There is a breadth of Problems in diagnosing SLI, the first strategy is to try to group these types into similar speech therapy problems, to facilitate their development as well as their treatment. We can imagine the existing problems regarding the TE conceptL and the way to identify it, and consequently, the numerous classifications to establish subtypes of this disorder.
Of all these classifications, The most internationally known is that of Rapin and Allen (1987, 1988), who from an analysis of many clinical cases distinguished up to a total of 6 subtypes of SLI, whose characteristics are summarized in the following table:
1. EXPRESSIVE DISORDERS: People with this subtype of specific language impairment have marked limitations in language production without any problems with comprehension.
- Phonological programming disorder: where there is a certain fluency of production, but with confused articulation (almost unintelligible utterances). There is a notable improvement in the quality of articulation in tasks involving the repetition of isolated elements (syllables, etc.) with normal or near-normal comprehension.
- Verbal dyspraxia: We find a massive inability to express fluency with severe impairment of articulation (even complete absence of speech). The patient produces utterances of one or two words, whose articulation does not improve with repetition. The patient's comprehension is normal or close to normal.
2. COMPREHENSION AND EXPRESSION DISORDERS:In general, it is considered that if there are problems with language comprehension, there will also be severe difficulties in production or expression. In this type of disorder, therefore, difficulties can be observed both in producing and understanding speech.
- Syntactic phonological disorder: This is a mixed receptive-expressive deficit with impaired verbal fluency. We find altered speech articulation and poor syntax: short sentences, omission of links and morphological markers, and laborious sequential formation of utterances. Comprehension is better than expression, although there are variables that contribute to comprehension difficulty: length of utterance, structural complexity of the utterance, semantic ambiguity, contextualization of the utterance, speed of emission.
- Auditory-verbal agnosia: This is what is known as verbal deafness with impaired verbal fluency. Comprehension of spoken language is severely impaired or absent. Expression is absent or limited to single words, with severely impaired articulation but normal understanding of gestures.
3. DISORDERS OF THE CENTRAL TREATMENT PROCESS AND FORMULATION: This is a subtype of Specific Language Disorder in which different problems can be observed that do not correspond entirely to the actual act of understanding or expressing language, but rather with aspects such as the presence of altered syntax and slight stuttering or comprehension difficulties due to the literalness with which the language is not understood or does not adapt to the situations.
- Semantic pragmatic disorder: We find a more or less normal initial language development with normal articulation or with slight difficulties. Speech is fluent, often logorrheic, incessant, and unstoppable, and the child may utter memorized sentences. His utterances are well-structured grammatically, but he has significant difficulties in comprehension; he may only understand literally and/or respond to one or two words of the interlocutor's utterance. There is a lack of adaptation of language to the interactive environment: poor pragmatic adjustments to the situation and/or the interlocutor, unstable thematic coherence, probable echolalia or perseveration.
- Lexical-syntactic disorder: This disorder presents fluent speech with occasional pseudostuttering due to recall problems. Articulation is normal or with minor difficulties. Fluent slang is present, especially in young children. We find disturbed syntax: difficult complex formulation, interruptions, periphrases and reformulations, difficult sequential order, incorrect use of morphological markers, and frequent use of filler words. There is normal comprehension of single words with poor comprehension of utterances.
We hope this classification is clear, but remember that in the end, it's nothing more than a classification that will help you acquire observational skills. Each child is unique and influenced by their surroundings. So, encourage them with your heart and a little intuition!
Cristina Oroz Bajo