Ann Clark and colleagues from the SLI in Scotland SIG Committee look at the use of terminology to describe the needs of children they supportcaslpub3239pu

Allstaff, Linda

Carter, Glenn

Chalmers, Cara

Clark, Ann

Ross, Eilidh

Simpson, Sarah

Queen Margaret University eResearch

Bulletin September 2013 | www.rcslt.org20FEATURETHE SLI  SERIES PART 4Tangled terminology: what’s in a name?Ann Clark and colleagues from the SLI in Scotland SIG Committee look at the use of terminology to describe the needs of children they support  “We are moving towards an opportunity to pin down a more transparent term”The Speciﬁ c Language Impairment Speciﬁ c Interest Group (SIG) in Scotland has 260 members and plays a key role in raising awareness of children who have diﬃ  culties in learning language in the absence of an identiﬁ able cause. One of the key challenges facing the SIG and the profession is in putting a label on the diﬃ  culties such children experience. Discussions at previous SIGs, at the 2013 National Association of Professionals Concerned with Language Impairment in Children (NAPLIC) conference and in this Bulletin series (Norbury, 2013; Ebbels, 2013) suggest this is a key area for us to decide as a profession.  Survey of membersWe asked our members about the terminology they use to describe the needs of children they support. We received 108 responses (96 SLTs, three specialist SLTs, two SLT support workers, three additional support for learning (ASL) teachers, one ASL assistant, two head teachers and a parent). Responses came from 11 out of the 14 health boards in Scotland.Speciﬁ c language impairment is the most commonly used term. However, respondents used as many as 10 other terms, and nearly half reported they use the term ‘language disorder’ (table one). Th is is notable given that ‘language disorder’ is the preferred term in the latest revision of the Diagnostic and Statistical Manual of Mental Disorders, DSM-V (American Psychiatric Association, 2013). Th e reported use of SLI aligns with recent and historical research literature, for example. a longitudinal series of cohort studies (Conti-Ramsden et al, 2012) and research into grammatical deﬁ cits (Rice and Blossom, 2013). However, Conti-Ramsden et al’s ﬁ ndings oﬀ er a further challenge. For one-third of the children in their cohort study, the growth of non-verbal skills slowed as they got older. Hence, ILLUSTRATION Dan Woodger020-021_Feature_SLI.indd   20 21/08/2013   10:37September 2013 | www.rcslt.org  Bulletin 21FEATURETHE SLI  SERIES PART 4Table one: Terminology used by SIG membersTerminology used % (number) using this terminology Specifi c Language Impairment (SLI) 85% (88) Signifi cant Language Impairment (SLI) 5% (5) Specifi c Language Disorder 20% (21) Specifi c Speech and Language Impairment (SSLI) 6% (6)Primary Language Impairment (PLI) 11% (11) Language Disorder 45% (47)Language Delay 27%(28)Other: language impairment, expressive language disorder/delay/diffi  culty7% (7) Th e survey, therefore, highlights a range of diﬀ erent terms, used in diﬀ erent ways and in diﬀ erent professional contexts. Th is relates to historical use, the usefulness of SLI as a descriptive term and the ability of SLTs to conﬁ rm the diagnosis via consideration of non-verbal skills assessments or inclusionary criteria. Professional debate requiredEbbels (2013) reminds us of importance of use of accurate terminology in our practice. With emerging data from practice and research, we are moving towards an opportunity to pin down a more transparent term. ‘Language disorder’ is one contender; however, we need an informed professional debate about others. Whichever term we opt for, a more universal approach in practice and the education of future SLTs would help us communicate with families and other agencies. Speciﬁ c language impairment has a low public proﬁ le compared with autism spectrum disorder (Bishop, 2010). Having a clearer and more universal term would increase our ability to raise the educational and political proﬁ le of children experiencing language diﬃ  culties in the absence of an identiﬁ able cause and help to bring them in from the cold.     ■Ann Clark Queen Margaret University, Linda Allstaﬀ  Fife Education Services, Glenn Carter and Cara Chalmers NHS Forth Valley, Eilidh Ross NHS Dumfries and Galloway, and Sarah Simpson NHS Highland.References & resourcesAmerican Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Association, 2013.Bishop D. The common childhood disorders that have been left out in the cold. 2010. The Guardian. Notes and Theories. http://tinyurl.com/33rh2cjConti-Ramsden G, et al. Developmental trajectories of verbal and nonverbal skills in individuals with a history of SLI: From childhood to adolescence. Journal of Speech, Language and Hearing Research 2012; 55, 1716-1735.Norbury C. Where are the boundaries? RCSLT Bulletin April 2013; 732, 12-14.Ebbels S. Guest Editorial: Introducing the Bulletin SLI series. RCSLT Bulletin April 2013; 732, 3. Rice M, Blossom M. What do children with specifi c language impairment do with multiple  forms of DO? Journal of Speech, Language, and Hearing Research 2013; 56, 222-235.for that group of children, their ‘SLI’ was not speciﬁ c. So how relevant is the word ‘speciﬁ c’ in SLI? Context of useIn our survey, SLTs also commented on when they used ‘SLI’. Comments included, “I only use SLI with SLT colleagues. With colleagues in education and with parents, I would use more descriptive terminology, probably along the lines of ‘diﬃ  culties with language’”. Another commented, “In the SLT team we speak about children having an SLI proﬁ le but in correspondence and reports etc I tend not to use that term as I feel I have insuﬃ  cient information from other agencies on their non-verbal skills, and I speak about a child having a language disorder’. 020-021_Feature_SLI.indd   21 21/08/2013   10:37

Tangled terminology: what's in a name?

Ann Clark and colleagues from the SLI in Scotland SIG Committee look at the use of terminology to describe the needs of children they suppor

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Tangled terminology: what’s in a name?

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Tangled terminology: what's in a name?

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