What is an intellectual disability?
An intellectual disability is characterized by below average intellectual functioning and delayed children with the condition are often slow to reach developmental milestones compared to their peers. In clinical terms, a person with an IQ of 70 or lower is diagnosed with an intellectual disability, and people with the disability often exhibit difficulties in areas of self-care, communication, self-direction, social interactions and managing work or leisure activities. Generally, individuals with an intellectual disability require ongoing support and training from their family or carers, and many also become engaged in formal support services.
What is speech therapy?
One of the most common and evident effects of an intellectual disability is that on the person’s speech and communication, with many children progressing poorly with speech and language skills. A speech therapist (or speech pathologist) is a trained allied health professional who works with people with communication disorders and difficulties. Speech therapists help individuals attain their communication potential and improve overall speech and language skills.
Individuals with an intellectual disability may have a speech and/or language disorder and it is important to recognize the distinction between the two. A speech disorder is where the person has difficulty producing the sounds of speech necessary to communicate effectively with others. This can include difficulties with articulation, fluency, voice or phonological disorders. On the other hand, people with language disorders do not usually have struggles with producing speech sounds or pronouncing words, but have difficulty comprehending language and its rules and processes. This often includes problems with utilizing correct grammar and developing adequately constructed sentences. Language disorders are generally categorized into expressive (problems with explaining or expressing their needs) or receptive (difficulties with understanding language and its meaning) language disorder.
How can speech therapy help an individual with intellectual disability?
People with an intellectual disability often have difficulties with processing and learning new information, following directions, understanding and utilizing written and spoken language (e.g. unable to follow conversation or verbally communicate their thoughts to others), comprehending detailed information and completing tasks. A person with an intellectual disability and communication deficits may also struggle with social skills and understanding non-verbal communication, such as understanding facial expression, gestures or social etiquette. In people who are non-verbal or have limited verbal abilities, they can help to develop alternative communication methods, such as using assistive technology.
What does speech therapy usually involve?
As with most therapeutic interventions, the first step generally involves the therapist obtaining a complete background of the person’s social, education and medical history, as well as their current level of functioning in regard to speech and communication. Using a standardized assessment tool is often useful to gain a formal assessment of the person’s baseline communication functioning and needs, which can then be used to formulate therapy goals. Speech therapy also often works better with the involvement of the person’s parents or carers, so they too can improve how they communicate with the person.
Below is a description of how speech therapy can enhance communication skills of specific disorders or difficulties:
- Speech therapy and receptive language:Speech therapists can help children and adults with receptive language challenges by working on areas such as building eye contact, utilizing minimal instructions and basic language, expanding the individual’s vocabulary and focusing on specific words to learn, and incorporating visual cues such as pictures, gestures or body language to enhance understanding. Speech therapy for receptive language often involves asking the child to relay what has been said to them and helping the person recognize an instruction or concept by displaying the activity.
- Speech therapy and expressive language: Expressive language hardships can be improved by constant engagement in conversation such as asking them to describe their ideas or actions, modelling the mechanism of generating speech sounds and words to the person, utilizing books to tell stories and encouraging letter writing. It is also important to continually broaden the person’s vocabulary, which is often done by exposing them to social experiences, reading or consuming other media, or engaging in exercises where they have to name objects or actions in everyday activities.
- Speech therapy and social language: Social or pragmatic communication skills are required to properly adopt language within a social context. These skills are often paramount for a person to engage in their community and with their peers, and involve how we use language in various ways (e.g. making requests of other people, social greetings); adapting how we use language to the social situation (e.g. we often speak differently to our peers than we do to a stranger or a person older than us); and appropriate adoption of social etiquette and standards (e.g. understanding social cues, importance of taking turns). Speech therapists can enhance pragmatic language skills by applying aids and modelling appropriate behaviours in specific social contexts (e.g. greetings, manners), using play therapy and role playing and teaching the individual to better read and understand facial expressions. It is also critical for the person to be engaged in various social interactions in everyday life.
- Speech therapy and children who are non-verbal: When a child is showing signs of being unable to produce sounds or speak, it becomes necessary to find alternative ways of communication. This often includes the use of gestures and body language, visual aids and objects (e.g. picture boards or cards), electronic computers or gadgets to relay types messages, adopting specialized voice-output devices, or learning sign language. Therapy usually has an initial focus of developing the child’s skills to be able to communicate practical messages, such as how to show that they are hungry and represent emotions (e.g. using picture cards to display if they are tired or happy). It may take some time to identify what is most comfortable for the child to use in terms of alternative communication approach. As therapy progresses and the child’s communication skills increase, the speech therapist will work to enhance the child’s ability to manage complex tasks and instructions that include more actions.