Grammar is the main challenge for children with Specific Language Impairment (SLI)

Language is a toolkit. For many kids, grammar is the tool that’s toughest to master. In the world of DHA-speaking therapists, we often see a very clear pattern: grammar stands out as the primary hurdle for children with specific language impairment. Let me explain why that happens, what it looks like day to day, and how families and clinicians can partner to support meaningful progress.

Grammar is the backbone of sentence structure

If you’ve ever tried to tell a story with proper tense, number, and article use, you know how a tiny grammatical shift can change everything. In children with SLI, the main snag tends to be grammar—how sentences are built, how verbs change with time, how plurals are marked, and how little words like a, an, and the fit into a sentence. It’s not that they don’t understand words or meaning; it’s that the rules that organize those words into fluent, accurate sentences can lag behind.

Think of it this way: you might have all the vocabulary in your pocket, but the road signs—tense markers, subject-verb agreement, and proper word order—aren’t always easy to follow. A child may understand the idea you’re conveying yet produce, say, “The dog run” instead of “The dog runs,” or omit the past tense when it’s needed. Those errors aren’t about memory or laziness; they’re about the grammatical system not being fully integrated yet.

Pragmatics, semantics, and phonology aren’t forgotten

People often ask if grammar is the only area affected. The honest answer is: issues can ripple into other language domains, too. Pragmatics—the way we use language in social settings—can be a bit wonky when grammar is underdeveloped. A child might know the word “why” but not use it smoothly in conversation, or they may struggle with taking turns and staying on topic because the structure of sentences isn’t helping them plan what to say.

Semantics—the meaning of words—can appear delicate as well. A child might know the word “play” but mix up related words like “laugh” or “grow,” especially when those words require subtle grammatical cues to convey the exact meaning. Phonology—the sound system—might show up as well, but often it’s the grammar that remains the loudest marker of SLI. In some kids, sound accuracy is relatively good; the sticking point is how those sounds are stitched into correct sentence forms.

What this looks like in everyday life

In the classroom, at home, or during play, grammar challenges show up in small, persistent ways. A child may narrate a simple event with choppy sentences or drop key endings in verbs. They might tell a story that sounds like a list of actions rather than a cohesive sequence. You’ll notice:

• Tense problems: “Yesterday we go to store” instead of “Yesterday we went to the store.”

• Plural and article use: “two cat” or “a cat is sleeping” becoming “cat sleep.”

• Subject-verb agreement issues: “The dogs runs fast” rather than “The dogs run fast.”

• Word order quirks: questions formed incorrectly, like “What you are doing?” instead of “What are you doing?”

These patterns aren’t just academic concerns. They shape how a child shares experiences, asks for help, and follows directions. The good news is that grammar, while challenging, can be targeted in thoughtful, supportive ways that fit into everyday routines.

How clinicians think about grammar in SLI

Clinicians don’t rely on a single test to tell the whole story. A typical picture includes multiple data points:

• Language samples: Watching a child tell a story or describe a picture helps reveal how grammar functions in natural speech.

• Standardized measures: Tools that assess grammar skills provide benchmarks and help identify strengths and gaps.

• Observations across contexts: Children often show different levels of grammar accuracy at home, in school, or with peers.

• Dynamic understanding: Listening to how a child learns a new grammar rule during a session can reveal how flexible their system is.

The goal isn’t to label or limit the child; it’s to map what’s happening with grammar and plan supports that feel doable in daily life. When grammar becomes clearer, other language areas often begin to click more easily, too.

Focused strategies that support grammar

If you’re working with a child who shows pronounced grammar difficulties, certain approaches tend to be especially helpful. They’re practical, kid-friendly, and designed to fit into everyday activities.

• Explicit grammar models: Demonstrating correct forms in a natural context helps children notice the rules. It’s less about drilling and more about hearing and practicing real usage.

• Recasting and expansion: When a child says, “dog runs,” a clinician or caregiver might respond with, “Yes, the dog is running quickly.” This provides the correct form while keeping the conversation flowing.

• Focused elicitation: Short, targeted prompts invite the child to use a specific grammatical form, such as past tense or plural markers, in a meaningful sentence.

• Concrete practice with feedback: Repetition in meaningful contexts helps consolidate form. Feedback should be gentle and constructive.

• Functional communication contexts: Use play, daily routines, and stories where the target grammar naturally arises. This makes learning feel relevant, not academic.

Therapy happens in the real world, not just the office

The best progress tends to come when grammar work travels beyond the therapy room. Parents, teachers, and therapists can coordinate to build a shared language-learning environment. Simple, consistent prompts in everyday routines—like describing steps while baking, telling about a favorite game, or recounting what happened at the park—provide ongoing opportunities to hear and use correct grammar.

Here are a few easy, family-friendly ideas:

• Read together and pause to highlight sentence shapes. After a page, ask the child to tell the next part of the story using a correct tense or plural form.

• Play sentence-building games. Give a picture and a few word cards; the goal is to assemble a grammatically correct sentence that describes the image.

• Create “expand and extend” moments during conversation. If a child says, “Dog runs,” you can add, “Yes, the dog runs fast in the yard.” Then invite a similar expansion from them.

• Use routine routines to practice. Breakfast, bath time, and bedtime offer built-in moments to practice simple past tense, articles, or plural endings without taking over the moment.

A few myths to keep in mind

• Myth: Grammar is the only thing that matters. Reality: It’s a central marker, but strong language use across contexts supports overall communication and learning.

• Myth: If a child can understand language, they’ll eventually speak it correctly. Reality: Comprehension and production aren’t always in sync. Grammar requires explicit attention in many cases.

• Myth: All kids with similar looks of SLI progress at the same rate. Reality: Each child learns along their own path, often with bursts of gains that surprise everyone.

Putting it all together

Specific language impairment often presents most prominently as a grammar challenge. That doesn’t mean other areas are irrelevant, but it does explain why therapists focus on sentence structure, tense, and agreement as a starting point. When grammar becomes clearer, a child’s ability to share experiences, follow instructions, and engage with peers can improve as a whole.

If you’re a caregiver or a professional interacting with children who show these patterns, you’re not alone. The work is collaborative, practical, and very much rooted in the child’s daily world. By aligning goals with everyday communication, we can help a child move from “dog runs” to “the dog runs quickly in the yard,” opening doors to more confident conversation and richer learning experiences.

A quick takeaway

• Grammar is often the primary hurdle in SLI, even when meaning and sounds are relatively intact.

• Other language areas can be affected, but the strongest pattern tends to center on sentence structure and verb forms.

• Everyday language activities, patience, and targeted, supportive strategies make a real difference.

• Clinicians rely on multiple sources of information to map strengths, gaps, and the best paths forward—paths that weave through home, school, and community contexts.

If you’re exploring how language develops or how to support a child with SLI, remember this: grammar is a powerful lever. When we help a child feel confident with sentence structure, we’re nudging the whole language system toward smoother, more expressive communication. And that sense of momentum—seeing a child say, “The cat is sleeping on the couch” instead of “Cat sleep on couch”—that’s when progress feels truly meaningful.