Exceptional Child Matrix: Specific Language Impairment

Meredith Paige, Shannon Graham, Alyssa Hazlegrove

Characteristics - May not produce first words until around 2 years of later
- May talk around the age of 3, but may not be understood
- Struggle to learn new words and make conversation
- Difficulty using verbs
- Deletion of -s from present tense verbs, past tense and “be” or “do” verbs
when asking questions
- Reduced spoken vocabulary
- Smaller phonetic inventories
- Also called developmental language disorder, language delay, or
developmental dysphagia
- One of the most common childhood learning disabilities
- Previously thought to include two subtypes: expressive and mixed
expressive/receptive
- But argued that all children with SLI have some receptive issues
- Language acquisition follows normal sequence but overall profile may
look very different
- Language development appears asynchronous
- Considerable heterogeneity in language symptoms

*SLI descriptor used by public school programs to describe the population of

children who receive any speech and language service

Etiology - Unknown cause

- 5-10% of school aged population (Spear-Swerling, 2006)
- Absence of other known factors and with no clear evidence of sensory or
neurological disorder (either structural or functional)
- Growing evidence that genetic factors play an important role
- Genetic contribution is complicated, likely multifactorial etiology
- Theories of Etiology:
- Familial Factors
- More prevalent in boys than girls (4:1)
- Higher rates of concordance of SLI in identical than
fraternal twins
- May have a strong genetic link - 50% to 70% of children
with SLI have at least one other family member with the
disorder.
- Perceptual Deficit Explanation
- Children with SLI have difficulty processing and
sequencing rapidly presented auditory signals
 - Linguistic Deficit Explanation
- Children with SLI have fundamental problem in learning
grammatical rules
- Normal Distribution Explanation
- There is no “disorder”; the children in this group are just on
the low end of normal in their ability to learn and produce
language

Effects of - Delay in starting to talk - first words around 2 years or later

learning - Struggle to learn new words and make conversation
- Delayed production of speech sounds
- Simplified grammatical structures
- Restricted vocabulary (production and comprehension)
- Difficulties with short-term memory and repetition tasks
- Difficulties in understanding complex language
- Pragmatic skills are better than language skills
- Takes longer to acquire CVC syllable and multisyllabic word productions

Diagnostic - Not appropriate to make the diagnosis until age 4 or later (Rescorla &
Factors Lee, 2001)
- Language is significantly below level (age and IQ)
- Nonverbal IQ and nonlinguistic aspects of development (self-help, social
skills) fall within normal limits
- DSM-5 labels it as the neuro-developmental communication disorder
- MLU, phonology (ability to produce initial weak syllables, word-final
consonants), and expressive vocabulary may also give clues

Relevant General:
Interventions - Embedded work on morphology and syntax in functional USE of
language
- Facilitate successful entry into, development of, and maintenance of peer
interactions
- Develop both breadth and depth of vocabulary learning
- Support literacy learning
Imitation-Based Approach:
- Dominant approach during the early years of treatment research
- Clinician produces sentence/phrase and child asked to repeat it
- Child’s attention is usually drawn to the detail in the utterance serving as
the target of interest
- Target structure of interest may be presented in smaller units
- Later asked to imitate longer units
- Gradually encouraged to use target structure without hearing it
first
Modeling Approaches:
 - Child observes clinician produce examples of utterances containing the
linguistic form of focus
- Child not asked to imitate
- Version 1:
- Child observes only
- Version 2:
- Child asked to take turns with the model, producing new examples
of the target form after the observation period
Focused Stimulation:
- Relies primarily on the high frequency of presentation of the target forms
and the unambiguous contexts in which the forms are used
- Can be embedded in stories, simple descriptions of play, etc.
Milieu Teaching:
- Reliance on child’s surroundings
- Highly natural setting
- Setting arranged to increase likelihood that child will make some attempt
at communication
- Natural contingencies applied to child’s production of target form
- Overlap between Milieu and variations of focused stimulation
Conversational Recasting:
- Clinician responds to child’s utterances that serves as a relevant
conversational turn but with some linguistic form as focus

*Treatment can take a comprehensive approach, employing wide variety of

techniques