Teenager with Specific Language Disorder< back to case studies
N was 14 when I began working with him. His mother asked me to see him after she had become increasingly worried about the problems her son was experiencing at school and in his personal development because of difficulties he had with speech and language. N had been seen by NHS Speech and Language Therapists but had since been discharged and with little light been shed as to the underlying causes of Ns language difficulties. The prognosis though was grim and his future educational career was bleak.
In school N was not however flagged up as a child with serious language impairment, he resisted drawing attention to himself and was not troublesome. His teachers viewed him as a quiet nice boy who was just another unexceptional child within the felid of literacy and language. He was however a very gifted artist and musician.
I saw N once weekly at home and worked closely with both his parents. After about 2months it became obvious that N was experiencing a severe Specific Language Impairment (S.L.I.). The severity was such that he could become conversationally inert and often what he said made little sense at all even though he knew what he wanted to say. Typically as with all these youngsters he was very immature, seeing the world in very black and white terms, which certainly complicated the presenting picture and the impact of his language processing deficits. However it became evident very quickly he wasn’t intellectually impaired on the contrary he showed considerable insight into the difficulties he faced. It was his insight that made his struggle with language so unbearable however, and it became obvious that N was hovering on the brink of a severe depression.
As is so often with many of the young people I work with, far from being intellectually incapable, their processing deficits prevent them from accessing and expressing with those around them their inner thoughts and ideas, which can often be rich and creative. Their attempts to do so are constantly dogged by the inadequacies of their processing systems and the sheer exhaustion of trying to keep up. The crippling impact of this cast a huge shadow of doubt as to their own real potential, particularly as they see others who they view as less able as them finding what they struggle with so easy.
This can unfortunately be made worse by the understandable ignorance of those around them, who simply due to a lack of understanding as to the nature of this condition, see the children as stupid or lazy and therefore fuel the youngsters growing self doubts. Until eventually they yield crushed by ongoing sense of failure and criticism. The catastrophic impact of this cannot be overstated, the corrosive impact of this reflected and wrongly constructed belief of failure is such that some consider suicide and I believe this is one of the reasons why SLI is seen to be so therapy resistant.
Given the potential for such self harm I knew I had to work not just to help N to develop his language processing system, but to simultaneously work with the emotional impact of his impairments. Uncoupling negative and painful associations from the underlying language processing deficits was always at the heart of our work together and therefore it had to be taken slowly.
Critical to the progress of the therapy was, to utilise Ns ability to see and reflect on what we were doing as we went along. However this inevitably aroused his toxic fear of failure and criticism and meant that he often became very resistant and extremely angry in response to the demands of the tasks. However because of Ns own wish to improve and his parents support and persistence, the therapy survived the emotional storms and bartering that were so much a feature early on.
Three years later N’s struggles are far fewer. He would still be described as language disabled but because of the progress he has made, the level of impairment has moved from severe to moderate to mild. Conversationally, he flows and is more coherent and he rarely dissipates into rage or distress when his words evade him or disappear from his mind. He will now ask if he hasn’t understood. He has made big steps in his ability to express and sift ideas though writing and reading.
More importantly he is more confident, in himself as someone who can achieve and is less fearful of facing failure. He his better able to view his language impairments as just that and is rarely resorts to anger or depression as a way of avoiding dealing with his language deficits.
N has been accepted into an FE College to study music.
What People Have Said About Geraldine Wotton ...
"Her advice and therapy is immensurable and I would recommend Geraldine to anyone whose child is struggling with speech and language. She supported me as a mother with a child with Autism and helped me to feel positive about the future for our son. She has helped him accomplish things I never thought possible."
Mother of child with autism
"Her years of experience mean she knows how to get the best from my at times very challenging daughter using praise, patience and humour. My daughter has been seeing Geraldine for 7 years and in that time made such progress with her that the difference is noticeable to children of a similar age. This progress is as a result of Geraldine’s skills."
Mother of Daughter with Down Syndrome
"Geraldine has worked with a variety students at North Hertfordshire College to ensure they receive the continued speech and language skills they require to access the curriculum, communicate with their peers and gain further independence skills in communication. The students related well to Geraldine and staff were able to use the strategies suggested throughout the week and feedback on their progress. Geraldine completed all reports and assessments in a timely and professional way and the students benefited from the feedback given. Parents/carers were able to use some of the strategies suggested in the home and reported that obvious improvements were being made by their son/daughter."
Course Co Ordinator for Adults with Learning Needs at North Herts College
"It was an absolute pleasure to see how Geraldine engages with her patients. The holistic and intuitive approach she adopts reflects the vast amount of experience Geraldine has in working with children and adults with a range of communication disabilities. I was inspired by the sheer joy and devotion she demonstrated in her work and it is no wonder her clients are so committed to her."