RECOMMENDATIONS:
RECEPTIVE LANGUAGE DISORDERS
and/or
CENTRAL AUDITORY PROCESSING DISORDERS

I.  ABILITY RECOMMENDATIONS

1. Compensatory strategies and interventions among children presenting with receptive language disorders tend to focus on enhancing conditions for input including: (a) maintaining low background levels of noise, (b) use of slow and deliberate articulation and (c) requiring eye contact with speakers (ie., “look at me” before speaking).

2. Compensatory strategies and interventions among children with receptive language disorders tend to emphasize enhancing conditions for processing through the use of use of parroting (ie., requiring the child to repeat instructional sets).  Use of parroting across settings tends to insure or maximize input and eventual comprehension.  Processing may also be enhanced by providing opportunities for the individual to use visual skills (reading) to decode instructions.  Writing down instructions (using child words, symbols or pictures) may be beneficial. 

II. SKILL RECOMMENDATIONS

3. Children with receptive language disorders tend to encounter significant difficulties in phonetic processing with resulting negative effects upon reading/spelling skill development.  As a result, interventions that rely upon phonetic reading strategies tend to be of limited benefit.  In contrast, interventions that rely upon more well-developed visual learning strategies tend to be effective.  In particular, it is recommended that reading/spelling be addressed through: (a) the whole word reading method including use of flash cards (memorization) and (b) learning of spelling words by writing the words multiple times (ie., increase visual input). 

4. Children (older and adolescents) with receptive language disorders typically encounter difficulties in decoding lengthy lectures or novel material within the classroom setting.  In response, the child is often required to invest significant effort in order to keep pace with the lecture.  Introduction of demands for simultaneous note writing often divides attention and further undermines decoding of lectures.  In response, children with receptive language disorders tend to show significant benefits to provision of class notes from the teacher (or other student).  Within this context, “homework” may include requiring the child to copy all of the notes over into their own hand-writing.  In addition, studying for quizzes/tests likely will be more effective if the child re-writes notes several times to enhance their visual learning of the material. 

5. Children with receptive language disorders (including central auditory processing disorders) tend to pose significant challenges to parents, grandparents, family and teachers/educators with resulting high levels of frustration.  The primary method of confronting this challenge is via education.  In response, it is strongly recommended that parents assist in educating others regarding their child’s processing disorder.  Resources for this education process include: www.ldonline.org and http://pages.cthome.net/cbristol/capd.html

III. COPING RESOURCE RECOMMENDATIONS

6. Children with receptive language disorders typically have reduced verbally based coping resources and, as a result, often externalize their distress.  It has been found that, while an estimated 1-3% of children may present with a receptive language disorder, this same group is dramatically over-represented among juvenile delinquents (estimated 15%).  To facilitate internalization of coping resources, it is recommended that interventions employ a cognitive-behavioral therapy approach.  Specific cognitive-behavioral therapy components include: (a) increasing self-observer functions by labeling emotions (ie., “it looks like you are feeling…”) to assist the child in articulation of negative emotions, (b) providing cues/assistance in identification of antecedents or triggers for negative emotions (ie., “when did you begin to feel that way?  where were you?, etc.) to assist in identification of trigger zones or antecedents, (c) learning to identify that behaviors are choices (ie., “what did you choose to do with those negative emotions?”) to enhance higher level executive or “coaching” contributions to behavior, (d) assistance in identification of outcomes (ie., “how did that work out for you?”) to facilitate self-observation and utilization of feedback, (e) assistance in recognition of the extent to which outcomes influenced triggers (“did those outcomes change the triggers?”) to avoid vicious cycles in which behaviors have no impact on the triggers and (f) encouraging development of alternative strategies (ie., “what might you do differently next time?”) to enhance expansion of the child’s repertoire or range of coping skills.  Existing research indicates that cognitive-behavioral therapy (CBT) – type interventions are among “what works” among children involved in juvenile probation.  Parental instruction in the use of these techniques is often very important.