Understanding Language Disorders

By The Understood Team

 

Language disorders can make it difficult for kids to understand what people are saying to them and to express their own thoughts and feelings through speech. They can also affect how kids learn and socialize. If you’re concerned your child has a language disorder, you’re not alone. They’re surprisingly common childhood conditions. And there are many ways to treat them.

Learning more about language disorders is a good first step toward helping your child. Read on for key facts about language disorders and suggestions for how you can help your child.

What are language disorders?

A language disorder[1] is an impairment that makes it hard for someone to find the right words and form clear sentences when speaking. It can also make it difficult to understand what another person says. A child may have difficulty understanding what others say, may struggle to put thoughts into words, or both.

You may notice that your child’s vocabulary is very basic and his sentences are short, ungrammatical and incomplete. While his peers chat and tell jokes, your child may have trouble following the conversation and miss the jokes. He also may speak in two-word sentences and have trouble answering even simple questions.

It’s important to note that a language disorder is not the same as a hearing issue or a speech disorder.[2] Children with language disorders typically have no trouble hearing or pronouncing words. Their challenge is mastering and applying the rules of language, like grammar. They aren’t simply “late talkers.” Without treatment, their communication problems will continue and may lead to emotional issues and academic struggles.

Types of Language Disorders
There are three kinds of language disorders.

  • Receptive language issues involve difficulty understanding what others are saying.
  • Expressive language issues involve difficulty expressing thoughts and ideas.
  • Mixed receptive-expressive language issues involve difficulty understanding andusing spoken language.

Language disorders can either be acquired or developmental. An acquired language disorder, like , shows up only after the person has had a neurological illness or injury. This could be a stroke or traumatic head injury.[3]

A developmental language disorder is much more common in children. Kids with developmental language disorders often start speaking later than their peers. This delay isn’t related to their intelligence level. In fact, kids with developmental language disorders typically have average or above-average intelligence. They usually have problems with receptive and expressive language skills before the age of 4.

 

How common are language disorders?

As many as 5 percent of school-age children are believed to have a language disorder. This makes language disorders some of the more common childhood disorders.[4]

Of the 6.1 million children with disabilities who received  under IDEA in public schools in the 2005–2006 school year, more than 1.1 million were served under the category of speech or language impairment.[5]

 

What causes language disorders?

Experts aren’t sure what causes language disorders. Most of the research has focused on the broader category of speech and language impairments (SLI), which includes language disorders and speech disorders. That research has been extensive and suggests some possible causes for SLI, such as:

  • Genes and heredity: Research has found that 20 to 40 percent of children with a family history of speech and language impairment have the condition themselves, compared with about 4 percent of those with no family history of SLI.[6]
  • Prenatal nutrition: Some research has shown that when a woman takes prenatal folic acid supplements during pregnancy, her baby is less likely to have severe language issues.[7]
  • Other conditions: , Down syndrome, intellectual disabilities and premature birth might also cause language disorders.

What are the symptoms of language disorders?

Problems with oral communication are the most common sign of language disorders. It’s not clear if there are signs in infancy that might point to an increased risk.[8] The National Institute on Deafness and Child Development (NIDCD) is currently funding a study that will track babies for specific language impairment and autism spectrum disorder until age 3, so we might have more information soon.

Kids with receptive language issues may have trouble understanding what other people say. They could also have difficulty following simple directions and organizing information they hear. Receptive language issues can be hard to spot in very young children.

Expressive language issues can be easier to identify early. This is because kids with expressive language issues may be late to start talking and not speak until age 2. At age 3, they may be talking but hard to understand, and the problems persist into preschool. Some kids, for instance, might understand the stories read to them but not be able to describe them even in a simple way.

Here are other signs of expressive language issues:

  • Has a limited vocabulary compared to children the same age
  • Frequently says “um” and substitutes general words like “stuff” and “things” for more precise words
  • Has trouble learning new vocabulary words
  • Leaves out key words and confuses verb tense
  • Uses certain phrases over and over again when talking
  • Seems frustrated by inability to communicate thoughts
  • May not talk much or often, but understands what other people say
  • Is able to pronounce words and sounds, but sentences often don’t make sense
  • Uses a limited variety of sentence structures when speaking
 

What skills are affected by language disorders?

Language disorders can affect kids in a number of ways, both socially and academically. Here are some examples.

  • Social skills: Understanding what others are saying and expressing themselves through words helps children form relationships. When kids can’t communicate clearly, they may struggle to make friends and be part of a social group. They may prefer to be alone and become shy or distant.[9] They might also become the target of bullies or act aggressively because they can’t resolve problems verbally.[10]
  • Academic struggles: Some research suggests that children with language disorders also have reading issues. Some kids also struggle with writing because of their limited vocabulary and poor grasp of grammar.
 

How are language disorders diagnosed?

Many children with delayed speech are “late talkers” and catch up on their own. However, most experts recommend seeking help if you suspect your child’s development is lagging. Talk to your child’s pediatrician if your child isn’t meeting language milestones.

Here are some signs that your child might have a receptive language delay:

  • At 15 months, does not look or point at people or objects when they are named by a parent or caregiver
  • At 18 months, does not follow simple directions, such as “get your coat”
  • At 24 months, is not able to point to a picture or a part of the body when it is named
  • At 30 months, does not respond out loud or by nodding or shaking the head and asking questions
  • At 36 months, does not follow two-step directions, and does not understand action words

Here are some signs of expressive language delay:

  • At 15 months, is not using three words
  • At 18 months, is not saying, “Mama,” “Dada,” or other names
  • At 24 months, is not using at least 25 words
  • At 30 months, is not using two-word phrases, including phrases with both a noun and a verb
  • At 36 months, does not have at least a 200-word vocabulary, is not asking for items by name, repeats exactly questions asked by others, seems to have lost some language skills, or is not using complete sentences
  • At 48 months, often uses words incorrectly or uses a similar or related word instead of the correct word

The first step in evaluating the problem is to rule out a hearing problem. Hearing issues are a common cause of language problems. If no hearing issues are found, and you’re still concerned about your child’s language development, you can seek an evaluation from a (also called a speech therapist). There several ways to do this:

  • Seek professional help privately. Speech-language evaluations may be provided at low cost or for free by local universities that train speech-language pathologists. You also can receive a referral from your pediatrician.
  • Contact your state’s  system. If your child is a baby or toddler, you can request an evaluation, free of charge. No referral is required. The early intervention system is mandated by the federal (IDEA). It provides services for infants and toddlers with disabilities, and their families. If your child is found to have a delay or disability, the staff will work with you to develop an Individualized Family Service Plan(IFSP). (If your child is being treated privately, this plan would be called a treatment plan.)
  • Contact your local school district. If your child is already in school, you can contact your local school district to request an evaluation. You can request an evaluation from the public school even if your child is enrolled in .

How a Speech Therapist Conducts an Evaluation
A proper evaluation by a speech therapist involves testing your child for both “receptive language” (the ability to understand what others say) and “expressive language” (the ability to express thoughts). When expressive language development lags far behind receptive language abilities, it could be a sign of expressive language issues.

If your child’s  is not English, your child should be tested in his. (When kids aren’t tested in their native language, problems with communicating in a second language could make it seem like they have a language disorder, even when they don’t.)

The speech therapist also will interview you and observe and analyze your child’s speech in different situations. That way she can assess if and how weak communication skills hamper his ability to do the things other kids his age do, like playing certain games.

During the evaluation, the therapist also may try out different tactics to figure out how your child responds to treatment. Once the therapist makes a diagnosis, she’ll work closely with you to develop an effective treatment plan.

 

What conditions are related to language disorders?

Some kids with language disorders also have related conditions. This is referred to as comorbidity. Related conditions include:

  • Reading issues: Dyslexia is common among kids with mixed receptive-expressive language issues. A growing number of studies[11] have found that many children at risk for  also have difficulties with spoken language.
  •  and mental health issues: Research has shown a link between language disorders and ADHD. One large study of children with language disorders found that many also had ADHD (19 percent), followed by anxiety disorders (10 percent) and oppositional defiant disorder (ODD) and conduct disorder (7 percent combined.)[12] It may be that attention issues make it harder for some kids to develop language skills. But kids with attention issues also may appear to have language problems because they’re so distractible during testing.

Many factors also play into mental health issues. ODD and conduct disorder sometimes are associated with poverty, which can be linked to poor language development.

 

How can professionals help with language disorders?

It’s important to treat children with language disorders as early as possible. According to the American Speech Language Hearing Association (ASHA), about 200 studies have found that speech-language therapy helps children with language disorders. In fact, 70 percent of preschoolers show improvement after treatment.[13] Treatment strategies that may help your child include:

  • Individual : A speech therapist can work one-on-one with your child to build his vocabulary and improve his grammar. The therapist will also show you how to work with your child at home.
  • Psychotherapy: If your child has emotional difficulties as a result of language issues, you might want to consider psychological help. Take a quiz on whether your child might benefit from psychotherapy in Decision Guide.

There are several ways public schools can help students with language disorders. If your child has qualifies for special education services, you and a team of educators will develop an Individualized Education Program (). The IEP might include speech therapy, social skills training and in-class support.

If you’re unsure if your child qualifies for special education services, you can request a formal evaluation.

If your child doesn’t qualify for an IEP, the school may recommend (or you can request) a504 plan for your child. This is a written plan that details how the school will accommodate your child’s needs. Some accommodations[14] including having teachers adapt their methods. Here are some examples of  teachers can use to help children with language disorders:

  • Model the desired behavior. When the child answers a question with a one-word sentence, the teacher responds by modeling back with a full, correct sentence, so that the child hears the words in correct order.
  • Give choices. Instead of asking your child open-ended questions, the teacher can ask either-or questions, so your child has to choose the correct one.
  • Plan ahead. Teachers tell students in advance that they’ll be called on. This gives kids more time to compose their thoughts.

Even without a formal plan in place, some teachers will still provide some of the accommodations described above. Learn more about how to request informal supports for your child.

 

What can be done at home for language disorders?

There are ways you can boost your child’s oral language skills at home. Here are a few ideas:

  • Communicate with your child as much as you can. During the early childhood years, sing and play lots of music. Talk about what you see when you’re driving in the car or at the supermarket. Listen to your child. Give your child plenty of time to respond, and resist the temptation to jump in and fill the silence.[15]
  • Make reading an interactive experience. Discuss the book’s pictures, and let your child make up a new ending or act out the story with puppets. Read to your child and encourage nursery rhymes.[16]
 

What can make the journey easier?

Whether you’re just beginning to learn about language disorders or you’re far along on your journey, this site can help.

  • Know your child’s issues. Educating yourself about your child’s difficulties is the first step to getting the best help. Understand more about your child’s trouble with spoken language.
  • Get behavior advice. Parenting Coach provides expert tips for all kinds of tricky behaviors.
  • Learn about special services. Get more information on IEPs and 504 plans.
  • Connect with other parents. Get tips from parents who have been there in our community. Their support could be just the nudge you need to move forward with confidence.

Key Takeaways

  • Language disorders are common in children.
  • Speech therapy can help kids with language disorders.
  • With help and understanding, your child can learn to manage his language disorder and make the most of his strengths and talents.

Sources

[1] "Language Disorder - Children." Nlm.nih.gov. U.S. National Library of Medicine. Web.http://www.nlm.nih.gov/medlineplus/ency/article/001545.htm

[2] Ervin, Margaret. "SLI: What We Know and Why It Matters."Http://www.asha.org/. The Asha Leader.
http://www.asha.org/Publications/leader/2001/010626/sli.htm

[3] "Encyclopedia of Mental Disorders: Expressive Language Disorder."Minddisorders.com. Advameg. Web. http://www.minddisorders.com/Del-Fi/Expressive-language-disorder.html#ixzz2glJtjtgF

[4] "Language Disorder - Children."

[5] U.S. Department of Education. Twenty-Ninth Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act: 2007.

[6] Choudhury, Naseem, and April A. Benasich. "A Family Aggregation Study: The Influence of Family History and Other Risk Factors on Language Development." Journal of Speech, Language, and Hearing Research 46 (2003): 261–72. ASHAWire. Web.http://jslhr.pubs.asha.org/article.aspx?articleid=1781178

[7] Roth, C., P. Magnus, S. Schjolberg, C. Stoltenberg, P. Suren, I. W. McKeague, G. Davey Smith, T. Reichborn-Kjennerud, and E. Susser. "Folic Acid Supplements in Pregnancy and Severe Language Delay in Children." JAMA: The Journal of the American Medical Association 306.14 (2011): 1566–573. JAMA Network. Web.http://jama.jamanetwork.com/article.aspx?articleid=1104494

[8] "Specific Language Impairment." Specific Language Impairment. NIH, NIDCD, Mar. 2011. Web. http://www.nidcd.nih.gov/health/voice/pages/specific-language-impairment.aspx#3

[9] Spiliotopoulou, Vasiliki. "Expressive Language Disorder and How It Connects with Mood and Behavior Disorders: A Guide for Parents." Sbbh.pitt.edu. School-Based Behavioral Health, Nov. 2009. Web. http://www.sbbh.pitt.edu/files/audio/podcasts%202113%20fall%202010/
Exprsv_Lang_Disordr_Spiliotopoulou.pdf

[10] Whitehouse, Andrew J. O., Helen J. Watt, E. A. Line, and Dorothy V. M. Bishop. "Adult Psychosocial Outcomes of Children with Specific Language Impairment, Pragmatic Language Impairment and Autism." International Journal of Language & Communication Disorders 44.4 (2009): 511–28. NCBI. Web. 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835860/

[11] Catts, H. W., S. M. Adlof, T. Hogan, and S. Ellis Weismer. "Are Specific Language Impairment and Dyslexia Distinct Disorders?" Journal of Speech, Language, and Hearing Research 48.6 (2005): 1378–396. NCBI. Web.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853030/#!po=84.7826

[12] Sadock, Benjamin J., Harold I. Kaplan, and Virginia A. Sadock. Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2007. Print.

[13] Goldstein, H., and P. Prelock. Treatment Efficacy Summary. ASHA. Web. 
http://www.asha.org/uploadedFiles/public/TESChildLanguageDisorders.pdf

[14] "Expressive Language Disorder." Learnalberta.ca. Government of Alberta. Web.http://www.learnalberta.ca/content/inmdict/html/
expressive_language_disorder.html

[15] "Speech and Language Delay and Disorder." Med.umich.edu. University of Michigan Health System, Nov. 2012. Web. http://www.med.umich.edu/yourchild/topics/speech.htm

[16] Learning Disabilities Association of America. "Nurturing Oral Language Skills." LD OnLine. WETA. Web. http://www.ldonline.org/article/6314

About the Author

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The Understood Team is composed of writers, editors and community moderators, many of whom have children with learning and attention issues.

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Bob Cunningham, Ed.M., serves as advisor-in-residence on learning and attention issues for Understood.