The history of Specific Language Impairment (SLI)

The history of Specific Language Disorder is not fortuitous and we would like to make a note of how this term has evolved and appeared since many times in different professionals and countries we find a disparity of names that could lead to great confusion in the terms.
Within the framework of studies on language disorders, numerous terms have been used to refer to problems that today can be categorized as specific language disorder.
At first, it was called “evolutionary aphasia,” referring to a series of receptive or productive-receptive disorders in children that showed similarities with the language disorganization that is typical in adult aphasias. In this case, since the term “aphasia” has always been related to linguistic problems derived from neurological damage and pathologies, many authors determined that this term was not appropriate in children whose case did not show such neurological problems.
Then the concept of "language delay" was coined and there were two main types:
- Primary language delay: characterized mainly by a gap in the acquisition of linguistic skills according to chronological age, without biological or psychological causes that explain it.
- Secondary language delay : due to other neurological, motor, psychological pathologies, etc. Logically, SLI cases would fall within primary language delays, reserving the other category for speech therapy problems associated with mental retardation, autism, etc.
This categorization of “primary delay” was still very broad and of little use for clinical work, so it was again subdivided into two new concepts:
- Simple language delay: it would apply to young children (up to about 6 years old) in whom there is a gap in language learning if we compare it with the usual evolutionary rhythm of acquisitions.
- Childhood dysphasia: it would be understood as an oral language deficit that manifests mainly from the age of 6, in the form of an evolving language disorganization.
These two concepts of "simple delay" and "infantile dysphasia" were well integrated in the scientific and speech therapy community, being used extensively; even today.
Despite this, many voices continued to criticize this terminology, based on the fact that in practice they were very difficult to distinguish , since basically the typical problems of simple delay could also be found in dysphasia and vice versa. Furthermore , the 6-year criterion is very problematic , since children do not have an evolutionary rhythm that can be divided categorically based on chronological age.
For all these reasons, they tried to find a consistent solution and “started from scratch”, using a new term to describe this case. Thus, based on the proposals of several authors and later on the recommendations of the ASHA (American Speech-Hearing Association) , the term "specific language disorder (SLI)" emerged as a significant language limitation in children who present a normal development and that show no obvious cause for said limitation.
Within the existing literature on Specific Language Impairment, a small number of works have studied the evolutionary development of children with this type of problem , emphasizing the differences found with the development of "normal" children. In general, the initial development of children is normal or practically normal in motor, social, intelligence, etc. aspects, with only the linguistic ones being altered. However, these same works show that these deficits in language and communication will subsequently cause greater impairment in development that can mainly affect the following areas:
- Prerequisite behaviors for learning: in order to learn, children must possess minimum behaviors such as:
(a) basic communication skills, (b) attention, (c) verbal imitation and (d) following instructions.
Children with Specific Language Impairment show difficulties with these prerequisite behaviors, so their subsequent learning is severely limited by the inability to take advantage of them.
- Disruptive behaviors: due to the problems they have communicating with others and the frustration that this produces, it is common for children with SLI to show behaviors such as throwing things, screaming, throwing themselves on the ground, etc. In this way they manage to put an end to situations that are aversive to them, such as interacting with others, school, learning, etc.
- Intelligence: Verbal skills are an essential part of what is considered "intelligence"; In fact, the most used test (the WISC-R) has a scale designed exclusively to measure this type of abilities. Therefore, a linguistic deficit will cause these children to score low on intelligence tests, reaching a borderline level or mild mental retardation.
- Affectiveness and social aspects: problems with language production and understanding often cause children to withdraw from social contact, or to be considered "clumsy" by others. This social withdrawal can become severe and affect the development of affectivity and socialization behaviors.
- Academic performance: Of course, children with SLI have very poor academic performance, since most of the curriculum is built on skills that have a verbal component.
The idea that SLI entails certain developmental problems should be taken with great caution , since it is plausible that these problems are not a necessary consequence of the disorder, but rather are caused and/or mediated by multiple factors such as education, family, social relationships, the way you interact with children, etc. Thus and repeating what was stated in the previous topic , we should not assume developmental problems in children with SLI as something inevitable and that they will be present in all cases, but rather as a possibility that will have to be explored in the corresponding evaluation.
Cristina Oroz Bajo
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