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SPECIFIC LANGUAGE IMPAIRMENT KUNNAMPALLIL GEJO JOHN

KUNNAMPALLIL GEJO JOHN


INTRODUCTION 

A language problem in a child who is apparently normal in most if not all aspects is commonly called specific language impairment. Children who exhibit SLI do not have other significant clinical condition or conditions that implies that the impairment is specific to language which means that the child has only one impairment, which is restricted to language skills. These children are roughly comparable to normally developing children.

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A brief review about SLI and terminological issues

1922 : Gall Vaisse : Congenital aphasia. German literature : Hearing mutism (Coen). Froschels : Delayed speech development

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McCan : Congenital word Deafness.

Worster : Congenital Auditory Imperfections

Karlin : Congenital Verbal Auditory Agnosia

20th century : Aphasia

Gesell and Amatruda : Infantile Aphasia.

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Kerr : Developmental Aphasia Expressive Developmental Aphasia Receptive Expressive Developmental Aphasia.

1960’s : Dysphasia

1980’s : Developmental Dysphasia

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Since the 1968, the following terms have appeared in the literature: Infantile speech (Menyuk, 1964) Delayed speech Deviant language (Leonard, 1972) Specific language deficit.

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Leonard in 1981 :

SPECIFIC LANGUAGE IMPAIRMENT

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DEFINITIONS: The American Speech Language Hearing Association (ASHA) has proposed defining language disorder as impairment in comprehension and/ or use of a spoken, written, and/ or other symbol symptom. The disorder may involve (1) The form of language (phonologic, morphologic and syntactic system) (2) The content of language ( semantic system) (3) The function of language in communication (pragmatic system) in any combination.

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SLI is a ‘ significant limitation in language ability, yet the factors usually accompanying learning problems – such as hearing impairment, low non-verbal intelligent test scores and neurological damage are not evident.

- ( Leonard,1998)

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In DSM 1V (American Psychiatric Association, 1994) didn’t use the term “Specific language impairment” but it includes 2 disorder that cover much of the same term. They are expressive language disorder and Mixed receptive – Expressive language disorder.

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EXPRESSIVE LANGUAGE DISORDER a) The score obtained from standardized, individually administered measures of expressive language development are substantially below those obtained from standardized measures of both non verbal intellectual capacity and receptive language development. The disturbance may be manifest clinically by symptoms that include having a markedly limited vocabulary making errors intense or having difficulty recalling words or producing sentences with developmentally appropriate length or complexity. ď ˝

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b) The difficulties with expressive language fire with academic or occupational achievement or with social communication. C) Criteria are not met for mixed receptive expressive language disorder or persuasive developmental disorder. d) If mental retardation, a speech motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.

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Mixed Receptive- Expressive language disorder(APA,1994) a) The scores obtained from a battery of standardized individually administered measures of both receptive and expressive language development are substantially below those obtained from standardized measure of non-verbal intellectual capacity. Symptoms include those for expressive language disorder as well as difficulty understanding words, sentences or specific types of words, such as spatial terms. KUNNAMPALLIL GEJO JOHN


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b) The difficulties with receptive and expressive language significantly interfere with academic or occupational achievement or with social communication. C) Criteria are not met for pervasive developmental disorder. d) If mental retardation, a speech motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.

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PREVALANCE

SLI are more seen in males than in females and more likely in children to have parents and siblings with history of language learning problems ( Leonard, 1998). SLI is seen approximately in 7% of kindergarten ( Tomblin, 1997).

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Etiology - (Suspected causes )

Risk factors include : a) Genetics b) Difference in brain structure and function. c) Environmental variable d) Linguistic and cognitive account e) Processing factors

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Others are: ◦ ◦ ◦ ◦

family history birth order parents level of education gender M> F (Bishop, North, 1995)

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GENETICS: Concerned with role of genetic mechanism & their interaction with environmental factors. 30% of the immediate familial members of children with SLI had a history of language problem (Robinson 1987, Stollwerck 1998). Clark (1996) showed that 63% parents of SLI children scored lower than parents of control group children.

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FOX P2 – Language gene ,any defect in this gene will result in language acquisition deficit even though they have any intellectual or other cognitive deficits. KE Family – brought to the attention of scientific communication (1980) In 3 generation- half of the family members had severe difficulty in speaking, their speech was unintelligible.

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This disorder were associated with the mutation of single autosomal dominant gene. Location of this gene is on Chromosome 7( 7q 31) (Kadem et al 1995,Barlette et al 2002) Mutation of FOX P2 gene result in SLI This gene plays part in development of language. Protein encoded by FOX P2 gene present in number of species in addition to humans.

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It is believed that slight variation in the protein is the reason why human can speak and chimpanzees cannot.

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In family studies, the family members of a proband (i. e an affected person who is the focus of the study) are examined to determine whether they show evidence of the characteristic or disorder under study at rates higher than would be expected on the general population. KUNNAMPALLIL GEJO JOHN


Difference in brain structure and function: Despite the exclusion of known brain damage from strict definitions of SLl, a relatively large number of studies using MRI and less frequently examination have been undertaken to determine whether subtle differences in brain structure and function can account for the difficulties faced by· children with SLI. (Ganger and Leonard, 1997). KUNNAMPALLIL GEJO JOHN


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Two areas of the cerebral hemisphere in which such variations are seen have been identified are the planum temporale and the perisylvian area. Examinations of the plana temporale in individual with SLI were sparked by a 1985 autopsy study (Galaburd et al.) of adults who had written language deficits. Detailed examination of these individual brain after death showed an typical aymmetry between the planum temporale on the left and the one on the right. KUNNAMPALLIL GEJO JOHN


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This pattern contrasted with the more typical asymmetric arrangement in which the planum temporale on the left is bigger than that on the right, with the larger size thought to reflect greater involvement in language processing.

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. Environmental variable Environmental variables include physical, social, emotion or other aspects of the developing child's surroundings from conception onward. Two types of environmental variables, have recorded the greatest amount of attention for SLI. (a) Variable constituting the social and Linguistic environment in which children with SLI are acquiring language . (b) Demographic variables, such as parental education, birth order and family and socio-economics status that affect the environment in the direct ways. KUNNAMPALLIL GEJO JOHN


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Studies suggest that the conversation partners (patents, other adults and peers alike) make allowances for their diminished language skills and are thus reacting to, rather than causing the children's problem. For eg. Mother of SLI may used shorter utterances (especially incases where both comprehensions and expression were affected or asked fewer question) during a structural task compared to mothers of normally developing children (Cunningham et al).

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Diagnostic criteria for SLI, Leonard (1998)

FACTORS

CRITERIA

Learning ability

Learning test scores of -1.25 SD or lower, at risk for Social devalue.

Non verbal IQ

Performance IQ of 85 or higher

Hearing

pass screening at conventional levels.

Otitis media with effusion

No recent episodes.

Neurological dysfunction

No evidence of seizures disorders, CP, brain lesions, not under medication of control of seizures

Oral structure

No structural anomalies

Oral motor function

Pass screening using developmentally appropriate items

Physical and social interaction

No symptoms of impaired reciprocal social interaction or restriction of activities KUNNAMPALLIL GEJO JOHN


Classification:

1) Rapin & Allen classification (1988) These authors subdivided language impairments including acquired impairments into 3 main categories some of which are further divided into subtypes a) Disorder of phonological decodingincludes only one type of language impairment that is acquired verbal auditory agnosia in which child loses the ability to decode & comprehend & consequently to produce speech b) Disorder of phonological encoding 2 subtypes

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Verbal dyspraxia – in which child has severe oromotor programming deficits & extremely dysfluent speech Phonological programming deficit syndrome- in which only articulation is severely affected but sp is otherwise adequate & fluent c) Disorder of higher level processing 2 subtypes Semantic pragmatic deficit syndrome Lexical syntactic deficit syndrome KUNNAMPALLIL GEJO JOHN


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2) KORKMANS CLASSIFICATION (1994 ) This classification is based on an empirical study of 80 children with SLI it includes 4 specific disorders which may overlap The specific verbal dyspraxia subtype – they have deficit in organizing the phonological motor patterns involved in speech production. poor results on repetition of complex words and non sense words as well as on task requiring the production of oromotor sequences (such as P T K).

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B) The Specific Comprehension Subtype – Common characteristics are problem in the domain of comprehension. Difficulties in comprehending verbal instruction and concepts. They may not have difficulties in auditory phonology discrimination and processing (eg: sound blending and deletion task). C) The specific dynamic subtype characterized by impaired performance on naming tasks. such as speed naming & naming learning. If specific affected children do not have articulation or comprehension problems. Their SLI may be detected until the problem is manifested as dyslexia. KUNNAMPALLIL GEJO JOHN


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D) The global subtype: children in this category are characterized by global & severe language disorders affecting all domains of language comprehension, naming, expression, &articulation.

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3.DSM-IV CLASSIFICATION (APA1994 ) DSM-IV proposes a classification has a) Expressive language subtype: limited speech and vocabulary, word – findings errors, shortened and simplified sentences, with better comprehension skills. b) mixed receptive- expressive language disorders: same as above with additional difficulty in understanding word & sentences. c) Phonological Disorder- failure to produce or sequence speech sounds in a way that is appropriate for child’s age. The disorders includes both a primarily motor variant, in which the articulation is deficient and more perceptual condition, in which linguistic categorization of speech sound is deficient

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CONTI-RAMSDEN & HER COLLEAGUES (1997): Three sub groupings of children of SLI, Expressive SLI Expressive – Receptive SLI Complex SLI (i. e; children who demonstrated problems learning lexical, syntactic & pragmatic competencies but had no phonological component to the disorder). SLI was a “dynamic condition” because individual strengths & weakness would be likely to change over time. Bishop& Edmundron (1987) had noted that approximately 37% of the children they had studied who had been diagnosed with SLI age 4 were no longer performing like children with SLI when reached age 5 1/2 .

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Early Communication Deficits Early communication deficits are the first warning sign of SLI. Infants and toddlers who show deficiencies in early communicative behavior are at risk for developing SLI later years. Hamaguchi (2001) described the following patterns of deficiencies in early communication skills Does not engage in mutual eye gaze Does not display typical vocalization Produces only few consonant sounds in babbling Does not imitate or does not respond to care giver KUNNAMPALLIL GEJO JOHN


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Birth to 12 months Avoids eye contact Rarely babbles usually quiet Does not consistently respond to whispered speech Show little interest in imitating gestures , such as bye-bye Cries often without changing pitch or intensity Shows little emotions.

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12 to 18 months avoids eye contact Does not say mama or dada Does not point to common body parts Cannot follow simple one step directions Other signs includes Lack of social smile Lack of play activities Over reliance of gestures rather than oral language

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What is the relationship between 'Late talkers' and SLI The child who is late to begin talking, both in terms of acquisition of first words , and production of first word combinations, maybe at particular risk for the development of SLI. The proportions often discussed are between 25 to 50% children diagnosed as 'late talkers' eventually are diagnosed as SLI. Due to the variability in developmental course, Leonard (1998) has suggested that a diagnosis of SLI prior to age 3 is not yet a . possibility. KUNNAMPALLIL GEJO JOHN


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Rate of vocabulary development and use of communicative gestures have been the prime language behavior data collected in studies of 'late talkers". Late talkers have also been shown to demonstrate less mature development of their phonological systems (Rescorla and Bernstein Ratner, 1996), symbolic play behaviours (Rescorla and Goosens, 1992) and limited socialization skills (pauI, et al99l) when compared with age matched, normally developing peers. KUNNAMPALLIL GEJO JOHN


Two year old 'late talking' children who were more likely to catch up with their peers by age 3 were children who utilized gestures to enhance their limited verbal output ( Thal eta1.1991). Leonard (1998) noted that point to a significant proportion of ‘late talkers' catching up with their age-matched peers by the time they reach the early school year , should not suggest that early intervention is not a useful and clinically appropriate endeavor with this population. KUNNAMPALLIL GEJO JOHN


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There is a great deal of variability of language performance within the population. This heterogeneity can affect the severity of language problem, the area of learning affected, and the modality or modalities affected.

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We also know that children diagnosed with SLI are likely to demonstrate social interactive problems that manifest themselves later as conversational and other pragmatic deficits. There is sufficient literature to suggest that the problem of SLI is ongoing. By the time diagnosed by SLI demonstrate problem in reading and writing

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PROCESSING FACTORS IN SLI Although children with SLI demonstrate typical non verbal intelligence , they may also demonstrate cognitive impairments not exhibited on standard intelligence measures. Information processing problems of children with SLI occur with incoming information in memory and in problem solving. Although interpretation of rapid sequenced auditory input , especially of linguistic information is difficult for children with SLI, isolated non linguistic signal processing is normal. KUNNAMPALLIL GEJO JOHN


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Rapid sequenced visual and tactile stimuli are also difficult for children with SLI to interpret. Short term auditory sequential memory or memory for item order & problem solving of complex reasoning tasks are also affected in children with SLI. ( gentry 1990).

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Gina Conti-Ramsdon studied about processing & linguistic markers in young children with SLI. In his study 32 five year old children with SLI & 32 chronologically age (CA) controls completed 4 tasks that were considered potential positive markers for SLI. Children’s performance on two linguistic tasks (non word repetition and digit recall) were examined. This approach allowed the examination of more than one type of marker simultaneously facilitating both comparison between markers and also the evaluation of combination of marker in relation to identifying SLI. KUNNAMPALLIL GEJO JOHN


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Children with SLI performed significantly worse than CA controls in all 4 marker tasks. Specificity/sensitivity analysis of the 4 marker tasks revealed non word repetition & the past tense task to have the best overall accuracy at the 25th and 16th percentile. Finally stepwise discriminant analysis revealed non word repetition and past tense marking to be the best markers for identifying young children with SLI.

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The surface account assumes that children with SLI have no fundamental gaps in their grammatical knowledge apart from the deficiencies that arise because of their slow intake of relevant data due to processing limitations. it is assumed that children with SLI are capable of perceiving segments of brief duration, but these children limited processing capacity is taxed when such challenging forms play a morphological role.

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In this case additional operations must be performed ; such as discovering the grammatical function of these segments and placing them in the proper cell of a morphological paradigm. These operation must be performed while the child is dealing with the rest of the sentence that is being heard. The additional operations together with the brevity of the morpheme will sometime result in incomplete processing of the morpheme. Specifically

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A) Inflection might decay completely & be lost before morphological analysis is complete. B) Inflected words might decay partially & be mistaken as the bare stem because of the similarity of these two forms C) Processing of the inflected word might be abandoned prior to the inflection in favor of next word appearing in the utterance.

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TEMPORAL PROCESSING According to literature, children with SLI perform quiet poorly on tasks requiring the processing of brief stimuli & the processing of stimuli that are presented on rapid succession. In either case demands are placed on the children that seems to have a more detrimental effect on their performance( Tallal & Pregy 1983) Robin et al 1998 Mc Greger & Allen (1992)

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The children with SLI participating in the experimental condition in the Tallal, Miller, Jenkins & Merzenic (1996) study heard speech that was prolonged by 50% and selectively amplified such that fast transitional element were boosted by up to 20dB .The children with SLI serving in the control condition heard the same material in a modified form.

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The children with SLI participating in the experimental condition in the Tallal, Miller, Jenkins & Merzenic (1996) study heard speech that was prolonged by 50% and selectively amplified such that fast transitional element were boosted by up to 20dB .The children with SLI serving in the control condition heard the same material in a modified form.

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Early notion of deficit in auditory processing LOWE & CAMPBELL (1965) pursued this idea by comparing children with SLI & age controls on two different tasks. In the first task , the children were tested on there ability to detect the appearance of two identical pure tone presented in close succession. Difficulty with this tasks result in children reporting only a single tone presentation. In the 2nd task the children were asked to sequence two pure tone of different frequencies presented at varying inter stimulus intervals. KUNNAMPALLIL GEJO JOHN


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In the first task the children with SLI required inter-stimulus interval that were almost twice as long as those required for control children before two tones were perceived. In the 2nd task the children with SLI could correctly sequence the tones only when the ISI exceeded 250ms, whereas the age control succeeded with intervals of 40ms. Results highly similar to those of the first task were reported in a later study by Mc Crosky & Kidder (1980)

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Non-verbal stimuli Tallal & Piercy ( 1973) employed two non verbal auditory stimuli of 75ms, composed of frequencies in the speech range distributed in a way that did not correspond to the output of the human vocal tract. School age children with SLI and normal participated in the study. After the children were taught to press the panel corresponding to each stimulus the ISI between the 2 stimuli varied. The age controls performed above the level of chance at all ISI. The children with SLI on the other hand, performed at above chance level only when ISI exceeded 300ms. KUNNAMPALLIL GEJO JOHN


Identical results were seen the other panel when they are different. Because the same- different task required only discrimination of the stimuli. Tallal & Piercy concluded that the sequence difficulties exhibited by the children with SLI in the first task were secondary to their problem with discriminating the two stimuli when presented in rapid succession. TALLAL & PIERCY (1973) in same experiment varied ISI are found poorer discrimination at smaller ISI. They said this might be due to general immaturity in perceptual skills of children with SLI. KUNNAMPALLIL GEJO JOHN


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REDUCED SPEED OF PROCESSING APPLIED TO LANGUAGE PRODUCTION Reduced speed of processing in SLI children must have an effect on the process of language production as well. Children with SLI usually differ from normally developing children in the degree to which they express particular linguistic information not in whether they express such information. Thus particular word that are called for in the situation seems less likely to be used when needed, and especially closed class morphemes are used less frequently in obligatory contexts KUNNAMPALLIL GEJO JOHN


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Bishop (1994) studied a group of children with SLI who displayed considerable inconsistency in their use of grammatical inflection. On close inspection she found instances of inconsistencies involving the same lexical items. Leonard et al (1997) found evidence of the same type for each of the children with SLI participating in their study. Bishop also found some evidence suggesting that errors in grammatical morphology increased with the amount of material already generated in the utterance KUNNAMPALLIL GEJO JOHN


Bishop (1994) suggested that the types of grammatical errors she observed might be profitably considered as a result of slow processing with in a speech production model. Hagerly & Stamm (1978) used a dichotic listening tasks were clicks are presented in both the ears & the person has to indicate whether he heard one or two clicks. The children with SLI required longer ISI than the age control. Thus the processing of rapidly occurring stimuli represents an area of difficulty for children with SLI as indicated by various studies. KUNNAMPALLIL GEJO JOHN


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VERBAL STIMULI The children with SLI show a poor discrimination for vowel pair as compared to normal children. Phonetic identification as well as discrimination was examined by Sussman (1993) the children with SLI performed as well as two groups of normally developing children . However on the discrimination task the children with SLI were less accurate on the endpoint stimuli.

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Heinz (1996) studied vowel perception in children with SLI. On identification task SLI children performed as well as normal child but were poorer in discrimination tasks mainly on short duration vowel.

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THE LANGUAGE CHARACTERISTICS OF SLI Children with SLI are a heterogeneous group, exhibiting different combination of deficiencies in various aspects of language comprehension & production .In addition many children diagnosed with SLI have concomitant problems with sp production, commonly diagnosed as phonological disorders. The following sections describe commonly observed sp & lang behaviors of children with SLI. KUNNAMPALLIL GEJO JOHN


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1) LEXICAL ABILITIES A)

The early lexicon : Children with SLI appear to be late in acquiring their first words. Bender (1940) observed a child who failed to produce word until age 4. A child studied by Warner(1945) did not using first word until after age 5. In one of the few investigators dealing with more than a single child. Morley, Miller, Court, Garside (1955) noted ages of first word acquisition ranging from 1.6 to 5 among 15 children with SLI

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Weeks (1974) reported a child whose production lexicon did not reach 50 words until age 2.4. More recent work on 71 children with SLI is done by Trauner, Wulfech, Tallel & Hesselink (1995) indicated an average age of first word of almost 23 mths compared with an age of almost 11 mths reported by parents of normally developing children. The finding that children with SLI acquire their first word at later than expected age is not surprising, but it is not logically neccesary. KUNNAMPALLIL GEJO JOHN


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It could have been possible for eg: for first word to appear on schedule but for lexical development thereafter to have problem or for lexical development to proceed normally up to the point of word combination. That is not case suggests that signs of language problem are evident atleast from the point when communication is expected to take a verbal form. The type of words used by children with SLI during the early period of language development seem to match the types observed in the sp of young normal children. The lexical types in the vocabulary include General nominals – 55 % ( eg: names of objects, substances, animals ) Word referring to actions-12% Word referring to properties-12%(Leonard Camarat ,Rowan & chapan 1982) KUNNAMPALLIL GEJO JOHN


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Children with SLI seem to vary in whether they use many general nominals & few personal social words (eg: please, thank you,) or the converse (Weiss, Leonard, Rowan 1983). By the time children with SLI begin to produce multi word utterances their lexical abilities are not so easily characterized as matching those of younger normally developing children. Verbs in particular begin to show deficiencies that seems to go beyond the general lag in these children lexical abilities. KUNNAMPALLIL GEJO JOHN


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b) Lexical learning in pre school years

Rice, Buhr, & Nemath(1990) employed a task in which give unfamiliar name from each of the categories of objects, actions, were presented to 5 yr old children with SLI. The words were incorporated into stories & appeared ten times each. The children with SLI showed poorer overall mapping ability on a comprehension task than did both age control and MLU controls. The names of actions were especially difficult for each group of children.

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Verbs differ widely in the types of meaning they convey. Thus it is possible that differences between children with SLI & control might have as much to do with the distribution of the types of verb meaning employed in the study as with fact that they were verbs. Investigators have also examined whether the manner in which the novel words are presented plays an important role in lexical learning.

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In a study conducted by Leonard, Schwartz, & their colleagues (1983, 1982, 1989) comparison were drawn between 3-4 year old children with SLI & single word production level & younger normally developing children with comparable lexical sizes and utterance lengths. Across studies the 2 groups performed in a similar manner. Both groups comprehended & produced more object word than action words & comprehension was superior to production. The children with SLI were less able to extend newly learned object names to unnamed

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The findings of these studies were suppressing earlier studies had showed that during the period of development in question lexical acquisition in children with SLI was slow, yet children with SLI in these studies acquired as many word as the control children.

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Study done by Oetting , Rice,Swank (1995) revealed that the school-age children with SLI learned object names as well as did age controls, but then learning of action names fell below that of their same peers. word finding problem , that is, a problem in generating a particular word called for in the situation Leonard 1995. These difficulties have been variously described as ‘’ lexical look-up problems’’ (Menyuk 1975) & problems involving delayed speed of word retrieval.( E Schwartz 1980) KUNNAMPALLIL GEJO JOHN


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According to the clinical literature, the chief problems of word retrieval problems are Usually long pauses in speech Frequent circumlocution Use of non specific words Naming error

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Thus it seemed possible that the words were present in memory but the children used in inefficient or inappropriate means of assessing them.

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Anderson (1965) examined naming response time in children with SLI. A group of school age children with SLI named picture of common objects with slower response time than a group of age controls

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The age of first word combination appears to be later in children with SLI than in normally developing children.

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Morphosyntax can be divided into syntactic structure Grammatical morphology syntactic structure – structural relationship between constituents. Grammatical morphology- close class morphemes of the language both the morphemes seen in inflectional morphology. (‘’play’’ ‘’played’’ ) and derivational morphology ( eg : ‘’ fool’’ ‘’foolish’’) and functional words such as articles and auxiliary verbs. KUNNAMPALLIL GEJO JOHN


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Menyuk (1964). She collected spontaneous speech samples from children with SLI age 3-5 yrs & normally developing children matched according to the age. The result indicated that a greater number of age controls showed evidence of transform actions, whereas a greater number of children with SLI deviated from adult grammar. Omission were the most common type of deviation

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Ingram (1970, 1973) compared children with SLI with a MLU matched children. The 2 groups were found to be similar in the syntactic rules reflected in their speech with a few important exception. The children with SLI did not use major syntactic categories( eg: noun, verb embedded sentence ) in as many different sentence contexts . On average as the MLU controls.

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In SLI children problems in production will be more severe than comprehension problems. However children with SLI who have production problem ere not free of comprehension problem (Bishop 1974, 1982,Lilly & Harris 1990)

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Laurence B Leonard studied on surface forms and the grammatical functions: past tense and passive participle use by children with SLI. IN THIS STUDY Passive participle-ed as well as past tense –ed was examined SLI-used in fewer obligatory contexts SLI- GREATER DIFFICUKTY WITH PAST TENSE –ED THAN PASSIVE PARTICIPLE-ED 

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Leonard ,Eyer, Bedore, & Grela (1997) compared pre-schoolers with SLI age control & MLU control on their use of set of morphemes. The first set consisted of finite verbs inflection & copula be form; the second consisted of a collection of inflection & function words that were unrelated to non plural s generative-s & articles. The children with SLI showed less% of use of both sets than did the MLU controls age controls. KUNNAMPALLIL GEJO JOHN


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The choice of grammatical morphology as a potential clinical marker has strong empirical basis. difficulty with a range of grammatical morphemes including present 3-rd person singular inflection , regular past inflections, articles & copula forms. ( Rice & Wexler 1996, Rice, Wexler & Cleare 1995)

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Evidence that grammatical morphology may be among the weakest area of language in children with SLI comes from studies in which their childhood are compared with young normally developing children matched for MLU.

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Phonological deficits rarely occur alone. During the pre school years, if children exhibit deficits in morphosyntax and lexical skills, they almost invariably show weakness in phonology as well. If children are identified first on the basis of phonological problems, a majority will also show problems in other areas of language.

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Children with SLI are late in acquiring the segments of the language. Segments that are acquired early by normally developing children. ( eg: lnl, lml, lbl, lwl) are likewise the first to be acquired by children with SLI, at a later age segments that are acquired later by normally developing children ( eg: lsl, lvl) can continue to be difficult for children with SLI well into their school years ( eg: farwell 1972 )

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The distinctive feature patterns represented in the speech of children with SLI resemble those seen in the speech of younger normally developing children. However there are two Strident Menyuk(1968) observed that once segment carrying ( + strident) appear in the speech of normally developing children, this feature is relatively resilient, even if other features in the target sound are in error. However data from Leonard ( 1973) and Mc Reynolds & Husten ( 1971) suggest that children with SLI retain (+ strident) least often KUNNAMPALLIL GEJO JOHN


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The distinctive feature patterns represented in the speech of children with SLI resemble those seen in the speech of younger normally developing children. However there are two Strident

Menyuk(1968) observed that once segment carrying ( + strident) appear in the speech of normally developing children, this feature is relatively resilient, even if other features in the target sound are in error. However data from Leonard ( 1973) and Mc Reynolds & Husten ( 1971) suggest that children with SLI retain (+ strident) least often.

KUNNAMPALLIL GEJO JOHN


o

Voice

The best documented difference between children with SLI & young normally developing children concerns( + voice). Although children with SLI are not as proficient as their same age peers in their ability to produce voicing contrast ( eg: coal, goal) ( Catts & Jensen 1983). This aspect of phonology seems to be a relative strength in these children at least in word initial or pre vocalic position.

KUNNAMPALLIL GEJO JOHN


ď ˝

Unusual error pattern is seen when the child production constitutes an addition of an adult form eg: Nasal added to the initial form D. Ingram (1976) or in addition of nasal to final position or nasal inserted before alveolar stops (eg: ltondl for ltoadl)

KUNNAMPALLIL GEJO JOHN


Domain

production

comprehens ion

Semantic: lexical abilities & early wd combination

Delay in acquiring first wd & wd combinations  delay in wd acquisition with over use of some common verbs (eg: do, go. Get) Word finding difficulties especially noted in school age children.

Deficient in learning to understand new words particularly those involving actions.

KUNNAMPALLIL GEJO JOHN


Grammatical morphology

Grammatical morphology constitutes a relative & sometimes enduring weakness in children with sli

Limited research suggests poorer comprehension of grammatical morphemes especially those for errors involving grammatical morphemes

KUNNAMPALLIL GEJO JOHN


Phonology

 although occasionally occurring

alone, phonological deficits are almost always accompanied by other lang deficits & vice versa Delays are most frequently seen with most errors resembling those of younger normally developing children.  unusual errors in production occur rarely, but probably are more often than in normally developing children.  greater variability in production than children without SLI at similar stages of phonological development

KUNNAMPALLIL GEJO JOHN


. . Many children relay on specific gestures & stereotypic phrases to convey specific language function . The pragmatic ability of children with SLI have been examined primarily within dialogue & within narrative discourse.

KUNNAMPALLIL GEJO JOHN


2 major categories of intention ďƒ˜ imperative performance: attempts to get listener to perform an act. ďƒ˜ declarative performance: attempt to inform the listeners attention on an object. Shydes (1978) observed that language impaired children generated both imperative and declarative performance but those children were more likely to rely on non-linguistic means when formulating their per formatives than were normally developing peers of same age.

KUNNAMPALLIL GEJO JOHN


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Prinz (1982) examined the requests of more advanced 5-7 yrs old children with SLI

ď ˝

Overall findings indicate that requesting & commenting major communicative intentions are apparent in the discourse of children with SLI from single words at approximately 3-9 yrs of age.

KUNNAMPALLIL GEJO JOHN


ď ˝

Shyder (1978) examined the presuppositional behavior of children with language disorder & children with normal language development at one word stage. She found that both group of children encoded new or changing aspects of the situation rather than old or unchanging aspects. In contrast to children with normal language, the children with language disorder used more nonlinguistic means when expressing these relationships. KUNNAMPALLIL GEJO JOHN


ď ˝

Sharakes & Greenfield (1982) examined the presuppositions of children with language disorder who were beyond the one word stage. They found that both language disordered (SLI) children & normal language matched controls encoded the new or changing elements on the situation rather than unchanging elements and for both groups. This encoding was primarily verbal.

ď ˝

These studies reveal that children with SLI demonstrate basic presuppositional knowledge.

KUNNAMPALLIL GEJO JOHN


 

VERBAL & NON-VERBAL TURN TAKING Craig & Evens (1989) investigated the verbal & non-verbal characteristics of successful & unsuccessful turns produced by boys with SLI & boys with normal language matched for age & language. They found that children with SLI differed from those of children with normal language in the following ways. children with SLI produced significantly less other- directed speech fewer multi utterance turn& less highly timed turns that their age-makes. KUNNAMPALLIL GEJO JOHN


TOPIC MAINTANENCE Schellelter (1996) found that a group of 7 to 8 year old children with SLI were less likely to pronominal a referent more than once relative to 5 to 7 yrs old normally developing children. One possible explanation for this finding is that children with SLI changed topic more quickly & thus new referents were introduced requiring full noun phrases rather than pronouns. KUNNAMPALLIL GEJO JOHN


ď ˝

The normally developing children modify their speech style and complexity as a function of the listeners age, language ability and social status. Researchers tried to find out whether children with SLI make similar speech modifications. The children with SLI showed a clear propensity to make these adjustments.

KUNNAMPALLIL GEJO JOHN


ď‚– NARRATIVES Mc Larchlan & Chapan (1985) found that the children with language disorder demonstrated significantly greater rate of communication breakdown for narration than for dialogue. This indicates that narrative discourse function may be more difficult than dialogue for children with SLI. KUNNAMPALLIL GEJO JOHN


ď ˝

The narrative produced by the children with SLI differ from normally developing children. Their narration seems to be less complete than those of normal. (Liles 1987) they contain fewer utterance and exibit communication breakdown.

KUNNAMPALLIL GEJO JOHN


ď ˝

ď ˝

Several studies have documented problems that children with language learning disabilities in upper elementary school confront when learning mathematics.( Cawley , Shaw, Bates 1979) A prior investigation of mathematical abilities in children with SLI examined that pre-school children with SLI encountered learning to count.( Fazio 1994)

KUNNAMPALLIL GEJO JOHN


ď ˝

To detect the nature of the difficulties that children with SLI exhibited in mathematics they compared mental age and language age comparison group with that of SLI. Tasks examined were conceptual, procedural & declarative knowledge of mathematics. Results indicated that children with SLI displayed a marked difficulty with declarative mathematical knowledge that required an immediate response such as counting by 10, reciting numerals backward from 20 etc.

KUNNAMPALLIL GEJO JOHN


ď ˝

Levi et al (1982) conducted a study to find out if reading and writing difficulties persist in children with language disorders. The study was conducted on 32 children who were diagnosed with a language disorder at 3 years of age. When these children were at around 67 yrs of age their & writing skills were evaluated . Results indicated that 75% of these children continued to exhibit these problem.

KUNNAMPALLIL GEJO JOHN


Related Problem Children with SLI have fewer related problems compared to children with other language disorder. Despite the more restricted nature of their difficulties however children with SLI are at increased risk for a number of significant ongoing problems in addition to a lengthening list of subtle perceptual & cognitive deficiencies. These may be emotional, social & behavioral difficulties. In addition there is increased risk for ongoing academic difficulties. ď ˝

KUNNAMPALLIL GEJO JOHN


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The possibility that children with SLI may be at risk for difficulties in personal adjustment has been examined at several levels of severity. Studies looking at this issue differ in a large number of methodological variables ( age studies, method used to define language impairment, & other problem area.)

KUNNAMPALLIL GEJO JOHN


Specific language impairment / KUNNAMPALLIL GEJO JOHN