A therapist helps a kid with language disorder imitate pronounciation in Lianyungang, Jiangsu. Photo: CFP 

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When discussing language degeneration, we often think of the elderly. Due to physiological aging, even healthy older adults may experience varying degrees of language decline, such as difficulty recalling words or clearly expressing thoughts. Moreover, diseases prevalent among the elderly, such as Alzheimer’s, Parkinson’s, cerebrovascular disease, and hypertension, can also impair language function. This manifests as unclear speech, speech disfluency, and incomprehensible statements, even to oneself. Other cooccurring symptoms can include frequent repetition and reading and writing difficulties. Compromised expression or comprehension difficulties among seniors usually indicate language degeneration.  

Furthermore, it is not only the elderly who suffer from language degeneration. Neurodevelopmental regression in small children may also manifest in language impairment. Some toddlers exhibit normal or near-normal language development before age 2, but become less talkative around that age, sometimes even losing the ability to say “mom” or “dad.” Acquired language abilities may significantly regress or be entirely lost. Some children retain partial language function, but lack spontaneous functional speech and communication motivation, and difficulty interacting with others. 

Numerous studies show that such children’s language development and related social and adaptive abilities are significantly impaired, with bad long-term prognoses. Language degeneration among the young and the elderly impacts millions of families and is hence of great concern to people’s well-being. It is essential to provide adequate support to those affected for their wellbeing and that of their families.

Family-oriented

Language is the fundamental means of communication in human life. It can even be said that to a large extent, our everyday life is one that concerns mainly languages. Various activities related to language can be included in the scope of language life. Linguist Li Yuming divides language life into macro-level national language life, meso-level language life in various industries and regions, and micro-level individual family language life. He believes that language life at the micro level is closely related to an individual’s survival and development, as well as the normal functioning of society’s basic cell organization. It should be given attention, guidance, and assistance.

Language degeneration, whether caused by physiological aging or disease, or by neurodevelopmental disorders, can be included in the broad category of language impairments. Some forms of language impairment, such as post-stroke aphasia or language development delays, can be treated to varying degrees through language intervention and therapy. Some patients are even able to recover their language abilities almost entirely. However, for elderly people or young children experiencing language degeneration, it is often challenging to regain language abilities through language therapy and rehabilitation.

In such cases, it is crucial to focus on creating a supportive and understanding environment for individuals with language degeneration. This includes paying attention to their non-verbal communication cues, being patient listeners, and integrating advanced communication technology into their daily lives. In this way, we can help them maintain a sense of dignity and identity in communication, enabling them to continue participating in family and social life as much as possible. While it may be difficult to fully regain lost language abilities, a harmonious language life can significantly enhance the quality of life for these individuals and their families.

The family is the primary setting in which the elderly live and children grow. For those with language degeneration, home is not only their main living area but also the key connection point between them and the community and society as a whole. At present, in the absence of effective medical rehabilitation measures, families provide more support for the language impaired population. Many studies have shown that the vast majority of language impaired people require family care throughout their lives. In family life, due to their limited language ability, the language impaired often have difficulty communicating and cannot fully express their daily needs. If this situation persists for a long time, it can easily lead to loss of temper, emotional instability, disobedience, and non-cooperation with family caregivers. Over time, this can also cause family members to become frustrated, disappointed, and anxious, further increasing the pressure of communication between both parties and bringing negative impacts to daily family life. To ensure a good quality of life for the language impaired, their family language life must be protected.

Construction path

As early as 2006, the National Language Commission proposed the idea of “building a harmonious language life.” This concept covers both macro and meso-level language life issues, such as Mandarin and dialects, standard characters and variant characters, conventional expressions, and internet language. The concept also includes the construction of language life at the micro-level, such as the language support provided by caregivers in their children’s early childhood. The concept targets not only the general population but also special needs groups. Special needs groups, such as the hearing impaired or the visually impaired, face vastly different challenges in their family language life. To build a harmonious family language life for the language impaired people, it is necessary to start from the actual situation and address specific problems.

Firstly, it is necessary to provide them with proper language assistance. For individuals suffering from language degeneration, an inclusive and accepting family environment is crucial. While they continuously learn to communicate with family members and integrate into family life, family members should also take part in their lives by using everyday language for equal communication and avoiding technical or directive language. It is also important to listen to and observe their reactions to spot problems and help them express themselves. Even if people with language degeneration still retain some language abilities, their expressions are often unclear and not fluent. When they express their demands through words, family members should become active listeners, and avoid correcting them constantly. Patience is essential. Family members should wait for them to finish talking before repeating the sentences or keywords from their previous dialogue to help keep the conversation flowing. 

Often, individuals with language degeneration may struggle to express themselves, and this is when family members need to act like “mind-readers” by interpreting their most likely thoughts based on the situation and express them for them. For example, during a meal, family members can try to ask specific questions like “you want to eat that vegetable, right?” This can help reduce their difficulty in expressing themselves. Meanwhile, one can also vary one’s stress or intonation to emphasize core information, such as “vegetable.” This helps them form language memories. In the long run, even if they still cannot express themselves, this method will aid their understanding and help them respond faster in language life situations.

Secondly, it is necessary to understand content and emotional expression in non-verbal communication. As their language abilities stagnate and regress, those with language degeneration may go from speaking complex sentences to uttering only fragments or even simple nouns. In such cases, simply using spoken words is insufficient for expressing their needs. Therefore, when they have communication needs and expectations, their usage of non-verbal communication methods such as eye contact, facial expressions, and body movements like postures and gestures may gradually increase. To understand these non-verbal expressions, one must live together with the person with language degeneration for an extended period and familiarize themselves with each other. Only in this way can we quickly understand what they want to say and do in order to respond actively in a way they can understand. 

Studies have shown that individuals with severe cognitive impairments can still perceive their surroundings, feel emotions conveyed by the environment, and express emotions. Sometimes they may be even more sensitive and intense than the unimpaired. Traditional family care tends to focus on eating, drinking, and sleeping- physiological, and pathological indicators. However, paying attention to the family language life of this group of people requires us to re-emphasize a person’s capabilities and mental life, something often neglected in traditional family care. Therefore, family members should not only be familiar with their physical and mental conditions but also be sensitive to their abnormal emotional expressions and subtle changes. As their language abilities decline, people suffering from language degeneration may use laughter, crying, or interjections like “um,” “ah,” and “oh” to interrupt conversations. Though these expressions have no fixed meaning, they still carry special emotional content based on different scenarios, which needs to be interpreted by family members patiently.

Thirdly, we need to introduce advanced communication technology into family language life. Augmentative and alternative communication (AAC) systems, which have been widely used in clinical rehabilitation and special education, can help certain individuals with communication difficulties, including those with language degeneration. The system can assist by compensating for the users’ communication deficits and improving their language abilities. An AAC system consists of four components: communication symbols (such as text, images, among other visual information), communication aids (such as speech devices), communication technology (such as language technology), and communication strategies. The most commonly used systems are the Picture Exchange Communication System (PECS) and speech-generating devices. The PECS can significantly enhance oral expression and increase proactive social behaviors in individuals of different age groups, as well as improve emotional cognition and expression, and reduce problematic behaviors. 

With the development of information technology on mobile devices, incorporating the PECS into family language life can make family communication more fun, while boosting the family language life experience. Speech-generating devices, on the other hand, can directly enable basic natural language expression and simple communication with family members.

Moreover, research shows that compared to speech recognition technology, end-to-end models for speech conversion can help people with communication difficulties. This type of technology can help those with hearing impairment or oral muscle atrophy by making their speech clearer. This makes it easier for others to understand them and enhances their verbal communication abilities, hence reducing the frustration of communication. It is only a matter of time before such models serve the family language life of individuals with language degeneration.

Linguist Guo Xi believes that language life is an essential part of social life; one could even say that without language life, there is no social life. As a terminal social organization, the family connects individuals with society. For those with language degeneration, a harmonious family language life functions as a bridge between them and society by helping them gain more social cognition. A sound family language life helps them establish a sense of identity in communication and helps their transition from family life to community and social life. Li believes that the level of civilization and health in language life reflects, and even determines, the degree of civilization in social life. Helping those in need and guiding them towards a harmonious language life is an act of social kindness. It remains society’s responsibility to do so as it addresses population aging and low birth rates, while trying to move from merely providing for the elderly and nurturing the young to ensuring the well-being and all-round development of both.

Zhao Hao is from the Center for Foreign Linguistics and Applied Linguistics at Xi’An International Studies University. Guan Fang is from Jiangsu Provincial Center for Disease Control and Prevention. Chi Xia is from Department of Child Health Care,Nanjing?Maternity and Child Health Hospital.

Edited by WENG RONG