Case Study

Albert: A Second Grade Boy with an Expressive Language Disorder

Albert was referred to me by a friend of his family. When I met him he was seven years old, in second grade, and getting some speech therapy at his public school. Albert was a late talker; his mother said he was not really putting words together until he was age three. When he did begin talking, his sentences were immature-sounding and even in kindergarten and first and second grade he was making below-age-level grammar mistakes (referring to females and males both with the pronoun “he;” dropping the “is” verb occasionally; and mis-producing past tenses of verbs, especially the irregular verbs like “go-went.” He was also having difficulty with syntax (word order), especially question syntax so that when he asked me “how that get in there,” he meant” how did that get in there” Albert also had difficulty with precisely expressing his thoughts in specific words and phrases. This seemed to reflect problems with word retrieval, choosing just exactly the word needed to express his intent, and it also included difficultly organizing his thoughts into sentences that exactly expressed his intent. For example, one day he was describing a birthday party he had attended and he spoke of the birthday boy’s mother putting “firesticks” on the “birthday food thing.” When he came to a word or phrase that was hard to retrieve, he substituted a vague word or series of words that negatively affected listener understanding. Albert was also experiencing difficulty in school with reading comprehension and expression as well as writing, and spelling.

Our work in speech therapy included identifying the specific grammar targets and practicing their appropriate use first in drills and then in conversation, and also teaching strategies to help with word retrieval. We worked especially hard on understanding the meanings of the words “vague” and “specific” by practicing identifying utterances as either “vague” or “specific” and then using specific utterances to describe pictures and real-life occurrences. I stayed in close contact with Albert’s school speech-language pathologist while I worked with this young man.

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