For six years we have included the use of NeuronUP in the treatment of Specific Language Impairment (SLI). Our priority is to offer our patients an innovative, dynamic, ecologically valid and customizable tool that helps them to advance in their intervention.

Specific Language Impairment (SLI)

Specific Language Impairment, SLI, is a neurodevelopmental disorder that affects the acquisition and development of oral language because it can alter the comprehension area, the expressive area or both.

Essentially, we can say that a specific language disorder exists when the level of language skills affects the child’s ability to meet the social and educational expectations expected at his or her age.

It qualifies as a heterogeneous disorder. First, no two specific language disorders will ever be the same. Secondly, the symptoms vary greatly from one child to another and do not always present the same form and intensity.

Involvement of language components

Specific language impairment may involve one or several language components: phonetic and phonological, semantic, morphosyntactic or pragmatic.

• Phonetic/phonological area: in this area we usually find children with unintelligible speech. Consequently, this implies phonological simplification errors, multiple dyslalia or difficulties in auditory discrimination.
• Semantic area: in this area we find children with a reduced vocabulary and difficulties in accessing the lexicon; likewise, they know the words but find it difficult to evoke them. For this reason, they tend to use very general words and circumlocutions. Also, they have great difficulty in expressing and understanding anything abstract, anything that cannot be contextualized, and it is very difficult for them to learn new vocabulary.
• Morphosyntactic area: this area is the most affected. They usually make use of simple sentences with few elements and poorly structured with concordance errors, poorly conjugated verbs, omissions of prepositions or pronouns, among other errors. Of course, if the morphosyntactic area is not affected, we cannot speak of a specific language disorder.
• Pragmatic area: it is always altered in people with SLI, since it is difficult for them to establish social relationships through play, as well as to understand and respect rules; likewise, they show difficulty in understanding emotional states and solving interpersonal problems. Likewise, it is a great obstacle for them to make inferences, that is, to understand everything that is not literal or contextualized, such as ironies, double meanings, metaphors or jokes. Consequently, all this significantly marks the way they relate to others.

Warning Signs in Specific Language Impairment

Between 0-12 months

• Between 3-4 months presents a weak cry.
• At 3 months does not smile at familiar faces or voices.
• By 4 months does not imitate or produce sounds.
• Does not orient to sounds or the human voice at 5 months.
• At 8 months does not babble.
• Does not pay attention to repetitive interaction games.
• By 12 months does not use gestures such as bye-bye or clapping.

Between 12-24 months

• Barely babbles.
• Shows little response to familiar names.
• Lack of communicative gestures.
• Does not point to show or ask for something.
• Does not respond to name.
• At 18 months does not respond to “give me”, “look” or “come”.

Between 2-3 years of age

• Does not use simple words.
• Is unable to respond to naming familiar objects or actions out of context.
• Does not understand simple commands.
• Unintelligible productions.
• Does not construct sentences of 2 elements.
• Shows an echolalic language repeating everything that is said to him/her.
• Lack of interaction with others.
• Play is repetitive or restricted.
• Becomes frustrated in communicative situations.

Between 3-4 years of age

• Shows difficulty in emitting sentences of 2 – 3 elements.
• Does not use adjectives or pronouns.
• Does not formulate questions, such as, what? or where?
• Has difficulty expressing what he/she is doing.
• Incomprehension of sentences out of context.
• Has difficulty finding the right word to express ideas or thoughts.

Between 4-5 years of age

• Difficulties with pronunciation.
• Uses sentences of 3 elements or less.
• In sentences omits nexuses, pronouns, verbs.
• Has a reduced vocabulary.
• Difficulty in answering “what” or “where” questions.
• Difficulty in recounting experiences.
• Shows comprehension problems with long sentences, or with abstract meaning.
• Does not show interest in playing with other children.

Between 5-6 years of age

• Difficulties with pronunciation persist.
• Presents errors in the structure of sentences.
• Shows difficulty in responding to interrogative particles.
• Difficulty in understanding temporal and spatial concepts.
• Difficulty with activities that require periods of sustained attention.

Causes of Specific Language Impairment

Although the prevalence of SLI is between 2% and 7% of the child population, the cause of specific language impairment is unknown. However, there are findings that suggest a strong genetic link. For this reason, children with this disorder are more likely to have parents and siblings who have also had speech difficulties and delays. In fact, 50% to 70% of children with SLI have at least one family member with the disorder.

Research on Specific Language Impairment

The National Institute on Deafness and Other Communication Disorders (NIDCD) supports a wide range of research that seeks to understand the genetic basis of SLI and the nature of the language deficits that cause it. They also seek to improve the diagnosis and treatment of children with the disorder.

Specific Language Impairment Intervention

At the clinic we design an individual therapeutic plan based on the linguistic profile of the child with SLD and his or her level of communication.

We focus the treatment on the specific deficiencies presented by the patient with specific language disorder in terms of comprehension and phonetic, semantic, morphosyntactic or pragmatic skills. In addition, we analyze their environment and try to create a favorable environment for language development, advising communication guidelines in the family and school environment.

For the last six years we have included in the treatment of TEL the use of the NeuronUP tool, to offer the possibility of working with our patients through face-to-face and online sessions, in a dynamic, interactive, ecologically valid and totally personalized way. Of course, stimulating cognitive skills that help to advance in the intervention of patients with specific language disorder:

• Temporal orientation.
• Executive functions.
• Memory.
• Attention.
• Social cognition.
• Language.

Conclusion

Experience tells us that perseverance and maintaining the enthusiasm for learning allow us to achieve great advances in our patients with Specific Language Impairment (SLI). For this reason, we chose a powerful, innovative, versatile and ecologically valid tool, NeuronUP.