Child Assessment Service
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Developmental Disorders Series Specific Language Impairment What is Specific Language Impairment? Specific Language Impairment (SLI) refers to significant difficulties in spoken language ability when there are no obvious accompanying conditions such as mental retardation, neurological damage or hearing impairment. Language delay is used to describe language problems in young pre-school children with otherwise normal development. While many children with language delay may outgrow their difficulties, others may have persistent symptoms of SLI. How does Specific Language Impairment affect children? SLI affects children in a variety of ways relating to the everyday use of language, starting with the basic grasp of grammar and word recall. The symptoms may extend to affect the ability to follow directions, convey a message, report an event, or retell a story. These various impairments lead to difficulty in starting and maintaining a reasonable conversation in social settings. Does my child really have Specific Language Impairment? Language difficulties in some conditions may be confused with the presentations of SLI. These include developmental delay, autistic spectrum disorder and hearing impairment. It is important that these possibilities are considered and clarified during initial assessment. What causes Specific Language Impairment? Biological factors It has been thought that SLI may be associated with atypical development affecting parts of the brain responsible for language function. Clustering in families suggests that there is a genetic cause. The language environment of the child may also play a role, but this theory still lacks conclusive evidence. Process mechanisms Several theories on discussing language processing mechanisms (problems) have been put forth. These include incomplete learning of particular rules and principles of language, longer time needed to process its more difficult aspects, deficits (weaknesses) in the processing of speech perception, and deficits (weaknesses) in the retention of verbal information. Environmental factors Inadequate language input is not considered a cause of SLI by most investigators, but language input can be modified to facilitate growth in language ability. How common is Specific Language Impairment? In western countries, SLI affects approximately 7 out of 100 children. There is no formal epidemiological data available yet in Hong Kong. With the launching of the first formal tool for assessing Cantonese speaking school aged children, The Hong Kong Cantonese Oral Language Assessment Scale (HKCOLAS), an estimated prevalence of approximately 5% was obtained in 2006. What can be done if my child is suspected to have Specific Language Impairment? The management of SLI lies in early identification and treatment. A thorough assessment of the overall development of the child is needed for excluding other causes of language delay, as well as screening for co-existing conditions. What services are available in Hong Kong to help children with Specific Language Impairment? Speech therapy for preschool children is available from the Hospital Authority and Social Welfare Department, while school aged children can receive speech therapy support from the Education and Manpower Bureau at mainstream schools. Therapy is also provided in the private sector for both age groups. Will children with Specific Language Impairment improve with age? Whilst the language abilities of many children with SLI develop normally as they grow up, a longitudinal study showed that a portion of children with SLI at age the age of 5.5 years continued to have oral and written language problems at age 15.5 years, and those whose SLI apparently resolved at age 5.5 years still showed difficulties in short term memory and speech sound processing. References Leonard, L. (1998).Children with Specific Language Impairment. London: The MIT Press.Mabel L. Rice, Steven F. Warren. Mahwah, N.J. (2004). Developmental language disorders: from phenotypes to etiologies. Lawrence Erlbaum. Stothard, S. E., Snowling, M. J., Bishop, D. V. M., Chipchase, B. B., & Kaplan, C. A. (1998). Language-impaired preschoolers: A follow-up into adolescence. Journal of Speech Language and Hearing Research, 41, pp. 407-418. Tomblin, J.B., Records, N.L., Buckwalter, P., Zhang, X., Smith, E. & Brien, O.M. (1997). Prevalence of specific language impairment in kindergarten children. Journal of Speech, Language and Hearing Research, 40, 1245-1260. Webster, R.I., Shevell, M. I. (2004). Neurobiology of Specific Language Impairment. Journal of Child Neurology, 19(7): 471-481.
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Last revision date: 25 May 2010