Difficulty Matching Words to Meaning

Difficulties matching words to meaning could be the result of a receptive or expressive language disorder or delay. Kids with this symptom are probably struggling with semantics, which means understanding the meanings of words. Similarly, a child's lexicon refers to the words that a child already knows and is able to say.

Learning word meaning is how kids get more words into their lexicon. It's not as simple as just learning definitions of words! Kids have to learn different layers of meaning to truly understand them. Kids who have some trouble in this area may have trouble following conversations, answering questions, following instructions, or making sense of figurative language. These may be linked to the difficulty in the following areas:

• Categorizing: Is the child having trouble grouping this word into a known category?

Apples are fruits, which are food.

• Determining function: Can they describe what this person, place, or thing does?

What runs, pants, and barks? - Dogs

• Associating: Can they point out what other words typically go along with it?

Napkins often go with forks, spoons, plates, etc.

• Describing: Can they use other words to say what it looks, feels, sounds, or tastes like?

Pretzels - salty, crunchy, small

There are several assessments that SLPs and other professionals can use to determine if a child is struggling to match words to their meaning:

• Comprehensive Assessment of Spoken Language, Second Edition (CASL-2): measures language expression and comprehension with 14 subtests across 4 domains: Semantics, Syntax, Supralinguistics, and Pragmatics. The CASL-2 can be used to assess individuals between the ages of 3 and 21. It is flexible enough that it can be used in both clinical and non-clinical and non-clinical settings. Also, it is a norm-referenced test that is pretty easy to score.

One disadvantage of this test is that it is pretty long (about 45 minutes) for children between 0 and 5. However, the CASL-2 subtests can be administered in isolation. The SLP could select only the subtests relevant to semantic ability to save time.

• Clinical Evaluation of Language Fundamentals, 5th Edition (CELF-5): broad assessment of overall language including semantics, morphology, syntax, and pragmatics. Like the CASL-2, this assessment is flexible and individual subtests like Semantic Relationships can be used in isolation to assess specific skills relevant to word meaning. Also, this is another norm-referenced assessment that is fairly easy to score like the CASL-2.

Unfortunately, the CELF-5 is geared for 5-21-year-olds, so it will not be able to be used for toddlers. Also, the CASL-2 has more relevant subtests than the CELF-5 for this area of communication.

Considering the several difficulties and assessment types associated with this symptom, there are also several language intervention approaches for children struggling to connect words with their meanings. Two different routes of treatment include:

• Phonological Therapy: Phonological therapy focuses on identifying syllables and letters, and matching pictures or objects that rhyme or begin with those particular syllables and letters. This form of therapy is a great way to make sure kids are understanding the sounds and letters that go along with meanings as well.

One downside to this treatment approach is that it tends to improve only the words targeted in therapy and does not usually generalize to words outside of therapy.

• Semantic Therapy: Semantic therapy tends to focus on developing knowledge of different categories, attributes, definitions, and associations between words. Research shows that this kind of therapy leads to faster and more accurate naming of target items post-therapy.

Unfortunately, despite the speed at which kids can acquire semantic skills with this form of therapy, their word-finding difficulties still persist in regular conversation outside of naming and labeling.

There are several ways outside of therapy that teachers and parents can make environments more accessible to kids who have difficulty matching words to meaning. In a classroom, it may be useful to have labels of objects' functions and categories next to them.

• In the kitchen, a parent could put a label that says "fruit" next to where they keep the fruit with pictures of different types of it. This will help their child create associations between objects and their meaning. The same could be done with kitchen utensils as well.

• In the classroom, teachers do something similar. For example, it is a good idea to have labels on the containers where school supplies are kept. Another idea may be to include a picture with the label that describes the function. For example, on the drawer where pencils are kept, the teacher could put a label that says "pencils" in addition to a picture of a person using a pencil to write. Although this approach is not active instruction on how to create meaning, it can reinforce connection between word and function whenever a student goes to that drawer.