Case Study: Speech and Language Intervention for a 12-Year-Old Boy 

Background:
A (annonymous name) a 12-year-old boy, was referred for speech and language therapy due to persistent expressive language deficits, social communication difficulties, and delayed speech development. His profile included impaired verbal organisation, tangential responses during conversation, and limited affective expression. These communication challenges negatively impacted his self-esteem, academic participation, and peer interactions.

Assessment and Therapy Goals:
Initial assessment highlighted impairments in expressive language formulation, pragmatic language use, and emotional literacy. Therapeutic goals were centered around enhancing verbal expression, improving pragmatic competence, fostering emotional awareness, and developing narrative skills to support both academic performance and social integration.

Intervention Strategies:
A multimodal, individualised therapy plan was implemented, incorporating evidence-based and interactive methods to facilitate language development and social communication. Key interventions included:

• Cognitive-Linguistic Stimulation:
  Use of “What’s Wrong?” scenario cards introduced humorous and incongruent situations, promoting verbal problem-solving, inferencing, and structured discussion. This reduced communicative pressure and encouraged spontaneous language use in a relaxed setting.
  
  
• Emotional Competence and Pragmatic Language:
  “What Can I Do?” cards were utilised to scaffold emotional recognition and appropriate response formulation in real-life social scenarios. These activities supported perspective-taking, emotional labelling, and socially appropriate expressive responses.
  
  
• Social Cognition Development:
  The “Thinking It or Saying It” activity targeted the development of Theory of Mind and pragmatic boundaries by helping A differentiate between internal thoughts and context-appropriate verbalisations.
  
  
• Expressive Language Enhancement:
  Techniques such as sentence starters, recasting, and modelling of target language were systematically employed to support syntactic structure, vocabulary expansion, and coherence in spoken discourse. Verbal and visual scaffolds further supported content relevance and output quality.
  
  
• Processing and Planning Support:
  Allowing increased processing time before verbal responses enabled improved linguistic planning and response accuracy, while minimising communicative breakdowns.
  
  
• Interactive and Narrative-Based Tasks:
  Engagement in turn-taking games, role-play, and guided storytelling exercises fostered conversational turn-taking, topic maintenance, narrative sequencing, and expressive fluency.
  
  

Progress and Outcome:
Over the course of intervention, A demonstrated measurable improvements in expressive language abilities, conversational appropriateness, and emotional expression. His confidence in verbal interactions increased, and he began initiating and sustaining conversations with greater relevance and clarity.

Collaborative Support:
Ongoing liaison with school staff and caregivers ensured that therapeutic strategies were generalised across educational and home environments, promoting consistency and long-term gains.

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References 

Norbury, C. F. (2014). Practitioner review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications. Journal of Child Psychology and Psychiatry, 55(3), 204–216. https://doi.org/10.1111/jcpp.12154

Speech Pathology Australia. (n.d.). Practice guidelines for speech pathologists. Retrieved May 12, 2025, from https://www.speechpathologyaustralia.org.au/

The Hanen Centre. (n.d.). Programs for parents and professionals. Retrieved May 12, 2025, from https://www.hanen.org

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