Speech-Language Impairment Disorder by Shelley James

Speech-Language Speech-Language Impairment Impairment

DisorderDisorder

by Shelley Jamesby Shelley James

Speech-Language Impairment Speech-Language Impairment

Disorder (SLI)Disorder (SLI) Speech-Language Impairment Disorder Speech-Language Impairment Disorder

(SLI) predominately means having (SLI) predominately means having difficulty with spoken language. difficulty with spoken language.

In May 2008 approximately 7% of children In May 2008 approximately 7% of children between kindergarten age and year 2 between kindergarten age and year 2 with otherwise normal development, with otherwise normal development, were believed to have SLI in Western were believed to have SLI in Western

Australia alone. Australia alone.

Communication difficulties in children are Communication difficulties in children are the second most common additional the second most common additional

need in education today. need in education today.

Speech-Language Impairment Speech-Language Impairment

Disorder (SLI)?Disorder (SLI)? There is a distinct difference between speech and

language.

• Speech involves the sounds a person makes by the physical process of turning air into consonants and vowels.

• Language, on the other hand, is the system of spoken and written words, grammar, vocabulary and gestures used to express ourselves (expression) and to understand others (comprehension).

Children with SLI would continue to have special needs throughout their lives although the type and severity may change over time.

The Cause and Diagnosis of The Cause and Diagnosis of SLI?SLI?

Speech-Language Impairment Disorder is the Speech-Language Impairment Disorder is the impairment of the neurological, cognitive and/or impairment of the neurological, cognitive and/or physical structures of the brain and body related physical structures of the brain and body related to speech and language processing.to speech and language processing.

Some causes of neurological impairments include:Some causes of neurological impairments include:• Heredity - Learning difficulties often run in the Heredity - Learning difficulties often run in the

family. family. • Problems during pregnancy and birth - Learning Problems during pregnancy and birth - Learning

difficulties can result from anomalies in the difficulties can result from anomalies in the developing brain, illness or injury, foetal exposure developing brain, illness or injury, foetal exposure to alcohol or drugs, low birth weight, oxygen to alcohol or drugs, low birth weight, oxygen deprivation, or by premature or prolonged labour. deprivation, or by premature or prolonged labour.

• Behavioural Factors Behavioural Factors • Social Environment Factors Social Environment Factors • Cognitive FactorsCognitive Factors


A child would have significantly delayed language A child would have significantly delayed language development than his/her peer group and no other development than his/her peer group and no other apparent developmental delay or disorder present to apparent developmental delay or disorder present to explain such delay and would require a differential explain such delay and would require a differential diagnosis over a significant period of time from a diagnosis over a significant period of time from a speech-language pathologist and a psychologist. speech-language pathologist and a psychologist.

A differential diagnosis is the process of determining which of a number of possible conditions or disorders, the presenting condition actually is.

Additional information would be gathered from parents, Additional information would be gathered from parents, education providers and other professionals that are education providers and other professionals that are involved with the child’s development and this involved with the child’s development and this information is taken into consideration, along with information is taken into consideration, along with formal assessments, when making a diagnosis.formal assessments, when making a diagnosis.


The 4 main criteria that must be present to The 4 main criteria that must be present to be diagnosed with SLI are:be diagnosed with SLI are:

• Evidence of on-going history of poor Evidence of on-going history of poor performance in speech and/or language performance in speech and/or language ANDAND

• Descriptive evidence and analysis of the Descriptive evidence and analysis of the range of educational interventions already range of educational interventions already provided and their outcomes provided and their outcomes ANDAND

• Scores obtained from formal assessment Scores obtained from formal assessment testing of expressive and/or receptive testing of expressive and/or receptive language development showing 2 language development showing 2 standard deviations below the mean (IQ) standard deviations below the mean (IQ) ANDAND

• Poor educational functioning that can not Poor educational functioning that can not be explained by any other meansbe explained by any other means


Children with SLI have average to above Children with SLI have average to above average intelligence but their verbal average intelligence but their verbal comprehension scores are below average comprehension scores are below average falling between 70 and 84. The Wechsler falling between 70 and 84. The Wechsler Intelligence Scale for ChildrenIntelligence Scale for Children uses uses subtests that generate a Full Scale score subtests that generate a Full Scale score (FSIQ,) and four composite scores: Verbal (FSIQ,) and four composite scores: Verbal Comprehension (VCI,) Perceptual Comprehension (VCI,) Perceptual Reasoning (PRI,) Processing Speed (PSI) Reasoning (PRI,) Processing Speed (PSI) and Working Memory (WMI.)and Working Memory (WMI.)


The factors that are not considered in The factors that are not considered in assessing SLI are:assessing SLI are:

• Physical impairments – hearing, vision, Physical impairments – hearing, vision, intellectual or multiple impairmentintellectual or multiple impairment

• Autistic Spectrum Disorder (ASD)Autistic Spectrum Disorder (ASD)• Central Auditory Processing Disorder (CAPD)Central Auditory Processing Disorder (CAPD)• Medical disorders such as Attention Deficit Medical disorders such as Attention Deficit

Hyperactivity Disorder (ADHD)Hyperactivity Disorder (ADHD)• Environment - lack of educational Environment - lack of educational

opportunities and experience or significant opportunities and experience or significant social/emotional factors for example, social/emotional factors for example, childhood abuse and/or neglectchildhood abuse and/or neglect

Recognising SLIRecognising SLIChildren with SLI can have a speech impairment

or a spoken language impairment or both and have difficulty with one or more of these areas listed as follows:

Speech ProductionSpeech Production• Speech is virtually non-existent or difficult to Speech is virtually non-existent or difficult to

understandunderstand

Speech ProcessingSpeech Processing• Difficulty in recognising and interpreting Difficulty in recognising and interpreting

speechspeech

Recognising SLIRecognising SLI

Language ProductionLanguage Production

• Difficulty producing spoken languageDifficulty producing spoken language• Disordered development of grammarDisordered development of grammar• Hesitant conversation when finding the Hesitant conversation when finding the

right wordsright words• Use of non-specific words eg: thing or Use of non-specific words eg: thing or

stuffstuff• Makes changes to words or sentencesMakes changes to words or sentences• Use short sentences with immature Use short sentences with immature

language for age grouplanguage for age group


Language ProcessingLanguage Processing• Difficulty understanding spoken languageDifficulty understanding spoken language• Difficulty answering questions and Difficulty answering questions and

explaining answersexplaining answers• Difficulty understanding long and/or Difficulty understanding long and/or

complex sentencescomplex sentences• Difficulty following instructions accurately Difficulty following instructions accurately

needing extra time to process and respondneeding extra time to process and respond• Difficulty understanding multiple meaning Difficulty understanding multiple meaning

words and figurative speechwords and figurative speech• Takes spoken language literallyTakes spoken language literally


Language UseLanguage Use• Difficulty in choosing appropriate Difficulty in choosing appropriate

language to suit circumstanceslanguage to suit circumstances• Difficulty interpreting other’s intentions Difficulty interpreting other’s intentions

and meaning in relation to contextand meaning in relation to context• Difficulty staying on topicDifficulty staying on topic• Rarely initiates conversationsRarely initiates conversations• Difficulty telling or re-telling stories or Difficulty telling or re-telling stories or

sharing informationsharing information

Individual Education Plan (IEP)Individual Education Plan (IEP)An Education Team is formed to discuss the specific An Education Team is formed to discuss the specific

educational and social needs of the student and educational and social needs of the student and can consist of:can consist of:

• The teacher or education providerThe teacher or education provider• The speech-language pathologist who develop The speech-language pathologist who develop

learning strategies for speechlearning strategies for speech• The school psychologist who assess the student The school psychologist who assess the student

(IQ) and reports and develops strategies for the (IQ) and reports and develops strategies for the areas that need developingareas that need developing

• The parents or carer of the student who provide The parents or carer of the student who provide information on the behaviour, habits, speech, information on the behaviour, habits, speech, comprehension and temperament of the student comprehension and temperament of the student and their concerns and their concerns

• Any other professional/s involved with the Any other professional/s involved with the student’s developmentstudent’s development

Individual Education Plan (IEP)Individual Education Plan (IEP)Together, the Education Team: Together, the Education Team: • discuss and develop specific learning goals discuss and develop specific learning goals

in an Individual Education Plan in an Individual Education Plan • document a range of specific educational document a range of specific educational

interventionsinterventions• provide outcomes for the students specific provide outcomes for the students specific

individual needs. individual needs.

These strategies are applied over a six month These strategies are applied over a six month period then reviewed and adjusted when the period then reviewed and adjusted when the learning needs for each goal has been met. learning needs for each goal has been met.

In The ClassroomIn The ClassroomThe use of multi-sensory techniques in the The use of multi-sensory techniques in the

classroom in addition to the goals being classroom in addition to the goals being implemented in the IEP is recommended to implemented in the IEP is recommended to assist teaching a student with SLI assist teaching a student with SLI effectively. effectively.

It involves input from all 5 senses and It involves input from all 5 senses and cognitive input to process information. cognitive input to process information.

Pairing up visual and auditory stimuli within Pairing up visual and auditory stimuli within activities promotes understanding and activities promotes understanding and builds on previously learned knowledge and builds on previously learned knowledge and allows the student to use their strengths allows the student to use their strengths while developing their weaknesses. while developing their weaknesses.

In The ClassroomIn The ClassroomSome strategies that are useful in the classroom are:Some strategies that are useful in the classroom are:• Encouraging the student to ask for assistance Encouraging the student to ask for assistance

when he is unsure of what steps to takewhen he is unsure of what steps to take• Using a variety of teaching styles - visual, verbal Using a variety of teaching styles - visual, verbal

and hands-on activities and present them in a and hands-on activities and present them in a step-by-step mannerstep-by-step manner

• Using diagrams, flow charts, dot points, stop and Using diagrams, flow charts, dot points, stop and go signs, colour coding, font variations and clear go signs, colour coding, font variations and clear sentences or summariessentences or summaries

• Working at students current skill level and paceWorking at students current skill level and pace• Allowing extra time to process information and Allowing extra time to process information and

complete taskscomplete tasks

In The ClassroomIn The Classroom• Giving simple and concrete instructions, ensuring Giving simple and concrete instructions, ensuring

the student understands the requirements and the student understands the requirements and provide reminders during the taskprovide reminders during the task

• Providing one-to-one assistance and small group Providing one-to-one assistance and small group learninglearning

• Using repetition and practice to help with the Using repetition and practice to help with the retention of information and the understanding retention of information and the understanding of conceptsof concepts

• Using positive reinforcement statements for work Using positive reinforcement statements for work achieved and sustained concentration during a achieved and sustained concentration during a task to build self-esteemtask to build self-esteem

• Using appropriate aids and equipmentUsing appropriate aids and equipment• Using role playing and drawingUsing role playing and drawing• Speaking to the student with respect and Speaking to the student with respect and

patiencepatience

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Speech-Language Impairment Disorder by Shelley James