The neuropsychologist specialized in child development Carmen Miranda explains in this article the child neuropsychological intervention for specific language impairment that she has carried out in her center NKI Neuropsicológica with NeuronUP.

Within the field of child neuropsychological intervention, Specific Language Impairment (SLI) represents a challenge that requires specialized attention. This disorder affects language development in children, causing difficulties in comprehension and verbal expression.

Diagnosis and assessment of SLI

The first step in addressing SLI is to make an accurate diagnosis. A child neuropsychologist, language therapist and/or speech therapist will conduct a comprehensive assessment to determine the language areas affected and establish an individualized profile of the child.

Standardized tests and questionnaires will be used to identify language difficulties and to rule out other developmental disorders or problems.

This first diagnostic step is essential to define the language level (phonological, morphological, semantic, syntactic and/or pragmatic) at which the difficulty is found, as well as the degree of severity of the difficulty, since depending on the results and specific characteristics, the objectives of the intervention will be established, as well as the choice of activities to be included in each session.

Objectives of neuropsychological intervention in SLI

Neuropsychological intervention in SLI is primarily aimed at improving the child’s language skills and reducing the impact of the disorder on his or her daily life.

Some of the specific goals may include promoting verbal comprehension, stimulating vocabulary, improving fluency and grammar, as well as promoting compensatory strategies to address communicative difficulties.

It is essential to adapt the objectives to the individual needs of each child, considering his or her age, developmental level and specific characteristics of the disorder.

For example, one of the specific goals of neuropsychological intervention in SLI could be to “promote verbal comprehension”; to achieve this, several strategies can be used, such as working on identifying key words in a conversation, practicing comprehension of simple and complex instructions.

Specifically with a NeuronUP activity: “Written Comprehension with Questions”, it is possible to address this objective in older children.

By tailoring these objectives to the individual needs of the child, a personalized intervention plan can be designed to fit the child’s age, developmental level and specific characteristics of the disorder, thus improving the child’s verbal comprehension skills and enabling more effective communication in daily life.

Intervention strategies for SLI

There are different approaches and strategies that can be used in neuropsychological intervention for SLI. Some of them are the following:

1. Language therapy focused on phonological skills: work is done on the sounds of language to improve auditory discrimination and the correct production of sounds. For this purpose, interactive activities and word games can be used.

2. Vocabulary stimulation: techniques are used to expand the child’s vocabulary through the use of images, objects and real contexts. Word association games, vocabulary cards and categorization activities are useful resources in this strategy.

3. Development of verbal comprehension: exercises that promote comprehension of instructions, identification of concepts and answering questions are used. Pictures, active listening exercises, and following directions activities can be used.

4. Improving verbal expression: focuses on developing the child’s ability to form grammatically correct sentences, use appropriate vocabulary, and express ideas coherently. Sentence building exercises, storytelling and guided conversations are effective resources for this purpose.

Use of NeuronUP in neuropsychological intervention for SLI

NeuronUP being a digital platform designed for cognitive and neuropsychological rehabilitation, offers numerous tools and resources to address SLI.

Both interactive activities and paper-based materials facilitate the intervention and motivate the child during the process.

Some of the resources available on NeuronUP for SLI include word association games, verbal comprehension exercises, and grammar and sentence construction activities.

Examples according to language level

1. Phonological level

• Game of association of words with images: the child must associate images of objects with words that have the same initial sound (Example of NeuronUP activities: Where is the Little Letter?; Identify Sounds in Names of Images).

• Auditory discrimination exercise: sounds are played and the child must identify if they are the same or different.

2. Semantic level

• Word categorization activity: different images are presented and the child must group them into semantic categories (Example of NeuronUP activities: Tidy Up the Mess; Connected Drawings; Common Items; Search and You Will Find!).

• Vocabulary exercises: for naming and identification (Example of NeuronUP activities: Matching Nouns to Images; Correct Image Name; What’s its Name?).

3. Morphological level

• Word formation activity: Provide a root or base word and ask the child to add suffixes or prefixes to create new words. For example, if the word base is “play,” the child can add the suffix “-er” to form “player.”

• Morpheme identification exercise: Present the child with a series of words and ask him/her to identify the morphemes (prefixes and suffixes) they contain. For example, if the word “uninteresting” is shown, the child must identify the prefix “un-” and the suffix “-ing”. As a support, it is possible to use the activity “Naming objects with phonological clues” by eliciting the word and then asking the child to provide a derivative of the word found.

• Sentence completion activity: Present incomplete sentences and ask the child to choose the correct option to complete them. For example, “The cat __ on the roof” (sleeps, would sleep). This will allow working on the proper use of morphemes in context.

• Exercise of listing words according to their morphological structure: Provide a list of words (the words used in the activity “Where is the Little Letter?” can be used) and ask them to classify them into categories according to their morphological structure. For example, bull, bullfighter.

For all the proposals at this level it is possible to use each of the vocabulary activities offered by NeuronUP.

4. Syntactic level

• Sentence building exercise: an image is presented and the child must create a grammatically correct sentence to describe it (Example of NeuronUP activities: Make Up a Story with Pictures. At a more advanced level the activity: “Create Stories from Words” can be used).

• Sentence completion activity: an incomplete sentence is provided and the child must choose the correct option to complete it (Example of NeuronUP activities: Form Sentences).

5. Pragmatic level

• Guided conversation exercise with the NeuronUP activity “What is the Best Thing to Do?”

• Present the child the hypothetical situation, ask “What would you do?”

• Encourage participation in a guided conversation, using appropriate pragmatic skills such as initial greeting, asking relevant questions, keeping turn to speak, and answering appropriately to the interlocutor’s responses.

• Provide support and model examples of appropriate responses, encouraging empathy, active listening, and perspective taking during conversation.

Non-literal language comprehension activity

• Present idiomatic expressions or phrases with non-literal meanings, such as “You need to put your cards on the table” or “It’s pouring rain.”

• Ask him to explain the real meaning of each expression and to use them in sentences to demonstrate his understanding.

• Provide additional examples and explanations to help him understand the figurative or non-literal meaning of these expressions, and practice using them in different contexts.

For this activity, it is possible to use the NeuronUP resource “When Would You Show the Following Emotion?“. Before starting the session, review the worksheets and elaborate a non-literal sentence for each worksheet, in this way, in addition to intervening in social cognition, you will also integrate pragmatics.

Conclusion

Remember that activities should be adapted to the child’s age, developmental level, communication skills, and the results of the assessment previously conducted.

In addition, it is important to provide positive feedback and reinforcement throughout the process to encourage improvement in pragmatic skills. These activities will help the child understand and use language more effectively in social and communicative situations.

Neuropsychological intervention using the NeuronUP platform can be a valuable tool in addressing Specific Language Impairment. The customization of intervention objectives and strategies, combined with the use of graphic resources and interactive exercises, allows the enhancement of language skills in children with SLI.

The implementation of this tool in a comprehensive rehabilitation program can make a difference in the language development and quality of life of children with SLI.

Bibliography

American Psychiatric Association – APA. (2014). Manual diagnóstico y estadístico de los trastornos mentales DSM-5 (5a. ed. –.). Madrid: Editorial Médica Panamericana. 

Kidd, E., & Garcia, R. (2022). How diverse is child language acquisition research?. First Language, 42(6), 703-735. 

Tellez, M. G. Y. (2016). Neuropsicología de los trastornos del neurodesarrollo: diagnóstico, evaluación e intervención. Editorial El Manual Moderno. 

Zelazo, P. D. (2023). Language, levels of consciousness, and the development of intentional action. In Developing theories of intention (pp. 95-118). Psychology Press. 

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