Asking the Right Questions: Differentiating Language Difference from Language Impairment
The Dilemma
As speech-language pathologists, most of us expect to carry out extensive, time-consuming testing when confronted with an English language learner (ELL) who may have a language impairment. We often dread the process of finding an interpreter and coming up with the most appropriate nonbiased testing instrument—and we are always worried about our methods and materials being legally sound and defensible.
We don’t want to over-identify ELLs as needing speech-language services, but we don’t want to under-identify them either. We don’t want to withhold help from those students who genuinely qualify for our services.
Our problem is frequently that these ELL students underperform academically due to social and environmental issues such as poverty, lack of preschool experience, lack of literacy in the home, and limited English proficiency. I’ve had students who don’t speak any language well, not even their first language. My district is currently the third largest recipient of refugees in the U.S.; our fastest-growing language is Dari, a language of Afghanistan. Many students, even teens, have had very little schooling, and as a result they struggle academically in our schools.
How do we tease out who has an underlying language impairment and who is a typically developing student whose problems can be traced to social and environmental issues? While these children should certainly receive extra assistance outside of special education, the typically developing student should not be on our speech caseloads.
What are some quick and easy red flags we can look for when deciding to test a child for an actual language impairment that goes beyond environmental issues?
A Potential Solution: Identifying Key Red Flags
I am a practicing SLP in the public schools; I work with preschool students, elementary-age children, and teens. I have repeatedly found that when an ELL is referred for assessment for a potential language impairment, asking the right questions before I begin the assessment process can save a great deal of time.
Here are some of the most effective questions I use, which give me excellent guidance in terms of spotting potential red flags that may indicate the student has a language impairment and not just a language difference.
1. How old was the child when they:
- Said their first word in the first language? This should occur around the age of 12 months.
- Put two words together in the first language? This should occur around the age of 18 months.
2. When the child turned 24 months old, did they speak 200 to 300 words in the first language and speak mostly in phrases?
If not, this is clinically significant. Multiple research studies show that an expressive language delay at 24 months old predicts spoken and written language problems later;1 behavior issues are common as well.2
I remember once working with a fourth grade Vietnamese student named Lam. No one could figure out if he had a language impairment or was just underperforming because of environmental issues. I had the interpreter call Lam’s mother, and we found out that Lam didn’t say his first word in Vietnamese till he was 4 years old. It’s safe to say that he did in fact have an underlying language impairment! Mystery solved!
3. Did the child learn the first language more slowly than their siblings? Do the parents see a real difference in them versus their siblings in first language development?
In my clinical experience, if the child in question is markedly slower than their siblings, there is definitely an underlying language impairment or other special need.
4. Does the classroom teacher believe that this particular student is struggling a lot more than their peers from a similar cultural and linguistic background?
If so, that’s a big red flag!
5. Has the student been provided with multiple “extras” like tutoring, after-school homework club, a peer buddy, or summer school and shown “treatment resistance”?
My clinical experience, backed by plenty of research, shows that when underperforming students are provided with extra learning opportunities, they should show observable progress. If they don’t, that’s a red flag that their language problems go deeper than just environmental issues.
Differentiating a language difference from an underlying language impairment in an underperforming ELL student is complex and challenging. Before we even begin the assessment process, we can ask questions such as those above. I’ve repeatedly found that if those questions yield answers indicating that the student does not show those red flags, they typically just need more time in school as well as non-special education “extras” to boost their performance. But if the answers to the above questions point to the presence of an underlying language impairment, extensive testing always verifies my concerns.
To learn more about this and similar issues, watch my MedBridge course series on English language learners.
We can save ourselves a lot of time and energy by asking the right questions before we start testing. Good luck!
- Del Tufo, S. N., Earle, F. S., & Cutting, L. E. (2019). The impact of expressive language development and the left inferior longitudinal fasciculus on listening and reading comprehension. Journal of Neurodevelopmental Disorders, 11, 37.
- Peterson, I. T., Bates, J. E., D’Onofrio, B. M., Coyne, C. A., Lansford, J. E., Dodge, K. A., & Pettit, G. S., et al. (2013). Language ability predicts the development of behavior problems in children. Journal of Abnormal Psychology, 122(2), 542 – 557.
