Detecting Specific Language Impairment (SLI) in children

Specific Language Impairment (SLI)

Mabel L Rice analyses the cause of Specific Language Impairment (SLI) and the need to identify it early on in children to provide a solution

Children around the world acquire their native language, or languages, without the need for explicit formal teaching. Yet children vary in how well they manage this task in comparison to their age mates. Children’s language continues to grow during childhood as they acquire sentence structures, grammatical elements to mark case, person, tense, agreement of subject and verb, vocabulary, and a host of other details. Some children are behind at the beginning but catch up to their peers by four or five years of age; other children continue to trail behind their peers into adulthood, leaving them with less robust language abilities for negotiating life’s educational demands, interactions with unfamiliar people, and employment positions. Most of this group of children have a language disorder that delays the mastery of language in children who have no hearing loss or other developmental delays, known as Specific Language Impairment (SLI) (1,2).

SLI is likely to be undetected by parents and teachers, given the lack of an obvious cause of the condition. This means that a primary need is for how to identify children with SLI. Once identified, children should receive help to overcome their limitations in learning a language. Robust language skills for every child are robust assets for the individuals to contribute to their families and their societies to the benefit of others and themselves.

Around the world, solutions to these needs and increased likelihood of a good life for all children depend on a careful scientific study across languages of the children’s pathways into their native languages.  Detection of how one child is different from others of his or her own age requires an understanding of how children master different language skills at different ages. In turn, this knowledge requires a good understanding of the details of each language and similarities across languages. Much of the available research is based on English-speaking children, although there are rapid advances underway in documenting how children acquire many of the world’s major languages.

The ultimate objective is to provide guidance for the development of effective teaching practices to assist children who do not acquire language as easily as their age peers, in order to prepare them for a productive life as an adult. Although this may seem to be obvious, perhaps just a matter of insisting a child talk better or for adults to talk more to a child. Neither of these approaches are likely to be effective. It would be like insisting that a child be taller or have different hair colour. Instead, effective teaching approaches require a consideration of four factors that vary considerably from country to country around the world.

Governmental/societal policies

There is considerable variation across developed countries in the organisation of governmental resources and oversight for services for children with SLI. In the United States (U.S.), the public schools are required to provide speech/language pathology services for children with language impairments, in the context of an individualised education plan (IEP) developed in teams of classroom teachers and other educational specialists. Speech/language pathologists are required to be certified at the level of a master’s degree. States vary widely in the exact definitions of eligibility for services. Some states would exclude children with SLI whereas others would include them and encourage them to be enrolled in services.  Schools are not the exclusive setting for services in the U.S. Private practitioners, usually but not exclusively speech/language pathologists, also enrol children with SLI in treatment, which is usually but not always paid by private health insurance plans. Less likely are services provided through military benefits or in association with a medical practice, such as a paediatrician who specialises in SLI.

In contrast, in many countries services are implemented under a public health system, sometimes in arrangements with schools and sometimes in private practices with a government-sponsored insurance program. Around the world, there are various configurations of these country-wide policies. The availability of speech/language pathologists with specialised training, and the level of training required, also varies greatly.

Teaching settings

The settings in which language teaching can occur also vary widely. Across the world, the most prevalent setting is a home, although home-based professional services are expensive and unlikely. Instead, the school classroom is the likely setting, as part of the teacher’s approach to teaching each child in the age-defined classroom. Obviously, this has limitations related to the size of the classroom and the teacher’s training. In the developed nations there is widespread recognition of the impact of preschool settings designed to enhance children’s language abilities, as a strong platform for later education including the transition to reading. Private practice services are more likely to be with an individual teacher than in a group setting.

Specialised training

Teacher training, as well as paediatric training, involves a wide range of content areas and usually does not include specialised information about linguistic structures and sociolinguistic skills that are essential to the identification of children with SLI or teaching methods. Speech/language pathologists in the U.S. are likely to receive this training although training approaches vary widely. There is a great need for the specialised training that will benefit all children.

Child characteristics

Some children are more at risk than others. During the toddler age range, boys are later to acquire language than are girls, a gap that can persist to five or six years of age. Little is known about how gender differences play out over childhood. A recent well documented but surprising finding is that adolescent girls score lower than boys on vocabulary understanding, with the lowest performance by adolescent girls with SLI (3). Some risk factors have been widely assumed, such as low levels of maternal education or low levels of a child’s nonverbal intelligence, although the evidence for these generalisations is not straightforward, suggesting that the generalisations do not always hold. (1,2)

How to teach

Teaching should be culturally sensitive and effective for enhancing each child’s language development across multiple dimensions of language, including grammar, vocabulary, and social uses of language. Note that the big challenge is how to teach language to a child with SLI in a way that causes them to learn language faster than their age peers in order to catch up. The catch-up period may extend over the years, requiring sustained treatments, and the age of first intervention will matter.

These are formidable challenges and no one method has been shown to reliably meet them. It is most likely that a well-formulated combination of approaches will be needed, across different forms of service delivery. The new world of electronic teaching methods shows promise for how to teach in new settings, using innovative methods, at times when children are available and interested. It is essential to continue research across many languages in order to arrive at the knowledge needed to teach children with SLI what most children acquire without explicit teaching.

Please note: this is a commercial profile

References

1 Rice, M. Specific Language Impairment in Children.  https://www.openaccessgovernment.org/specific-language-impairment-in-children/40152/ 2017.

2 Rice, M. Specific Language Impairment in Children. Part II. https://www.openaccessgovernment.org/specific-language-impairment-in-children/2018.

3 Rice ML, Hoffman L. Predicting vocabulary growth in children with and without Specific Language Impairment (SLI): A longitudinal study from 2 1/2 to 21 years of age Journal of Speech, Language & Hearing Research. 2015;58:345-359.

Mabel L Rice

Fred & Virginia Merrill Distinguished Professor of Advanced Studies

University of Kansas

Tel: +1 785 864 4570

mabel@ku.edu

US Election 2020

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