A Beginner's Guide to Understanding Language Disorder
Language is the foundation for how we communicate with each other as humans. It allows us to share our experiences, express our thoughts and ideas, and work together to accomplish many amazing feats. When we are able to communicate effectively, tasks are completed effortlessly and events run smoothly. However, when there is a disconnect in the communication, mistakes happen and we are left feeling frustrated.
In the first year of a child’s life, parents spend a lot of time and energy pushing their child towards those first big milestones. There’s often so much focus on what will be the first word spoken by the child. Sometimes, parents even compete against each other, trying to ensure the first word will be “Mama” or “Dada.” Those repeatable sounds are the first instances of talking, which allows a child to better communicate their wants and needs to their parents. Before language, infants use crying and eventually gestures in an attempt to let their parents know what they need. However, a parent may feel very frustrated and helpless when a child continues to cry and they are unable to determine what the infant needs. The use of language clarifies the needs and provides the parent and child with a stronger, more dependable line of communication.
As children grow, their vocabulary expands and they learn the grammar rules of their language. As a result, they are able to more accurately express their ideas and communicate more complex constructs. However, this is not the case for all children. Some have difficulty expressing themselves in ways that allow others to understand. Others struggle to grasp the full meaning of what they are being told. Many children have difficulty in both areas.
If your child has difficulty in the area of communication, either on the giving end, receiving end, or both, it may be the result of an undiagnosed Language Disorder. Let’s learn more about Language Disorder, identify the characteristics you may notice in your child, and discuss ways to help your child manage the symptoms of this disorder.
WHAT IS LANGUAGE DISORDER?
As with learning disorders, Language Disorder is a result of the brain processing information differently and is developmental in nature. In other words, it is a challenge seen throughout an individual’s development. It will continue to be present, to varying degrees, over the course of the individual’s life. While it can be well managed and the impact can be minimized through various strategies, it is not something that will simply “go away.”
According to the Diagnostic & Statistical Manual of Mental Disorders (5th edition; DSM-5; American Psychiatric Association, 2013), Language Disorder is defined as:
Persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production that include the following:
1. Reduced vocabulary (word knowledge and use).
2. Limited sentence structure (ability to put words and word endings together to form sentences based on the rules of grammar and morphology).
3. Impairments in discourse (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation).
Just as with many other learning challenges, those diagnosed with Language Disorder are often unique in their presentation of the disorder. Although the three main areas listed above can be impacted, it may look differently depending on the specific child. This uniqueness is further impacted by the fact that most individuals with Language Disorder are also struggling with additional neurodevelopmental disorders such as dyslexia, dysgraphia, dyscalculia, or attention-deficit/hyperactivity disorder.
There are two main aspects of language: expressive and receptive. Expressive language refers to the way a person is able to express their thoughts and ideas, either verbally or in a written format. This includes skills such as using a variety of vocabulary words, easily and concisely defining words, accurately retrieving words, adhering to grammar rules, and generating appropriate phrases and sentences that effectively communicate the desired information. In contrast, receptive language refers to the ability of a person to comprehend what is being communicated to them. Receptive language skills are necessary to understand and follow directions, comprehend stories, and grasp meaning within conversations.
Those with challenges in expressive language may struggle to fully communicate their knowledge about a particular topic, use limited vocabulary, pause for lengthy periods before responding as they are working on what they want to say, or provide long answers that are convoluted, making it difficult for the listener to follow and understand the main point of the response. Children with difficulty in the area of receptive language may struggle to correctly follow instructions, recognize sarcasm, or keep up with the fast pace of a conversation. Language Disorder can impact a children’s academic performance and their ability to connect socially.
It is important to note that the language difficulties of Language Disorder are not related to the mechanics of hearing language or generating speech. This means that a child who has articulation difficulties (e.g., talking with a lisp or trouble pronouncing certain sounds or letters) is not automatically diagnosed with Language Disorder. Although this impacts expressive language, the challenges experienced are the result of trouble with mouth formation, not a product of the child’s brain processing language differently. Similarly, a child diagnosed with an auditory processing disorder may have weak receptive language abilities due to their difficulty differentiating between sounds. This is related to how the ear transmits sound into the brain and is not exclusively related to language. Although these issues may impact language development, they do not cause nor are they symptoms of Language Disorder.
CHARACTERISTICS OF A LANGUAGE DISORDER
As noted previously, Language Disorder can impact expressive language, receptive language, or both. Therefore, each child that struggles with Language Disorder is unique. However, below is a list of some ways that Language Disorder may present itself.
Trouble with word retrieval (difficulty recalling a specific word or when trying to rapidly recall information)
When asked a question, may provide a long answer that often includes information only moderately related to the question (tends to dance around the simple, direct answer as they attempt to generate a response; listeners and speaker may get lost in the answer)
Pauses for several seconds before answering a question that was asked, especially with broad, open-ended questions
Has great difficulty in foreign language classes
Frequently requests repetition and clarification
Greatly benefits from examples to understand what is required
May follow directions incorrectly due to a difficulty understanding what they were supposed to do
Avoids raising hand to answer questions in class
May experience anxiety when called upon in class or when taking tests (especially when timed and require written responses)
Work on tests and timed assignments frequently do not show the total of what the child knows about the subject
Difficulty comprehending material provided orally
Struggles with reading comprehension, particularly understanding the big picture or inferring what may happen next
Struggles to organize thoughts on written tasks (writing may appear to follow a stream of consciousness or have no logical path to follow)
Difficulty recognizing and responding to sarcasm or quick wit
Has a hard time keeping up with the fast pace of a conversation
May shy away from large groups or situations that have many people talking at once (e.g., socializing at lunch in school)
Struggle to know how to respond to others in the moment
Prefers to text rather than talk on the phone or in person
Many children diagnosed with Language Disorder also struggle with other learning disorders or ADHD. Particularly, there are many overlaps in the above characteristics and those of dyslexia and dysgraphia. This is because of the language component inherent in both dyslexia and dysgraphia. If you have concerns, have your child complete a thorough psychoeducational evaluation to determine how your child’s brain processes information and what diagnoses are accurate. Your child may also benefit from an evaluation by a speech language pathologist or an audiologist depending on the presenting concerns.
MANAGING A LANGUAGE DISORDER
Depending on the aspects of language that are impacted for the individual, there are different avenues that are recommended for managing the characteristics of the Language Disorder. A speech language pathologist is often recommended for younger children and can assist children with improving their articulation, provide strategies to improve word retrieval, and tactics for enhancing their comprehension of information presented orally. Many times, children also benefit from working with tutors trained in multisensory approaches, such as Orton-Gillingham, Wilson, or Lindamood-Bell. These tutors help the student develop strategies to increase reading comprehension and writing mechanics. Additionally, cultivating strong study skills and test-taking skills can improve the child’s ability to accurately demonstrate their knowledge of the subject on tests. Although many of these recommendations can help a child improve, they will likely also need accommodations to ensure that their academic performance matches their intellectual potential.
Examples of common accommodations:
Extended time
The use of a computer for writing assignments
Flexibility in foreign language requirements
One-on-one instruction
Repetition of material
Providing clear and concise instructions with adequate examples
Allowing additional time to organize thoughts when called upon in class
Permission to record lectures
Opportunities to ask for clarification
Testing in a distraction-reduced setting
For additional information or to schedule an evaluation for your child to determine the existence of ADHD or a learning disorder, contact Center for Psychological Performance.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.