Language disorder is a communication disorder in which a person has lasting difficulties in the acquisition and/or use of spoken, written, and sign language. Individuals with language disorder have language abilities that are significantly below those expected for their age, and may struggle with the form, content, or function of language. They exhibit a limited vocabulary, difficulties with sentence structure, and limitations in their abilities to hold conversations. This limits their ability to communicate or participate in social, academic, or occupational environments.
The problems seen cannot be solely ascribed to sensory issues, including hearing loss, medical and neurological conditions, or motor issues, or more accurately accounted for by a developmental or intellectual disability (American Psychiatric Association, 2013). Language disorder in children can be classified as:
- Expressive language disorder: Problems with getting their meaning or message across to others
- Receptive language disorder: Problems with understanding the message coming from others
Current data indicates that 7% of young children display language disorder, with boys being diagnosed twice as much as girls. About 3.3% of US children ages 3-17 have a language disorder. Around 6-8 million people in the US have some form of language impairment.
Symptoms of Language Disorder
Symptoms of language disorder first appear during early development when children begin to learn and use language. It is possible that the symptoms don’t become obvious until later in life, when more complex language is needed to be used. The symptoms can be as follows:
- Delay in learning or speaking their first words and phrases
- Struggling to understand meanings of words and sentences
- Struggling to put words in proper order
- Inability to follow verbal instruction
- Vocabulary size is smaller and less varied than expected
- Sentences are shorter and less complex with respect to their age, and with grammatical errors
- May have trouble finding the right word at times
- Repeat a question while thinking of an answer
- In conversation, they may not be able to provide adequate information about the key events and to tell a coherent story
- Confuse tenses (for example, using past tense instead of present)
- Struggle with academics and socializing with peers
- Often supplementary words or prepositions are omitted, resulting in a telegraphic sort of speech: “He was going to school” becomes “He going school.”
- Word order may be garbled: “Him like too me” for “I like him too.”
- They may seem reluctant to engage in conversation and appear shy.
Causes of Language Disorder
Language disorder is also strongly associated with other neurodevelopmental disorders, such as specific learning disorder (literacy and numeracy), attention deficit hyperactivity disorder, autism spectrum disorder, and developmental communication disorder. fMRI studies suggest structural and
functional abnormalities in the frontal and temporal areas of the brain in those with language disorder. A number of toxic agents have been associated with communication disorders, particularly lead.
Risk of developing language disorders is increased by:
- Low birth weight
- Premature birth
- General birth complications
- Male gender
- Family history
- Low parental education
- Child neglect in the early developmental period
Diagnosis of Language Disorder
A diagnosis of language disorder is made based on the synthesis of the individual’s history, direct clinical observation in different contexts (i.e., home, school, or work), and scores from standardized tests of language ability that can be used to guide estimates of severity. The core diagnostic features of language disorder are difficulties in the acquisition and use of language due to deficits in the comprehension or production of vocabulary, sentence structure, and discourse. DSM-5 lists the following diagnostic criteria for language disorder (American Psychiatric Association, 2013):
- Lasting difficulties in the acquisition and use of spoken, written, and sign language due to problems with comprehension or production that include the following:
- Reduced vocabulary
- Limited sentence structure
- Impairments in discourse
- Language abilities are substantially below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, and/or occupational performance
- Onset of symptoms is in the early developmental period
- The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability or global developmental delay
Treatment of Language Disorder
The treatment for language disorder consists primarily of speech and language therapy. Psychotherapy can be helpful to manage the emotional and behavioral issues that may arise in children with language disorder.
The outcome varies, based on the cause. Brain injury or other structural problems generally have a poor outcome, in which the child will have long-term problems with language. Other, more reversible causes can be treated effectively.
Here are some tips to help you deal with your child at home:
- Speak slowly, clearly, and concisely when asking your child a question.
- Wait patiently for your child’s response.
- Reduce anxiety by keeping the atmosphere relaxed.
- Ask your child to put your instructions in their own words.
American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Publishing.