Does My Child Have
Comprehension Difficulties?

If your child struggles to understand instructions or conversations, especially when they’re given without clear context, you might wonder how much they understand. Many children with developmental delays, such as Autism Spectrum Disorder (ASD) or Developmental Language Disorder (DLD), find it easier to understand when instructions are paired with familiar settings, gestures, or visual cues. Try this simple activity to see their comprehension in action.

Activity: Exploring Contextualised vs. Decontextualised Language

To see how context helps your child understand language, try this activity during a familiar playtime with a baby doll:

Materials: Baby doll, toy bottle, toy bed

Contextualised Instruction: While playing with a baby doll (e.g., feeding or cuddling it), say, “Feed the baby the bottle,” with the toy bottle visible. Note their response. Do they pick up the bottle and pretend to feed the doll?

Decontextualised Instruction: During the same playtime, say playfully, “Feed the baby the bed,” without pointing or gesturing. Observe their reaction. Do they seem confused, repeat the words, not respond, or follow the familiar routine of feeding the baby the bottle?

Compare and Check: When you say, “Feed the baby the bottle,” see if your child picks up the toy bottle and feeds the doll, showing they understand the familiar task. When you say, “Feed the baby the bed,” note if they hesitate, repeat the phrase, look puzzled, or feed the baby the bottle instead. Hesitation or puzzlement suggests they recognise the instruction as unusual but may struggle to understand it. Feeding the bottle indicates reliance on the familiar routine, showing the decontextualised instruction wasn’t fully processed.

Why It Happens: The instruction “Feed the baby the bed” requires the child to:
- Understand the pretence framework (i.e., it’s not a real action).
- Process the word order and meanings of “feed,” “baby,” and “bed.”
- Override the familiar routine of feeding a baby a bottle to perform an absurd action.

Typically developing 4- to 5-year-olds can usually perform this by pretending to “feed” the bed to the doll (e.g., holding the bed near the doll’s mouth), showing they grasp the symbolic and playful nature of the request. Children with ASD or DLD, however, may struggle with this even at older ages due to deficits in symbolic play, Theory of Mind (ToM), and working memory (Westby, 2022; Boucher, 2012).

This activity shows why familiar routines and cues are key for your child’s comprehension and how unusual instructions reveal ongoing challenges.