Introduction to Comprehension

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12/12/2016 7:54 PM

Language comprehension is the ability to understand spoken language. The term is often used interchangeably with receptive language. A child’s language comprehension is the combined product of several components, including lexical,syntactic, and pragmatic knowledge. Additionally, factors outside of the domain of language, such as social cognition, perceptual reasoning, memory, and processing speed, play important roles in supporting comprehension and contributing to its development over time.

Language comprehension can be classified into linguistic comprehension, sometimes called pure comprehension, and language comprehension in context, sometimes called pragmatic or discourse comprehension (Miller & Paul, 1995). The former refers to comprehension demonstrated in response to a language stimulus alone, whereas the latter refers to comprehension demonstrated in response to both the language stimulus and other cues, usually social cognition-related ones. Both types of language comprehension are highly relevant the ability to function in everyday life, as situations vary in the amount of contextual support that is available to a person.

Because so much of the information we are exposed to is delivered through the medium of language, language comprehension is critical to a child’s ability to learn fromthe environment and experience a wide variety of desirable outcomes. Baseline receptive language has proven to be a strong predictor of speech and language outcomes in longitudinal studies of
several populations, including late talkers, preterm children, children with autism spectrum disorders, and pre-lingually deaf individuals who received cochlear implants (Lyytinen, 2005; Rousset, Dowell, & Leigh, 2016;Suh et al., 2017; Thal & Tobias, 1991). Other studies suggest that the influence ofreceptive language may extend beyond achievement in the domain of language,into psychological well-being and adaptive skills. Yew and O’Kearney (2013)reviewed the literature on emotional and behavioral outcomes among children with specific language impairment (SLI) and found that children with combined receptive-expressive impairments experienced higher levels of internalizing and externalizing psychological symptoms compared to children with only expressive impairments.

Comprehension
Development

Early language comprehension in infants is often conceptualized as arising from prerequisites that can be observed even prior to 8 months of age. These prerequisites include grossly intact hearing,as evidenced by motor responses to noise, and a tendency to pay attention to voices and faces. After 8 months of age,children may begin to show comprehension of afew words in the context of familiar routines. For example, an infant may respond the direction “splash,” only in the bathtub (Miller & Paul, 1995). Later, children are gradually more able to demonstrate understanding outside of routines, but comprehension remains limited to words that refer to objects and events in the immediate environment. Importantly, early language comprehension is strongly supported by aspects of social cognition, especially joint attention and imitation skills, as well as learning and memory for routines or typical object-action relationships. Thus, children sometimes appear to have linguistic comprehension when they are actually relying on comprehension in context, or non-linguistic comprehension strategies (ex. following their mother’s eye-gaze toward an object).

Following the gradual increase in comprehension in context, comprehension expands to include objects that are out of view as well as some two-word combinations(action-object, agent-action, possessor-possession). Next, children begin to demonstrate some understanding of three-word constructions(agent-action-object), but have difficulty using information from word order to correctly interpret unlikely sentences (ex. “baby feeds mommy”). They also begin to understand some questions(who, what, where, and whose), spatial concepts (in and under),and a few comparative concepts (ex. first and bigger). Following this, children’s syntactic comprehension expands to include use of word order cues. They also begin understanding “how” questions and their repertoires of spatial and comparative concepts expand.

Comprehension
in Children with Developmental Disabilities

Researchers have investigated language comprehension in a variety of specific conditions associated with developmental disabilities. Many of these studies have included comparisons of expressive and receptive language, as well as discussion about how deficits in other domains,especially oral motor and gesture, likely interfere with either the development
of language or the ability to demonstrate language skills. Literature on the language of children Down syndrome generally indicates relatively stronger receptive language compared to expressive language, which could attributable to limitations placed on expressive language by severe impairments in articulation or oral motor skills (Luyster, 2011). However, a few studies that examined receptive language in a more fine grained manner suggest that receptive syntax may also be an area of specific weakness, while receptive vocabulary is stronger (Abbedutoet al., 2003; Næss, Lyster, Hulme, & Melby-Lervåg, 2011).

Studies of preterm children suggest that language is generally delayed, though the gap between preterm and full term children in performance on language measures decreases over time from toddlerhood to the school years (Luu et al., 2009). Poorer language outcomes among preterm children are associated with the presence of periventricular leukomalacia (PVL)and/or intraventricular hemorrhage (IVH) (Luu et al., 2009). In terms of specific domains of language, a 2011 meta-analysis indicated relatively even delays across expressive and receptive language skills (Barre, Morgan, Doyle, & Anderson, 2011).

Literature on children with cerebral palsy suggests that their language skills are relatively stronger compared to visuo-spatial skills (Fennell & Dikel, 2001). However, many children with cerebral palsy nonetheless have language impairments secondary to either intellectual or oral motor impairments (Pirila et al., 2007; Sabbadini, Bonanni, Carlesimo,& Caltagirone, 2001). Researchers have suggested that receptive language may be a relative strength compared to expressive language for a subset of children with cerebral palsy, due to the fact that oral motor impairments, especially dysarthria and anarthria, may limit the development of expressive language (Geytenbeek, Heim, Vermeulen, & Oostrom, 2010).

Research on children with ASD also suggests relatively even delays in receptive and expressive language, which are widely understood to be the result of broad deficits in early social cognition that characterize ASD (Yoder, Watson, & Lambert, 2015). However, concerns have also been raised that standardized tests may underestimate the receptive language of children wit hASD due to difficulties in gesture prohibiting pointing. A recent study of language comprehension in children with ASD using eye-tracking indicated that this methodology may be able to detect lexical knowledge that would have been missed in if another response format was required (Venker, Haebig, Edwards, Saffran, & EllisWeismer, 2016).

Conclusions

Language comprehension is crucial to a child’s ability to learn from the environment, cope with emotions, and regulate behavior. Studies of typically developing children provide us with information regarding the progression of language comprehension skills over time and the order in which milestones are most usually achieved. Studies of children with developmental disabilities highlight the complex nature of language comprehension and the challenges of measuring language comprehension in children with unique profiles and complex communication needs.

References

Abbeduto,
L., Murphy, M. M., Cawthon, S. W., Richmond, E. K., Weissman, M. D.,
Karadottir, S., & O’Brien, A. (2003). Receptive language skills of
adolescents and young adults with Down or fragile X syndrome. American
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Barre, N., Morgan, A., Doyle, L. W.,
& Anderson, P. J. (2011). Language Abilities in Children Who Were Very
Preterm and/or Very Low Birth Weight: A Meta-Analysis. The Journal of
Pediatrics, 158(5), 766–774.e1.
https://doi.org/10.1016/j.jpeds.2010.10.032

Fennell, E. B., & Dikel, T. N.
(2001). Cognitive and neuropsychological functioning in children with cerebral
palsy. Journal of Child Neurology, 16(1), 58–63.

Geytenbeek, J. J. M., Heim, M. M. J.,
Vermeulen, R. J., & Oostrom, K. J. (2010). Assessing Comprehension of
Spoken Language in Nonspeaking Children with Cerebral Palsy: Application of a
Newly Developed Computer-Based Instrument. Augmentative and Alternative
Communication, 26(2), 97–107.
https://doi.org/10.3109/07434618.2010.482445

Luu, T. M., Vohr, B. R., Schneider, K.
C., Katz, K. H., Tucker, R., Allan, W. C., & Ment, L. R. (2009).
Trajectories of receptive language development from 3 to 12 years of age for
very preterm children. Pediatrics, 124(1), 333–341.
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Luyster, R. J. S., AnneTalbott, Meagan
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Lyytinen, P., KennethLyytinen, Heikki.
(2005). Language Development and Literacy Skills in Late-talking Toddlers with
and without Familial Risk for Dyslexia. Annals of Dyslexia, 55(2),
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Miller, J. F., & Paul, R. (1995). The
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Næss, K.-A. B., Lyster, S.-A. H., Hulme,
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Pirila, S., van der Meere, J.,
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Rousset, A., Dowell, R., & Leigh, J.
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Sabbadini, M., Bonanni, R., Carlesimo,
G. A., & Caltagirone, C. (2001). Neuropsychological assessment of patients
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Suh, J., Eigsti, I.-M., Canfield, A.,
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Venker, C., Haebig, E., Edwards, J.,
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Comprehension in Young Children with ASD: Comparing Eye-Gaze Methodology and
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Yew, S. G. K., & O’Kearney, R.
(2013). Emotional and behavioural outcomes later in childhood and adolescence
for children with specific language impairments: meta-analyses of controlled
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Yoder, P., Watson, L. R., & Lambert,
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in Initially Nonverbal Preschoolers with Autism Spectrum Disorders. Journal
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Language comprehension

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