Specific Language Impairment: A Common Learning Impediment With an Uncommon Physiological Origin

Introduction

Whenever teachers take charge of children whose acquisition of speech and reading ability is painfully slow, the tendency is to look for physiological problems that affect intellectual, emotional, neurological, and sensory development. These problems include dyslexia, aphasia, autism, and Down syndrome, among other disorders and syndromes. In recent years, however, the attention of psychologists and counselors in the preschool system has been drawn into a language learning deficiency that exhibits no defects associated with the usual conditions influencing speech and learning retardation. The newly discovered problem is now termed Specific Language Impairment (SLI), which continues to baffle experts as to proper treatment because affected children seem to be healthy and intelligent in all aspects except for their particular difficulty in language learning. This paper investigates SLI as to causes, symptoms, and the possible consequences if school children with perceived SLI were treated like normal pupils and not placed apart for special instruction.

Rationale of the Study

There is a need to undertake a comprehensive study of any condition that retards speech and language learning for the purpose of spreading the benefits of education among all school entrants. This is in line with the No-Child-Left-Behind Act of 2001 in the US, which seeks to ensure that no school children lag behind in academic achievement because of physical, cultural, or intellectual handicaps. The primary concerns of the NCLB law are school children with physical and emotional disabilities and those with ethnic roots, who often take time in acquiring the much-needed language skills. For this reason, an early childhood education program is considered important in the school system, of which the key feature is the early identification of slow learners for the appropriate intervention and treatment. Specific Language Impairment has been shown to delay the speech and reading process for children and thus deserves a closer academic examination if only to determine the methods by which to mitigate the condition. Such a study may be misled by the fact that children with SLI function as normally as other children in non-linguistic areas like social interaction, play, and self-help skills.

Research Question

• What are the causes, symptoms, and consequences of Specific Language Impairment?

Sub-questions

• How does SLI prevent the normal development of speech and language abilities in children?
• Is SLI an acquired or inherited condition?
• Do children with SLI need a special method of instruction and reading curriculum?

Definition

When SLI was detected among preschoolers in the early 2000s, it was initially labeled as “childhood dysphasia” because its symptoms correspond to this disorder in language acquisition. However, this term was abandoned over time as subsequent studies revealed that SLI cannot be attributed to any brain injury, which is the common cause of dysphasia (Leonard, 2000). Since SLI is not attributed to brain injury, hearing loss, and other developmental disorders, it came to be defined as a “pure” language disorder, in which the problem is confined to language without any disease or disorder involved (Cohen, 2002). The specific problem is a child’s slower ability to receive and express language.

According to Leonard (2000), children with SLI show a significant limitation in language ability, but the factors usually accompanying language learning problems are not evident, such as hearing impairment, low non-verbal intelligence test scores, and neurological damage. Thus, SLI began to be defined as a manifestation of a specific deficit in grammatical aspects of language, which include phonology, syntax, and morphology (Rice, 2000). The same definition identifies the main SLI-related problem as poor phonological awareness, or the difficulty in combining and selecting speech sounds of language into meaningful units (Conti-Ramsden, 2004; Cohen, 2002). This problem is characterized by the difficulty in finding words, learning new words, and a very limited vocabulary (Bishop, 1997). Distinctions should be made between speech impediments and language disorders. A child with a speech impediment might mispronounce words or stutter but has no problem with a language disorder. Recent research sets SLI as a speech disorder problem and not a language disorder. This means that children with SLI have difficulty understanding and using words in sentences, with receptive and expressive skills typically affected (Leonard, 2000). Nonetheless, they are believed to have a good grasp of the language.

Once a preschool child is found with SLI, the risk of faring poorly in school stays and even increases as he/she reaches school age. For this reason, there is the possibility that the language learning deficiency among children with SLI may become indistinguishable from such reading disorders like autism and Down syndrome (Bishop, 1997). On the prevalence rate, the estimate for all 5-year-olds is 7 percent, and it is more common among boys than girls. The percentage for 2-year-olds is higher at 10 percent but it is interesting to note that the figure dwindles as the children under study reach age 3 or 4, which indicates that some of the difficulties associated with SLI actually resolve by themselves over time (Byrne, et al., 2005).

Causes

Further studies of SLI have established that it is not caused by any form of brain abnormality, or if there is one, it cannot be detected by existing diagnostic technologies (McCauley, 2001). For example, children with SLI showed no brain lesions or anatomical differences in the brain hemisphere, which are common among dyslexics. According to Bishop (1997), there is no strong evidence for neurological damage in the left hemisphere of the brain, such that the etiological factors are unclear. Even the possible genetic link, which was suggested by a 2004 study (Lyytinen, et al., 2005), is suspect because it is difficult to determine the exact genetic cause because of the different manifestations of SLI. Bishop (1997) also found no evidence of chromosome abnormality or the presence of a single major gene.

In a study of a family with 30 members from three generations, Gopnik & Goad (1997) found 16 family members with various types of language disorders whose problem arose from a genetic deficiency. However, a subsequent study with other members of this family showed that the problem was not limited to morphology since six members had low non-verbal intelligence although normal in oral skills. The conclusion was that genes do not cause SLI behavior and are the result of multiple, interacting causes. There are suspicions that SLI may be genetic in origin. Studies show that 50 to 70 percent of children with SLI have at least one other family member with the disorder and that when one of the twins has SLI the other also has it. In 2001, British researchers successfully found the chromosome that affected 15 of 37 members of a London family with a severe speech and language impairment (McCauley, 2001).

Symptoms

SLI is characterized by delayed development of vocabulary, grammar, and discourse skills, and is especially pronounced in the improper use of the verb “be,” the third person singular pronoun, and when to use words in the past tense (Fletcher & Ingham, 1995). Other than this difficulty, children with SLI may be intelligent and healthy in all other areas. In fact, they may be extraordinarily bright with high nonverbal IQs (Ervin, 2009). Leonard (2000) identifies the specific characteristics of SLI as follow:

• The slow rate of language development.
• Difficulties in every area of languages, such as morphology, syntax, phonology, lexicon, and pragmatics.
• Problems on language output or production as well as input or reception.
• Difficulty in understanding or expressing language.

Bishop (1997) and Donaldson (1995) blame all these on such psychological terms as verbal auditory agnosia, verbal dyspraxia, phonologic programming deficit syndrome, phonologic-syntactic syndrome, lexical-syntactic syndrome, and semantic-pragmatic deficit syndrome. For his part, Leonard (2000) sets two types of SLI-affected children: those who exhibit difficulty in producing syntax and phonology, and those with problems with comprehension and production of the same language skills.

The difficulty in oral language among children with SLI may be initially detected during the preschool years just before formal schooling. The SLI child will not stutter like those suffering from other language disorders but he/she will have a deficit in grammatical and syntactic development, semantic and phonological skills. correct verb tenses, word order, and sentence structure (Share & Leikin, 2004). Grammatical and syntactic development involves knowledge of correct verb tenses, word order, and sentence structure, while semantic development relates to vocabulary. As for phonological development, it relates to the awareness of sounds in a spoken language. Fletcher & Ingham (1995) listed some examples of the spoken and written words of SLI children:

• Many table (without the plural s).
• He talk (no –ed) yesterday.
• Mommy putting juice (no auxiliary verb).
• Me want the doll.
• Here they got eyes to me.
• My mum was take me a picture.
• What we can make?

In many cases, children with SLI omit the determiner “the” or “a,” the infinitive particle “to” and the proper pronouns. At preschool age, SLI children appear to acquire their first words later than normal and could not learn new words on short exposure (Rice, 2002). They are also prone to long pauses, circumlocutions, and non-specific words, naming errors, overgeneralizations, and difficulty synonyms, opposites, and collocation. However, it has been established that a child with SLI does not suffer from a low IQ or poor hearing. The primary diagnosis for difficulties in communicating is often mental retardation, autism, hearing loss, or cerebral palsy but a child with SLI scores within the normal range for non-verbal intelligence. Hearing loss is not present and motor skills, social-emotional development, and the child’s neurological profile are all normal. The only setback is with language (Donaldson, 1995).

Consequences

The social life and future prospects for personal growth will be at risk for children with SLI. According to McCauley (2001), the self-esteem of SLI children is expected to suffer when they enter school because they are likely to interact with fewer peers, converse with fewer peers, and be rated as socially less skilled by teachers. As a result, their educational achievement may be inhibited in later years, with their future economic success doomed as well (Scarborough, 2007). One study showed that children diagnosed with SLI continued to perform poorly in language even upon reaching age 18 or 20 (Catts, et al., 1999). This means that SLI is a disorder that persists until old age. For example, Rice (2002) chronicled the story of a 35-year-old Kansas businessman in a management position whose trouble with language shows during grammar tests. In effect, the businessman breezes through his demanding job but struggles over questions that would be easy to a normal 7-year-old. What is interesting is that this businessman had a 7-year-old son with SLI too.

SLI thus puts children at clear risk for later academic difficulties precisely because of this reading and writing disorder. Studies show that from 40 percent to 75 percent of children with SLI will have problems in learning to read, since reading depends upon a wide variety of underlying language skills, including all of the associated language abilities related to grammar and syntax, semantics, and phonological skills (Fey, et al., 1995). Moreover, children with continuing language problems at school entrance are not the only ones at risk; kindergartners with previous SLI who appear to have “caught up” to their age peers in language abilities still are at increased risk of reading difficulties, relative to children with no history of SLI (Ervin, 2009). However, the preschoolers at greatest risk of future reading problems are those whose language difficulties are persistent over time, affect multiple components of language, or are severe, even if only in a single component of language (Shipley & McAfee, 2001).

Treatment

There is no known way of prevention but intervention can be done by focusing on the specific language learning problems. Intervention depends on the type and severity of the problem (Whitehurst & Lonigan, 2002). The recommended diagnosis is to compare the child’s linguistic abilities with those of his/her age group. If the child lags behind his peers in language development, SLI is likely (Williams, 2008). One recommended procedure is for the teacher to ask the child’s parents to check his/her range of vocabulary words, then write down examples of two-word sentences that the child knows. If his vocabulary contains less than 50 words and can’t use any two-word sentences, this is an indication of SLI (McCauley, 2001).

According to Ervin (2009), schools can establish a comprehensive reading curriculum that provides explicit and systematic instruction in the abilities important to reading, which are phonemic awareness, phonics, fluency, vocabulary, and comprehension. This should involve a high-quality reading curriculum, careful monitoring, and prompt and appropriate intervention measures. Rice (2002) believes that speech-language practitioners can also help SLI children with strategies and exercises that will make the navigating language easier. In effect, early identification and intervention are considered best practices that can minimize the possible academic risks (Hoff, 2005). This means that SLI can be diagnosed precisely and accurately. In 2001, the first comprehensive test for SLI was conducted by the Massachusetts Institute of Technology and the University of Kansas based on research funded by the National Institutes of Health. This assessment test for SLI is now used by speech pathologists for preschool children to identify the specific gaps in a child’s speech and language abilities and determine the appropriate treatment.

According to Rice (2002), early intervention can begin during preschool when the child is about age 3 or 4 when the signs of SLI become present. Equipping a child for academic success at such an age is expected to lead to positive experiences in kindergarten. By age 5, parents can then secure a conclusive diagnosis, but being proactive in the preschool years is often time well spent. The preschool age is considered the best time to test children for SLI and to implement a language development program. This preschool intervention program may use children that develop normally to serve as models for those found with SLI. It is suggested that the classroom activities focus on the learning of new words that the children will find interesting and can relate to. This kind of preschool setting will encourage interaction between children and will build rich layers of language experience. It may even include techniques from speech pathology that solicit from children the kinds of practice they need to build their language skills (Shipley & McAfee, 2001). In addition to the children’s participation in such class activities, preschool children with SLI may be sent by their parents to a speech or language pathologist for professional treatment. This professional can assess the child’s needs, engage in structured activities, and can send home some materials for enrichment (Rice, 2002).

Case Study

To validate the theories and findings set forth in the literature, a case study was conducted for this research involving a kindergarten teacher who has been tasked to provide specialized instructions to a child suspected to suffer from SLI. The school directress assigned the kindergarten teacher to this job based on the request of the child’s parents who detected a delayed development in the vocabulary, grammar, and discourse skills in their child. In the interview, the teacher confided that except for the perceived deficiency in language skills, the child is otherwise healthy and intelligent especially in non-verbal school tasks. However, the symptoms of SLI were evident in the child’s difficulty in understanding and expressing language. Here are some samples of the child’s attempts at written and spoken language:

• Me go weewee.
• I eat eggs in morning.
• There many people at mall.

As part of the intervention program for SLI child, the teacher used a specially prepared reading curriculum that emphasizes phonemic awareness, phonics, comprehension and vocabulary words. The child is also instructed on role-playing and time sharing, which has been going on for six months before the interview. The teacher confessed that during this period, no changes were noticed in the child’s language skills. For this reason, the teacher said she had recommended to the school directress that a speech or language pathologist be called in to measure the progress of the child in a more accurate way.

The same recommendation is made by many of the scholarly sources used for this research, which include Bishop (1992), Byrne, et al. (2005), Catts, et al. (1999), Cohen (2002), Conti-Ramsden (2004), Gopnik & Goad (1997), Leonard (2000), Lyytinen, et al. (2005), Scarborough (2007), Share & Leikin (2004), Weiss (2001) and Williams, et al. (2008).

Conclusion

When children do not ask questions or tell adults what they want, this is the first sign of SLI. The problem becomes more evident as the children attempt to put their thoughts in words, betraying such difficulties as omitting verbs and proper tenses, confusing pronouns and having difficulty remembering new words. This will put children at imminent risk for later academic difficulties and even future success. However, there were instances when children with SLI recovered from the condition and proceeded to develop their reading ability in the higher grades, which means that teachers can help children with a preschool diagnosis of SLI. In this process, schools can do a number of things, such as devising a separate reading curriculum to provide SLI children with specialized instructions on the specific language impairments associated with this condition. The early signs of reading problems and the transition of the child from preschool to formal schooling should be monitored as closely as possible to see if changes in the instruction modules are necessary. In some cases, schools may need expert services on speech language learning. Professional advice is important to provide children with specialized reading instructions and holistic speech-language services. In sum, such a reading curriculum, close monitoring, timely and proper intervention can help reverse the effects of SLI and allow children diagnosed with this condition to achieve academic success and go on to lead a normal, productive life.

Bibliography

Bishop, D. (1997). “The Underlying Nature of Specific Language Impairment.” Journal of Child Psychology and Psychiatry 33.

Donaldson, M.L. (1995). “Children with Language Impairment: An Introduction.” London: Jessica Kingsley.

Byrne, B., Wadsworth, S., Corley, R., Samuelsson, S., Quain, P., DeFries, J. Willcutt, E., & Olson, R. (2005). “Longitudinal Twin Study of Early Literacy Development: Preschool and Kindergarten Phases.” Scientific Studies of Reading 9.

Catts, H.W., Fey, M.E., Zhang, X. & Tomblin, J.B. (1999). “Language Basis of Reading and Reading Abilities: Evidence from a Longitudinal Investigation.” Scientific Studies of Reading 3.

Cohen, N.J. (2002). “Development Language Disorders.” In Outcomes in Neurodevelopmental and Genetic Disorders, P. Howlin & O. Udwin (eds), Cambridge University Press.

Conti-Ramsden, G. (2004). “Processing and Linguistic Markets in Young Children with Specific Language Impairment.” Journal of Speech, Language and Hearing Research 47.

Ervin, M. (2009). “Specific Language Impairment – What we Know and Why it Matters.” American Speech-Language-Hearing Association.

Fey, M.E., Catts, H.W. & Larrivee, L.S. (1995). “Preparing Preschoolers for the Academic and Social Challenges of School.” In M.E. Fey, J. Windson & S.F. Warrant (eds), Language Intervention: Preschool through the Elementary Years, Baltimore MD: Brookes Publishing Co.

Fletcher, P. & Ingham, R. (1995). “Grammatical Impairment.” In P. Fletcher & B. MacWhinney (eds), The Handbook of Child Language, Oxford: Blackwell.

Gopnik, M. & Goad, H. (1997).” What Underlies Inflectional Error Patterns in Genetic Dysphasia?” Journal of Neurolinguistics, Vol. 10, No. 2-3.

Hoff, E. (2005). “Language Development.” 3^rd ed., Belmont: Wadsworth.

Leonard, L.B. (2000). “Children with Specific Language Impairment.” The MIT Press: Cambridge.

Lyytinen, P., Eklund, K. & Lyytinen, H. (2005). “Language Development and Literacy Skills

In Late Talking Toddler with and without Familiar Risk for Dyslexia.” Annals of Dyslexia 55.

McCauley, R.J. (2001). “Assessment of Language Disorders in Children.” London: Lawrence Erlbaum Associaties.

Rice, M.L. (2002). “A Unified Model of Specific and General Language Delay: Grammatical Tense as a Clinical Marker of Unexpected Variation.” In Y.Levy & Schaeffer (eds), Language Competence across Populations: Toward a Definition of Specific Language Impairment, Mahwah, NJ: Lawrence Erlbaum.

Scarborough, H.S. (2002). “Connecting Early Language and Literacy to Later Reading (Dis)abilities: Evidence, Theory and Practice.” In S.B.Neuman & D.K. Dickinson (eds), Handbook of Early Literacy Research, New York: Guilford Press.

Share, D.L. & Leikin, M. (2004). “Language Impairment at School Entry and Later Reading Disability: Connections at Lexical versus Supralexical Levels of Reading.” Scientific Studies of Reading 8.

Shipley, K.G. & McAfee, J.G. (2004). “Assessment in Speech-Language Pathology: A Resource Manual.” 3^rd ed., Clifton Park: Thomson.

Weiss, A.L. (2001). “Preschool Language Disorders Resource Guide: Specific Language Impairment.” San Diego, CA: Singular Thomson Learning.

Whitehurst, G.J. & Lonigan, C.J. (2002). “Emergent Literacy: Development from Pre-readers To Readers.” In S.B. Neuman & D.K. Dickinson (eds), Handbook of Early Literacy Research, New York: Guilford Press.

Williams, D., Botting, N. & Boucher, J. (2008). “Language in Autism and Specific Language Impairment: Where are the Links?” Psychology Bulletin 134.

Research Log

Feb. 22

• Preparations started in earnest by settling the question of which topic shall the research focus on. Speech Language Impairment, the subject proposed by the Instructor, is too broad and commonplace to be worthy of an academic investigation. One of the suggestions in the literature is that research must explore something new and then attempt to resolve the issue.
• After a scan of the Publication Manual of the American Psychological, 5^th edition, we decided that Specific Language Impairment is worthy of our research effort. As a speech and language disability, SLI is said to exhibit the same symptoms as the more common disorders but it is not associated with mental retardation or dyslexia.

Feb. 23

• The library and web search related to SLI began, after which we set a time table or research schedule that targets March 1 as completion date. The literature search will end on Feb. 26 and writing begins on Feb. 27.
• One of the issues that the research seeks to resolve is whether SLI is a genetic phenomenon.
• Based on our initial reading, we crafted the research questions, which basically ask why SLI is considered a speech and reading disability when children with such condition often behave like normal children do.
• The initial challenge is that there is a dearth of literature on SLI as a specific language learning disability. Of the 7 books we identified, only Weiss (2001) deals exclusively with SLI. The other 6 books – Whitehurst & Lonigan (2002), Rice (2002), Hoff (2005), Fletcher & Ingham (1995), Fey, et al. (1995) and Donaldson (1995) – refer to SLI only as part of a greater problem.
• The scholarly sources we found were more specific, such as Bishop (1992), Ervin (2009), Williams, et al. (2008), Leonard (2000), Conti-Ramsden (2004) and Byrne, et al. (2005)..

Feb.24

• On pp. 219-235 of Byrne, et al. (2005), the authors maintain that SLI runs in the family. This finds support in Rice (2002, p. 122), which cites the example of a 35-year-old businessman with SLI who had a 7-year-old child with the same condition.
• The rest of the authors doubt that SLI is inherited, such as Weiss (2001, p. 176), Fey, et al. (1995, p. 332), and Shipley& McAfee (2004, p. 109).

Feb. 25

• The interview is conducted with a kindergarten teacher for the case study on an SLI child, whose identities and opinions volunteered were treated in utmost confidentiality as part of ethical conduct in research. We found that most of the problems recorded by the teacher on the delayed language acquisition of her ward concur with those observed in the literature.

Feb. 26, 27 & 28

• Drafting of the paper takes three days.

March 1

• Finishing touches done on the completed paper.