Kaisa Launonen

Increasing prevalence of specific language impairment (SLI) in primary healthcare of a Finnish town, 1989–99

BACKGROUND The increasing prevalence of specific language impairment (SLI) is a matter of current debate. AIMS Speech and language therapists and other authorities in Finland have discussed the prevalence of SLI since the 1990s. This discussion has been based on international studies because of the lack of national studies. This paper presents the first Finnish prevalence study of SLI in primary healthcare and, thus, participates in the international discussion on the prevalence of SLI. Furthermore, two samples of delayed language development (DLD) were studied. METHODS & PROCEDURES This is a retrospective study from 1989-1999. It was conducted on the population of one of the biggest towns in Finland, and was collected from the statistical records of speech and language therapists. OUTCOMES & RESULTS The prevalence of SLI increased, and this increase was statistically significant. The prevalence of SLI was less than 1% in age group 0-6 years and, thus, presents a much lower prevalence than international discussion has suggested. SLI seems to be present particularly in boys though it was also increasing in girls. Furthermore, children with SLI seem to be more affected by receptive difficulties over the period studied. Particularly important is the observation that the prevalence of DLD was also increasing, and together with SLI they suggest a prevalence rate of 2.5% in Finland. CONCLUSIONS The low prevalence of SLI in this study might be a consequence of the path of intervention that effectively separates SLI from delayed language development. Furthermore, the questions of language specific features needs to be emphasized. The findings of this study suggest that the prevalence of SLI increased as did the prevalence of DLD. The range of prevalence estimates of SLI in different studies raises the need for national and international epidemiological studies of SLI with equal criteria of assessment in each language.

Use of language tests when identifying specific language impairment in primary health care.

Objective: To evaluate the ability of language tests to identify children with specific language impairment (SLI) in primary health care. All the language tests presently in clinical use in Finland were applied. Method: All the children with SLI living in one city in Finland constituted the cohort. Test scores were collected from 83 subjects drawn from a birth cohort of 4,553 children. Finally 31 case-control pairs were studied. All SLI diagnoses were set in secondary health care. Test scores of 14 language tests were examined that, together with subtests, included 39 different tasks. Results: Out of 39 performed tests, the difference in test scores between children with SLI and their matched controls was statistically significant in 26 tests. A group of six tests had good sensitivity and moderate specificity for SLI diagnosis and they correctly classified children with SLI to either F80.1 or F80.2 diagnosis category. Conclusion: The results suggest that most of the language tests in Finnish identify children with SLI and, furthermore, that these tests identify language deficits that are consistent with those found in other studies. More studies with larger age-matched populations are needed.

Specific language impairment (SLI) and reading development in early school years

Specific language impairment (SLI) is a condition that affects children’s emerging language skills. Many different language skills can be affected in SLI, but not all individuals with SLI have the same set of difficulties. As a result, SLI is a highly heterogeneous condition. The ability to read and understand written text is a higher function of language, which has its base on the language skills that may be affected by SLI. Previous studies suggest that children with SLI are at risk of developing literacy difficulties at school age. To test this hypothesis a longitudinal follow-up study of SLI was performed in an urban city in Finland. Forty-three children diagnosed with SLI completed tests for lexical and rapid automatized naming (RAN) and reading ability (technical reading and reading comprehension). Children were tested in schools in years one to three, at the end of each school year. At the age of 10 (year 3) children with SLI had relatively weak technical reading abilities with somewhat stronger reading comprehension abilities and concomitant lexical retrieval impairments, but age-appropriate RAN abilities. These findings lend further support to the view that SLI imposes a considerable risk in learning to read. Even in an orthographically highly transparent language, such as Finnish, technical reading skills often seem to remain poor. In this study, the findings on the development of lexical retrieval abilities support the Matthew-effect model in reading development (Stanovich, 1986), while the results of the development of RAN abilities support the developmental lag theory (Stanovich et al., 1988). All in all, these children with SLI had great difficulties in learning to read, which places them at a serious risk of developing concomitant learning problems.

Communication aid provision and use among children and adolescents developing aided communication: an international survey

Abstract A fundamental requirement of a supportive language development for young children who need aided communication is that an aided communication system is made available and its use is supported. There is limited information about the age at which children are typically provided with a communication aid or about how aided communication is used in everyday situations. Using questionnaire-based interview data, this study investigated (a) the pattern of provision of communication aids to 84 children and adolescents, (b) parents’ and professionals’ evaluation of the quality of communication across contexts, and (c) availability and use of aided communication in these contexts. The age at which the participants received their first aided system varied considerably across the group; however, most were considerably older than the age at which children with typical development usually begin to speak. Parents and professionals rated most everyday situations as good communication situations but reported that the participants did not have their main form of expressive language available in many of these situations, or did not use it much. Parents rated their child’s education in relation to aided language positively, but many professionals indicated that they had limited knowledge about the participant’s use of aided communication outside of the school environment, or about the parents’ attitudes. The study gives insights into the language learning situation of children and adolescents who develop aided communication.

Evaluation of the impact of supervisory support on staff experiences of training

Purpose – This paper aims to evaluate the role of the supervisors support on the effectiveness of a communication training program targeted at staff members who work with individuals who have profound and multiple learning disabilities. Design/methodology/approach – The aim was to explore which aspects of supervisory support influenced the staff members to participate in the programme and the results for the on-going effects of the training. Findings – Staff members reported a need for more supervisory support to maintain the results of the training and to disseminate the new practices to non-trained staff. Originality/value – Although supervisory support seems to benefit staff members during their participation in training programmes, even careful planning and execution of this support cannot ensure its continuation after the training is finished.

Type and Duration of Home Activities of Children with Specific Language Impairment: Case Control Study Based on Parents’ Reports

Parents of children with specific language impairment (SLI) are advised to promote language development at home. However, it is not known if children with SLI differ from healthy controls in their daily activities. This study collected prospectively information about the home activities of the children with SLI and their matched controls by using parents’ daily reports. Participants were 20 matched pairs. The ages of children in matched pairs were from 6 to 8 years. During one week, parents filled in daily questionnaires of listed home activities. The observed time was between 5 pm and 9.30 pm each day and it was divided into 30-minute scoring periods. Parents of children with SLI reported more varying home activities and fewer activities of playing outdoors than parents of control children. Home activities with literacy or screen time did not show difference between the two groups, and neither did playing table top games. Parents of children with SLI did more overlapping choices when scoring home activities than parents of control children. Children with SLI seemed to spend somewhat less time with home activities that, in particular, may ask for language and social skills and collaboration with peers.