What is Specific Speech and Language Impairment

Specific Speech and Language Impairment (SSLI for short) is a disability which is usually diagnosed in early childhood. SSLI is sometimes called SLI (specific language impairment or speech language impairment), SLD (specific language disorder), SSLD (specific speech and language disorder) or speech disorder. Children with SSLI have exceptional difficulty learning and generalising speech, language and communication skills. Their communication skills do not develop in the same way as other children's. Research suggests that SSLI occurs in about 5%-7% of the childhood population. (this figure is based on research done in the UK, nobody knows how many children have SSLI in Ireland). There is no known cause for SSLI. The speech and language difficulties in SSLI are specific and persistent and are not due to an overall learning difficulty, hearing loss, environmental deprivation or autistic spectrum disorder. SSLI is different to a speech and language delay. Speech and language delay is typically characterised by less severe difficulties which resolve over time or with therapy.

How is SSLI diagnosed?

SSLI is diagnosed by a speech and language therapist in conjunction with a psychologist. Detailed speech and language assessment highlights the areas of speech and language that are affected and determines the severity of the problem. Psychological assessment verifies that the child does not have an overall learning (intellectual) disability or any other developmental problem. Other professionals may be involved in the assessment process depending on the nature of the child’s presentation (e.g. paediatrician, child psychiatrist, occupational therapist). It can be difficult to decide if a very young child has severe SSLI or another developmental disorder (e.g. autistic spectrum disorder, intellectual disability). Ongoing evaluation with different professionals may be necessary to clarify the diagnosis over a period of time.

How do children with SSLI present?

Children with SSLI are all different. Here are some examples of what you might notice in a child with SSLI

Problems understanding language (receptive language) - In everyday situations the child may not be able to follow long instructions or get the point of a conversation. He may lose interest in play or conversation because he can’t follow what’s happening. Some children with SSLI are very good at masking their receptive language problems. They use visual clues in their environment to work out what is being said.

Problems using language (expressive language) - In everyday life you may notice that the child cannot form long sentences, gets words mixed up in sentences or cannot think of the words he wants to use quickly enough. Some children talk a lot but have difficulty getting to the point of what they are trying to say.

Problems pronouncing sounds (speech) – In everyday life you may notice that it is difficult to understand what the child is trying to say. He may use gestures with (or instead of) speech.

Sometimes children with SSLI find it difficult to socialise with their peers because they cannot communicate as effectively as other children.

What kind of support do children with SSLI need?

The type of service required varies according to the individual needs of the child, however all children with SSLI will need the support of a speech and language therapist at some stage. The role of the speech and language therapist is to work with the child and the family in an effort to help the child reach his potential. Speech and language therapists may also help teachers to adapt the curriculum for children with SSLI. Many children with SSLI are entitled to resource teaching in school to help them access the curriculum. The Dept of Education and Science have a defined set of criteria for the allocation of resource teaching hours. An application for resource hours must be made to the school principal. It is very important that people involved in supporting a child with SSLI work together in order to set appropriate goals which will enhance the child’s ability to communicate in everyday life. Parents may also need support to help them cope with their child’s communication difficulties. Realising that their child has SSLI can be a distressing event for a parent.

What is the prognosis for children with SSLI?

SSLI is a long term disability and it is important to recognise that therapy does not provide a cure. The aim of therapy is to help maximise the child’s communication potential rather than to achieve ‘typical’ speech and language skills. The long term outcome depends on many factors, not least the initial severity and nature of the problem. Children are likely to have some ongoing difficulties with communication but the nature of their difficulties will change over time. Most children with SSLI receive a significant benefit from speech and language therapy. Some children with SSLI are at higher risk of reading, spelling and writing difficulties so literacy development needs to be monitored closely.

Difference between SSLI and a speech and language delay

The term 'speech and language delay' is used to describe a child's speech and language profile that is developing along the normal developmental pattern but is delayed when compared to his/her peer group. The term SSLI implies a deviation in the usual rate and/or sequence with which speech and language skills emerge