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Specific language impairment: a convenient label for whom?

Sheena Reilly1, Bruce Tomblin, James Law

  • 1Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.

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PubMed
Summary

Specific language impairment (SLI) is an outdated diagnostic label. Research suggests removing "specific" and adopting inclusive criteria for language impairment diagnosis.

Keywords:
child languagelanguage impairmentspecific language impairment

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Area of Science:

  • Linguistics
  • Developmental Psychology
  • Clinical Psychology

Background:

  • Specific language impairment (SLI) has been used since the 1980s to describe children with language disorders and normal cognitive abilities.
  • SLI is defined by exclusionary criteria, focusing on what it is not, rather than its intrinsic characteristics.
  • The exclusion of SLI from DSM-5 has sparked significant debate among researchers and clinicians.

Purpose of the Study:

  • To investigate the historical emergence and definition of specific language impairment (SLI).
  • To evaluate the validity of the continued use of the term SLI.
  • To explore the impact of societal changes on the terminology used for language disorders.

Main Methods:

  • A comprehensive literature review was conducted to trace the origins of the term SLI.
  • Published evidence was analyzed to assess the term's validity.
  • New analyses of population data were performed to support the evaluation.

Main Results:

  • The term SLI has been a convenient label for researchers but is considered an arbitrary classification.
  • There is a lack of empirical evidence supporting the continued use of SLI.
  • The exclusionary criteria for SLI may hinder access to speech pathology services.

Conclusions:

  • The study supports the exclusion of SLI from DSM-5.
  • Recommendations include removing 'specific' from the label to use 'language impairment' and adopting inclusive criteria.
  • An international consensus panel is proposed to establish agreed-upon definitions and criteria for language impairment, incorporating service user and policymaker input.