The history of TEL is not fortuitous and we would like to make a note of how this term has evolved and appeared Since many times in different professionals and countries we find a disparity of names that could lead to great confusion in the terms.
Within the framework of studies on language disorders Numerous terms have been used to refer to problems that can now be categorized as specific language disorders.
At first it was called developmental aphasia referred to a series of receptive or productive-receptive disorders in children and which showed similarities with the language disorganization that is typical in adult aphasias. In this case, as the term of "aphasia" It has always been related to linguistic problems derived from neurological damage and pathologies, many authors determined that this term was not appropriate in children whose case did not show such neurological problems.
Then the concept of was coined language delay and there were two main types:
- Primary language delay: characterized mainly by a delay in the acquisition of language skills according to chronological age, without biological or psychological causes to explain it.
- Secondary language delay: due to other neurological, motor, psychological, etc. pathologies. Logically, cases of SLI would fall within primary language delays, reserving the other category for speech therapy problems associated with mental retardation, autism, etc.
This categorization of "primary delay" was still very broad and of little use for clinical work, so it was again subdivided into two new concepts:
- Simple language delay: It would be applied to young children (up to about 6 years old) in whom there is a delay in language learning compared to the normal evolutionary pace of acquisitions.
- Childhood dysphasia: It would be understood as a deficit in oral language that manifests itself mainly from the age of 6, in the form of a disorganization of evolving language.
These two concepts of "simple delay" and "childhood dysphasia" have been well integrated into the scientific and speech therapy community, and are still widely used today.
Despite this, many voices continued to criticize this terminology, based on the fact that in In practice they were very difficult to distinguish, since basically the typical problems of simple delay could also be found in dysphasia and vice versa. In addition The 6-year criterion is very problematic, since children do not have a developmental rhythm that can be categorically divided based on chronological age.
For all these reasons, an attempt was made to find a consistent solution and "start from scratch", using a new term to describe this case study. Thus, based on the proposals of several authors and later on the recommendations of the ASHA (American Speech-Hearing Association), the term arose Specific language impairment (SLI) as a significant language limitation in normally developing children who do not have an obvious cause for the limitation.
Within the existing literature on SLI, A small number of studies have studied the evolutionary development of children with this type of problem., emphasizing the differences found in the development of "normal" children. In general, the Early development of children is normal or practically normal in motor, social, intelligence, etc. aspects, only the linguistic ones being altered. However, These same studies show that these deficits in language and communication will cause, subsequently, a greater impact on development that can affect, mainly, the following areas:
- Prerequisite behaviors for learning: In order to learn, children must possess certain minimum behaviors, such as:
(a) basic communication skills,
(b) attention,
(c) verbal imitation and
(d) following instructions.
Children with SLI show difficulties with these prerequisite behaviors, so their subsequent learning is severely limited by their inability to take advantage of them.
- Disruptive behaviors: Due to the problems they have communicating with others and the frustration this produces, children with SLI often display behaviors such as throwing things, shouting, throwing themselves on the floor, etc. In this way, they manage to end situations that they find aversive, such as interacting with others, school, learning, etc.
- Intelligence: Verbal skills are an essential part of what is considered "intelligence"; in fact, the most widely used test (the WISC-R) has a scale designed exclusively to measure this type of ability. Therefore, a linguistic deficit will cause these children to score low on intelligence tests, reaching a borderline level or mild mental retardation.
- Affectivity and social aspects: Problems with language production and comprehension often cause children to withdraw from social contact or be considered "clumsy" by others. This social withdrawal can be severe and affect the development of affectivity and socialization behaviors.
- Academic performance: Of course, children with SLI perform very poorly academically, as most of the curriculum is built on skills that have a verbal component.
The idea that SLI involves certain developmental problems must be taken with caution. much caution, since it is plausible that such problems are not a necessary consequence of the disorder, but are caused and/or mediated by multiple factors such as education, family, social relationships, the way one interacts with children, etc. Thus, repeating what was stated in the previous topic Developmental problems in children with SLI should not be assumed to be inevitable and present in all cases, but rather as a possibility that must be explored in the corresponding evaluation.
Cristina Oroz Bajo