Slides to accompany RALLI video "How specific is Specific Language Impairment"

1. How specific is
Specific Language Impairment?
Dorothy V M Bishop

2. Specific language impairment (SLI)
• Identified when language development falls well
behind that of other children of the same age
• No obvious explanation. Typically exclude cases with:
– Permanent hearing loss
– Generally slow development in all areas
– Language problems after brain damage
– Medical syndromes
– Classic autism
– Physical abnormalities of mouth and tongue
– Problems just with second language learning

3. Other problems often occur with SLI
Dyslexia
SLI
Bishop, D. V. M., & Snowling, M. J. (2004). Developmental dyslexia and Specific
Language Impairment: Same or different? Psychological Bulletin, 130, 858-886.

4. Other problems often occur with SLI -2
SLI
ADHD
Tirosh, E., & Cohen, A. (1998). Language deficit with attention-deficit disorder: A
prevalent comorbidity. Journal of Child Neurology, 13, 493-497.

5. Other problems often occur with SLI -3
SLI
Hill, E. L. (2001). Non-specific nature of specific language impairment: a review of the
literature with regard to concomitant motor impairments. International Journal of
Developmental co-
ordination
disorder
(“dyspraxia”)

6. Other problems often occur with SLI - 4
SLI
Bishop, D. V. M., & Norbury, C. F. (2002). Exploring the borderlands of autistic disorder
and specific language impairment: A study using standardised diagnostic instruments.
Autistic spectrum
disorder
See also our slideshare
presentation on Autism
and SLI

7. Putting it all together!
Developmental co-
ordination
disorder
(“dyspraxia”)
Dyslexia
SLI
ADHD
Autistic spectrum
disorder
Bishop, D., & Rutter, M. (2008). Neurodevelopmental disorders: conceptual approaches.
In M. Rutter, D. Bishop, D. Pine, S. Scott, J. Stevenson, E. Taylor & A. Thapar (Eds.),
Rutter's Child and Adolescent Psychiatry (pp. 32-41). Oxford: Blackwell.

8. Boundaries between different
conditions are not clearcut

9. Dyck, M. J., et al. (2011). The validity of psychiatric diagnoses: The case of 'specific'
developmental disorders. Research in Developmental Disabilities, 32(6), 2704-2713.
608 children aged 3 – 14 years
 449 Typically-developing
 30 Autism spectrum disorder (ASD)
 24 Mental retardation (MR = UK learning disability)
 30 Receptive-expressive language disorder (SLI)
 22 Developmental co-ordination disorder (DCD)
 53 Attention deficit hyperactivity disorder (ADHD)
 Assessments of IQ, language, motor, attention,
social cognition, executive function
Western Australian study

10. Typical
Autism
MR
SLI
DCD
ADHD
Dyck et al: Differences between children
captured by two dimensions
Function 1
N.B.
No sharp boundaries
between disorders.
SLI overlap with other
conditions

11. A consequence of the overlaps:
Same child, different diagnosis
• Speech and language therapist: SLI
• Educational psychologist: Dyslexia
• Psychiatrist: Autism spectrum
disorder (ASD)
• Neurologist: Developmental
co-ordination disorder (DCD)
• Paediatrician: ADHD

12. Why are there overlaps between disorders?
• Technical term for co-occurrence is comorbidity
• One condition could increase the risk for the other:
e.g. Child with language problems may be inattentive if they
can’t understand instructions
• Another possibility: different conditions but with common
cause:
e.g. Genetic factors may affect development of brain
regions that are important for both motor and language
development
• Disentangling the possibilities is complicated! See
reference list for more information

13. For further reading
see reference list on:
http://www.slideshare.net/RALLICampaign/how-
specific-is-SLI