Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.
From the Individuals with Disabilities Education Act: IDEA (NICHCY)
Understanding that Speech and Language Impairments (SLI) fall into a unique classification of disabilities is important for those entering the field of Special Education, as is a basic understanding of how language is formed and developed and the types of things that can hinder language progression.
Linguists agree that there is a basic fundamental progression of language development in childhood and often an impairment will manifest early in life and be evident enough to professionals in early school grades to be diagnosed. Early treatment and learned strategies by children can tremendously aid in their integration into general education environments.
Beyond the languages of nations, the concept of language itself can be classified in multiple ways, and one of the basic two categories is receptive language and expressive language. The ability to hear and understand what we hear, what is communicated through body language, or visual stimuli and other socially accepted signals is receptive language. The ability to describe objects, the environment (physical setting), feelings, through words, gestures and writing is expressive language.
There are many types of speech and language impairments, and there are four areas of communication that can be affected:
- Articulation: sound production
- Fluency: smoothness of the speech flow
- Voice:
- Loudness: volume
- Pitch: tone level
- Resonance: sound quality muscles of speech (deepness, fullness, and reverberation
- Language:
- expression of needs, ideas, or information
- understanding of communication
If a child is suspected of having a SLI, a critical first step is to assure that the child’s hearing is not impaired, because a hearing impairment may impact speech and language, and an SLI may not have occurred if the child’s hearing was not impaired. In addition the stages of language progression occur extraordinarily similar for most people, however it is not uncommon for that progression to be slower for some individuals, and the delay of that progression should not be categorized as a “speech or language impairment”. (NICHCY) Roughly 7 to 8 percent of kindergarteners are affected a Specific Language Impairment (SLI) or a language delay. These students typically have no hearing loss or intellectual disability that would account for their impairment or delay. (Eske)
Linguists and Speech/Language Pathologists spend years studying the stages of language acquisition and are trained to diagnose the difference between a delay and an impairment. In addition to their training a Speech-Language Pathologist will use different methods of evaluation depending upon the person’s age, including:
- Observation
- Teacher and Parent interviews and questionnaires
- Assessments of the child’s learning ability
- Standardized reading and language comprehension tests
In 2019 there were 109,121 students diagnosed with Speech & Language Impairment in California and nearly 1.4 million students in the United States, which was 19 percent of the total students diagnosed with a disability, and 2.7 percent of the total student population, and that 2.7 percent of students having an SLI has been within two tenths of a point going back more than a decade. (DOE)
While 50 to 70 percent of children with an SLI have at least one family member with a similar impairment, no direct cause has been identified despite evidence pointing to a genetic link. (NIDOCD) Though there are many types of speech and language impairments, some common types are:
Childhood Apraxia of Speech (CAS): Characterised by choppy speech, in which the brain’s ability to fluently send communication messages is impaired. The muscles of speech in the lips, tongue, jaw are not impaired.
Orofacial Myofunctional Disorders: Abnormal growth of muscles and or bones leads to irregular speech.
Articulation Disorder: where certain sounds, such as “s” or “r” are incorrectly verbalized.
Stuttering: speech is blocked or prolongated.
While both a speech impairment and a language impairment make it harder for a person to communicate, speech disorders affect the ability to form correct sounds and language disorders affect the ability to learn words and understand what is said to them.
Stuttering, in which a person repeats sounds, vowels and words, a person gets stuck saying what their brain is telling them to say (blocking), or a person stretches out sounds or words when speaking, can be caused by genetic factors, developmental factors, or a brain injury. A brain impairment or neurological impairment is referred to as apraxia, which means that there is an impairment of the brain’s ability to control the physical structures of speech (vocal cords, tongue, lips, throat and mouth). A brain injury that weakens the ability to use those physical structures is called dysarthria, and may manifest in slurred speech, mumbling, tongue movement troubles, or slow, quick, or soft quiet speech.
There are many different types of speech disorders, and while a professional speech/language pathologist will diagnose a student it is helpful for teachers to recognize some symptoms, some of which are:
- Delay, distortion or repetition in combining sounds into words and sentences
- Rearranging sounds and/or struggle learning words and making conversation
- Struggle processing speech and verbal directions which is not due to lack of attention or cognition beyond processing speech
- Speaking very softly or with a hoarse/raspy voice
- Struggle following directions, not because of lack of attention or cognition, but because of specific language or speech processing
- Speech development delay, including grammatically
Symptoms common in older children and adults:
- Speech lacks complex sentences
- Struggle finding correct words
- Difficulty understanding figurative language
- Reading problems
- Disorganized storytelling and writing
Causes of SLI: (Eske)
- brain damage due to a stroke or head injury
- muscle weakness
- damaged vocal cords
- a degenerative disease, such as Huntington’s disease, Parkinson’s disease, or amyo
- trophic lateral sclerosis
- dementia
- cancer that affects the mouth or throat
- autism
- Down syndrome
- hearing loss
An SLI is not a learning disability, though it is a risk factor for one, especially since the condition often affects academic performance. Students with an SLI may struggle translating letters into sounds, and organizing thoughts into sentences. Language struggles may lead to math comprehension difficulties, especially with word problems. Children with aphasia are six times more likely to be diagnosed with reading and spelling disabilities, such as dyslexia or dysgraphia, and four times more likely to be diagnosed with math disabilities, such as dyscalculia. (Eske)
Some students with speech impairments may use Assistive Technology (AT), usually some sort of electronic communication system. Special education teachers should take the time to understand the use of these machines to the best of their abilities, so that they can be suggested to an IEP team if needed and be used properly if an IEP team recommends them.
A speech impairment can affect a students feeling of belonging in a classroom and feeling safe in school. In a now famous incident, President Joe Biden as an elementary school student ran from his classroom after his teacher mocked his stuttering while addressing the whole class. As teachers we strive to do much better than that, and arming ourselves with an understanding of Speech and Language Impairments is critical.
References:
CST Academy (2021) Difference Between Receptive Language and Expressive Language. https://cstacademy.com/articles/difference-between-receptive-language-and-expressive-language/
Eske, J. (2019, March 21) What are speech disorders?. MedicalNewsToday. https://www.medicalnewstoday.com/articles/324764
National Aphasia Association (n.d. Retrieved 2021, August 8) Aphasia Definitions. https://www.aphasia.org/aphasia-definitions/
National Center for Education Statistics (2021, February) Digest of Education Statistics. U.S. Department of Education, Institute of Education Science. https://nces.ed.gov/programs/digest/d20/tables/dt20_204.30.asp
National Institute of Deafness and Other Communication Disorders. (2019, October 21) Specific Language Impairment. U.S. Department of Health & Human Services, National Institutes of Health. https://www.nidcd.nih.gov/health/specific-language-impairment
National Institute of Deafness and Other Communication Disorders. (2021, May) Students With Disabilities. U.S. Department of Health & Human Services, National Institutes of Health. https://nces.ed.gov/programs/coe/indicator/cgg
NICHCY: National Dissemination Center for Children with Disabilities. (2011) Speech-Language Impairments (NICHCY Disability Fact Sheet11). https://files.eric.ed.gov/fulltext/ED572698.pdf
U.S. Department of Education. (2021/ January 28) Special Education — Technical Assistance on State Data Collection. https://www2.ed.gov/programs/osepidea/618-data/state-level-data-files/index.html#bcc
U.S. Department of Education. (2017, September 7) Twenty-Ninth Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, Parts B and C. 2007. https://www2.ed.gov/about/reports/annual/osep/2007/parts-b-c/index.html