DEVELOPMENTAL LANGUAGE DISORDER THERAPY

Understanding language and using it to express thoughts and feelings are two of the most crucial milestones in a child’s life. While children tend to develop new skills at different paces, most hit these milestones at their expected ages. But when a child’s language skills consistently fall behind his or her peers, it may be due to a developmental language disorder. Learn what is the link between executive functioning and language. Download our What is Executive Functioning Pamphlet!

A developmental language disorder (DLD) refers to language development problems in young children that persist even well into their school years and adulthood. It is a brain difference that makes it difficult for children to process and use language, whether in oral or written form. 

Children with a DLD have trouble with their expressive language using words and sentences to express meanings, thoughts, and feelings. They are also likely to struggle with understanding and processing words (receptive language/auditory comprehension) that they hear or read. This is also known as a mixed receptive-expressive language disorder or what researchers call specific language impairment.

The exact causes for a DLD are not entirely known, but research suggests that a DLD is heavily influenced by genetic factors. Struggling with a DLD can negatively impact a child’s social interactions, home life, and school performance. According to DLDandme.org, a DLD affects up to two children in every classroom and is five times more common than autism. 

A developmental language disorder can occur even without developmental disorders, intellectual disability, or other biomedical conditions. However, children with a DLD are likely to be at-risk for co-occurring conditions like autism, attention deficit hyperactivity disorder (ADHD), motor deficit, reading disorders, speech sound disorders, and social, emotional, and behavioral issues. Dyslexia is a language-based disorder. But so is developmental language disorder (DLD). Are they the same thing? Learn about the relationship between dyslexia and DLD.

Read SPELLTalk questions and answers about the language literacy network– which represents normal reading and writing processes.

Another condition is Social Communication Pragmatic Disorder (SCPD). Learn more about social communication pragmatic disorder, its symptoms, causes, and strategies parents can employ to support their child with this disorder.

Read about Early Childhood Developmental Milestones.

Children who struggle with a developmental language disorder develop vocabulary and grammar at a much slower pace than their peers. Aside from these, a DLD can also affect other aspects of language at varying degrees, including:

• Phonology or speech sounds – Children who struggle with phonology will have difficulties distinguishing and recognizing speech sounds.
• Syntax (grammar) and morphology – A child may struggle with creating grammatically correct sentences, adding prefixes and suffixes to verbs, and use of proper tenses.
• Semantics or vocabulary – Children with a DLD tend to have reduced vocabulary and struggle to understand that some words have different meanings. Read about Building Vocabulary With Critical Thinking Skills and Comparing Two Established Multimedia Approaches for Teaching Vocabulary to Students with and Without Disabilities. Word finding – Even when a child is familiar with a word, he or she will have trouble accessing or using it (tip of the tongue phenomenon).
• Pragmatics – This refers to social communication, inferencing, and figurative language. Someone who struggles with pragmatics may have trouble using appropriate language (including nonverbal communication) in different social situations and daily interactions. Learn more about social communication disorder.
• Discourse (narrative and conversation) – With a DLD, a child often has trouble telling stories or describing a sequence of events.
• Verbal memory and learning – Remembering words, particularly unfamiliar ones, is difficult for a child with a DLD. A child will also struggle to recall and understand long or complex sentences. These students have reduced working memory, which makes language learning more difficult for them. 

A child who shows signs of having a developmental language disorder can undergo an assessment by a speech-language pathologist (SLP) either privately or through the school or local school district. 

Signs of language disorders are often hard to detect, more so in the absence of co-occurring issues such as autism, hearing loss, or genetic conditions like Down syndrome. If a child exhibits the following symptoms, a DLD assessment should be considered.

• Significant language deficits in relation to one’s age that interfere with communication and learning in daily life.
• Persistent language problems that are likely to remain unresolved by age five.
• The language problems are not linked to any known biomedical condition.

During the evaluation process, the SLP will assess the child’s interest in communicating. Some SLPs are experts working with early childhood development whereas other speech language therapists work with the school age population.  The SLP will observe how understandable the child’s expressive language is as well as his or her ability to understand words and sentences. A typical evaluation consists of the following steps:

1. Interviewing the child’s parents, caregiver, and teacher to document the child’s family, health, and academic history. The SLP will ask about their own concerns and observations of the child’s strengths and weaknesses when communicating.
2. Observing the child during conversation or storytelling and noting pronunciation problems, finding the right words, building grammatically correct sentences, and other relevant information.
3. Taking a series of standardized tests to compare the child’s speech, language, and overall communication with expected levels for his or her age.

A developmental language disorder is a lifelong condition that cannot be permanently cured. But with the help of a speech-language pathologist, the child can learn strategies and techniques to help manage the condition. 

After a child is diagnosed with a DLD, the SLP will conduct further analysis and observations before creating an individualized program. The methods and strategies can vary from child to child, depending on their strengths and weaknesses. Eliciting, modeling, and scaffolding target linguistic features through specific modalities, e.g. expressive, listening, reading, writing,  is how a licensed language therapist/pathologist models, teaches, and reinforces aspects of language that need addressing, such as sounds, vocabulary, grammatical structures, and social use.

In younger children, therapy is typically interwoven into natural communication, such as conversation and play! For older children, interventions are typically embedded in the school curriculum or within literacy activities. It is also essential to have parents and teachers involved in the process, as learning must happen outside of the language therapists’ sessions! Read about the validity of an online oral narrative task (2023 study). The assessment task was developed to monitor children’s oral language progress in their first year at school as part of the Better Start Literacy Approach for early literacy teaching.

Listen to this podcast by Dorothy Bishop, Professor of Developmental Neuropsychology, about developmental language disorder (history, advocacy, terminology, co-morbidities, and so much more!)