As Children get older and enter into Kindergarten and beyond, sometimes the language delay that we suspected in preschool appears to be a language disorder or an issue with language that may continue throughout their lives.
Here is a description from the American Speech and Hearing Association:
A spoken language disorder (SLD), also known as an oral language disorder, represents a significant impairment in the acquisition and use of language across modalities due to deficits in comprehension and/or production across any of the five language domains (i.e., phonology, morphology, syntax, semantics, pragmatics). Language disorders may persist across the lifespan, and symptoms may change over time.
When SLD is a primary disability—not accompanied by an intellectual disability, global developmental delay, hearing or other sensory impairment, motor dysfunction, or other mental disorder or medical condition—it is considered a specific language impairment (SLI).
An SLD may also occur in the presence of other conditions, such as
The relationship between spoken and written language is well established (e.g., Hulme & Snowling, 2013). Children with spoken language problems frequently have difficulty learning to read and write. Additionally, children with reading and writing problems often have difficulty with spoken language, particularly as it relates to higher-order spoken language skills, such as expository discourse (Scott & Windsor, 2000).
Some children with language disorders may have social communication difficulty, because language processing, along with social interaction, social cognition, and pragmatics, comprise social communication. See social communication disorder.
Learning disabilities (LD) and language disorders are also closely linked, although the exact relationship between the two is not fully agreed upon. Language disorders are typically diagnosed before learning disabilities and frequently impact a child's academic performance. At that point, the child is often identified as having a learning disability, even though a language disorder often underpins the academic struggles, especially those associated with learning to read and write.
Here is a description from the American Speech and Hearing Association:
A spoken language disorder (SLD), also known as an oral language disorder, represents a significant impairment in the acquisition and use of language across modalities due to deficits in comprehension and/or production across any of the five language domains (i.e., phonology, morphology, syntax, semantics, pragmatics). Language disorders may persist across the lifespan, and symptoms may change over time.
When SLD is a primary disability—not accompanied by an intellectual disability, global developmental delay, hearing or other sensory impairment, motor dysfunction, or other mental disorder or medical condition—it is considered a specific language impairment (SLI).
An SLD may also occur in the presence of other conditions, such as
- autism spectrum disorder (ASD),
- intellectual disabilities (ID),
- developmental disabilities (DD),
- attention deficit hyperactivity disorder (ADHD),
- traumatic brain injury (TBI),
- psychological/emotional disorders,
- hearing loss.
The relationship between spoken and written language is well established (e.g., Hulme & Snowling, 2013). Children with spoken language problems frequently have difficulty learning to read and write. Additionally, children with reading and writing problems often have difficulty with spoken language, particularly as it relates to higher-order spoken language skills, such as expository discourse (Scott & Windsor, 2000).
Some children with language disorders may have social communication difficulty, because language processing, along with social interaction, social cognition, and pragmatics, comprise social communication. See social communication disorder.
Learning disabilities (LD) and language disorders are also closely linked, although the exact relationship between the two is not fully agreed upon. Language disorders are typically diagnosed before learning disabilities and frequently impact a child's academic performance. At that point, the child is often identified as having a learning disability, even though a language disorder often underpins the academic struggles, especially those associated with learning to read and write.
Treatment
Spoken language disorders (SLD) are heterogeneous in nature, and the severity of the disorder can vary considerably. Each individual with language difficulties has a unique profile, based on his or her current level of language functioning, as well as functioning in areas related to language, including hearing, cognitive level, and speech production skills. In addition to having a unique profile of strengths and needs, individuals bring different backgrounds to the treatment setting. For bilingual individuals, it is important that the clinician consider the language or languages used during intervention.
The goal of language intervention is to stimulate overall language development and to teach language skills in an integrated fashion and in context, so as to enhance everyday communication and ensure access to academic content. Goals are frequently selected with consideration for developmental appropriateness and the potential for improving the effectiveness of communication and academic and social success.
Roth and Worthington (2015) summarize steps in the selection and programming of treatment targets and provide sample case profiles for early intervention through adolescence. They also identify a number of basic principles of effective intervention regardless of client age or disorder. These include:
Intervention strategies for various age ranges are outlined in the sections below. Older individuals with severely impaired language may be functioning at developing language levels. Rather than being based on developmental sequences, interventions for these individuals may be more functional in nature, focusing on building independence in everyday settings.
Intervention For Elementary School Children (Ages 5–10)
The focus of language intervention for elementary school children with language difficulties is to help the child acquire the language skills needed to learn and succeed in a classroom environment. Interventions are curriculum-based, that is, goals address language needs within the context of the curriculum where these skills are needed.
Interventions may also address literacy skills (e.g., improving decoding, reading comprehension, and narrative and expository writing), as well as metacognitive and metalinguistic skills (e.g., increasing awareness of rules and principles for use of various language forms, improving the ability to self-monitor and self-regulate) that are critical for the development of higher-level language skills. See the treatment section of the Written Language Disorders Practice Portal page.
For children who speak a language other than English in the home, it may be necessary to use the home language as a mechanism for transitioning the child to using the language of the school. Planning and implementing an effective language intervention program is often a coordinated effort involving the SLP, classroom teacher(s), and other school specialists.
Areas targeted for this population typically include
phonology
Intervention For Adolescent Students (Ages 11 Through High School)
As students enter their adolescent years, curriculum demands increase. Children with language disabilities may have difficulty meeting increased demands of secondary school. Although basic language skills are still taught, it may not be possible to close the gap between skill level and grade level. At this point, interventions tend to focus on teaching ways to compensate for language deficits. Student involvement is important at this age to foster a feeling of collaboration and responsibility for developing and achieving intervention goals and to learn self-advocacy skills for the classroom (e.g., requesting priority seating in front of classroom).
Instructional strategies approaches that focus on teaching rules, techniques, and principles to facilitate acquisition and use of information across a broad range of situations and settings are often used with older students. Enhancing metalinguistic and metacognitive skills is fundamental to learning new strategies. The emphasis is on how to learn, rather than what to learn. Classroom assignments are often used to teach strategies for learning academic content. Some instructional strategies are discipline-specific, and others are generalizable across disciplines (Faggella-Luby & Deshler, 2008). Examples include strategies for using
The goal of language intervention is to stimulate overall language development and to teach language skills in an integrated fashion and in context, so as to enhance everyday communication and ensure access to academic content. Goals are frequently selected with consideration for developmental appropriateness and the potential for improving the effectiveness of communication and academic and social success.
Roth and Worthington (2015) summarize steps in the selection and programming of treatment targets and provide sample case profiles for early intervention through adolescence. They also identify a number of basic principles of effective intervention regardless of client age or disorder. These include:
- to the extent possible, teach strategies for facilitating communication rather than teaching isolated behaviors
- provide intervention that is dynamic in nature and includes ongoing assessment of the child's progress in relation to his or her goals, modifying them as necessary
- provide intervention that is individualized, based on the nature of a child's deficits and individual learning style
- tailor treatment goals to promote a child's knowledge, one step beyond the current level
Intervention strategies for various age ranges are outlined in the sections below. Older individuals with severely impaired language may be functioning at developing language levels. Rather than being based on developmental sequences, interventions for these individuals may be more functional in nature, focusing on building independence in everyday settings.
Intervention For Elementary School Children (Ages 5–10)
The focus of language intervention for elementary school children with language difficulties is to help the child acquire the language skills needed to learn and succeed in a classroom environment. Interventions are curriculum-based, that is, goals address language needs within the context of the curriculum where these skills are needed.
Interventions may also address literacy skills (e.g., improving decoding, reading comprehension, and narrative and expository writing), as well as metacognitive and metalinguistic skills (e.g., increasing awareness of rules and principles for use of various language forms, improving the ability to self-monitor and self-regulate) that are critical for the development of higher-level language skills. See the treatment section of the Written Language Disorders Practice Portal page.
For children who speak a language other than English in the home, it may be necessary to use the home language as a mechanism for transitioning the child to using the language of the school. Planning and implementing an effective language intervention program is often a coordinated effort involving the SLP, classroom teacher(s), and other school specialists.
Areas targeted for this population typically include
phonology
- enhancing phonological awareness skills,
- eliminating any residual phonological processes.
- improving knowledge of vocabulary, including knowledge of curriculum-related vocabulary,
- improving depth of vocabulary understanding and use, including
- subtle differences in meaning,
- changes in meaning with context,
- abstract vocabulary,
- figures of speech;
- understanding figurative language and recognizing ambiguities in language (e.g., words with multiple meanings and ambiguous sentence structures);
- monitoring comprehension, requesting clarification;
- paraphrasing information.
- increasing the use of more advanced morphology (e.g., monster/monstrous, medicine/medical, school/scholastic);
- increasing the ability to analyze morphologically complex words (e.g., prefixes, suffixes);
- improving morphosyntactic skills (e.g., use of morphemes in simple and complex clauses, declarative versus questions, tag questions and relative clauses);
- improving the ability to understand and formulate more complex sentence structures (e.g., compound sentences; complex sentences containing dependent clauses);
- judging the correctness of grammar and morphological word forms and being able to correct errors.
- using language in various contexts to convey politeness, persuasiveness, clarification;
- increasing discourse-level knowledge and skills, including
- academic discourse,
- social interaction discourse,
- narrative discourse,
- expository discourse,
- use of cohesive devices in discourse;
- improving the ability to make relevant contributions to classroom discussions;
- improving the ability to repair conversational breakdowns;
- learning what to say and what not to say;
- learning when to talk and when not to talk.
Intervention For Adolescent Students (Ages 11 Through High School)
As students enter their adolescent years, curriculum demands increase. Children with language disabilities may have difficulty meeting increased demands of secondary school. Although basic language skills are still taught, it may not be possible to close the gap between skill level and grade level. At this point, interventions tend to focus on teaching ways to compensate for language deficits. Student involvement is important at this age to foster a feeling of collaboration and responsibility for developing and achieving intervention goals and to learn self-advocacy skills for the classroom (e.g., requesting priority seating in front of classroom).
Instructional strategies approaches that focus on teaching rules, techniques, and principles to facilitate acquisition and use of information across a broad range of situations and settings are often used with older students. Enhancing metalinguistic and metacognitive skills is fundamental to learning new strategies. The emphasis is on how to learn, rather than what to learn. Classroom assignments are often used to teach strategies for learning academic content. Some instructional strategies are discipline-specific, and others are generalizable across disciplines (Faggella-Luby & Deshler, 2008). Examples include strategies for using
- context to deduce meaning and infer and identify main ideas;
- deciphering of morphologically complex words associated with different academic course work (e.g., history, literature, chemistry, algebra);
- checklists and graphic organizers to plan assignments (e.g., book reports, presentations, research papers);
- spell check and grammar check to edit written work composed in an electronic format;
- digital technologies (e.g., Internet, collaboration sites) to access and evaluate information, share and collaborate with classmates, produce shared products, etc.