Speech-Language Impairment Disorder

1. Speech-Language Impairment Disorder by Shelley James

2. Speech-Language Impairment Disorder (SLI) Speech-Language Impairment Disorder (SLI) predominately means having difficulty with spoken language. In May 2008 approximately 7% of children between kindergarten age and year 2 with otherwise normal development, were believed to have SLI in Western Australia alone. Communication difficulties in children are the second most common additional need in education today.

3. Speech-Language Impairment 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.

4. The Cause and Diagnosis of SLI? Speech-Language Impairment Disorder is the impairment of the neurological, cognitive and/or physical structures of the brain and body related to speech and language processing. Some causes of neurological impairments include: • Heredity - Learning difficulties often run in the family. • Problems during pregnancy and birth - Learning difficulties can result from anomalies in the developing brain, illness or injury, foetal exposure to alcohol or drugs, low birth weight, oxygen deprivation, or by premature or prolonged labour. • Behavioural Factors • Social Environment Factors • Cognitive Factors

5. The Cause and Diagnosis of SLI? A child would have significantly delayed language development than his/her peer group and no other apparent developmental delay or disorder present to explain such delay and would require a differential diagnosis over a significant period of time from a 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, education providers and other professionals that are involved with the child’s development and this information is taken into consideration, along with formal assessments, when making a diagnosis.

6. The Cause and Diagnosis of SLI? The 4 main criteria that must be present to be diagnosed with SLI are: • Evidence of on-going history of poor performance in speech and/or language AND • Descriptive evidence and analysis of the range of educational interventions already provided and their outcomes AND • Scores obtained from formal assessment testing of expressive and/or receptive language development showing 2 standard deviations below the mean (IQ) AND • Poor educational functioning that can not be explained by any other means

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

8. The Cause and Diagnosis of SLI? The factors that are not considered in assessing SLI are: • Physical impairments – hearing, vision, intellectual or multiple impairment • Autistic Spectrum Disorder (ASD) • Central Auditory Processing Disorder (CAPD) • Medical disorders such as Attention Deficit Hyperactivity Disorder (ADHD) • Environment - lack of educational opportunities and experience or significant social/emotional factors for example, childhood abuse and/or neglect

9. Recognising SLI Children 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 Production • Speech is virtually non-existent or difficult to understand Speech Processing • Difficulty in recognising and interpreting speech

10. Recognising SLI Language Production • Difficulty producing spoken language • Disordered development of grammar • Hesitant conversation when finding the right words • Use of non-specific words eg: thing or stuff • Makes changes to words or sentences • Use short sentences with immature language for age group

11. Recognising SLI Language Processing • Difficulty understanding spoken language • Difficulty answering questions and explaining answers • Difficulty understanding long and/or complex sentences • Difficulty following instructions accurately needing extra time to process and respond • Difficulty understanding multiple meaning words and figurative speech • Takes spoken language literally

12. Recognising SLI Language Use • Difficulty in choosing appropriate language to suit circumstances • Difficulty interpreting other’s intentions and meaning in relation to context • Difficulty staying on topic • Rarely initiates conversations • Difficulty telling or re-telling stories or sharing information

13. Individual Education Plan (IEP) An Education Team is formed to discuss the specific educational and social needs of the student and can consist of: • The teacher or education provider • The speech-language pathologist who develop learning strategies for speech • The school psychologist who assess the student (IQ) and reports and develops strategies for the areas that need developing • The parents or carer of the student who provide information on the behaviour, habits, speech, comprehension and temperament of the student and their concerns • Any other professional/s involved with the student’s development

14. Individual Education Plan (IEP) Together, the Education Team: • discuss and develop specific learning goals in an Individual Education Plan • document a range of specific educational interventions • provide outcomes for the students specific individual needs. These strategies are applied over a six month period then reviewed and adjusted when the learning needs for each goal has been met.

15. In The Classroom The use of multi-sensory techniques in the classroom in addition to the goals being implemented in the IEP is recommended to assist teaching a student with SLI effectively. It involves input from all 5 senses and cognitive input to process information. Pairing up visual and auditory stimuli within activities promotes understanding and builds on previously learned knowledge and allows the student to use their strengths while developing their weaknesses.

16. In The Classroom Some strategies that are useful in the classroom are: • Encouraging the student to ask for assistance when he is unsure of what steps to take • Using a variety of teaching styles - visual, verbal and hands-on activities and present them in a step-by-step manner • Using diagrams, flow charts, dot points, stop and go signs, colour coding, font variations and clear sentences or summaries • Working at students current skill level and pace • Allowing extra time to process information and complete tasks

17. In The Classroom • Giving simple and concrete instructions, ensuring the student understands the requirements and provide reminders during the task • Providing one-to-one assistance and small group learning • Using repetition and practice to help with the retention of information and the understanding of concepts • Using positive reinforcement statements for work achieved and sustained concentration during a task to build self-esteem • Using appropriate aids and equipment • Using role playing and drawing • Speaking to the student with respect and patience