The results of a pilot study into meta-syntactic therapy using visual coding for four children (age 11-13 years) with severe receptive and expressive specific language impairment (SLI) are presented. The coding system uses shapes, colours and a system of arrows to teach grammatical rules. A time-series design established baseline pre-therapy measures of comprehension and production of both passives and 'wh' questions. All participants made progress with passives and this was significant in three cases of the four. Comprehension and production of 'wh' questions also improved in all participants, although this did not always reach statistical significance. The results indicate that meta-syntactic therapy of grammatical rules, capitalizing on visual strengths, can improve both comprehension and production in secondary age children with severe persistent SLI.
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