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What is comprehension?

The word ‘comprehension’ can mean different things in different situations. On this site ‘comprehension’ means:

  • The ability to understand words and language.
  • The ability to understand things that happen in the world around us (things we sense and experience).

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Language processing in the brain

Words are a series of sounds or symbols that the brain needs to make sense of. Learning what sounds mean is thought to start before we are born. Children learn much of the language they will use during their lives in the first five years of life, although it doesn’t stop there.

Any difficulties with the sense of hearing will change how a child learns language. Also, there are two areas in the brain that are very involved in language processing. Damage to these areas or how they are connected to other areas in the brain may have an impact on understanding and using language.

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Learning language

Any general learning problems may affect how well and how quickly a child learns to understand and use language. See the Learning page for more details. Learning language involves creating links between sounds and what they relate to: the ideas or concepts that the sounds represent. This happens for individual words (eg car or dog) and collections of words or sentences. (eg The car was driving fast. The cat jumped onto the fence.)

Learning how to read and write words and sentences usually starts around the time children start primary school (although there will naturally be differences between individuals). Learning to connect the symbols to sounds builds on what a child has already learned about how sounds and concepts or ideas are linked.

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How language comprehension can be affected by hydrocephalus.

A child or young person with hydrocephalus may have sensory difficulties with hearing and sight for example. Or they may have learning difficulties. These issues can have an impact on learning and using language. You can read about problems with 'sensation and perception' and ‘learning’ separately.

There are many different brain processes involved in comprehending language. Some of the key processes that might affect someone’s understanding of spoken or written language are:

  • How quickly the brain processes information e.g. the sounds that are heard or symbols that are seen.
  • The ability to keep an idea in mind while someone is speaking.
  • The ability to stay focused while a sentence/conversation progresses.

A child or young person with hydrocephalus may have problems with any of the above. These issues will make it difficult to keep track. If someone can’t keep up; remember what has just been said; or stay focused, they may not be able to understand the sentence or conversation. Difficulties understanding language can make it difficult to work out what to do in a situation. This can be particularly difficult when things are happening quickly or there are lots of things going on at once.

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Comprehension of behaviour and situations

Like language comprehension, understanding situations and other people’s behaviour means that we need to be able to generate an idea of what the situation or behaviour represents.

This means we need to use what we already know about:

  • The situation or situations like it.
  • The person or the behaviour they are displaying (eg what it means when someone shouts, or that a certain type of facial expression might show impatience).

A lot of the brain’s processes need to work together to help understanding happen. Problems with any of the processes could make it difficult for a child or young person to understand a situation or someone’s behaviour.

They might also have difficulties if the ‘executive functions’ that co-ordinate the brain’s processes have been affected by hydrocephalus. You will find links in the section below if you want to read more about the processes involved.

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Key processes involved in comprehending/understanding

Key processes involved in comprehending speech, written language or situations and the behaviour of others include:

  • Attention: the ability to focus and stay focused over time.
  • Working memory: the ability to keep things in mind while more information about the situation is gathered.
  • Memory: the ability to find and use known information that is relevant to the situation.
  • Problem solving: the ability to think and make decisions about what is happening and how to act based on what is known.
  • Executive functioning: the ability to involve the right processes at the right time so that we can think and act appropriately and in good time.
  • Processing speed: the speed at which signals move around the brain to involve the areas and functions that are needed.

Diagram of key processes involved in comprehending

key processes involved in comprehending

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Possible problems

Problems with comprehension may contribute to difficulties with:

  • Listening.
  • Responding to requests or instructions.
  • Working out what to do and when.
  • Classroom or playground activities when there might be a lot going on and things can change quickly.
  • Social situations generally, particularly when there is a lot happening.
  • Inappropriate behaviour such as: talking too much; irrelevant speech; appearance of being ‘bossy’, ‘pushy’, unco-operative; over familiarity. See self-expression for more detailed discussion.

People are unique anyway but every individual will be slightly different in the way their thoughts and actions are affected by hydrocephalus (and associated conditions). While this site aims to give something to suit everyone, it is important to think about each individual’s pattern of strengths and difficulties. Patience, determination and trial and error are likely to be needed to find solutions that suit your child’s unique needs. Dip into the Living with Hydrocephalus section to find hints and tips on how to deal with different issues and difficulties.

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