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sli2012

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Janice Greenberg, Program Director at The Hanen Centre (Toronto), presented a workshop on Hanen Programs, which are specialized therapeutic programs involving intensive education of groups of parents (whose children have language delays) or educators (who work with young children in educational settings). Hanen programs are based on the philosophy that children learn to communicate within the natural conversations of everyday life and that parents and educators are the child’s best language facilitators if they are taught to do this effectively.

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conference

The Conference ”SLI – Specific Language Impairment – diagnosis, prognosis, intervention” was held  in Warsaw in Sofitel Victoria Hotel, Królewska 11 Street on 5-8 July 2012. 

 

The conference was an opportunity to:
- present the state of the art and the research on SLI,
- exchange information and specialist knowledge
- strengthen international cooperation


July 6th 2012 (day two)

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Lecture 1. Professor Leslie A. Rescorla.
Late talkers: identification, characteristics and outcomes

 

The opening lecture of the second day of the Conference was held by professor Lesie Rescorla from Bryn Mawr College in Pennsylvania. The longitudinal studies conducted by professor Rescorla and her collaborators provided evidence that late talkers have numerous and long-term school difficulties, as well as  emotional and interpersonal problems. That is why it is so important to do screening tests – the results and intervention provided as a consequence of the screening may have an important impact on the child’s development.
 Language Development Survey (LDS) is one of the diagnostic tools that can be used to test language development. It is a measure that allows to identify about two-year-old children, whose linguistic development is slower then typically. The survey is composed of 300 words. The parent’s task is to choose the words which the child knows expressively, that is the words the child uses spontaneously, even if they are pronounced incorrectly to some extent. There are separate norms for boys and girls aged 24-35 months, because studies have shown that girls at this age have on average much larger vocabulary size than boys. LDS is a very reliable measure: in successive studies it gave comparable results of 97-99%. Test results coming from parents surveys also match the results of the tests that are used with children. The tool is very effective in indentifying irregularities in  language development of children who come from various social groups. In the diagnostic process, it is important to exclude autistic spectrum disorders, neurological problems, personality disorders and other serious developmental disorders. Children that were diagnosed as having SLI will in the future have worse reading and writing and will have poorer vocabulary if they come from disadvantaged environment. This shows the great importance of early identification of problems and their sources, as well as implementing individually adapted intervention.
 
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Lecture 2. Professor Magdalena Smoczyńska
Late Language Emergencje, SLI and Dyslexia in Polish speaking children: A follow-up study

 

Professor Smoczyńska presented longitudinal studies of ca. 100 children in the age of 2 to 10. About 1900 children were assessed in a screening and two groups were formed: a group of late talkers and a control group of children with typical language development. A polish test of sign language that would make it possible to diagnose SLI is not available, so children were tested with 5 tasks: nonword repetition, sentences, sentence comprehension, sentence modeling and an inflection task. The results analysis made it possible to divide the children into three groups: children in risk of SLI, late bloomers who catch up with typically developing children and the so called ‘undetermined group’, who perform about half of the tasks correctly. Only about 1/3 of children have autonomously recovered in terms of linguistic competence. In a later study on literacy, regression was observed in some cases and there were also changes  in the problems and symptoms within the undetermined group. It means that  early and continuous intervention for children at risk of SLI is very important. Interestingly, no statistic relation was observed between language delay or SLI and dyslexia. 

 

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Lecture 3. Professor Patricia Eadie, Professor Sheena Reilly
Prevalence, pathways, and co-morbidities of Late Talking and Language Impairment in a community cohort (2-7 years)

 

Professor Eadie, who represents a research group working at the ELVS project, started her lecture thanking professor Smoczyńska for the invitation for the Conference. She described the rationale on which the Project ELVS is based. It is a longitudinal study, conducted on a large group of Australian children (ca. 1900) chosen from the community cohort. In the following stages of the study, skills such as language development, children’s behavior, general development, mental health were taken into consideration. Also demographic data was collected. The results indicated that until the age of 7, changes in language and communication skills are so common that it might be difficult to qualify a child to a particular group (with language delay or with typical language development), because children move from one group to the other. The conclusion is that it is worth to monitor the child’s language development for a longer time than it is usually done. Some of the co-morbidities of language delay are: stuttering, articulation problems and literacy skills. It seems quite obvious that children affected by the mentioned problems have more serious education problems than their typically developing peers. From the social perspective, language delay is a serious problem: it is characterized by a high degree of prevalence and long-term negative effects. That is why health policy should deal with the problem as soon as possible.  Studies indicate that children with language impairments are at higher risk of other problems: educational, interpersonal and emotional problems.

 

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Lecture 4. Dr Stephanie Orloski
Differentiating profiles of late-talking children and of children with autism.  

 

The lecture given by dr Orloski described the differences between children with delayed language and children with autism. As previous speakers, she stressed the importance of accurate early differential diagnosis of children suffering from autistic spectrum disorders. Early diagnosis of autism is important, because the earlier it is recognized, the more effectively the brain plasticity may be used in therapy. The symptoms of autism described in DSM-IV include impairment of social interactions, communication disorders, limited or stereotyped behavior patterns. Autistic children show deficits in so called social reciprocity, they cannot accurately react on behavior of the partner in interaction, coordinate attention between the partner and an object of joint attention, control their gaze, gestures, facial expression or adapt their tone of voice to expressed utterances. They also have problems with expression of their emotions and imitation of other people’s actions. In older children the difficulties deepen, which leads to social isolation. When it comes to communication, first words spoken by children with autism appear much later than in typically developing children. 20-30% of children with autism does not at all acquire language. Common traits of children with autism and children with delayed language are: lower communicative skills, ineffective use of gaze, lower (than in typically developing children) attempts to initiate communicative behaviors. The main difference between autism and language delay is that children suffering from autism demonstrate permanent impairment of social aspects of communication whereas late talkers do achieve the social communicative competence with time.

 

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Lecture 5. Professor Elżbieta Szeląg
The application of training in temporal information processing in children with SLI

 

Professor Szeląg began her lecture stressing the relation between temporal information processing and cognitive processes, including speech production. On the basis of cross-linguistic studies, a thesis on the existence of temporal universals in language processing may be advanced. It was also proved that cognitive deficits co-occur with deterioration of temporal information processing. On this basis the researchers started to ask the question whether temporal training may serve as a method of neuropsychological rehabilitation. In other words, the question is whether the training in temporal information processing may cause improvement of the untrained cognitive skills. Research conducted under the coordination of professor Szeląg confirms that such training is possible and hence her team is now working on the preparation of innovative therapy programme for people with language and cognitive impairments. The advantages of the programme are i.a. its low cost and customizability. The training includes tasks on attention, short-term memory, learning and motor control. The programme is part of the international action COST: TIMELY, which gathers researchers from over 19 countries in Europe.

 

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Lecture 6. Professor Elin Thordardottir
Specific Language Impairment in Icelandic, English, French and in bilingual children: Differences and similarities.  

 

Professor Thordardottir works on language impairments in Icelandic, French (which are her native languages) and English, the language she uses in Montreal, where she lives. In her lecture, she reflected on the importance of grammatical knowledge for specific language impairment (SLI), to some extent contrary to the main concepts based on the results of morphology. She stressed that there are surprisingly few cross-linguistic studies, which is especially peculiar knowing how useful they are – as she described the differences in vocabulary size of English- and French speaking children, she showed that such research can provide us with a lot of information on both language structure as well as language impairments. For instance, French speaking children do not make many errors in the early stage of language development. Such errors occur once more complex structures are introduced. In Icelandic the morphological correctness of children with SLI is about 80%. It may result from the fact that there is rich, but regular inflection, so children are trained to use it. Research that compared nine year old English speaking children with Icelandic speaking children both typically developing and with SLI have shown tat Icelandic speaking children commit less errors and their utterances are longer than the ones of English speaking children.  
Professor Thordardottir concluded that SLI does not necessarily need to be characterized by lack of morphological precision and that it is more relevant to describe SLI through delay of  particular stages of language acquisition. Children with SLI need more time to acquire language. Research on typically developing bilingual children have shown that both the vocabulary size and grammatical skills depend on the time of exposure to the language. Characteristics of the language are also important, e.g.  children with equal time of exposition on English and French committed less errors in French. The profile of English use showed deficits similar to these in children with SLI. The discussion finished with professor Smoczyńska’s comment, who expressed her concern that scientific way of thinking about language may be limited  by the perspective of the English language: “I can believe that the child is born with a grammar handbook in their hand. But why would that be Chomskyan grammar?”.

 

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Lecture 7 Profoessor Ester Dromi (Tel Aviv University, Israel)
A developmental model for the evaluation of communication, language and speech disorders in very young children

 

In her lecture, Professor Dromi presented a developmental model which was designed by her in order to facilitate the speech and language pathologists in planning of individual therapeutic programmes for young children with language impairments. It was inspired by the developmental theory of dynamic models, formulated in the nineties, used for both basic and applied research.   Professor Dromi started his lecture from introduction into the basic assumptions of developmental Dynamic System Theory. The first of them states that language development can be conceptualized in the same way the physical or biological systems can. The second assumption determines the requirement of using external resources to develop the system. The third assumption defines the systems as autocatalystic. According to the fourth assumption, dynamic systems undergo a constant change and reorganization. Professor Dromi stressed the relation between language and other cognitive systems and the important role of plasticity of the brain on the development of linguistic system.
Professor Dromi talked later about the interactions of emotional regulation in the mother-child dyad as a particular example of dynamic system. She showed that such regulation may in the early stages of life have influence on the hormonal level. Mutual interaction evolve until they reach fully intentional character. Within the Adamson model (1995), she later explained interaction in the adult-child-object triad, which is an important indicator of whether the child has developed the ability to form symbolic representations. After this theoretical introduction, professor Dromi moved to explaining the developmental model proposed by her. She has described its structure as “onion-like structure”. The core of the model is formed by the emotional engagement and the following layers are: communication, symbolic representation, comprehension, motor planning and sensory regulation, and in the end – articulation. Only providing the child with the conditions to develop all the structures lead to early and undisturbed development of the child’s speech. Professor Dromi devoted the following part of the lecture to a more detailed description of each of the layers included in her developmental model and of the categories that can serve to identify the development of each of the layers. After this description, professor Dromi formulated practical advice  for clinicians on gathering data on the child who might be at risk of language impairment. In order to asses the child’s skills appropriately, it is necessary to test the child in the conditions as close to the natural environment as possible, observing his/her spontaneous behavior both when the child is alone and in the interaction with others.

Gathering data should include all elements indicated in the model. When summing up her lecture, professor Dromi stated that the aims of the therapy should be appropriate for the current psychological profile of the child, and the profile should be presented to the parents, so that they know the weaknesses and the strengths of their child. It was also stressed that observation of the child should be repeated and the diagnosis should be made only after gathering all the data and after its careful analysis.
In the discussion after the lecture various issues were raised, from the importance of a variety of proper names for the development of the child  to the application of Developmental System Dynamic Theory in fields other than developmental psychology and psycholinguistics.

 

 

Lacture 8: Marilyn Nippold (University of Oregon, USA)
Reading comprehension and syntactic deficits in children with SLI: Implications for the classroom

 

Beginning her lecture, professor Nippold asked a basic question for the topic: what is necessary for reading comprehension? She specified four factors: decoding of difficult words, understanding of words, parsing and reasoning beyond what is stated explicitly. Then she moved to the next, more detailed question: why is reading so difficult for children with SLI? She stated that problems of children with Specific Language Impairment come from the difficulties in skills mentioned by her. To illustrate the difficulties that children with SLI may encounter while reading with special focus to the requirements posed to them at school, professor Nippold talked about textbook passages used in 4th, 6th and 8th grades in the USA. She indicated the linguistic means used in texts, characteristic of textbooks, but not typical for natural discourse. They can cause difficulties for children with SLI, because they include difficult vocabulary (abstract, polysyllabic, morphologically complex words that are not often used in every-day conversations), complex concepts and long, complex sentences. The speaker placed special emphasis on syntactic analysis of the cited sentences, showing how they exceed the developmental level of syntax comprehension in children with SLI. Summing up the first part of the lecture, she stressed again that school textbooks are getting more complex linguistically both in the context of vocabulary and syntactic complexity. Talking about syntactic complexity, professor Nippold presented the typical path of child’s syntax development and compared it with the one in children with SLI and NLI. She presented the results of her research which showed that children form both groups lack the categories mentioned in the beginning of the lecture in comparison to the control group (difficult words, complex syntax, reasoning beyond what has been stated explicitly). She also stated that  with age the best predictors for reading comprehension change – in some stages of development it is the vocabulary size that is most important, in other – syntax comprehension. Professor Nippold moved from research to practical recommendations, proposing a thesis that in order to improve reading comprehension it is important that teacher work with students individually, especially on trying to engage them in the topic. She also stated that clear structure of the lessons and of the explanations given has a significant impact on reading comprehension. It is crucial to familiarize children with strategies of effective word learning, as well as the methods of morphological analysis and phonological awareness of the child. Professor Nippold presented also strategies that aim at helping children with language impairments, including breaking down complex sentences into simpler elements and reconstructing the meaning on the basis of  specified elements. Increasing students’ metalinguistic awareness is also important: to label the parts of the speech and sentences, types of sentences or draw attention to word - nests (e.g. such as geology, geologist, geological). Another solution that may support children with difficulties in reading is application of computers – sentences typed into text editor are much easier as they allow for manipulation of their components in simpler way. Summing up her lecture, professor Nippold stated that activities that aim at supporting reading comprehension should be planned on a long-term basis, in numerous sessions, and should be linked to school curriculum, especially through teacher’s active engagement in the process of reinforcing children with language impairments. The activities should also be cognitively stimulating for children and appropriate for their skills. Fulfilling these conditions is not an easy task, but the gain for society in case of success of the proposed programme are, according to professor Nippold, definitely worth accepting the challenge. Language deficits can have severe and long-term consequences for the whole society (for instance teenagers that are frustrated with their school failures and ineffective communication are more prone to crime activates), which is why early intervention is so important. During the discussion, issues concerning children’s individual motivation to work and to search topics which are interesting for them were raised. Dale stressed that textbook authors should consult linguists in order to adapt the language to the level of the recipients, but – which is equally important – not to simplify it too much. A doubt was also expressed on whether all students can actually improve their language skills – according to professor Nippold, it is worth to work will all children, even the ones suffering from severe impairments, to at least help them realize the potential that they have and to overcome the frustration, and not necessarily to make them reach a very high level of academic knowledge.

 

 

POSTER SESSION

 

The poster session gathered numerous participants, who actively took part in discussions on the results presented in the posters. Some of the posters were prepared in two language versions, and the authors of the English versions were assisted by volunteers helping in communication with the participants of the conference.

 

The evening session
 
Lecture 9. Professor Dorothy Bishop (Oxford University)

videoconference

 

Professor Bishop briefly presented the differences and similarities between developmental dyslexia and SLI. Traditionally, the two disorders were objects of interest of two separate professional groups: SLI was studied by speech and language therapists whereas dyslexia was studied by psychologists. The two groups have rarely cooperated in either research or practice, which definitely did not serve well the children who needed help. The speaker drew the audience’s attention to the similarities between developmental dyslexia and SLI. She noticed that although one of the disorders is concerned with literacy skills and the other – with  oral language, other characteristics of the children affected by the disorders are similar (e.g. the non-verbal learning ability or IQ). Next, professor Bishop compared lexical representations in pre-literate children to the representations related to the written word. When the child learns to read, a connection of earlier phonological representation and orthographic form is created, which in the beginning might not have a holistic character. (no assignment of particular sounds to particular letters). In order to master reading, the child needs to learn that particular sounds correspond to particular letters. In children who have difficulties in reading, the relation of sound and letter is not conceptualized easily. The easiest way to test it is to use a nonword task–children with language difficulties cannot read them. The problem of translating letters into sounds is associated with categorizing of sounds – phonemes – and with the ability to differentiate them. It is not a trivial task: phonemes merge and have different acoustic realization depending on the neighborhood of other phonemes and on the individual pronunciation of the speaker, many phonemes are also quite similar to one another. A good illustration of how challenging the issue of sounds categorizing may be are the tasks in which children are asked to choose words that rhyme or that begin with the same sound – such tasks may be very difficult for pre-literate children. Similar difficulties may be observed in tasks where phonemes are manipulated within words. The tasks are problematic also for adults with dyslexia. Rapid automatised naming (RAN) is another task that allows for concluding about dyslexia. It is quite difficult for typically developing children and even more difficult for children with dyslexia, who need a lot of time to find the labels for what they see in the picture. It is not known whether phonological tasks and RAN are associated with the same aspects of problems with learning to read. Professor Bishop did not expand on the issue, but she stressed that there are two dimensions of problems associated with reading: phonological processing and speech comprehension.
The next topic was the relation of speech deficits related to SLI with problems in reading difficulties.
The research conducted by Bishop on groups of typically developing children, children with dyslexia and children with SLI has shown that both children with SLI and children with dyslexia have lower scores in phonological tasks than typically developing children. However, the groups differ on nonword repetition task, in which children with SLI have lower scores. The most serious difficulty of children with SLI is not decoding but reading comprehension. Verbal deficits may be compensated with high level of nonverbal abilities. Hence, the explanation of  reading problems may be the lack of lexical representations: a child who is learning to read can see the word ‘melon’, but even if he/she knows how to pronounce it, it is possible that he/she does not relate the phonological representation with the concept and world knowledge. That is why the child does not understand the word. Further research of the same children in the age of 15 has shown that if the child has problem with oral language (as children with SLI do), the problems are transferred to literacy skills and that the problems will preserve into adulthood. It is striking that children with SLI at the age of 15 still have problems not only with word reading but also – different than children with dyslexia – also with comprehension. Towards the end of her lecture, professor Bishop presented a model of language skills developed with professor Snowling. One of its dimensions are skills associated with oral language and the other one – with phonological processing. Children with SLI score low at both dimensions and children with dyslexia – only on the phonological dimension. There are also children who do not have phonological problems but despite this fact are poor language comprehenders. They differ from children with pure SLI by the fact that they have good phonological processing and that they are not identified by teachers and parents. Bishop described the group as poor comprehenders.
Studies conducted by Bishop and her collaborators have shown, to the surprise of the authors, that low scores in RAN obtained by the group are associated with phonological processing. Hence, the distinction between SLI and dyslexia proved to be inappropriate because many children suffering from dyslexia have problems with oral language that go beyond poor phonological processing.

dzieci

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The prevalence of Specific Language Impairment in children is 7% and is characterized by difficulties in using language. Children with SLI learn to talk later than typically developing children and once they start talking, their linguistic abilities are limited: they have limited lexicon, problems with grammar, they do not understand complex sentences. Dyslexia is also common among them. Children with SLI, even though they have correct hearing, are intellectually capable, do not have neurological disorders nor features of autism, are prone to severe education failures, which has a negative impact on their lives. It is estimated that there are about 300 thousand children with SLI in Poland. Most of them are not diagnosed and have no chance of receiving the necessary treatment.



 

 

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As we were preparing for the international Conference on SLI in Poland, a group of four prominent British academics: Dorothy Bishop, Professor at Oxford University; Gina Conti- Ramsden, Professor at the University of Manchester; Dr Courtenay Norbury from the University of London and Maggie Snowling, Professor at the University of York, had launched in May 2012 a joint initiative: Raising Awareness of Language Learning Impairments (RALLI). Within the campaign, short videos are published on youtube, in which specialists explain the characteristics of language impairments, including SLI, stressing their negative impact on the people affected. Children with SLI themselves also talk about their experiences. We would like to encourage you to watch the RALLI videos.


http://www.youtube.com/RALLIcampaign

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