Health - Communication and Interaction Difficulties in more detail

Communication Difficulties

1. Receptive Language Issues (Understanding Language)

• Struggles to understand questions, especially “why” or “how” types.
• Needs visual cues or gestures to follow spoken instructions.
• Appears to ignore people speaking, but may actually not process the language.
• Misunderstands jokes, sarcasm, or figurative language (e.g., “pull your socks up”).

2. Expressive Language Issues (Using Language)

• Uses vague words like “thingy” or “stuff” instead of specific vocabulary.
• Talks in short, fragmented sentences or uses incorrect grammar.
• Finds it hard to retell events or stories in sequence.
• May rely heavily on memorised phrases or scripts.

3. Pragmatic Language Difficulties (Social Use of Language)

• Interrupts frequently or doesn’t wait for conversational turns.
• Talks excessively about one topic, regardless of listener interest.
• Doesn’t adjust language for different audiences (e.g., speaks to adults like peers).
• May not greet people or respond to greetings appropriately.

4. Speech Sound Disorders

• Speech is unclear or difficult to understand beyond expected age.
• Substitutes or omits sounds (e.g., “tat” for “cat”).
• Frustration when others don’t understand them, leading to emotional outbursts.

Interaction Difficulties

1. Social Awareness and Reciprocity

• Doesn’t notice when someone is bored, upset, or wants to end a conversation.
• May not respond to social cues like facial expressions or tone of voice.
• Doesn’t initiate play or conversation with peers.
• May seem “in their own world” or overly self-directed.

2. Play and Imagination

• Prefers repetitive play (e.g., lining up toys) over imaginative scenarios.
• Struggles with role play or pretend games.
• May not understand rules of group games or cooperative play.
• Plays alongside others but not with them (parallel play beyond expected age).

3. Emotional Regulation in Social Settings

• Overreacts to minor changes in routine or environment.
• Becomes anxious or withdrawn in group settings.
• May lash out or shut down when overwhelmed by social demands.
• Difficulty expressing emotions verbally, leading to physical behaviours.

4. Friendship and Peer Relationships

• Has few or no close friends despite wanting them.
• May be overly trusting or naïve in social situations.
• Struggles to resolve conflicts or negotiate during disagreements.
• Often misinterprets others’ intentions (e.g., thinks teasing is bullying).

Other Overlooked Indicators

These may not seem directly related to communication or interaction but often co-occur:

• Sensory sensitivities (e.g., covering ears in noisy environments, avoiding touch).
• Rigid routines or rituals (e.g., needing things done in a specific order).
• Unusual prosody (tone, pitch, rhythm of speech may sound robotic or sing-song).
• Hyperlexia (early reading ability but poor comprehension or social use of language).
• Selective mutism (speaks freely at home but not in school or public settings).