MU

language disorderes 9/3/25

Key Concepts and Goals for Today

  • Understand how language disorders are defined, distinguished, and diagnosed in children, including the different terminology and how models shape practice.
  • Learn the major approaches to deciding when a language difference, delay, or disorder is present, and how environment and normative data interact in assessment.
  • Explore the two overarching perspectives on language disorders (environmental/naturalistic vs norm-referenced) and their limitations.
  • Become familiar with the ICF framework as a tool to organize information about a child and guide assessment and intervention planning.
  • Review important terminology and definitions (Developmental Language Disorder, DLD; Specific Language Impairment, SLI; congenital aphasia; language difference; language delay) and how they’re used in practice.
  • Understand the domains and modalities of language (content, form, use) and the distinction between receptive and expressive language.
  • Recognize common assessment practices (parent tools, standardized measures like PPVT/Peabody) and the cautions about relying on a single measure.
  • See how to apply classification in real cases (e.g., bilingual child, child with Down syndrome, toddlers with delay vs disorder) and how to use the ICF and environment to inform decisions.
  • Review how to integrate environmental factors, protective/risk factors, and multi-domain data to plan intervention and advocacy.
  • Practice conceptualizing a case with the ICF framework and understand why multiple data sources are necessary before diagnosing.

Terminology and Core Definitions

  • Language difference vs language disorder vs language delay:
    • Language difference: child communicates effectively within a different language system or dialect; not impairing functional communication; may present challenges in school or in a different context.
    • Language delay: child’s language development is slower than typical but follows typical pathways; may catch up with time or intervention.
    • Language disorder: significant language impairment that deviates from typical development and interferes with daily functioning.
  • Developmental Language Disorder (DLD): umbrella term used in contemporary practice to cover language disorders in development that are not explained by a known biomedical condition; also used when a clear cause is not present.
  • Specific Language Impairment (SLI): older term still found in literature; many articles continue to discuss SLI, but current practice often uses DLD as the umbrella term.
  • Congenital aphasia: older, less common term for language impairment due to a neurological event present from birth or early life.
  • Language deviance and language impairment: older terms still referenced in literature; terminology evolves, but the core idea is profiling how language differs from expected development.
  • Developmental Language Disorder (DLD) as the primary topic: emphasizes developmental onset and the array of possible etiologies and presentations.
  • Secondary vs primary diagnosis: in medical terminology, a language issue is often considered secondary to a primary medical/diagnostic condition.

Key Definitions and Criteria (ASHA and Paul)

  • ASHA (American Speech-Language-Hearing Association) view:
    • DLD is an impairment in comprehension and/or use of spoken, written, or symbolic systems.
    • Impairment can involve one or more of the language domains (form, content, use).
    • The disorder affects function in real life (content, function) beyond raw test scores.
  • Paul’s perspective (as discussed):
    • Language disorder is defined by a significant deficit in learning to talk relative to norm-referenced expectations and in relation to the environment.
    • Emphasizes that significant deficits must be interpreted in context (environmental expectations, daily life impact).
  • Norman architecture of terms:
    • Form: phonology, morphology, syntax
    • Content: semantics, vocabulary
    • Use: pragmatics
    • Modalities: receptive (comprehension) vs expressive (production)
  • The preferred umbrella term in this course/module: Developmental Language Disorder (DLD).
  • Common alternatives and how they relate:
    • SLI (Specific Language Impairment): historical term still in literature; often re-labeled as DLD in modern practice.
    • Language delay: slower development but typical pathway; not necessarily a disorder.
    • Language difference: language development that is typical for a different language/dialect; not disordered.

The Two Perspectives on Language Disorders

  • Environmental/Naturalistic Perspective (informal, everyday observations):
    • Noticed by teachers and caregivers; impacts social and academic functioning.
    • Emphasizes real-world use and participation (ICF-like focus).
    • Highlights how environment shapes language development and need for supports.
  • Norm-Referenced Perspective (statistical/psychometric):
    • Focuses on test scores and deviations from normative data.
    • Defines disorder by scores falling below a reference threshold.
    • Common thresholds discussed: below the 10th percentile; below 1.5 standard deviations (SD) from the mean; sometimes 1.25 SD below the mean is cited (though the transcript notes 1.25 SD and then references