Stuart Bowyer, 3 1/2 years old, had difficulty learning to talk, wouldn't play with other children or adults and seemed unable to follow directions. Last September, his parents, Tom and Leslie Bowyer, decided to have his communication skills evaluated by the Hearing and Speech Agency of Metropolitan Baltimore, (HASA).
Now, Stuart is enrolled in a HASA program called the Gateway School, which is helping him develop both his language and social skills.
HASA, at 2220 St. Paul St., has been running programs for children and adults with communication disorders since 1927. The term "communication disorder" covers a range of problems relating to hearing, speaking and understanding language, says Holly North, educational director of Gateway as well as another HASA program, the Bridges School.
Some children with communication disorders have trouble hearing, others have muscular or neurological problems which make it physically difficult to form words or sounds, making their speech difficult for others to understand, and still others have trouble connecting words with ideas, making them unable to understand someone else's speech or to express their own thoughts, so that holding a conversation is difficult or impossible.
The difficulties which all these children have with spoken language will lead to later difficulties with written language unless the problems are corrected, Ms. North says.
Since September, Stuart has been using more words, interacting more with other people, and following directions more accurately. Tom and Leslie have found company and comfort in Gateway's bi-weekly parents' support group, where parents share experiences arising from the problems they and their children have in dealing with the everyday world, which tends to be unfamiliar with communication disorders.
"It's been invaluable," Leslie Bowyer said. "It's a very nurturing environment. The teachers and staff became like family members because it's such a unique disability, such a unique need."
Because children with communication disorders have trouble using language to learn about the world, the world is a confusing place for them. They are not clear about their roles or what is expected of them. They may appear intentionally ill-behaved and uncooperative, when in fact they simply do not understand instructions or know which behaviors are appropriate in a given situation, Ms. North said.
While they share many characteristics with children with learning or emotional disabilities or behavioral problems, their needs are distinctly different. They must learn to overcome physical limitations which make speech difficult, and to develop an understanding of how language works which will allow them to function in academic and social settings.
"This agency is somewhat unusual in that we offer a continuum of services for kids with special language needs," Ms. North says.
Gateway provides one-on-one speech therapy, physical therapy, and social services, as well as a state-approved conventional academic curriculum. All services occur on site and as a program tailored to each child's needs.
Most typically, a referral results when parents notice their child's speaking or comprehension skills seem deficient when compared with the skills of other children of a similar age. When a child first enrolls at Gateway, a staff of special education teachers, aides, speech pathologists, social workers, psychologists, audiologists, occupational and physical therapists and registered nurses works with the child's parents to agree on a set of goals for that child.
The staff and parents then work together to achieve a common objective.
In practice, the line between academics and other services is fine. A unit on urban housing in a social studies class is reinforced in speech therapy by treating the issue as a focus of conversation, and a social worker may discuss a child's own family's living situation with that child. Children with language problems learn by doing and seeing, Ms. North says, so opportunities for hands-on experiences are frequent and often involve the use of computers.
The overall context within which goals are set rests on the conviction that early intervention can offer a child with a communication disorder the chance to eventually approach normal social and academic functioning. "We feel really strongly that if children get a lot of intensive services when they're young, they can go into less restrictive environments and function there later on," Ms. North says.