex problems first, so your students has more control over their body.
You can’t expect them to sit through either therapies if they’re unable to control their hands and legs meaningfully.
However, each case is different. Talk to your kid’s OT and speech provider to establish the best course of action.
Who needs to help you
Obviously you need someone to diagnose these problems. I know my students’ families took them to see many occupational therapists, audiologists, and speech pathologists to diagnose and offer individualized treatment plans.
Consult with all these people on best strategies and work on making sure the therapy you and the family choose will have the most impact, without being impossible for the child to complete.
Final Thoughts
Ultimately our job as SEITs is to improve the child’s overall ability to learn and engage with life. Telling the difference between Processing versus Expressive Language problems can be difficult but is so important for being able to help our kids learn and grow.
If you think one of your students has this issue, talk to their family, and reach out to your network to see if there is anyone in your community who can perform an assessment to confirm your suspicions.
The more information you have the more effective your planning and interventions can be.
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