A practical guide for parents to understanding early language development and supporting the next step.
For the most part, speech therapists are not ones to use terribly technical words. We use fairly common terms like communication, speaking or attention. But occasionally, we do use technical terms.
For example, if you've had an appointment with a speech and language therapist for your toddler, you've probably heard them describe your child as being at the 'one-word level' or 'two-word level'.
What does this actually mean?
This might be one of those times when you think, 'How technical can this be? Of course I understand what one-word level means.'
But bear with me — you might not have got it quite right.
Understanding language levels
A speech therapist typically assesses your child across various dimensions of language development. These include attention, comprehension, speaking, articulation, play and social skills.
Of these, comprehension and speaking, particularly at the early stages, are often described using terms such as 'one-word level', 'two-word level' and so on.
Let's look at comprehension first.
What does understanding at the one-word level mean?
If you thought that one-word level simply means hearing a single word from your child, such as amma or appa, you're not entirely wrong. But there's more to it.
When we're assessing comprehension, the one-word level refers to understanding one key word that is essential to carrying out an instruction.
Let me explain with an example.
Imagine I am assessing your child. There is a ball and a cup on the table. I give your child the ball and ask him to put it in the cup. At the same time, I point to the cup and gesture that he should put the ball inside.
Your child does exactly what I ask.
But here's the thing: he didn't really have to understand any of the words to follow my instruction.
I gave him the ball, showed him the cup and gestured what he needed to do. He could have completed the task simply by following my gestures.
Now, let's change the situation slightly.
There is a ball, a brick and a cup on the table. This time, I ask your child to take the ball and put it in the cup. I still point to the cup and gesture that he should put something inside it.
Your child now needs to understand at least one word — ball. He needs to know that I asked him to take the ball, not the brick.
Because I pointed to the cup and gestured what to do, he didn't need to understand those parts of the instruction.
This is understanding at the one-word level.
What about the two-word level?
Now imagine that there is a brick, a ball, a cup and a box on the table.
This time, I don't point or gesture at all.
I simply say, "Take the ball and put it in the cup."
To carry out this instruction correctly, your child needs to understand two key words:
- Ball — not brick.
- Cup — not box.
He has to identify the correct object and the correct container, using the words alone.
He is therefore operating at the two-word level of comprehension.
Notice that the instruction itself contains several words. We are not counting every word in the sentence. We are counting the key words your child needs to understand to complete the instruction.
And this is how we work upwards.
You might hear speech therapists describe comprehension at the three-word, four-word or even five-word level. As language develops further, your child may be ready for a standardised assessment or more detailed assessments of grammar and sentence understanding.
For example, we might look at whether your child understands simple sentences, and later, compound and complex sentences.
What about spoken language?
When it comes to spoken language, the principle is similar, although now we are looking at what your child says rather than what he understands.
Let's start with the one-word level.
If your child says amma, that is one word. It has a unique meaning and refers to a particular person.
But what if your child says "Shraddha amma"?
Let's imagine Shraddha is his mother's name, and he has learnt to call her that because he has heard his father doing so.
Although he is saying two words, both words together still refer to just one person. He is not necessarily expressing two separate ideas.
This would therefore still be considered the one-word level.
What we are looking for is a meaningful association between a word and the unique concept it represents.
The same applies when a child can say amma and then copies "bye-bye amma" after the therapist.
If bye-bye doesn't yet carry a unique meaning for the child, and he is simply repeating what he has heard, we wouldn't count this as meaningful two-word language.
At the two-word level, we are looking for the child to combine words meaningfully. For example, "amma come" or "more biscuit".
As children progress, they begin combining three words and then longer phrases and sentences, allowing them to communicate more information.
But the important thing is not simply how many words we hear. It is whether the child understands what those words mean and is using them meaningfully.
What's wrong with copying?
Nothing, necessarily!
But copying is not always the same as using meaningful language.
Generally, you'll find that a speech therapist will not assess copying in quite the same way that parents might tend to view it.
Copying can be positive in a child with autism, as it may offer some glimpse into the possibility of verbal language. But copying is not always a true reflection of meaningful, independent language use.
Though there are exceptions to the rule, consider this example.
You ask your child, "What did you do yesterday?"
He doesn't answer.
You then prompt him by saying, "Say, 'I went to the park.'"
Your child repeats, "I went to the park."
While he has produced a complete sentence, this would not be rated as spontaneous language. He has copied the words you provided rather than independently telling you what he did.
This is why speech therapists pay attention not only to the number of words a child uses, but also to how those words are being used.
So, what does your child's language level tell you?
When a speech therapist describes your child as being at the one-word, two-word or three-word level, they are trying to give you a clearer picture of what your child currently understands or can express.
It is important to know whether the therapist is referring to comprehension or spoken language, because the two may be at very different levels.
It is also worth remembering that these descriptions are not simply a count of the words in a sentence. They tell us something about the meaning your child is able to understand or communicate.
Well, I hope this has helped you understand your child's speech and language assessment report a little better.
And if you have any questions, use the Ask the Therapist button on our website to shoot us one!
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