Language Delays in Children with Fetal Alcohol Syndrome

In 2002, about 10 percent of pregnant women in the United States reported using alcohol in the past 30 days; about 2 percent reported binge drinking or consuming alcohol frequently, according to the Centers for Disease Control and Prevention. Drinking alcohol during a pregnancy has serious consequences for the fetus — the alcohol passes through the placenta, causing damage to the fetus. Fetal alcohol spectrum disorders include a group of disorders that can occur from alcohol consumption during pregnancy, with fetal alcohol syndrome being the most severe. The in utero alcohol exposure can result in neurological damage, causing several different cognitive and behavioral problems. Language development problems associated with fetal alcohol syndrome are not uncommon; Michael W. Church and James A. Kaltenbach, authors of the article, “Hearing, Speech, Language and Vestibular Disorders in the Fetal Alcohol Syndrome: A Literature Review” note that children with fetal alcohol syndrome can have problems with language acquisition, expressive language and receptive language.

Children with this condition may display a variety of problems with language. If the child displays problems with expressive language, she has problems getting her message out to other people. She may have trouble with semantics or syntax. For example, if the child has problems with semantics, she may not be able to recall a word that she knows. British Columbia’s Ministry of Education gives the example of calling toast “warm bread.” If the child has issues with syntax, then she has difficulties creating grammatically correct sentences; for example, she may use the wrong verb form in a sentence. Children with fetal alcohol syndrome may have “cocktail party” conversation. While they may have fluent speech, they do not have content to what they are saying. For example, they may have issues with appropriate responses in a conversation or starting a conversation.

If the child has issues with receptive language, then she has difficulties understanding. Issues with receptive language development due to fetal alcohol syndrome can affect the child’s memory, sequencing, discrimination, comprehension, selective attention, and association and generalization. For example, a child with problems with receptive language may not be able to remember what the teacher said. The National Institute on Alcohol Abuse and Alcoholism notes that children with fetal alcohol syndrome have issues with encoding in verbal memory — the processing of information to then recall later — which can result with a receptive language development delay.

Children with this syndrome may also display problems in speech production. Church and Kaltenbach state that in a study with 22 children who had fetal alcohol syndrome, 21 children had significant issues with voice quality, word formation, fluency and articulation. British Columbia’s Ministry of Education notes that articulation problems caused by fetal alcohol syndrome may be identified before the child begins school, though speech and language problems that are more subtle may not be noticed until the child is already in school.

With fetal alcohol syndrome, language development difficulties can impact a child’s performance in the classroom and her interaction with her peers. For example, the child may have problems drawing conclusions or following verbal instructions. When participating in classroom discussions, the child may go off-topic. British Columbia’s Ministry of Education states that a child with fetal alcohol syndrome may have trouble “distinguishing between talking and effectively communicating,” which can affect interaction with peers.

Special education teachers can use different classroom interventions to help students who have language difficulties due to fetal alcohol syndrome. Teachers can use a language development checklist, such as one from British Columbia’s Ministry of Education, to document what areas of language the child has problems with. With younger students who have receptive language delays, combining visual representation, such as pictures or puppets, can help them follow a story the teacher is reading to the class. If the child is reading, provide her with a tape recorded version to listen to at the same time.

If vocabulary is a problem, teachers can have the student use a picture dictionary. Students may benefit from making sight word cards for vocabulary being taught in class. If the student is having problems with abstract concepts, British Columbia’s Ministry of Education suggests using art projects to make those concepts more concrete for the child.

Concrete communication is important when communicating. Teachers may use visual cues along with verbal instruction to help the student follow along. Verbal cues, such as songs, may also help the student. Some students may benefit from using assistive technology, such as word processing and electronic spell checkers. If the child is in speech therapy, teachers can see what techniques are helping her language development and progress and try implementing them in the classroom.