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Developmental Language Disorder

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  • Article summary:

    Developmental Language Disorder or DLD (previously known as Specific Language Impairment or SLI) is a persistent type speech, language and communication need that cannot be explained by an obvious cause.

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Developmental Language Disorder

If you haven’t heard of Developmental Language Disorder (DLD) it may be because as a public facing term the name is a relatively new one. It was chosen by a panel of experts in early 2017 as part of the CATALISE project - a multinational and multidisciplinary Delphi consensus study identifying language impairments in children - and describes what was previously known as Specific Language Impairment (SLI).

Children with Developmental Language Disorder do not have autism spectrum disorder (ASD), apraxia of speech, brain damage or hearing impairment but still experience language based communication difficulties that disrupt their life and do not go away by the age of 5. Every case of DLD is unique and individuals will vary in the severity of the disruption to communicative ability.

Symptoms range from trouble with pronunciation, to challenges with learning vocabulary, problems manipulating syntax (grammar), and/or using the correct language for a particular context (pragmatics). Problems with language retrieval, similar to what is seen in aphasia/dysphasia, may also be observed. And while DLD mainly addresses issues with spoken communication, children tend to struggle with literacy skills as well.

Developmental language disorder can affect both receptive and productive skills. When the processing of spoken language is an issue, a child may have trouble segmenting the speech stream in order to extract meaningful input. He or she may not be able to match speech to print, follow spoken narratives, understand questions and directions, or recognize familiar words.

When expressive skills are disrupted, there can be an inability to produce clear and intelligible speech that fully captures what the child is trying to say. There may be difficulties with pronunciation, but they are not caused by issues with the muscles involved in articulation, as in apraxia of speech. Mixing up the sounds in language, experiencing false starts, not being able to name words, learn songs, rhyme, or adjust tone depending on person and context are just some of the issues that kids with expressive DLD may experience.

Because every child with Developmental Language Disorder is different, school age learners will require their own unique plan of accommodations and strategy training, including in many cases working with a Speech and Language Therapist. In the UK, students with DLD are often grouped under Speech, Language and Communication Needs (SLCN) at school.

For more information regarding assessment of DLD you can consult the Clinical Evaluation of Language Fundamentals (CELF) test. Also be aware that it’s possible for DLD to co-occur with dyslexia, dyspraxia and ADHD. Learn more about helping students with dyslexia, dyspraxia and ADD/ADHD in the classroom in these articles.

Speech and language development

All children go through the same set of developmental stages to master the basics of spoken language, including phonology (sounds), semantics (the meaning of words), grammar, and pragmatics (the social rules of communication). Though children progress through each stage at different rates, depending on cognitive and environmental factors, kids with DLD are often well behind same-aged peers – in some cases not speaking until they are three or four years old. It’s important to note that language delays are also common in kids with phonological dyslexia and hearing impairment.

However, in these cases delays are related to trouble hearing sounds or splitting words into their component sounds. The main difference between kids who experience language delays and children with Developmental Language Disorder is that the former may take longer to speak, but eventually get there in the end, whereas kids with DLD continue to struggle past their 5th birthday.

5 Issues for school-aged children with DL
1.Developing literacy skills
Problems with language production and comprehension inevitably impact on a child’s ability to learn how to read and write. Children with DLD can struggle to master the alphabet, follow and construct narratives, and memorize nursery rhymes – all skills that are important for beginner readers. They might also lack an understanding of how books work, such as not knowing when to turn the pages when someone is reading aloud. This contributes to difficulty with early reading and spelling instruction.

How to help: Ensure children with DLD get plenty of exposure to books. Read to them on a regular basis, take them to library events, and use multi-sensory approaches to teach the alphabet and numbers. Learn more in these posts on developing pre-literacy skills in children and a multi-sensory approach to reading.

2. Limited vocabulary knowledge
Difficulty manipulating language in spoken input, including recognizing words and being able to learn them, can mean that kids with DLD often end up with much smaller working vocabularies than same-aged peers. This makes it harder for a child to express him or herself in writing but also negatively impacts on reading comprehension.

How to help: Because school-aged children achieve most of their vocabulary learning gains through incidental learning in reading, it’s important to choose graded readers that will help a child guess at the meaning of new words encountered in context. The most favorable conditions for learning are those in which 90% or more of words are familiar. Actively drilling vocabulary before and after reading can also help! Try multi-modal flashcards that include image and audio to reinforce learning through diverse sensory input.

Top Tip: If you’re not sure a text is appropriate for your child with DLD, have him or her read a page or several paragraphs and lift up a finger for every word that is unfamiliar. If at the end all five fingers are up, you may want to choose something that is less challenging.

3. Difficulty taking notes 
When language is an issue, taking notes is even more problematic because it’s a process that has to happen quickly during lessons. Notes are important because they help a child review what he or she is learning in class, and they are even more crucial when an individual struggles to process spoken language.

How to help: Pair a child with a note-taking buddy or allow him or her to type notes on a computer. The latter works even better if the student can touch-type without looking at the keyboard.

4. Poor performance on assessment measures
Because producing language, both in speaking and in writing, can be difficult for children with Developmental Language Disorder, not all assessment measures will provide an accurate reflection of what a student knows. This is true in written projects where a child may receive lower marks for writing in simple and short sentences and during oral reports when children can muddle language and fail to express themselves clearly.

How to help: Find alternative ways to assess what a student does or doesn’t know. Multiple-choice tests may be better than open-ended questions that require free writing. Whenever possible, provide access to a dictionary so kids can look up vocabulary words they are unclear about.

5. Low confidence and self-esteem
Children with Developmental Language Disorder are not less intelligent than their peers, they just engage with language in a different way. This can lead to feelings of frustration and anxiety, particularly at school when performance is poor despite children having understood the concepts being taught. Awkward language skills can also have a negative impact on a child’s ability to fit in with peers. Over time, a child may lose confidence and develop a negative self-image that makes it even harder to stay motivated and overcome the challenges posed by DLD.

How to help: Avoid calling on students in a group setting as speaking can be particularly challenging when the spotlight is on them. Teach strategies and provide appropriate accommodations but also be there as a source of emotional support. Learn more in self-esteem and language-based learning disabilities.

More information for parents and teachers
Technology provides much needed support for kids with DLD, particularly in later grades. Look into computer programs that enhance language perception. Multi-modal vocabulary learning and multi-sensory language courses, particularly those that offer deliberate instruction and plenty of repetitive drilling, can be effective.

You may also consider allowing kids with DLD to type school assignments on a computer vs. writing by hand because it gives them access to grammar and spell checks. It’s important to teach communication skills too. Coping strategies give kids the tools they need to deal with the challenges of Developmental Language Disorder as they explore future career and education opportunities.


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