Thoughts of a secondary school SLT

Category: secondary school

  • Do language disorders go away?

    In 2017, a panel of international experts described a language disorder as language difficulties that are likely to persist into middle childhood and beyond (Bishop et al, 2017). So, by definition, a language disorder is a condition that does not go away or resolve on its own. Indeed, there is now plenty of research suggesting that many early language difficulties endure into adolescence, and even adulthood.

    In one longitudinal study, Stothard et al (1998) found that two thirds of children who had impaired language skills at ages five to six continued to have significant difficulties at ages 15 to 16. And in Walter Loban’s groundbreaking study (1976), he found that the language abilities of his three groups remained surprisingly stable over time. That is, most of those in the high and low language ability groups stayed in those same groups all the way from kindergarten to Grade 12 and did not get much better or worse.

    Despite this evidence, there is a lot of misinformation and confusion surrounding this issue, even amongst professionals. In a series of online interviews conducted with young people with Developmental Language Disorder (DLD) and their families, many felt that their concerns were not taken seriously by General Practitioners (GPs), who claimed that “children often grow out of it” (RCSLT, 2023). Part of this confusion probably stems from the difficulties involved in diagnosing very young children.

    It is likely that a certain amount of normal variability exists in the language abilities of pre-schoolers. A child who begins talking late may be considered a “late bloomer” who does not have anything particularly “wrong” with them (Paul & Norbury, 2012). In fact, many children identified as “late talkers” around the age of 2 do catch up without any special help and go on to have normal language abilities (Bishop, 2014, Bishop et al, 2016).

    However, some do not. And other studies have found that even those who appeared to catch up with their peers were at continued risk later on in their development. For example, Rescorla (cited in Paul & Norbury, 2012) found in 2002 and 2009 that late talkers who were judged to have normal language abilities at ages 5 and 6 went on to display subtle, residual difficulties in language and literacy skills later on.

    The picture is unclear, and it is difficult to predict which late talkers will go on to have long-term problems and which will not (Bishop et al, 2017). However, the older the child is, the easier it is to judge. Whilst it is particularly difficult before the age of 3 (Bishop et al, 2017), Stothard et al (1998) noted that outcomes at 15 to 16 could be predicted fairly accurately by a child’s score at 5 to 6 years of age. A child identified at this point could be reasonably expected to have lifelong difficulties.

    But if a language disorder is a lifelong condition, then why don’t we treat it as one? Whilst Speech and Language Therapy (SALT) support for early years is widely available, along with a fair amount at primary school, this drops off considerably thereafter. Larson and McKinley (2003) found that only a fraction of older students were receiving services. And more recently, the Royal College of Speech and Language Therapists (RCSLT) (2023) observed that services were rationed, with little support available at secondary schools, and even less at further education colleges. No DLD services are currently provided for adults on the National Health Service (NHS).

    Early intervention may be effective (Paul & Norbury, 2012) in improving language skills, school success and longer term outcomes, but it is not a cure-all. In my opinion, the heavy emphasis placed on it risks undermining the need for ongoing support at different stages in a young person’s development.

    Larson and McKinley (2003) note that these early programs perform only part of the task, and that children’s difficulties are likely to re-emerge later, especially when the linguistic demands of a new context increase, such as in the transition to secondary school. They observe that discharging children in Year 6 only makes sense if the end goal is Year 6 level language skills.  

    Many experts in the field now advocate for services to be made available not just throughout childhood and adolescence, but also periodically throughout adulthood (RCSLT, 2023). This is something I feel strongly about, given the high costs to both the individual and society of not providing support.

    For more information on DLD, please see my post: https://secondaryschoolslt.wordpress.com/2026/01/02/what-is-developmental-language-disorder-dld/

    Notes

    Bishop, D.V.M. (2014). Ten questions about terminology for children with unexplained language problems. International Journal of Language & Communication Disorders, 49(4), pp. 381-415.

    Bishop DVM, Snowling MJ, Thompson PA, Greenhalgh T, CATALISE consortium (2016) CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children.

    Bishop, D.V.M., Snowling, M.J., Thompson, P.A., Greenhalgh, T., and the CATALISE-2 consortium (2017). ​ Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. ​ Journal of Child Psychology and Psychiatry, 58(10), pp. ​ 1068–1080.

    Larson, V.L. and McKinley, N.L. (2003) Communication solutions for older students. Thinking Pub. 

    Loban, W. (1976) Language Development: Kindergarten through Grade Twelve. Urbana, IL: National Council of Teachers of English.

    Paul, R. and Norbury, C. (2012) Language Disorders from Infancy Through Adolescence: Listening, Speaking, Reading, Writing, and Communicating. 4th edn. St. Louis, MO: Elsevier.

    Royal College of Speech and Language Therapists (RCSLT). “A Vision for Developmental Language Disorder (DLD) for the UK” London: RCSLT, 2023. https://www.rcslt.org/wp-content/uploads/2023/10/A-Vision-for-Developmental-Language-Disorder.pdf. 

    Stothard, S. E., Snowling, M. J., Bishop, D. V. M., Chipchase, B. B., & Kaplan, C. A. “Language-impaired preschoolers: A follow-up into adolescence.” Journal of Speech, Language, and Hearing Research 41, no. 2 (1998): 407-418.

  • Later language development: what Speech and Language Therapists need to know about the secondary school years

    Until relatively recently, the topic of later language development had been somewhat neglected. Whilst early childhood is seen as a time of rapid linguistic growth, later language development has been described as “gradual and protracted” (Nippold, 1998, p.3). Still, recent research has elucidated the many important advancements that occur during this period, calling into question the myth that language development is complete by school age.

    What’s normal?

    Whilst the early period is still considered the time of primary language acquisition, there is now a consensus that language development continues into adulthood and has no fixed end point. In the case of vocabulary, for example, even older adults may learn new words as they pursue different hobbies and read widely. On the other hand, some adults never master all grammatical structures, especially if they did not continue on to further education, where more scholarly forms are in more common usage (Nippold, 1998).

    Wide variation is thus characteristic of language development in the later years. As students begin secondary school, choose certain subjects, drop others, and take on extra-curricular activities, they also develop increasingly specialised vocabularies to match their interests: language becomes ever more individual to the student (Nippold, 1998). What’s more, with slang terms, hesitations, and non-specific phrases such as “like” and “stuff” increasingly common in adolescent language, even typical development may appear disordered (Larson and McKinley, 2003). Nippold (1998) points out that even well-educated adults make grammatical errors from time to time.

    These factors make it more difficult to set guidelines and to define what is “normal” during the adolescent years. And because change is slow and gradual, we may need to compare students across very different age groups to see the differences (Nippold, 1998, p.3).

    Walter Loban (1976) was the first person to document language growth into early adulthood through a longitudinal study comparing a low language ability group with a high language ability group. Since then, various other experts in the field have written about the topic, and a body of research now exists in the area. I have drawn mainly on the amazing work of Marylin Nippold in writing this blog post, particularly her book, “Later language development” (Nippold, 1998).

    Vocabulary

    One important development that occurs during the later years is the expansion of vocabulary. Whilst a 6 year old knows roughly 18,000 words, this increases to at least 60,000 in early adulthood (Nippold, 2024). As students progress through school and participate in the “literate” activities of reading, writing, academic discussion and accessing the curriculum, they begin to acquire more technical and specialist vocabulary, as well as concepts such as adverbs of magnitude and likelihood, and metacognitive and metalinguistic verbs (Nippold, 1998).

    Learning a word is also a gradual, rather than an all or nothing process (Nippold, 1998), and many qualitative improvements occur over time. As we encounter words in different contexts, semantic representations strengthen, and new meanings are added to words already in the repertoire: whilst a young child will typically know the physical meaning of a “double function” word such as “cold”, it is only later that she will learn its psychological meaning, and understand how these different meanings overlap (Nippold, 1998, p.15). Slowly, an organised semantic network develops, as connections between similar words are strengthened (Nippold, 1998).

    The way that we learn words also changes. When we are young, we learn words incidentally, through oral input, but when we begin secondary school, a lot of curriculum vocabulary is taught directly in class. Another important source of learning at this age is the written word, as students are exposed to more unusual, abstract and complex vocabulary and structures through their independent reading. Many young readers learn to utilise morphological and contextual clues to figure out the meanings of unfamiliar words they encounter, supported by developing metacognitive skills and a greater awareness of derivational morphology (Nippold, 1998).

    Syntax

    Syntax also develops in various, subtle ways. Considerable growth occurs at both the intrasentential1 and the intersentential2 levels. Individual sentences increase in length, complexity, and density of information (Nippold, 1998). Loban (1976) observed small, but regular increases in sentence length throughout the school years, although Nippold (1998) cautions us that the length of utterance depends very much on the context. All speakers tend to use shorter sentences when communicating in informal, conversational contexts, and longer sentences in more formal contexts, or when required to explain and give detailed information, such as when telling the rules of a game (Nippold, 1998, 2014).

    Clausal density is another sign of mature development. Whilst a 5 year old may be able to form grammatically correct sentences containing a range of subordinate clauses, the ability to construct longer sentences containing multiple, embedded subordinate clauses to express increasingly complex and abstract thoughts continues to develop into adulthood (Nippold, Mansfield, Billow and Tomblin, 2009). Improved understanding and use of a range of subordinating, coordinating and correlative conjunctions goes alongside this (Nippold, 1998).

    Certain types of clause, such as nominal, adverbial and relative clauses are also used increasingly (Nippold, 2024); the latter, in particular are a common sign of maturing language (Loban, 1976). For a detailed look at these, and other aspects of advanced grammar, I highly recommended Nippold’s book: “A grammar guide for Speech-Language Pathologists” (Nippold, 2014).

    Still, a long, clunky sentence is not necessarily a sign of mature language skills when the message could be expressed more succinctly. Loban (1976) found that during the later stages of adolescence, his low language ability group unexpectedly appeared to catch up with his high language group at one point, in terms of the average number of dependent clauses used per communication unit. However, upon deeper analysis, he found that the higher language group were using more sophisticated sentence structures which enabled them to be more concise.

    Rather than continuing to add on further clauses, sentences may be expanded in other ways, such as elaboration of noun and verb phrases through the use of appositives, infinitives, gerunds, prepositional phrases, and others. Indeed, the presence and combination of low-frequency syntactic structures such as these is another characteristic of mature language (Nippold, 1998). Students also learn to link different sentences together using adverbial conjuncts and other devices to produce cohesive discourse (Nippold, 1998).

    Discourse & comprehension

    Narratives are the most dominant type of discourse throughout primary school, and young children already know a lot about storytelling. At secondary school, students learn to construct longer, more detailed and organised narratives containing multiple episodes, whilst giving more space for their characters’ feelings and motivations. At the same time, other types of discourse, such as expository discourse3, persuasion and negotiation come to the fore (Nippold, 1998).

    Comprehension also improves slowly, and older children develop the important ability to process larger units of discourse (Nelson, 1998). Still, Larson and McKinley (2003) caution that we should not expect pre-adolescents and adolescents to understand everything we say to them, since some grammatical structures may not even be understood by adults. Anyone who has read complex academic prose can tell you that some sentences are just harder to understand than others.

    Figurative language & pragmatics

    Abstract thought, and with it figurative language such as similes, metaphors, idioms and proverbs also develops over time. Research has found that preschoolers have some awareness of this type of language, but that deeper understanding emerges during the school years and adolescence. Similarly, jokes, slang and ambiguous language become increasingly important, since they are linked to students’ self-esteem and peer-acceptance (Nippold, 1998). Conversational and pragmatic skills also develop, with older students more able to adapt their communication to different contexts (Nippold, 2024).

    Whilst many linguistic achievements appear to be “built in”, we have seen how school itself, and the contexts in which students find themselves can influence language development. Similarly, the increasing demands of formal education, which typically include reading challenging material, and extended written assignments sometimes requiring independent research may push forward cognitive and linguistic growth (Paul and Norbury, 2012, Nippold, 2024). As Nippold says, “complex thought encourages complex talk” (Nippold, 2014).

    Final thoughts

    Despite the amount of research now available, later language development is still widely ignored. Larson and McKinley (2003) found that very few university programs across the USA offered modules on this topic, and my experience at a UK university in 2012 was similar. In a small survey that I carried out last year, around half of my fellow SLTs did not feel they had the knowledge to work with this age group, with a further 25% feeling unsure, suggesting that perhaps not much has changed. I hope this summary has helped; for a more in-depth look at later language development and a deeper understanding of grammar, I highly recommend Marilyn Nippold’s excellent books (Nippold, 1998, 2023).

    To find out more about what a language disorders might look like in the later years, please see my post: https://secondaryschoolslt.wordpress.com/2026/01/07/what-is-developmental-language-disorder-dld/

    Notes

    Larson, V.L. and McKinley, N.L. (2003) Communication solutions for older students. Thinking Pub. 

    Loban, W. (1976) Language Development: Kindergarten through Grade Twelve. Urbana, IL: National Council of Teachers of English.

    Nelson, N. W. (1998) Childhood Language Disorders in Context: Infancy Through Adolescence. 2nd edn. Boston, MA: Allyn & Bacon.

    Nippold, M.A. (1998) Later language development: The school-age and adolescent years. 2nd ed. Austin, TX: Pro-Ed.

    Nippold, M. A., Mansfield, T. C., Billow, J. L. and Tomblin, J. B. (2009) ‘Syntactic development in adolescents with a history of language impairments: a follow-up investigation’, American Journal of Speech-Language Pathology, 18(3), pp. 241–251. 

    Nippold, Marilyn. (2014). Language Intervention at the Middle School: Complex Talk Reflects Complex Thought. Language, Speech, and Hearing Services in Schools. 45. 153-156. 10.1044/2014_LSHSS-14-0027.

    Nippold, M.A. (2023). Grammar guide for speech-language pathologists: Steps to analyzing complex syntax. San Diego: Plural Publishing.

    Nippold, Marilyn. (2024). Language Development in School-Age Children, Adolescents, and Young Adults. 10.1016/B978-0-323-95504-1.00374-4.

    Paul, R. and Norbury, C. (2012) Language Disorders from Infancy Through Adolescence: Listening, Speaking, Reading, Writing, and Communicating. 4th edn. St. Louis, MO: Elsevier.

    1. Within sentences ↩︎
    2. Between sentences ↩︎
    3. Discourse aiming to explain or inform; this is the language of the classroom, of lectures, textbooks, reports, etc.  ↩︎

  • In at the deep end

    I began my Speech and Language Therapy journey sobbing in the Additional Learning Needs room in the autumn term of 2014. It was the beginning of the academic year and I’d just gotten my first job as a Newly Qualified Practitioner (NQP) at an “academy” in a deprived borough of London. Unusually for a mainstream secondary school, they’d hired a private Speech and Language Therapist – me! – to manage their huge caseload of around 100 students with language and communication needs. And I didn’t seem to be handling it all that well…

    “I get on well with teenagers”, I’d said during the interview, “and since everyone’s so focused on early intervention, I think they can get forgotten about. But I feel they deserve to be supported too…” That’s how I found myself leading (in the loosest sense of the word) seven Speech and Language Therapy sessions a day – for groups of disengaged young people who seemed keener on throwing the bean bag I’d brought as a “talking stick” at each other’s heads than in doing any of the activities I’d carefully planned.

    It didn’t help that I’d never worked in a secondary school before, let alone had a placement in one. Or that my postgraduate course back in 2012 had covered early language development, before moving swiftly onto acquired adult conditions, all but skipping the adolescent period. Although research into this age group is slowly building, it’s still only a fraction of what’s available for early years. You could be forgiven for thinking that language development ends at 5, and there’s nothing left to be done…

    On the contrary, as student after student came through my door for their assessments, a staggering level of need emerged that I’d never have expected to find in this ordinary secondary school. Many were struggling with basic sentence structures and vocabulary, yet they were expected to analyse Shakespearean tragedies and compose essays. The gap between where my students were and where they were expected to be seemed insurmountable – was it really my job to help them cross it?

    Meanwhile, as the only SLT at school, I had to wait for my weekly supervision session at the clinic for a sighting of one of my colleagues. This made for a slightly strange and isolating first year. And without anyone to ask advice on a daily basis, my students became a mirror for how I was doing. The reflection wasn’t always flattering. They’d often “act out” or refuse to come to my sessions. This was tough, but looking back, it was some of the clearest and most honest feedback I ever received.

    I only ended up staying at that first school for a year, but I did stick with the age group. Over the next decade I went on to work at a range of mainstream secondaries around London, mainly privately, but also as a locum for the NHS.

    Slowly, things started to get better, and I began to see my own progress reflected in my students. Their annual CELF-5 scores improved. They’d tell me that they were understanding more in class; that they were finding it easier to follow their teachers’ instructions. A memory strategy helped one remember his mum’s PIN so he could help her with the shopping (so he said!). Another would proudly show me his conduct card at the beginning of every session with admittedly fewer infractions than the previous term.

    But most of all, my students began showing up more – physically and mentally – to my sessions. And overwhelmingly they did so without complaining; it was almost as if they thought it was helping!

    I’m not a researcher or academic – just an ordinary SLT who’s been in the extra-ordinary position of having time, week in, week out, to try out a range of interventions with my students to see what worked. It’s taken a lot of trial and error, digging out random books and taking obscure courses to get to a point where I feel like I’m truly serving my students’ needs.

    My practice is by no means perfect, but I wanted to start this blog to pass on what I’ve learnt, and to share a window into my practice for anyone who’s interested. Whether you’re a student, SLT or another professional interested in finding out more, I hope this helps.

    Tawna

    You might like to start here: https://secondaryschoolslt.wordpress.com/2026/01/07/what-is-developmental-language-disorder-dld/