Specific language impairments

Written by: Jules Clarke | Published:
Photo: iStock

Specific language impairments can often be lost within the broad category of speech and language needs. Jules Clarke explains

Children from low socio-economic backgrounds are frequently affected by specific language impairment (Lascalles, 2013) and, although they may have greater needs than peers who have a diagnosis of autism, they receive little or no support in comparison.

In the Better Communication Research Programme (Lindsay et al, 2012) parents reported that they felt the reason behind the lack of support for their children was that specific language impairment (SLI) is a hidden disability and therefore not taken as seriously as dyspraxia or dyslexia, for example. They felt it was dismissed as a social disadvantage issue.

Would a change in terminology help teachers and parents to fully appreciate this type of impairment? Should we refer to SLI as dysphasia (a term used in many European countries)?

Many prefer to use the term speech, language and communication needs (SLCN) to describe children with a range of conditions. However, this doesn’t identify children who have specific needs with language and they end up being thrown into a category of very mixed and varied difficulties.

What is an SLI?

SLI can cover a broad range of issues. Some children have problems that are short-term while others have severe and persistent difficulties – both with talking and understanding.
Indeed, some children have such mild problems that a short burst of intervention with a therapist can drastically reduce the difficulties.

At the other end of the scale, some pupils have severe and persistent difficulties with both understanding and talking. These difficulties are not the result of disabilities such as cerebral palsy, hearing impairment or autistic spectrum disorders.

Speech and language therapists use very distinct terms for children who have language impairments.

Language delay, for example, is generally applied to children under the age of seven and, as it implies, the problem is a delay rather than a lifelong disability.

Therapists will use “language disorder” or the term “specific language impairment” to describe difficulties that are more permanent and are likely to hinder the pupil’s academic achievement and wellbeing throughout their education.

SLI is usually only diagnosed by a speech and language therapist and so as long as the child is seen by the therapist intervention will continue.

However, for pupils who “lose” their diagnosis when they start at a secondary school which has no speech and language therapist service, they often start to fail and flounder because the impairment is not recognised and therefore not addressed properly.

There is still a distinct lack of speech and language services for children in secondary schools and post-16 placements. Some children fail to ever get a diagnosis in the first place, as assessments are hard to come by, and thorough in-depth assessments by a speech and language therapist are required for diagnosis and specific treatment planning.

The parents in the Better Communication Research Programme said that when their children received generic therapy it made little or no difference to their abilities, resulting in them having to fight for a proper assessment and intervention that was tailored to their specific needs (Slonins, 2013).

SLIs in the classroom

Academically, these pupils are often as clever as their peers but they have difficulty in explaining or understanding because of a specific speech and or language disability (it may be written or verbal and can also manifest itself as a social difficulty).

Pupils with SLI are usually able and healthy but they have some level of difficulty with talking (writing and spelling too) and understanding language (reading and listening). In a classroom the pupil with SLI might:

  • Have difficulty expressing their ideas so never puts their hand up to answer.
  • Talk in sentences but is difficult to understand (poor syntax and grammar).
  • Muddle sounds so it is difficult to follow what they are saying (speech issues).
  • Find it difficult to understand long instructions and complicated words.
  • Have difficulty recalling the words they want to say.
  • Find it hard to join in and follow what is going on in group discussions and in social settings, such as at break-times.

The SEN Code of Practice

The new SEN Code of Practice was implemented last year. However, NHS speech and language departments will still have limited resources and although the local authority is obliged to publish a Local Offer outlining the resources available for SEN children and their families, we wait to see whether the reforms will result in better outcomes for SLI pupils.

Key sections in the new Code of Practice outline some of the responsibilities for schools and other professionals. They include:

  • Schools should assess each pupil’s current skills and levels of attainment on entry. Class and subject teachers, supported by the senior leadership team, should make regular assessments of progress for all pupils.
  • Where progress continues to be less than expected the class or subject teacher, working with the SENCO, should assess whether the child has SEN.
  • Local authorities, Clinical Commissioning Groups and other partners must work together in local Health and Wellbeing Boards to assess the health needs of local people, including those with SEN. This “Joint Strategic Needs Assessment”, informs a local Health and Wellbeing Strategy which sets priorities for those who commission services.
  • Schools should know precisely where children and young people with SEN are in their learning and development.
  • Schools should ensure decisions are informed by the insights of parents and those of children and young people themselves.
  • Schools should have high ambitions and set stretching targets for students with SEN and track their progress towards these goals.
  • Schools should keep under review the additional or different provision, promote positive outcomes in the wider areas of personal and social development, and ensure that the approaches used are based on the best possible evidence and are having the required impact on progress.

Conclusion

Accurate assessments are crucial to a pupil’s education. A thorough assessment will generate targeted therapy with specific treatment goals. Applied regularly by parents, support assistants and the speech and language therapist, the therapy will have a significant impact on a pupil’s abilities, their success in education and their emotional wellbeing, including self-confidence and self-esteem.

Many more schools are investing in the employment of their own speech and language therapists. Some schools buy an ad-hoc service to assess and screen for pupils at risk of speech, language, reading, spelling or social difficulties, while others employ them as part of the regular school team.

As with teachers, speech and language therapist levels of experience range from NQT (newly qualified therapists) through to senior, advanced and highly specialist levels.
NQTs must have an experienced therapist supervising them for at least 12 to 18 months until they have satisfied the requirements of the Royal College of Speech and Language Therapists (RCSLT) NQT Framework.

They are then transferred from the NQT register and are free to practice independently. Independent and NHS therapists will have their own standardised assessments and will usually produce reports that outline specific difficulties along with recommendations on how to address the issues.

All practising speech and language therapists must be registered with the RCSLT and the Health and Care Professions Council (HCPC) in order to practise legally.

  • Jules Clarke is a qualified speech and language therapist who has 16 years’ experience in providing direct therapy to children and training for professionals.

Further information


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