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Language Disorder

Receptive Language Disorder

What is Receptive Language Disorder?
Receptive language disorder means the child has difficulties with understanding what is said to them. The symptoms vary between individuals but, generally, problems with language comprehension usually begin before the age of four years.
Children need to understand language before they can use language effectively. In most cases, the child with a receptive language problem also has an expressive language disorder, which means they have trouble using spoken language.
It is estimated that between three and five per cent of children have a receptive or expressive language disorder, or a mixture of both. Other names for receptive language disorder include central auditory processing disorder and comprehension deficit. Treatment options include speech–language therapy.
There is no standard set of symptoms that indicates receptive language disorder, since it varies from one child to the next. However, symptoms may include:
  • Not seeming to listen when they are spoken to
  • Lack of interest when story books are read to them
  • Inability to understand complicated sentences
  • Inability to follow verbal instructions
  • Parroting words or phrases (echolalia)
  • Language skills below the expected level for their age.
The cause is unexplained in most cases
The cause of receptive language disorder is often unknown, but is thought to consist of a number of factors working in combination, such as the child’s genetic susceptibility, the child’s exposure to language, and their general developmental and cognitive (thought and understanding) abilities. Receptive language disorder is often associated with developmental disorders such as autism. In other cases, receptive language disorder is caused by brain injury such as trauma, tumour or disease.
The process of understanding spoken language
Understanding spoken language is a complicated process. The child may have problems with one or more of the following skills:
  • Hearing - a hearing loss can be the cause of language problems.
  • Vision - understanding language involves visual cues, such as facial expression and gestures. A child with vision loss won’t have these additional cues, and may experience language problems.
  • Attention - the child’s ability to pay attention and concentrate on what’s being said may be impaired.
  • Speech sounds - there may be problems distinguishing between similar speech sounds.
  • Memory - the brain has to remember all the words in a sentence in order to make sense of what has been said. The child may have difficulties with remembering the string of sounds that make up a sentence.
  • Word and grammar knowledge - the child may not understand the meaning of words or sentence structure.
  • Word processing - the child may have problems with processing or understanding what has been said to them.
Diagnosis methods
Assessment needs to pinpoint the child’s particular areas of difficulty, especially when they do not respond to spoken language. Diagnosis may include:
  • Hearing tests by an audiologist to make sure the language problems aren’t caused by hearing loss and to establish whether or not the child is able to pay attention to sound and language (auditory processing assessment).
  • Testing the child’s comprehension (by a speech pathologist) and comparing the results to the expected skill level for the child’s age.
  • Close observation of the child in a variety of different settings while they interact with a range of people.
  • Assessment by a neuropsychologist to help identify any associated cognitive problems.
  • Vision tests to check for vision loss.
Treatment options
The child’s progress depends on a range of individual factors, such as whether or
not brain injury is present. Treatment options can include:
  • Speech-language therapy
  • One-on-one therapy as well as group therapy, depending on the needs of the child
  • Special education classes at school
  • Integration support at preschool or school in cases of severe difficulty
  • Referral to a mental health service for treatment (if there are also significant behavioural problems).
Things to remember
  • Receptive language disorder means the child has difficulties with understanding what is said to them.
The cause of receptive language disorder is unknown, but is thought to consist of a number of factors working in combination. Treatment options include speech-language therapy.

Expressive Language Disorder

What is Expressive Language Disorder?
Expressive language disorder means a child has difficulty with verbal and written expression. The disorder can either be delayed or disordered or a combination of the two. The child generally has difficulties with spoken language. Their vocabulary (the number of words they know and say) tends to be smaller compared with other children of the same age. They are usually also below the average level for their age in:
  • Producing sentences
  • Putting words together to formulate thoughts
  • Recalling of words
  • Using language appropriately in different settings with different people (for example, home versus school and parents versus teachers).
Children all develop at different rates
Many children seem slow in the early stages of learning language, but some children continue to have problems with language and expression. Examples of expressive language disorder are:
  • A seven year old who cannot answer simple questions
  • A three year old who speaks only in two-word phrases.
Delayed or disordered types
Expressive language disorder can present in two forms, delayed or disordered language. These categories can overlap and it can be difficult to assess if the expressive disorder is delayed or disordered:
  • Delayed - is when a child is slow to develop language but the usual sequence, or pattern of development, is normal.
  • Disordered - is when language is slow to develop and the sequence of development and pattern of grammatical errors is different from normal.
Symptoms differ from one child to the next, and depend on the child’s age and the severity of the disorder. Symptoms can include:
  • Frequently having trouble finding the right word
  • Using the wrong words in sentences or confusing meaning in sentences
  • Making grammatical mistakes and using poor sentence structure
  • Relying on short, simple sentence construction
  • Relying on stock standard phrases and limited content in speech
  • Inability to ‘come to the point’ or talking in circles
  • Problems with retelling a story or relaying information
  • Inability to start or hold a conversation
  • Misnaming items - this is called dysnomia
  • Difficulty with oral and written work and school assignments in older children.
Cause is not always known
For many children the cause of expressive language disorder is not always known. However, for other children, the expressive language disorder is associated with known developmental difficulties or impairments (for example, children with Down syndrome, autism or hearing loss).
Expressive language disorder can be developmental or acquired. Acquired occurs after a period of normal development; it is usually the result of trauma or a medical condition. Research suggests that in many cases expressive language disorder is a genetic disorder (found frequently in more than one family member and across generations).
Treatment options depend on the degree of severity of the disorder. Treatment may include:
  • Group sessions with a speech pathologist
  • Individual therapy sessions with a speech pathologist
  • School-based language intervention programs
  • Assistance from special education teachers
  • Teachers aid support for children with severe language disorders.
Things to remember
  • Expressive language disorder means a child has difficulty with verbal and written expression.
  • The cause of expressive language disorder is often unknown.
Treatment depends on the severity but it includes therapy with a speech pathologist