Top Lang Disorders Vol. 34, No. 1, pp. 25–38 Copyright c 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Language Disorders Are Learning Disabilities Challenges on the Divergent and Diverse Paths to Language Learning Disability Lei Sun and Geraldine P. Wallach This article takes readers along the pathway of language learning and disorders across childhood and adolescence, highlighting the complex relationship between early (preschool) language dis- orders and later (school age) learning disabilities. The discussion starts with a review of diagnostic labels widely used in schools and other professional settings. The sometimes confusing interpreta- tions of labels such as specific language impairment and specific learning disabilities are discussed. We outline key relations that exist among language proficiency, language disorders, and school success and emphasize the centrality of language in literacy and academic success within a con- ceptual framework that addresses both inherent factors (e.g., abilities the language a child “comes with” to school including one’s foundational literacy levels) and external factors (e.g., classroom dynamics, textbook language). We argue that mismatches between these factors come together in a manner that is best captured by the term, language learning disability. We end with a summary of key points that encourage professionals to reevaluate and challenge the traditional view that children and adolescents with language disorders are a separate and distinct population from those with learning disabilities. Key words: continuum of changing demands, diagnostic labels, in- tervention directions, learning disabilities, language disorders, language disorders’ outcomes, language learning disabilities, specific language impairment, specific learning disabilities N THIS ARTICLE, we ask readers to con- A language learning disability (LLD) scenario: A I sider the complex nature of early language parent of a child who has been receiving services disorders, their overlap and continuity with at a speech–language–hearing center for a number learning disabilities, and the changing diag- of years has been pleased with her child’s language nostic labels that may accompany children development. Tim (a pseudonym) began his inter- with language and learning disabilities across vention journey in this particular clinic at about 2.5 years old as a child with delayed language.Tim time. The following scenario sets the tone. had difficulties with both language comprehension and expression in all areas of content, form, and use, as well as attention issues, but he also demon- Author Affiliations: Department of Communicative Disorders, California State strated many age-appropriate abilities, including University, Long Beach. motor development and cognitive-communicative The authors thank Dr. Joel Stark, the “Father” of LLD, skills (e.g., playing appropriately and using non- for his inspiration and support and for suggesting the verbal communication to make his needs known). title for this article. Thus, Tim received a diagnosis in the clinic as hav- The authors have indicated that they have no financial ing specific language impairment (SLI). When Tim and no nonfinancial relationships to disclose. entered school, he was tested by his school-based Corresponding Author: Geraldine P. Wallach, PhD, speech–language pathologist (SLP) and met eligi- CCC-SLP, Department of Communicative Disorders, bility requirements for services as a child with a California State University, Long Beach, CSULB 1250 Bellflower Blvd, Long Beach, CA 90840 (geraldine speech or language impairment (S-LI). By second [email protected]). grade, Tim was speaking in complete sentences DOI: 10.1097/TLD.0000000000000005 and understanding most everyday language, but 25 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 26 TOPICS IN LANGUAGE DISORDERS/JANUARY–MARCH 2014 he was struggling to meet academic standards, As the title of this article and Tim’s case including basic skills for reading and writing, example suggest, children and adolescents comprehending instructional language, and using facing language challenges may be identi- expressive discourse to express his ideas orally and fied with different diagnostic and service de- in writing. At one point, Tim’s mother said that livery labels at different points across their because of his academic difficulties and problems preschool years through high school and into with reading and writing, she and Tim’s teacher adulthood. It is our purpose in this article were concerned that he might have a specific learn- ing disability (SLD). She asked: “Is it true that to untangle misconceptions about the paral- Tim has another problem on top of his language lel and divergent pathways that children with problem?” language disorders may take through their de- velopmental years, sometimes shifting diag- The question asked by Tim’s mother in noses as they encounter new language and this scenario speaks to the confusion about literacy learning challenges. the relationships between preschool language We organize our arguments by presenting disorders (often called SLI by clinical pro- three theses about the relationships between fessionals and researchers) and eligibility la- language impairment and learning disabilities. bels associated with school service delivery First, the use of different labels by different (i.e., S-LI and SLD). Not only are parents un- professionals in different contexts should not clear about these relationships but profession- obscure the commonalities among children als are too. This may be one reason SLPs with language disorders, no matter what they do not do a better job of preparing parents are called. Second, children with a diagnosis and students to navigate the sometimes un- of SLI in the preschool years tend to have clear path taken among different diagnoses continued problems with language learning and service delivery models for children who throughout their school years and beyond, al- demonstrate language difficulties from their though their language disorders, as well as preschool through their school-age years. those of children newly identified as having The aforementioned scenario harkens to SLD, take on different forms as a consequence the classic question asked by Bashir, Kuban, of new contexts and learning tasks. Third, lan- Kleinman, and Scavuzzo (1984): “Are we guage is the embedded curriculum of school, speaking about a group of children, who by not only in the form of what is called “lan- virtue of learning context, are called by dif- guage arts” but also within all other parts of ferent names, but who in reality evidence a the curriculum. The implication of this is that continuum of deficits in language learning?” intervention choices should be based on stu- (p. 99). This, indeed, was our answer to Tim’s dents’ ongoing language learning and literacy mother’s question. It was not a new disor- problems within curricular contexts, regard- der, we told her, but a different manifestation less of their diagnostic labels. We end the ar- of Tim’s ongoing language disorder. The new ticle with summary points for consideration problems arose as he faced new challenges be- and a look toward future research. cause the language demands of the academic curriculum grow across grade levels, and this might happen again as Tim continued through DEFINITIONS AND DECISIONS: AN school. Tim’s two SLPs, one in the clinic and INTRODUCTORY ROADMAP the other in his school, needed to collaborate with each other and with his parents, teach- Our first thesis is that when profession- ers, and other specialists to co-construct a uni- als apply different labels in different con- fied picture of Tim’s strengths and needs that texts, commonalities among language disor- could inform treatment plans and help Tim ders are obscured. Identifying similarities re- gain new skills to meet curriculum standards quires merely looking at definitions across within new contexts. sources. Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Language Disorders Are Learning Disabilities 27 Under IDEA (2004), language disorders Definitions of SLI, in contrast, come from fall under the broad category of speech or the research literature. Leonard (1991) ob- language impairment (abbreviated S-LI in served that such definitions depend on sig- this article), which is defined as a “com- nificant and specific deficits in language, but munication disorder, such as stuttering, im- their identification is based primarily on ex- paired articulation, a language impairment, or clusion. He wrote, “Although these children a voice impairment, that adversely affects a exhibit significant deficits in language ability, child’s educational performance” (34 C.F.R. they show no evidence of frank neurological § 300.8(c)(11)). To provide services on the damage, their hearing is within normal limits, basis of language impairment, school-based and they perform at age level on nonverbal SLPs must find a child eligible for services as tests of intelligence” (p. 66). Specific language S-LI. The federal regulations, however, offer impairment is generally identified first when no eligibility criteria for diagnosing language children struggle to acquire oral language abil- impairment and no further definition of lan- ities in their preschool years. guage impairment; rather, criteria are estab- Specific learning disability may be identi- lished through state and local guidelines,