Specific language impairment

Specific language impairment (SLI) refers to difficulties that are particular to language only. Difficulties can occur with either comprehension or verbal expression or both.

Children who have specific language impairment may differ in severity and symptoms as Specific language impairment is a broad term used to describe lots of difficulties that can occur with language.

Our speech and language therapists can improve the language skills of children with specific language impairment by increasing language development using intervention techniques and exercises that are distinct to their area of difficulties.

Specific language impairment is a term used to describe difficulties with language. These difficulties are the child’s main and possibly only area of difficulty. The child’s difficulties with language are not the result of a language delay, or general difficulties / delay across development, they are not associated with difficulties with learning or any disorders or conditions that may impact language such as autism or cerebral palsy.

A child who has specific language impairment has the same IQ as their peers on non-verbal activities and appears healthy and well. Children who have specific language impairment should have normal hearing and vision. For this reason SLI is referred to as a hidden disability.

Specific language impairment is often unnoticed in children as many children develop coping skills such as watching and copying other children when instructions are given. Specific language impairment isn’t always noticed in children until the language demands on the child are increased.

The cause for SLI is currently unknown, however researchers believe there are certain factors that may add to the causation of specific language impairment.

Factors include:

• Differences in the way the develops and functions.
• Genetics.
• General difficulties with processing specific to language.
• Specific difficulties with processing within language.

It is estimated that approximately 7% of school aged children in the United Kingdom have a SLI.

Research suggests more boys than girls are impacted by specific language impairment. Furthermore children who have a family history of speech and language difficulties are more likely to have a SLI.

Specific language impairment is a broad term used to describe many difficulties with language across early childhood through to adult life. Therefore symptoms and severity of symptoms may vary between children. Although some children who are diagnosed at an early age can overcome their difficulties, others may find their difficulties increase through school as more demand is put on them to understand and express themselves using longer and complex language.

Difficulties with comprehension may include:

• Difficulty understanding spoken or written language.
• Difficulty understanding basic concepts e.g. colour, size, prepositions.
• Difficulty remembering instructions.
• Having a literal understanding of language.
• Inappropriate response to questions due to lack of understanding.
• Difficulty understanding morphology e.g. tense and plurals.
• Difficulty understanding sentences / utterances of varying grammatical structures.
• Difficulty following a processing instructions or increased amounts of information.
• May need longer processing time to understand what is being said.
• Difficulty understanding questions.
• Difficulty following narratives.
• Difficulty following conversational language.
• Difficulties understanding utterances that range in communicative function e.g. requests, responses, protests, commenting.
• Last to do what is asked by teachers, parents or other adults.

Difficulties with verbal expression may include:

• Difficulty using vocabulary- in one or more word categories e.g. nouns, verbs and adjectives.
• Difficulty naming things or finding the words to express themselves.
• Use of short and simple sentences or incomplete sentences.
• Dysfluent speech.
• Difficulty with word order.
• Difficulty organising information that they want to express.
• Verbal expression that sounds like rambling.
• Difficulty using morphology such as tenses and plurals.
• Difficulty retelling stories.
• Difficulty explain a situation using the correct amount of information.
• Difficulty answering questions.
• May need longer to express their thoughts.
• May use only a few communicative functions e.g. request and protest.

SLI can impact both comprehension and verbal expression therefore daily activities can become a struggle at both home and school. Many children can become reliant on a routine as they are aware of what is expected, changes in routine can show what difficulties a child is experiencing.

Specific language impairment can impact a child’s daily functioning in many ways including:

• May appear in a world of their own as the child may struggle to understand the world around them.
• May demonstrate poor listening and concentration skills.
• May interrupt and struggle with turn taking.
• May appear disorganised.
• Poor eye contact.
• Difficulty forming and maintaining relationships and friendships.
• Lack in confidence and self-esteem.
• May be shy or socially withdrawn therefore have poor interaction with others.
• May appear to be impulsive or aggressive and have behavioural problems.
• Higher risk of being bullied at school.
• Difficulty maintaining, initiating or joining a conversation.
• Difficulty accessing the national curriculum therefore poor academic attainment.
• Difficulty with reading and spelling.

Difficulties with language can impact a child’s wellbeing and quality of life. It can leave them feeling isolated and frustrated. Early intervention from our speech and language therapists can help to increase your child’s language skills. As well as reduce possible difficulties your child is experiencing or may experience. Our speech and language therapists can provide a therapy programme that is setup to target the specific difficulties your child is facing.

Our speech and language therapists can provide your child with a detailed assessment that outlines their specific difficulties within language. The assessment will show how your child’s difficulties with language may impact upon their daily activities. The assessments used by our speech and language therapists may vary according to your child’s needs and abilities.

Assessments provided by our speech and language therapists include:

• Receptive language assessment.
• Expressive language assessment.
• Social communication assessment.

Our speech and language therapists can provide your child with an individualised therapy programme that is specific to the difficulties your child is presenting with. Our speech and language therapy programmes aim to increase your child’s language skills by prioritising their goals and implementing their motivators within the therapy programme. Our speech and language therapy programmes work to the priorities of you, your child and their school.

A child who has SLI may struggle with understanding complex sentences and using the correct word order in verbal expression. Our speech and language therapists can provide therapy programme that works on gradually increasing the child’s understanding of sentences of different lengths and complexities. As well as working on their expressive word order skills.

Some therapy options provided by our speech and language therapists include:

• Receptive language therapy.
• Expressive language therapy.
• Social communication therapy.
• Group therapy.
• Individual therapy.
• Training, advice and support for parents, carers and professionals involved with your child.

There has recently been a new term for SLI introduced, specific language impairment will now be referred to as developmental language disorder (DLD). It has been identified that SLI excludes children with similar difficulties or those that will benefit from the same intervention as those diagnosed with SLI. It has been considered unfair that children are excluded from intervention due to environmental factors such as home language or family history or pre-existing learning and attention difficulties. Developmental language disorder now does not require a mismatch between non-verbal communication and verbal communication as it is considered unreasonable that these two factors are considered separately when they essentially develop together.

Those already diagnosed with SLI will continue to be assessed and treated as though they have developmental language disorder, but they may find it helpful to continue to identify with SLI. Those that have been excluded from SLI previously may see DLD as an appropriate diagnosis from them and may benefit from intervention, if you feel this is something you would benefit from, do not hesitate to contact SLT for Kids.