SLI may have a long-term impact on a child’s cognitive, educational and emotional development.
SLI and “Late Talkers”
Some children fail to acquire language at the same rate as their peers (some reports put the number of children affected as high as 7%). Many of these children go on to “catch up” in their language skills about the time they enter school. However, in about 4% of cases, the language difficulty persists. These children have a specific language impairment that has no physical cause but requires early intervention to support the child.
SLI: Diagnosis
A number of professionals are involved in the diagnosis, through targeted tests, of SLI. The child’s hearing, non-verbal skills and language ability will all be assessed. If the language difficulty is “primary”, in other words if it isn’t associated with hearing impairment, autistic spectrum disorder (ASD), global developmental delay, emotional problems or environmental deprivation the child will be diagnosed with SLI. If the language delay or difficulty is however “secondary” to another condition i.e., autism, the child is diagnosed with Language Delay. It is believed there may be multiple risk factors for SLI, a genetic link being one of them. Studies have shown that if a child has SLI there is a 25% chance another family member will also be affected. The condition is said to be more common in boys than in girls.
SLI: History
From the late 19th/ early 20th century the term developmental aphasia (or developmental dysphasia) was used to describe the condition. Interest in child language disorders focused in the latter part of the 19th century on aphasia (language loss or impairment after brain injury). The term was dropped because it implied neurological damage. Over the years many other terms have been used to describe SLI: speech language impairment, speech delay, language delay, developmental language disorder.
SLI: Range of Language Difficulties
Children with SLI usually begin talking late. Many will have limited vocabulary and produce only short utterances at 3 and 4 years old.However, children with SLI may have striking differences in what they are and aren’t able to say or understand. Language difficulties range from those who understand almost no spoken language and can say very few words, to those who talk at length but irrelevantly.
Possible Difficulties with Language Function Include:
- Phonology- the child may have difficulty with the sounds of his or her language i.e., he may find it difficult to recognise that two words begin with the same sound, or he may get sounds in the wrong sequence
- Syntax- the child may struggle with words or parts of words and how they are put together to form phrases and sentences i.e., he may struggle to acquire particular morphemes such as the 3rd person singular or he may speak single words clearly but struggle to link them together
- Semantics and Pragmatics- the child may find learning the meaning of words and how words are used in different contexts difficult to acquire i.e., he or she may speak clearly and at length but what they say seems irrelevant
- Prosody and Intonation –the “rhythm” of language may also be affected
This difficulty with various aspects of language (phonology, syntax etc) can affect the child’s receptive (understanding) or expressive (speaking) language skills or both. A problem with one language area is likely to affect other areas leaving the child with some impairment in vocabulary, grammar and discourse skills.
SLI: Other Associated Difficulties
Although children with SLI usually have thinking skills within the normal range, their language difficulty affects their educational progress as they may struggle to access the curriculum fully. It has been estimated that between 50-75% of children with SLI also have difficulty learning to read. Spelling and Maths typically pose additional problems for these children.
SLI: Prognosis
Early language impairment may have a profound effect on a child’s cognitive, social, and educational development. Children may become increasingly anxious, withdrawn, frustrated and possibly aggressive. Studies have shown their difficulty relating to others may result in low self-esteem and peer rejection. They are less likely to initiate conversations and more likely to be found playing alone.
How profound and lasting the effect on their lives is depends on the severity of the language difficulty and the support the child receives. Children whose language difficulty mainly involves articulation/ phonology generally fare better than those whose problems lie more with language processing.
Early intervention is vital. The speech and language therapist will support the child’s language development through an intervention plan. They may recommend the use of Alternative and Augmentative Communication (AAC) to enable the child to express him/ herself. It is important to note that although SLI has a long-term impact, as it isn’t a condition the child will “outgrow”, many people find their own strategies to cope and communicate with those around them.
Further Information
The American Speech-Language-Hearing Association and the UK charity Afasic provide information on language disorders in childhood.
