LANGUAGE DISORDERS

A. Understanding Language Disorders

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 youre
concerned your child has a language disorder, youre not alone. Theyre
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.
Language disorders or language impairments are disorders that
involve the processing of linguistic information. Problems that may be
experienced can involve grammar (syntax and/or morphology),
semantics (meaning), or other aspects of language. These problems may be
receptive (involving impaired language comprehension), expressive
(involving language production), or a combination of both. Examples
include specific language impairment and aphasia, among others. Language
disorders can affect both spoken and written language, and can also affect sign
language; typically, all forms of language will be impaired.
Current data indicates that 7% of young children display language
disorder, with boys being diagnosed twice as much as girls.
Preliminary research on potential risk factors have suggested
biological components, such as low-birth weight, prematurity, general birth
complications, and male gender, as well as family history and low parental
education can increase the chance of developing language disorders.
For children with phonological and expressive language difficulties,
there is evidence supporting speech and language therapy. However, the same
therapy is shown to be much less effective for receptive language difficulties.
These results are consistent with the poorer prognosis for receptive language
impairments that are generally accompanied with problems in reading
comprehension.
Note that these are distinct from speech disorders, which involve
difficulty with the act of speech production, but not with language.

1
 Language disorders tend to manifest in two different ways: receptive
language disorders (where one cannot properly comprehend language) and
expressive language disorders (where one cannot properly communicate their
intended message).

B. 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 childs 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.
Its 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 arent
simply late talkers. Without treatment, their communication problems will
continue and may lead to emotional issues and academic struggles.

C. Types of Language Disorders

There are three kinds of language disorders.
1. Receptive language issues involve difficulty understanding what others are
saying.
2. Expressive language issues involve difficulty expressing thoughts and
ideas.
3. Mixed receptive-expressive language issues involve difficulty
understanding andusing spoken language.
Language disorders can either be acquired or developmental. An
acquired language disorder, like aphasia, shows up only after the person has
had a neurological illness or injury. This could be a stroke or traumatic head
injury.

2
 A developmental language disorder is much more common in
children. Kids with developmental language disorders often start speaking
later than their peers. This delay isnt 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.

D. 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.
Of the 6.1 million children with disabilities who received special
education under IDEA in public schools in the 20052006 school year, more
than 1.1 million were served under the category of speech or language
impairment.

E. What causes language disorders

Experts arent 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.
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.
Other conditions: Autism spectrum disorder, Down syndrome, intellectual
disabilities and premature birth might also cause language disorders.

F. What are the symptoms of language disorders

Problems with oral communication are the most common sign of
language disorders. Its not clear if there are signs in infancy that might point

3
 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:
1. Has a limited vocabulary compared to children the same age
2. Frequently says um and substitutes general words like stuff and
things for more precise words
3. Has trouble learning new vocabulary words
4. Leaves out key words and confuses verb tense
5. Uses certain phrases over and over again when talking
6. Seems frustrated by inability to communicate thoughts
7. May not talk much or often, but understands what other people say
8. Is able to pronounce words and sounds, but sentences often dont make
sense
9. Uses a limited variety of sentence structures when speaking

G. 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.
1. Social skills: Understanding what others are saying and expressing
themselves through words helps children form relationships. When kids
cant 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 cant resolve problems verbally.[10]

4
 2. 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.

H. 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 childs development is lagging. Talk to your childs pediatrician if your
child isnt meeting language milestones.
Here are some signs that your child might have a receptive language
delay:
1. At 15 months, does not look or point at people or objects when they are
named by a parent or caregiver
2. At 18 months, does not follow simple directions, such as get your coat
3. At 24 months, is not able to point to a picture or a part of the body when it
is named
4. At 30 months, does not respond out loud or by nodding or shaking the
head and asking questions
5. At 36 months, does not follow two-step directions, and does not
understand action words

Here are some signs of expressive language delay:

1. At 15 months, is not using three words
2. At 18 months, is not saying, Mama, Dada, or other names
3. At 24 months, is not using at least 25 words
4. At 30 months, is not using two-word phrases, including phrases with both
a noun and a verb
5. 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
6. 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 youre still concerned about your childs

5
 language development, you can seek an evaluation from aspeech-language
pathologist (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 states early intervention 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
federalIndividuals with Disabilities Education Act (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 private school.

I. 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 childs primary language is not English, your child should be
tested in hisnative language. (When kids arent 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 dont.).
The speech therapist also will interview you and observe and analyze
your childs 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.

6
 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, shell work closely with you to develop an effective treatment plan.

J. 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 dyslexia also have difficulties with spoken
language.
ADHD 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.) 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
theyre 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.

K. How can professionals help with language disorders

Its 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. Treatment strategies that may help your child
include:
1. Individual speech therapy: 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.

7
 2. 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 (IEP).
The IEP might include speech therapy, social skills training and in-class
support.
If youre unsure if your child qualifies for special education services,
you can request a formal evaluation. If your child doesnt 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 childs
needs. Some accommodations including having teachers adapt their methods.
Here are some examples of accommodations teachers can use to help children
with language disorders:
1. 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.
2. 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.
3. Plan ahead. Teachers tell students in advance that theyll 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.

L. What can be done at home for language disorders

There are ways you can boost your childs oral language skills at
home. Here are a few ideas:
1. 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 youre driving in the car or at the supermarket. Listen to your child.

8
 Give your child plenty of time to respond, and resist the temptation to
jump in and fill the silence.
2. Make reading an interactive experience. Discuss the books 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.

9
M. What can make the journey easier
Whether youre just beginning to learn about language disorders or
youre far along on your journey, this site can help.
1. Know your childs issues. Educating yourself about your childs
difficulties is the first step to getting the best help. Understand more about
your childs trouble with spoken language.
2. Get behavior advice. Parenting Coach provides expert tips for all kinds of
tricky behaviors.
3. Learn about special services. Get more information on IEPs and 504
plans.
4. 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.

10
 REFERENCE

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

"Encyclopedia of Mental Disorders: Expressive Language

Disorder."Minddisorders.com. Advameg.
Web. http://www.minddisorders.com/Del-Fi/Expressive-language-
disorder.html#ixzz2glJtjtgF

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): 26172. ASHAWire.

Roth, C., P. Magnus, S. Schjolberg, C. Stoltenberg, P. Suren, I. W. McKeague, G.

https://www.understood.org/en/learning-attention-issues/child-learning-
disabilities/communication-disorders/understanding-language-disorders.

https://en.wikipedia.org/wiki/Language_disorder

iii

11