What Are Comprehension Difficulties?

Comprehension difficulties refer to challenges understanding spoken language, written language or both.
​Children with comprehension difficulties may hear words clearly but have difficulty understanding the meaning of what is being said.

Comprehension involves many different skills including:
  • Understanding vocabulary
  • Following instructions
  • Understanding questions
  • Listening comprehension
  • Reading comprehension
  • Understanding stories
  • Understanding concepts
  • Problem solving
  • Making predictions
  • Drawing conclusions
Types of Comprehension Difficulties

Listening Comprehension Difficulties
Children may have difficulty understanding spoken language.
Examples include:
  • Difficulty following instructions
  • Needing information repeated frequently
  • Misunderstanding questions
  • Difficulty participating in conversations
  • Challenges learning in classroom environments

​Reading Comprehension Difficulties
Children may be able to read words accurately but struggle to understand what they have read.
​Examples include:
  • Difficulty retelling stories
  • Difficulty answering questions about a text
  • Poor understanding of key concepts
  • Difficulty identifying main ideas
  • Trouble making inferences
​
Signs of Comprehension Difficulties by Age

Preschool Children (3-5 Years)
Possible signs may include:
  • Difficulty following simple instructions
  • Limited understanding of questions
  • Difficulty learning new vocabulary
  • Trouble understanding stories
  • Difficulty participating in group activities
  • Needing frequent repetition

Primary School Children (5-12 Years)
Possible signs may include:
  • Difficulty following classroom instructions
  • Poor reading comprehension
  • Difficulty answering questions
  • Trouble retelling stories
  • Difficulty understanding new concepts
  • Learning difficulties
  • Academic challenges

Teenagers
​Possible signs may include:
  • Difficulty understanding complex information
  • Challenges completing assignments
  • Poor reading comprehension
  • Difficulty summarising information
  • Problems organising ideas
  • Difficulty following multi-step tasks
What Causes Comprehension Difficulties?

Comprehension difficulties may occur for many different reasons.

Developmental Language Disorder (DLD)
Children with DLD may experience challenges understanding and using language despite otherwise typical development.

ADHD
Children with ADHD may appear not to understand information when difficulties are actually related to attention, working memory or executive functioning.

Autism
Some autistic children may experience differences in language development, social communication and understanding complex language.

Learning Difficulties
Children with dyslexia, dysgraphia, dyscalculia or broader learning difficulties may also experience comprehension challenges.

Hearing Difficulties
Hearing differences can affect language development and comprehension.

Intellectual Disability
Children with intellectual disability may require additional support to understand and process information.

Auditory Processing Difficulties
Children may hear sounds normally but have difficulty processing and interpreting spoken language.
Comprehension Difficulties and ADHD

Many children with ADHD experience difficulties with:
  • Listening to instructions
  • Retaining information
  • Working memory
  • Attention during conversations
  • Following multi-step directions

Sometimes a child may appear not to understand information when the primary challenge is attention rather than language comprehension.
​Assessment can help determine the underlying factors affecting learning and communication.
Comprehension Difficulties and Autism

Some autistic children may experience differences in:
  • Understanding abstract language
  • Understanding figurative language
  • Interpreting social communication
  • Following complex conversations
  • Understanding implied meanings
Support strategies are tailored to each child's communication profile and strengths.
Comprehension Difficulties and Reading

Reading comprehension is one of the most common concerns raised by parents and teachers.

A child may:
  • Read fluently
  • Recognise words accurately
  • Read aloud confidently
but still struggle to understand what they have read.

​Reading comprehension relies on:
  • Vocabulary knowledge
  • Language comprehension
  • Memory
  • Attention
  • Reasoning
  • Background knowledge
When reading comprehension difficulties are identified early, targeted support can help children develop stronger literacy skills.
How Speech Pathology Can Help

Speech Pathologists assess and support comprehension difficulties through:

Language Assessments
Identifying strengths and challenges in understanding language.

Reading Comprehension Support
Developing skills for understanding written information.

Vocabulary Development
Building understanding of words and concepts.

Listening Skills
Supporting understanding of spoken information.

Classroom Strategies
Helping children participate more successfully in educational environments.

Parent Coaching
Providing practical strategies that can be used at home.
When Should I Seek Support?

You may wish to seek support if your child:
  • Frequently misunderstands instructions
  • Has difficulty following conversations
  • Struggles to answer questions appropriately
  • Experiences reading comprehension difficulties
  • Falls behind academically
  • Appears to understand less than peers
  • Becomes frustrated during learning activities
Early support can help identify strengths, challenges and appropriate intervention strategies.

Have a question? or need more information

Our friendly team are happy to help call us on 08 9586 3934 or send us a message

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Frequently Asked Questions - Comprehension Difficulties

What are comprehension difficulties?
​Comprehension difficulties refer to challenges understanding spoken language, written language, or both. A child with comprehension difficulties may hear or read information accurately but have trouble understanding the meaning behind the words.
Comprehension skills are important for following instructions, participating in conversations, learning at school, reading books, answering questions, and completing everyday tasks. Difficulties can range from mild challenges understanding complex information through to significant difficulties understanding age-appropriate language.
Children with comprehension difficulties often benefit from assessment to identify the underlying factors contributing to their challenges and to guide appropriate support strategies.

Why would a child struggle with comprehension?
Children may struggle with comprehension for many different reasons. Difficulties can be associated with language disorders, ADHD, Autism, learning difficulties, hearing differences, developmental delays, intellectual disability, cognitive difficulties, or challenges with attention and memory.
Some children understand simple information well but struggle when language becomes more complex. Others may find it difficult to understand abstract concepts, infer meaning, follow multi-step instructions, or remember information long enough to process it effectively.
Assessment can help identify the factors affecting a child's understanding and guide appropriate intervention and support.

What are common comprehension difficulties?
Common comprehension difficulties may include:
  • Difficulty following instructions
  • Frequently misunderstanding questions
  • Trouble understanding stories
  • Poor reading comprehension
  • Difficulty learning new concepts
  • Challenges understanding classroom discussions
  • Problems answering questions about information they have heard or read
  • Difficulty understanding abstract language, humour, or figurative language
Every child presents differently, and difficulties may occur in spoken language, written language, or both.

What are the four types of comprehension?
Comprehension is often discussed in relation to four key areas:
  • Listening comprehension - understanding spoken language
  • Reading comprehension - understanding written language
  • Literal comprehension - understanding information that is directly stated
  • Inferential comprehension - understanding information that is implied rather than directly stated
Strong comprehension skills require children to use vocabulary knowledge, memory, attention, reasoning, and language processing skills together.

What causes poor comprehension?
Poor comprehension can occur for many reasons. Some children experience difficulties because they have trouble understanding language, while others may struggle due to attention difficulties, working memory challenges, processing speed differences, learning difficulties, or developmental conditions.
Vocabulary knowledge also plays an important role. If a child does not understand the words being used, they may struggle to understand the overall meaning of a conversation, story, or classroom lesson.
Identifying the underlying cause is important because different causes often require different support strategies.

How do I know if my child has comprehension problems?
Some signs that may suggest comprehension difficulties include:
  • Frequently asking for instructions to be repeated
  • Appearing confused by questions
  • Difficulty retelling stories
  • Trouble understanding conversations
  • Poor reading comprehension
  • Difficulty following classroom instructions
  • Challenges learning new information
  • Academic difficulties despite apparent effort
If these challenges are affecting your child's learning, participation, or confidence, an assessment may help identify their strengths and support needs.

Can ADHD affect comprehension?
Yes.
ADHD can affect comprehension in several ways. Children with ADHD may have difficulty sustaining attention, holding information in working memory, processing language efficiently, and following multi-step instructions. As a result, they may miss important information during conversations, classroom lessons, or reading activities.
Sometimes a child appears to have comprehension difficulties when the primary challenge is attention. In other cases, both comprehension difficulties and ADHD may be present. Assessment can help determine the factors contributing to a child's difficulties.

Does ADHD cause comprehension difficulties?
ADHD does not directly cause a language disorder, but it can affect the cognitive skills required for successful comprehension.
Children with ADHD may miss information because they become distracted, lose focus, forget details, or struggle to organise information effectively. These challenges can affect both listening comprehension and reading comprehension.
Understanding whether difficulties are primarily related to attention, language processing, or a combination of factors is important when planning supports.

Can Autism affect comprehension?
Yes.
Some autistic children experience differences in language understanding, social communication, inferential reasoning, and understanding abstract concepts. They may find it easier to understand literal language than implied meaning, sarcasm, humour, or figurative language.
Autistic children have highly individual communication profiles, and not every autistic child experiences comprehension difficulties. Assessment can help identify strengths, challenges, and appropriate support strategies.

Is poor comprehension a sign of dyslexia?
Sometimes.
Dyslexia primarily affects reading accuracy, reading fluency, spelling, and decoding skills. However, difficulties with reading can sometimes affect reading comprehension because a child is using significant effort to decode words.
Some children have strong decoding skills but poor comprehension, while others experience both dyslexia and comprehension difficulties. Assessment can help determine the underlying factors affecting literacy development.

Can a child have good reading skills but poor comprehension?
Yes.
Some children can read words accurately and fluently but still have difficulty understanding what they have read. This is sometimes referred to as a specific reading comprehension difficulty.
These children may appear to be strong readers because they can read aloud accurately, but they may struggle to answer questions, summarise information, identify key ideas, or make inferences about the text.

What is reading comprehension?
Reading comprehension is the ability to understand, interpret, and learn from written information.
Strong reading comprehension involves more than simply reading words correctly. Children need to understand vocabulary, remember information, identify key ideas, make connections, draw conclusions, and apply what they have read.
Reading comprehension is an essential skill for academic success across all subject areas.

What is listening comprehension?
Listening comprehension refers to the ability to understand spoken language.
It involves understanding vocabulary, following instructions, remembering information, processing conversations, and interpreting meaning from spoken communication.
Listening comprehension forms the foundation for many classroom activities, social interactions, and everyday communication skills.

Can comprehension difficulties affect behaviour?
Yes.
Children who struggle to understand information may become frustrated, overwhelmed, anxious, or avoid tasks they find difficult. Some children may appear inattentive, oppositional, or disengaged when the underlying challenge is actually understanding what is being asked of them.
Identifying comprehension difficulties can help families, teachers, and therapists develop strategies that reduce frustration and support participation.

Can comprehension difficulties affect friendships?
Yes.
Understanding conversations, social rules, humour, body language, and social expectations requires strong comprehension skills. Children who struggle to understand others may find it more difficult to participate in conversations, build friendships, or navigate social situations.
Support can help children develop communication skills that improve confidence and participation in social settings.

How can Speech Pathology help comprehension difficulties?
Speech Pathologists assess language understanding, identify underlying challenges, and provide targeted intervention to improve comprehension skills.
Support may focus on:
  • Vocabulary development
  • Following instructions
  • Listening skills
  • Reading comprehension
  • Story understanding
  • Inferencing skills
  • Social communication
  • Classroom participation
Intervention is tailored to the child's individual strengths and needs.

What assessment is used for comprehension difficulties?
Assessment may include language assessments, literacy assessments, cognitive assessments, educational assessments, and multidisciplinary evaluations depending on the child's needs.
A Speech Pathologist may assess receptive language, vocabulary, listening comprehension, and communication skills. Other professionals may assess cognitive, educational, or developmental factors that could be contributing to difficulties.

Can comprehension difficulties improve?
Yes.
Many children make meaningful progress when intervention targets their individual strengths and challenges. Improvement often occurs through a combination of therapy, school supports, home practice, environmental modifications, and targeted learning strategies.
Early identification can help children access support sooner and reduce the impact of comprehension difficulties on learning and participation.

What is the difference between comprehension difficulties and expressive language difficulties?
Comprehension difficulties affect a child's ability to understand language.
Expressive language difficulties affect a child's ability to communicate their thoughts, ideas, and needs effectively.
Some children experience only one of these difficulties, while others experience both receptive and expressive language challenges.

Do comprehension difficulties affect school performance?
Yes.
Comprehension skills underpin many aspects of learning, including reading, writing, classroom participation, following instructions, completing tasks, understanding lessons, and demonstrating knowledge.
Children with comprehension difficulties may find school significantly more challenging even when they are motivated and trying their best.

Does Belong Health provide support for comprehension difficulties?
Yes.
Belong Health provides Speech Pathology assessments and therapy for children experiencing comprehension difficulties across Perth, Mandurah, Rockingham, Baldivis, and throughout Western Australia.
Our team can help identify underlying factors affecting comprehension, develop practical strategies, and support children to participate more confidently at home, school, and in the community.
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Related Resources

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Autism Resources
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