What is Expressive Language Disorder?

Unlike speech sound disorders, which involve difficulties in producing spoken sounds, language disorders refer to problems using spoken language compared to peers. These expressive problems manifest in at least one of these areas: spoken vocabulary, complexity of what the child is saying (grammar), and social use of words (pragmatics). These issues become more apparent when children, older than 4 years of age, have difficulties telling stories and making friends. 

Language Disorders are classified as two types: 

Mixed Receptive-Expressive Language Disorder – Difficulty with comprehension or understanding the words or complexity of what the individual understands compared to peers and has an expressive language disorder. 

Expressive Language Disorder – Receptively, the individual is age appropriate but there are significant issues expressing oneself compared to peers. 

There is no such thing as just a receptive language disorder. If a child is misdiagnosed with this label, either the child has significant attentional difficulties, or the child’s expressive language skills were not thoroughly assessed. Speech language pathologists are the best professionals to thoroughly assess expressive language skills. 

Spoken or expressive language disorder is a lifelong condition and appears in early childhood. It is often developmental in nature but may also be caused by traumatic brain injury. An individual with expressive language disorder exhibits normal comprehension skills but has difficulty with written and/or verbal expression. This can impair academic achievement and make it more difficult to socialize in groups with peers. 

What Are the Signs of an Expressive Language Disorder?

In many cases, signs of an expressive language disorder may may be invisible to parents and teachers. Some signs and behaviors may not directly imply a language problem. According to research, one of the early signs of a language disorder in children is late talking. The Hanen Centre defines a late talker as a child between 18 and 30 months with a good understanding of language and typical development in other areas (hearing, vision, motor, and cognitive skills) but has a limited spoken vocabulary compared to peers for their age. However, late talking becomes a more serious concern for children who also exhibit other risk factors, such as:

• Quiet or little babbling as an infant
• Has a history of ear infections
• Limited consonant sounds
• Does not link pretend ideas and actions together during play
• Does not imitate words or sounds
• Uses mostly nouns and few verbs
• Difficulty interacting or playing with peers
• A family history of communication, learning, and academic difficulties
• Mild comprehension delay for their age
• Uses few gestures to communicate

Other signs of an expressive language disorder in children also include:

• less developed vocabulary than their peers
• often uses fillers like “um,” “uh,” and “huh”
• having no problems with understanding, but struggle with speaking, asking questions, or answering
• using short phrases or sentences or say the same words or phrases over and over;
• struggling with telling stories
• for toddlers, relying on using gestures
• lacking intonation and modulation when talking
• shying away from conversation and avoid social situations or group interactions
• may say a lot but not make much sense

Diagnosing Expressive Language Disorder

As with all speech or language disorders, it is always important to first ensure that there are no hearing issues affecting language development. A hearing assessment by an audiologist is necessary to rule out any issues with hearing (ears). Even undetected ear infections can interfere with acquiring language in younger children. 

To get your child diagnosed with an expressive language disorder, a speech-language pathologist (SLP) must do a thorough evaluation. A comprehensive assessment must be conducted with the help of the child’s family and teachers. This evaluation process includes both informal and formal assessments. Formal evaluation comes in the form of standardized tests, while informal evaluation involves interviews, observations, checklists, and language samples.

During this phase, speech language pathologists will need to know the child’s:

• full case history (including birth and medical records; history of language, speech, reading, or academic difficulties in the family; languages or dialects spoken at home; and, the family’s and teacher’s own observations and concerns)
• spoken language skills (phonology and phonological awareness, semantics, morphology, syntax, and pragmatics)
• level of reading and writing (if the child is school age) 

How to Treat Expressive Language Disorder

Once a diagnosis is made, the SLP will conduct further analysis and observations before creating an individualized program. However, it is important to remember that therapy will not offer a permanent “cure” for the disorder. Instead, SLPs can equip children with strategies and techniques to help them manage their condition. 

Therapy methods can vary, depending on the therapist and the child’s needs. Modeling target behavior is one technique where the therapist models and reinforces aspects of speech that need to be targeted, such as sounds, vocabulary, and grammatical structure.

Some areas that SLPs address are:

For preschoolers (ages 3 to 5):

• enhancing phonological awareness through rhyming, blending, and segmenting spoken words
• improving vocabulary and understanding of semantic relationships
• increasing sentence types, length, and complexity
• improving conversational skills
• developing narrative skills
• increasing language flexibility in different contexts
• building and encouraging literacy skills