Language Disorders

Specific Language Impairment

When a child has difficulty understanding others (receptive language) or has difficulty expressing herself (expressive language), she may have a language disorder. A child with a language disorder may not use the language commensurate with her peers. A language disorder is considered a Specific Language Impairment (SLI) when it is not accompanied by an intellectual disability, global developmental delay, hearing or other sensory impairment, motor dysfunction, or other medical condition.

A child with a language disorder, including SLI, may be delayed in acquiring the vocabulary, syntax, grammar and pragmatics of her age mates. The child may have some of the characteristics of the language expected for her age, say vocabulary, but may be behind in syntax. Another child may have difficulty understanding the pragmatics of language and not know what to say in a given situation, whereas vocabulary may be limited in yet another. These problems in language development may be correlated with problems in later developing language-related areas such as reading.

Like speech, language develops according to a timetable and in response to cognitive development. Some researchers would even say that language plays a role in shaping cognition. When an object is named, for example, the thinking process about that object is changed to include the attributes of the object that the child has experienced, i.e., shape, structure, taste, smell, color, etc. As the child develops a vocabulary, these words with their underlying meanings are then combined to create utterances according to rules of syntax and grammar. While the child is learning the vocabulary, syntax and grammar of her language, she is also learning the social customs regarding its use. These are internalized as pragmatic rules.

Language disorders are less easily recognized by parents and teachers than are speech disorders. The speech of the individual with a language disorder may not “sound” different. The individual, in fact, may be able to communicate with the listener, but communicative effectiveness may be reduced when the speaker is a poor listener or when the speaker has difficulty saying exactly what he means.  Communication involves bi-directional language skills. Receptive language encompasses all the skills needed for listening, including adequate hearing sensitivity, the ability to process sounds, especially rapid speech, the ability to derive meaning from the words which are carried by the sentence, and the ability to remember what has been heard. Expressive language encompasses all the skills needed for speaking, including formulating the speech sounds, words, syntax, and grammar needed to match the concept which is to be conveyed.

A child with a speech or language disorder is at risk academically, especially in learning to read and write. We know from research in the last two decades that the basic precursor of literacy development in the child is the knowledge of the speech sound structure of words. Children with language disorders, may not be able to perceive spoken language as separate units of speech sounds, produced one after the other. When reading is attempted, they may not “get” that the syllables or words on the page are made up of separate speech sound units which (roughly) correspond to the speech sounds they make.

How do I know if my child has a language disorder or a Specific Language Impairment?

Reviewing developmental milestone checklists is a good place to start. By looking at the developmental milestone checklists that are closest to your child’s age, you can see what most children at that age are typically expected to do. The developmental process for each child is unique so the information provided in checklists is best used as a broad guideline. A speech-language pathologist can conduct an assessment using a series of assessment tools to further establish whether or not your child’s language development is within typical limits. The assessment process can include collecting a spontaneous speech and language sample as well as presenting formal speech and language instruments which measure objectively how the child is developing in relation to other children of the same age. A formal report is prepared, and recommendations are made.

How can language therapy help?

Therapy for children with language disorders ranges broadly, depending on the age and needs of the child. For younger children, language therapy is often play-based emphasizing words and phrases within a play context. For older children, language therapy may be focused on foundational academic skills or other cognitive-language skills. For all children, language therapy can be the gateway to improved expression and a greater sense of being across all of their relationships.

What can I do to help my child?

Parents and caregivers play a critical role in their child’s therapy. We encourage you to participate with your child in therapy to learn foundational skills and receive support from your child’s clinician. As you develop skills to support your child’s language development, you can implement those new-found skills across all of your daily routines with your child, thereby providing the best possible outcome for your child.

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