A language disorder or delay is a type of communication disorder that involves difficulties in using and understanding spoken language. There are two types of language disorders: expressive and mixed expressive-receptive language disorders. These disorders can be due to inherited conditions, developmental disorders, or traumatic brain injuries. In most cases, language issues fall under expressive language disorder. This refers to problems in expression or putting words together to form coherent sentences and to get the message across to listeners.

However, there are cases wherein a child struggles with both expression and comprehension. Problems with understanding and comprehension are referred to as receptive language disorder. This involves difficulties in processing messages and information that one receives, whether through listening or reading. It is not a disorder of hearing, e.g. hearing loss. 

Before an individual can use language to communicate (expressive language), one must first understand and grasp spoken language. That is why most children with receptive language disorder also struggle with expressive language. This is called mixed receptive-expressive language disorder

When language disorders or delays are not quickly addressed, they cause children to fall behind in school. According to research, around 5% of pre-school-age children and 3% of those in grade school are found to have mixed receptive-expressive language disorders.

Read about Listening Milestones and Questions Answering and Asking Milestones.

Signs and Symptoms of Mixed Receptive-Expressive Language Disorder

Signs of language disorders do not become noticeable until it is time for a child to start talking. Organizing thoughts while trying to process what others are saying can be a struggle for children with a receptive language disorder. They often find it difficult to connect words and the ideas behind them. In some cases, they may also have trouble with pronunciation and speech sound production.

Symptoms of mixed receptive-expressive language disorder include:

  • low vocabulary and comprehension levels compared to their peers
  • issues with pragmatics or the social use of language in social contexts
  • difficulty inferring meaning
  • trouble with spontaneous language production, hence, unable to ask questions
  • problems understanding more complex questions and directions
  • difficulty understanding and applying grammatical rules (tenses in verbs, singular or plural verbs, determiners, pronouns, etc.)
  • problems with completing two cognitive operations at the same time, called working memory, and learning new words or morphemes
  • slow processing of auditory/receptive information

For pre-school and school-age children, these symptoms can manifest in various ways and affect one’s behavior, interactions, and performance at home and in school. In particular, you may notice a child with receptive language disorder in the following areas:

  • seems uninterested in conversations or when other people are speaking
  • infrequently asks questions when someone is speaking or sharing a story
  • does not seem to be listening or understanding lessons in school
  • has difficulty in following directions
  • often copies what other children are doing before acting on a task
  • misunderstands what is asked, said, or written 
  • gives off base responses to questions
  • has trouble getting along or communicating with peers


Assessing and Managing Receptive Language Disorder

If your child shows signs of having receptive language disorder, it is crucial to have him or her assessed by a speech language pathologist/speech language therapist. This can be done privately or with the help of your school principal, counselor, school district office, and through Early Intervention. It is also recommended to have your child tested for hearing problems by an audiologist, which can be a common cause of why the child is having difficulties acquiring language. 

Because children with receptive language issues are most likely struggling with expressive language problems as well, a speech-language pathologist (SLP) will test both your child’s speaking and comprehension skills. During the assessment, the SLP will want to know if the child:

  • knows what to do with toys or uses pretend play
  • follows directions and simple instructions
  • names everyday objects and actions
  • identifies colors, numbers, and letters
  • follows simple routines
  • sings songs or recites rhymes
  • changes his or her manner of speaking when talking to different people in different places
  • is easy to understand or speaks coherently

Once it is established that your child is struggling with acquiring and using language compared to his or her peers, the SLP will then design an individualized program to help you and your child improve their language skills. These strategies typically involve:

  • developing important connections between letters, sounds, and words
  • vocabulary development
  • practicing the use of language in social situations
  • multisensory techniques

Parents and teachers also play critical roles in managing language disorders. Particularly when it comes to language monitoring and stimulation. Some of the therapy goals that SLPs may set with parents and teachers are:

  • increasing the child’s understanding
  • improving how the child uses words to express feelings and ideas
  • teaching parents, family members, and teachers how to speak with the child and encourage conversation
  • helping the child use other ways of communicating (also known as augmentative or alternative communication), if necessary, such as using simple gestures, picture boards, or text-to-speech apps and software
  • learning early reading and writing skills


Helping Your Child at Home

Aside from speech language therapy, there are other ways you can help your child improve their language skills. Some of the things you can do at home include: 

  • talking and engaging with your child in conversation to improve their vocabulary
  • reading aloud to your child and pointing out words
  • speaking to your child in the language of which you are both most familiar and comfortable
  • listening and answering your child’s questions
  • encouraging your child to ask questions
  • allowing your child enough time to process and answer questions
  • setting limits on the use of gadgets, computers, and watching television
  • Increase time with toys and imaginary play. 
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