As I reflect on life during a pandemic as a practice owner, I can’t help but equate the experience to steering a tiny tugboat through very stormy and uncharted territory. To say the least, it has turned up a multitude of unexpected obstacles, and the ever-changing landscape made things even more unpredictable. Hopefully, now that we are drawing closer to stiller waters, I have had more time to ponder the lingering effects of this pandemic on communication development in children. Will there be an impact? If so, how so and to what degree?
What we do know?
Infants learn spoken language by intensely studying the faces of people around them to pick up on linguistic cues. Face coverings, although necessary, prevent a child from reading a facial expression to pick up social and emotional cues, learning how to articulate new sounds by watching the movements of a caregiver’s lips, and hearing speech sounds or words clear enough to provide a model that is rich enough to foster verbal expression. For a child already diagnosed with a communication or hearing disorder, the combined loss of visual cues, and the lack of speech clarity caused by face coverings and protective barriers create further difficulty.
Remote learning creates another level of separation between therapeutic providers and their clients or teachers and their students. Feeling the clinician’s fingers to help shapes the articulators or to prompt a vocalization, accepting hand-over-hand cues to manipulate a toy or learn how to write, touching and feeling therapy or instructional materials, etc., are just a few aspects of the learning process that can not occur as a result of the barrier of a computer screen. “Tactile-kinesthetic feedback”, is an important part of a multi-sensory learning experience. Most clinicians or educators would also agree that “hands-on” activities help maintain higher attention levels, especially when working with younger children. Based on research and experiential data, we know that optimal gains occur when clients receive rich and varied inputs from a combination of all the sensory pathways (Gilakjani, Abbas Pourhosein. “Visual, Auditory, Kinesthetic Learning Styles and Their Impacts on English Language Teaching.” Journal of Studies in Education 2.1
(2011): 104-113.) Of courses as a practicing clinician, I would be remiss not to say that telepractice and remote learning can still be quite effective despite some of the highlighted points. The learning or therapy process should be considered on a “case by case” basis, weighing the benefits against the risks, as opposed to applying a “one size fits all” model. It is the responsibility of the clinician and educator to make sure that measurable gains are still achievable using this approach, and when they are not, acting accordingly to make a change.
So will face coverings and computer screens impact communication development?
Bottom line - only time will tell. At this point, more research is needed to quantify the impact based on population. In the case of typically developing infants spending the majority of the time at home with an unmasked caregiver who provides rich linguistic models for their children, we can estimate that there will be no difference; however, for those infants and toddlers who spend the majority of their time in daycare settings where caregivers wore masks the entire day, we will need to pay very close attention and take swift action if we suspect something is not right. The school-age child will need tome to re-acclimate to consistently live instruction or live therapy services. Educators and therapists will likely need to take time to reassess skills and adjust methodologies accordingly.
What can we do in the interim?
Taking a vigilant approach by requesting an evaluation “sooner than later” if there are signs of communication struggle or frustration is one way to get started. For the toddler who is in early intervention or the student receiving services in school, supplementing an existing therapy program with private therapy may also be appropriate if remote treatment appears to have slowed down or inhibited progress. Familiarizing yourself with speech and language developmental age-referenced norms is yet another way to stay ahead of the curve.
American Speech-Language-Hearing Association (ASHA) provides one of the most widely referenced charts outlining speech, language, and hearing expectations by age range. https://www.asha.org/public/speech/development/chart/
Last but not least, reach out to an SLP directly if you are unsure what to do who will guide you in the right direction as to the next steps to take.
Lisa Jiannetto-Surrusco, MA, CCC-SLP, is the owner and director of Reach for the Stars LLC, a pediatric practice that specializes in speech, language, and feeding disorders, located in Cranford, NJ. She provides direct therapy and evaluation services and also provides clinical consultative services within the NYC Metropolitan Area.