Receptive and Expressive Language Development

Difficulties with receptive (understanding) and expressive (using) language can present in a variety of ways, including delayed onset of language or ongoing language challenges connected to another condition. Here we discuss these differences and how a Speech-Language Pathologist can help.

Understanding Developmental Language Disorder (DLD)

Among the types of language disorders, Developmental Language Disorder (DLD) stands out due to its pervasiveness and potential impact on a child's communication skills. DLD is a communication disorder, significantly affecting a child's capacity to acquire, comprehend, and effectively utilize language[2].

“DLD is a relatively NEW term (2017) for a condition we have known about for hundreds of years. This condition goes by many names: expressive-receptive language disorder, specific language impairment, speech-language impairment, and language delay among them. The current, consensus term in the English-speaking world is Developmental Language Disorder or DLD (Bishop et al., 2016; 2017).” (radld.org)

Unlike other communication disorders, DLD is not a consequence of other identifiable conditions like hearing loss or autism. Instead, it emerges independently, affecting how an individual uses language, understands language, and learns to read and write. Statistics suggest that it is far from a rare occurrence, with roughly two children in every classroom struggling with DLD. DLDandme.org and RADLD.org are two websites that focus on spreading awareness and resources for families and professionals working with children with DLD, as well as adults navigating a diagnosis of DLD themselves.

Language Disorder Associated with…

Sometimes, a child is diagnosed with a biomedical condition with known impacts on speech and language development. In these scenarios, the terminology is, “Language Disorder Associated with…”. For example, “Language Disorder Associated with Autism Spectrum Disorder”, or “Language Disorder Associated with Cerebral Palsy”. In these circumstances, the associated biomedical condition can give important insight as to what areas of speech and/or language may be most impacted. For example, children and adults who have suffered a traumatic brain injury (TBI) may demonstrate language difficulties mainly in the area of social communication (i.e., navigating misunderstandings, understanding sarcasm or indirect language, etc.). Speech-Language Pathologists know how to work with family members and the child’s support team in order to identify appropriate and functional goals based on how speech and language is impacted in each unique situation.

Receptive Language Delay

Language delay is sometimes further identified to be mainly in the domain of receptive language, meaning, how the child understands language. The qualifier, “delay”, is often specified for young children who are demonstrating delays, but have not yet had significant intervention. Before a child has been supported and given the chance to progress with targeted intervention, it is inappropriate to identify a language disorder (barring any known bio-medical conditions), and therefore the term delay is more appropriately used.

Children with receptive language delay may struggle with understanding vocabulary words, following directions, or processing the messages and information they receive from others. They may find it challenging to keep up with conversations or instructions, which can lead to confusion and frustration. These children may be able to follow the lead of their peers, or understand non-verbal cues such as gestures and routines, but may struggle with understanding the specific details of spoken instructions and comments, such as classroom instructions with more than one step (e.g., “Come to the carpet after you get your water bottle”)

Expressive Language Delay

Similarly, children may be identified as having an expressive language delay if their challenges lie mainly in expressing themselves clearly, though they may be able to understand and follow spoken language appropriately. Children with expressive language delay often face considerable difficulty structuring words into coherent sentences or phrases. They may use fewer words overall (meaning they have limited vocabulary to express themselves), have difficulty combining words into phrases, struggle with using appropriate grammar, and tell stories in brief, choppy or unclear sentences.

Identification of Language Delay or Disorder

SLPs use a variety of assessment methods to not only identify a language delay or disorder but also make recommendations and plan for specific areas of intervention to support the child in their next steps. Assessments are most successful when they are holistic and strengths-based. This means looking at many functions and modalities of language and identifying unique ways that each specific child’s life is impacted by their communication challenges, while also identifying areas of strength for the child and acknowledging their interests and talents. Assessments will often include:

  • a detailed history, including relevant family history or past medical history of the child

  • Conversations with family members and other relevant individuals in the child’s life, such as teacher or daycare educator

  • Formal assessments measure their development in areas such as vocabulary, comprehension, grammar, sentence structure and storytelling. “Formal” or “standardized” assessment results can then be compared to statistics from same-aged peers in order to determine their level of support needed and, most importantly, follow their own progress over time.

  • Dynamic assessment tasks (i.e., where the task is adapted to the child in order to best identify their level of skill with and without supports)

  • Informal assessments, such as conversations with child about their own attitudes and experiences with communication in a variety of settings.

Importance of Early Identification and Intervention

Identifying language delays and disorders early is not just a matter of enhancing communication skills; it also has far-reaching implications for a child's overall development. Language delays and disorders can impact many other areas of a child’s life, including poor self-esteem, peer relationships and diminished academic and social success.

Early intervention becomes crucial in this context. The sooner these issues are identified and addressed, the better the outcomes tend to be. Intervention measures can range from speech and language therapy to tailored educational programs that help improve language skills and overall communication abilities in children with language delays or disorders [3].

Children with language delays or disorders may experience frustration, self-doubt, or even isolation due to their difficulties with communication. As parents, teachers, or caregivers, it is crucial to foster a positive, patient, and empathetic environment. Such an environment can reassure these children that they are understood, supported, and not alone in their journey.

Conclusion

Language delay or disorder in children and youth can significantly impact a child's ability to learn, understand, and use language effectively. These challenges are not rare - approximately 2 children in every classroom struggle with Developmental Disorder. Other children navigate language disorders associated with another medical condition that impacts their lives. However, these challenges are not insurmountable. With a clear understanding of these disorders and their unique characteristics, we can devise and apply effective interventions.

In conclusion, addressing language delays or disorders is a multidimensional challenge that calls for understanding, early identification, and tailored interventions. Through such efforts, we can help children and their family understand these hurdles and enhance their communication skills, building their confidence, relationships and success.

    • [1] https://www.nidcd.nih.gov/health/developmental-language-disorder

    • [2] https://childmind.org/guide/quick-guide-to-language-disorder/

    • [3] https://www.asha.org/practice-portal/clinical-topics/late-language-emergence/

Understanding Language Delay

Language delay is a broad term referring to when a child is demonstrating difficulties reaching milestones associated with learning language. It can have a wide range of root causes and consequences. These impairments, varying in intensity and impact, can significantly influence a child's daily life. Such delays and disorders can be broadly categorized into three primary types - language delay (i.e., late talker), Developmental Language Disorder (DLD), and Language Disorder Associated with another biomedical condition. Sometimes, these difficulties are further identified as being primarily receptive (understanding language) or expressive (using language). This article aims to provide an in-depth exploration of these categories, shedding light on their characteristics, causes, and potential interventions.

Late Talkers

A “late talker” is most often identified as a child who is 18 months old and not yet using 20 words, or who is 2 years old and is not combining 2 words together (e.g., “more milk”, “daddy, help”) and has a total vocabulary of less than 100 words (see here for more information). Many children who are late to talk (some estimates note up to 80%) catch up with their same-aged peers, while others continue to need support due to ongoing speech and language difficulties. Parents working together with speech therapists can support their child and encourage their language development.

SLPs work with parents to support their “early communicators” by using strategies aimed at improving pre-verbal skills (i.e., communication-related skills that come before speaking) and encouraging functional vocabulary and combining words.

FAQs

Links & Resources for Language Delays

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