Definition and Background Information
Specific language impairment is a neurodevelopmental language disorder associated with difficulties using and learning languages in processing linguistic information. An individual affected with language impairment disorder has grammar, vocabulary, and putting words together (Gray, 2016, p 84). SLI has a 5-7% prevalence, and the language difficulties persist to adulthood. In addition, SLI mainly occurs during early childhood, is specific to language impairment, and has no association with other conditions such as mental retardation, hearing impairment, neurological injury, and psychological trauma (Gray, 2016). This literature review will explore the diagnosis, clinical manifestation of SLI, challenges associated with SLI, and best practices educators can implement to support kids with specific language impairment.
Diagnosis and Clinical Manifestation
Speech-language pathologists use the DSM-5 diagnostic criteria ( Diagnostic and Statistical Manual of Mental Disorders) to diagnose specific language impairment. For instance, Gray (2016, p84) notes that the diagnostic criteria for SLI include persistent difficulties using language in different modalities such as spoken, written, or sign languages. Also, according to NIH, trained professionals directly observes the child, interviews the child and the parents, asses learning capacity, and use standardized language performance test to determine if the child has SLI. Children with SLI have reduced vocabulary, limited sentence structure, reading problems, and difficulties forming and finding the right words (Gray 2016, p 84, NIH, 2019). In addition, they cannot connect sentences to form sentences, explain an event, have problems understanding figurative language, and experience common grammatical and spelling errors. The difficulties in language modalities result from deficits in comprehension and production below the expectations at a particular age. Generally, the DSM-5 clinical specifiers identify clinical manifestations of SLI.
Causes of Specific Learning Impairment.
Although there is no known cause of SLI, recent research links SLI to genetic factors. For one, NIH reports that children with specific language impairment have a high likelihood of having siblings or parents with communication difficulties and delayed speech (2016). 50-70% of children with SLI have at least one sibling with the disorder (NIH, 2016). Moreover, Chen et al.’s (2017) research of whole-exome sequencing of 43 unrelated probands links pathogenic gene variance to diverse language-related syndromes. These pathogenic variant genes include ERC1, GRIN 2A, and SPRX2 (Chen et al., 2017). Molecular research studies on twins with SLI also indicate a strong genetic correlation with SLI. Even though the cause of SLI remains unknown, there is a strong genetic correlation between children suffering from SLI and their genetic factors.
Challenges in the Classroom/Educational Setting
Learning Challenges
Children with language impairment experience more learning challenges than same-age peers. For example, children with speech and language issues have difficulties following oral instructions, especially if they contain multiple words or steps. Also, these children have difficulties learning how to read and spell. NIH (2019) and Helland & Helland (2017) argue that language impairment is a risk factor for children developing learning disabilities. Since children with SLI have difficulties learning the primary language, their classroom performance is significantly affected (NIH, 2019). Furthermore, the elevated risk of social exclusion leads to academic failure. In other words, children with SLI experience significant learning difficulties.
Due to comprehension and production deficits, children with SLI have difficulties translating letters into reading sounds. Their writing skills in class are further weakened by grammatical errors, limited vocabulary, difficulties comprehending thoughts and organizing them into coherent sentences (NIH, 2016). As a result of comprehension issues, children with SLI have difficulties with mathematical word problems, and some of them show signs of dyslexia. Unfortunately, SLI persists to adulthood, and by this time, adults with language impairment have more reading, spelling, and math disabilities.
Challenges Socializing with Peers
Children with SLI maintain low levels of language development and lag behind their peers through childhood and beyond. Children with SLI are socially withdrawn and fearful of social situations because of language difficulties and emotional difficulties. Since peer interactions are mediated by oral communication, SLI communication deficits put these kids at a disadvantage in the social arena. Hence children with SLI tend to depend on older adults or children who can comprehend and match their level of communication (Kiegman, 2020). Even after language-impaired children become fluent talkers, they cannot produce oral narratives as fluent as their peers. Their conversations are characterized by short stories, fewer prepositions, main ideas, and grammatical elements. Older children’s stories have fewer elements of mental state descriptions hence the dependence (Kliegman, 2020). Overall, children with SLI are socially isolated from their peers due to communication incompatibilities.
Challenges with full integration
Children with language impairment are easily overlooked due to their learning and social disabilities. According to Rice (2016), recent studies show that about 25% of language-impaired children received medical services, and 39% of language-impaired children with no diagnosis are referred to therapy. In addition to that, education services records show that children who are dropped from speech therapy at elementary school are later identified to need help at higher classes (Rice, 2016, p 312). Even when help is provided, there is often not enough time to fully integrate the child with SLI into the same communication and performance level as their peers in a classroom setting.
In addition, children are perceived as immature by their peers and adults due to their intellectual limitations. Therefore, children with SLI are disadvantaged socially and academically. Furthermore, since they are characterized by social, behavioral, and emotional problems, it is more challenging to fully integrate them into education settings (Rice, 2016, p312). As a result, it is hard to integrate children with SLI into school systems due to social and academic limitations.
Best Practices for Educators
Collaborations with Parents
Speech and language therapy is the key to addressing specific language impairments. Parents and teachers should collaborate through direct and indirect interventions to support children with SLI. Also, the parents can conduct indirect therapy in the early stages of development and through teachers in later stages (Law et al., 2019). The parent should seek early diagnosis and interventions once the speech-language pathologist has confirmed the SLI diagnosis. After diagnosis, children should join education programs that support children with SLI. Also, early language development can be facilitated at home by a speech-language specialist (SLP) (Law et al., 2019). Later, classroom learning can be facilitated with a speech-language pathologist. Archibald (2017) conquers with law et al. (2019) that SLP-based classroom educator programs will go a long way in promoting specific skills. Although preschool language intervention and classroom interventions will not eliminate SLP, they will significantly reduce many learning difficulties associated with the disorder.
Peer Interventions
Children with SLI have limited social interactions with their peers. The social interaction difficulties are characteristic in activities such as turn-taking during play. However, heterogeneity is noted, and peer interactions are strong in language-impaired children’s ability to make friends, use verbal and non-verbal cues to make joint decisions with peers, and participate in pretend play activities (Law et al.,2019). Therefore, educators should embrace a holistic approach to link these different skills domains to facilitate peer interactions. In other words, Increased peer interaction will reduce peer stigma and help improve social skills.
Effective Teaching Methods for Children with SLI
Classroom-based SLP (Speech-Language Pathologist) interventions are the best for kids with language impairment. SLP employs various delivery models outside the school environment, such as pulling out individuals or groups from the classroom for interventions (Archibald,2017). Through SLP programs, children can also be coached to promote specific skills. In addition, Archibald notes that collaboration with the SLP educator in classroom services will support SLI students with SLP curriculum expertise like phonological awareness (2017). Lastly, teachers should jointly engage SLP experts to deliver lessons in the classroom setting. SLP follows an individualistic approach that promotes specific skills and facilitates attentive learning in language-impaired children.
Conclusion
Specific language disorder is a developmental disorder linked to genetic factors and is characterized by significant discrepancies between cognitive and functional language levels. Clinically, it is manifested through delayed speech and communication difficulties. Also, specific language impairment can persist through adolescence to adulthood. However, even though children with SLI experience many problems in learning and social interactions, a combined educator, peer and parents support involving speech-language pathologists will significantly minimize their social and learning challenges.
References
Archibald, L. M. (2017). SLP-educator classroom collaboration: A review to inform reason-based practice. Autism & Developmental Language Impairments, 2, 2396941516680369.
Chen, X. S., Reader, R. H., Hoischen, A., Veltman, J. A., Simpson, N. H., Francks, C., … & Fisher, S. E. (2017). Next-generation DNA sequencing identifies novel gene variants and pathways involved in specific language impairment. Scientific reports, 7(1), 1-17.
Gray, S. (2016). Psychopathology-A Competency-Based Model for Social Workers (4th Ed.). Brooks Cole.
Helland, W. A., & Helland, T. (2017). Emotional and behavioral needs in children with specific language impairment and children with autism spectrum disorder: The importance of pragmatic language impairment. Research in Developmental Disabilities, 70, 33-39.
Kliegman, R. (2020). Nelson Textbook of Pediatrics-Language Development and Communication Disorders.
Law, J., Levickis, P., Rodríguez-Ortiz, I. R., Matić, A., Lyons, R., Messarra, C., & Stankova, M. (2019). Working with the parents and families of children with developmental language disorders: An international perspective. Journal of communication disorders, 82, 105922.
NIH. (2016). Specific Language Impairment. Nidcd.nih.gov. https://www.nidcd.nih.gov/sites/default/files/Documents/health/voice/Specific-Language-Impairment.pdf
Rice, M. (2016). Children with Specific Language Impairment and Their Families: A Future View of Nature plus Nurture and New Technologies for Comprehensive Language Intervention Strategies [pdf]. https://cldp.ku.edu/sites/cldp.ku.edu/files/docs/Rice_2016_Seminars_in_Speech_and_Language_Children_with_SLI_and_their_Families.pdf.
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