Sunday, 5 May 2013

Raising a child with a Speech and Language Impairment (SLI)

My 8 year old daughter suffers from a Speech and Language Impairment (SLI). 
My 3 daughters including my 8yr old who suffers from a SLI

This doesn't mean she isn't as healthy as other children or that she's stupid and behind her class with everything they can do. In fact she is very smart and just like every other 8 year old in her class, with just one slight difference - her speech is sometimes unclear as she struggles to make the correct sounds and to understand language. In fact, children like her, often find ways of getting by in class such as watching and copying, but having an SLI can be very frustrating and could lead to behavioural difficulties and/or shyness because of it. Often they will also have trouble learning to read and spell 

SLI is a very broad category, with some children having problems that are short-lived and others having severe and persistent difficulties with both understanding and talking. These difficulties aren't associated with other conditions, such as cerebral palsy, hearing impairment or autistic spectrum disorders and can be as unique as the child herself.

They may;
  • Have difficulty saying what they want to, even though they have ideas
  • Talk in sentences but be difficult to understand
  • Sound muddled, meaning it can be difficult to follow what they are saying
  • Find it difficult to understand words and long instructions
  • Have difficulty remembering the words they want to say
  • Find it hard to join in and follow what is going on in the playground. 
There is no obvious cause of an SLI. All that is known is that the speech and language part of the brain doesn't develop in the right way and that it could be hereditary as it is believed that genes play an important part in causing SLI. Unfortunately there is no medical test to see if a child has a SLI or not. 

Studies have shown that in 5 year olds, SLI affects about 2 children in every classroom (about 7%) and it is more common in boys than girls.
Reference ICAN - The Children's Communication Charity

Parents of a child with an SLI are often judged and made to feel guilty. I knew a women who had two sons and people judged her because both her sons had speech difficulties, saying she didn't talk to her sons enough and that's why they didn't talk. With both of them affected it was just proof of that fact (or so they claimed!). But that isn't the case at all! 

Children with a SLI don't learn language in the same way as other children, they need more help than just being spoken to and encouraged and it is very important to remember that there is nothing a parent could have done differently to avoid their child developing a SLI. These children need the right support to help them learn and develop their speech and language skills and without this help and support, having a SLI could cause the child lifelong difficulties. These children will continue to need support throughout school, support which needs to be catered to the needs and ability of the child as the type of difficulties a child faces can change as they get older, for example they may get better at understanding what other people are saying but still struggle to put sentences together. 

We realised with my daughter at quite a young age that there was something not quite right with her speech as it was slow to develop. Her older brother had learnt to talk quickly and easily, but she seemed to struggle. She began having speech therapy sessions when she was 3 and suffering from a SLI made her very shy as she knew people couldn't understand her when she talked and this made her unwilling to talk. In fact she never spoke a word to anyone whilst at playschool, but did start talking in nursery class at school. Having an SLI also affected her behaviour, and still does to this day, as she would tantrum in frustration if people couldn't understand what she wanted. However she was a very smart child and quickly learnt her own way of getting what she wanted, even if it meant dragging you and pointing to what she wanted. My mum would pretend it was her naughty ears making it hard for her to hear her rather than telling her she couldn't understand her. She was bullied in school because of it with nasty children telling her she was thick cos she couldn't talk properly and it has been a really long road to get to where she is now. 

Recently she was assessed at school to see how her SLI was developing. She was given a Test of Abstract Language and Comprehension (TALC), which looks at her understanding of abstract language with 4 levels of questions. Level 1 was the easiest and level 4 the hardest and she needed to score 80% to pass each level. She passed level 1 and 2 with 100% but level 3 was only just a pass at 82% and she just failed level 4 with 77%. Level 4, the level which she didn't pass, deals with abstract thinking and using language to justify problems.

She was also given a Test for Reception of Grammar (TROG) which looks at her understanding of different grammatical constructions. She scored 14/20 which puts her on the 37th percentile, within the average range.

However during the assessment she had some difficulty with remembering words that she knew. She frequently paused whilst trying to find the word and used fillers such as "um, uh"

Following her assessment, strategies and advice have been given to her school, in the form of an ICP (Individual Communication Plan) with resources to help follow her ICP and to help her develop. As her parents, we have also been given a copy of her ICP, along with behavioural policies that match her level of understanding of abstract languages. She is also to continue to receive speech therapy from her speech therapist in clinic to help with her speech sounds. 

The strategies in place for her are;
  • To assist with her word-finding difficulties in the classroom using mind maps and vocabulary maps can be used when introducing a new topic.
  • Use of strategies to develop her understanding of abstract language (e.g "why" questions and problem solving skills). 
Whilst she doesn't receive help in school anymore, she does still attend speech and language therapy. Something she has been having a break from recently as she became frustrated about still having to go. "I can talk now. Speech is for babies!" was her argument and because she didn't want to be there she wasn't paying attention and she wasn't making any progress! Hopefully, having had a break, she will be more willing once it's time to go back.

Having a child who suffers with a SLI can be heartbreaking at times. I've had her come home in tears because she wasn't understood or children have been making fun of her or calling her names! You want to protect them and shelter them from all hurt, but sadly there is nothing as cruel as children and they will pick-up on any difference. There was talk for two years running about her attending a specialist speech unit part time, but as there were limited places she wasn't offered one, which I take as a positive that her speech isn't that bad. 

She has made a lot of improvement and I am confident that with the right help, her speech and understanding will develop and whenever she feels down because of her speech I just give her a hug and remind her how far she has come already! She is still very shy, but even when she didn't seem to be making an improvement with her speech in therapy, just seeing the boost in her confidence was enough. Now she will try and answer in class, although she still needs to work on this and to put her hand up more often, but I can understand why she is reluctant to do so as she doesn't want to be misunderstood or seen as thick. What doesn't help is her older brother's favourite word is "retard" at the moment (I HATE that word and he is always told off for using it!) and whenever he uses it she thinks it is aimed at her.

When you first start off down the path of speech therapy and a SLI, it can seem like an uphill struggle, but eventually you will find yourself nearing the top and you will look at your child and realise that it was worth it!


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