Detailed Notes on Language Disorders and Developmental Language Disorder (DLD)

What is Language?

  • Language is defined as a system of systems.
  • It consists of different components that work in unison.
  • There are specific rules that govern the use of language.

Nature of Language

  • Components of Language:
    • Parts of Language: Different elements within the language system.
    • Content (Semantics): The meaning of words and phrases.
    • Form:
    • Syntax: Structure and grammatical rules.
    • Morphology: The structure of words.
    • Phonology: The sound system of the language.
    • Use (Pragmatics): How language is utilized in context or social interactions.

Learning Objectives

  • Understand language difficulties/disorders and their types.
  • Explore developmental language disorders (DLD).
  • Connect DLD knowledge to clinical practice through case studies.
  • Identify challenges related to language disorders.

Language Difficulties/Disorders

Types of Difficulties:

  1. Comprehension Difficulties:
    • Struggles with understanding words, phrases, and sentences during interactions.
  2. Expression Difficulties:
    • Challenges in verbal communication, including usage of words and phrases.

Developmental Language Disorder (DLD)

  • DLD is characterized by:
    • Difficulty in understanding and/or using language without associated disabilities (e.g., hearing loss, intellectual disabilities).
    • Impacts language skills such as speech, grammar usage, and storytelling.
    • Diagnosis typically occurs in preschool age.
    • Important to identify early to enhance communication skills.
  • Core Deficits:
    • Expressive and Receptive Language Deficits: Significant lower performance in language composites compared to peers, excluding other diagnosed medical conditions (Leonard, 2014).
    • DLD is often diagnosed at preschool age (Bishop, 2014; 2017).

Prevalence of DLD

  • Estimated prevalence: 7.58% of children aged 4-5 years may have DLD (Newbury & Eagle, 2023), translating to approximately 7-8 children per 100.

Risk Factors for Language Difficulties

Under 3 Years:

  • Comprehension difficulties.
  • Limited gesture use.
  • Family history of language or literacy challenges.

Ages 3-4 Years:

  • Impairments across various language areas.
  • Difficulty with sentence repetition.

Ages 5 Years and Older:

  • Persistent language difficulties may indicate long-term challenges.

Identification and Diagnosis of DLD

Framework for Diagnosis:

  • Use of speech and language assessments (formal/informal).
  • Assess functional impact through observations from parents, teachers, and professionals.
  • Consider child’s presentation at home/school, risk factors, and social/emotional health.

Case Studies

Example 1: Josh (6.7 years old)

  • All milestones on time except for first word; no family history of language issues.
  • Concerns about behavior, difficulty in understanding and answering questions, limited vocabulary, short phrases, missing grammatical markers.
  • Observed good performance in individual settings but struggles in groups.
  • School report indicates issues in writing and below-age performance.
  • Diagnosed with DLD with recommendations for intervention.

Example 2: Marama (3.5 years old)

  • Raised in a bilingual home with family history of DLD.
  • Parents concerned about comprehension; assessment shows limited grammar and reliance on single words.
  • Struggles with social initiation and tasks completion in school settings.
  • Recommended early speech-language therapy for improved communication and social skills.

Concerns in DLD Diagnosis

  • Educational and health requirements may differ from clinicians’ recommendations and the child's best interest.
  • Family involvement in decision-making is crucial.
  • Holistic approach to DLD should be prioritized, focusing on the overall well-being of the child.
  • Interdisciplinary support is essential to avoid fragmented services and overlapping diagnoses.
  • Sensitivity to the child’s identity development is important in intervention approaches to promote positive self-esteem.

References

  • Newbury, J., & Eagle, J. (2023).
  • Reilly, S., Bishop, D., & Tomblin, B. (2014).
  • Rice, M.L., & Hoffman, L. (2015).
  • Bishop, D.V.M. et al. (2017).