Developmental Language Disorder and Intellectual Disability

Definition of Developmental Language Disorder (DLD)

Developmental Language Disorder (DLD): A communication disorder affecting a child's ability to understand and/or use spoken language despite having normal hearing and intelligence and no other medical causes.

Grammar, Vocabulary, and Sentence Structure: Difficulties in using appropriate grammar, vocabulary, and arranging sentences properly.
Receptive Language Issues: Problems understanding spoken language, which affects their ability to comprehend instructions or conversations.
Expressive Language Challenges: Difficulties in articulating thoughts clearly, leading to challenges in effective communication.
Narrative Skills: Challenges with telling stories or organizing a sequence of events.
Word Retrieval Issues: Difficulty in recalling words during conversation, resulting in pauses or filler words.
Social Language Use: Struggles with using language appropriately in social contexts, such as turn-taking in conversation and understanding sarcasm.
Co-occurring Read and Academic Difficulties: While children with DLD typically possess nonverbal intelligence within the normal range, they often experience problems with reading and other academic challenges.

Foundation of Literacy: Language is crucial for literacy development; therefore, children with DLD experience significant challenges.

Phonological Awareness Deficits: Difficulty in recognizing and manipulating the sounds in spoken words, making decoding challenging.
Text Understanding Problems: Limited vocabulary and syntactic comprehension lead to difficulties in grasping the meaning of texts.
Morphological Knowledge Weaknesses: Lack of understanding of word forms affects spelling and grammar skills.
Narrative Organization Difficulty: Challenges in structuring narratives impede reading comprehension and writing clarity.

Intellectual Disability (ID): Characterized by significant limitations in intellectual functioning (reasoning, problem-solving, abstract thinking) and adaptive behavior (conceptual, social, and practical skills), originating before the age of 18.

Ecological Model: Emphasizes that functioning is the result of interactions between the individual and their environment.
- Contextual Factors: The model promotes the importance of support systems such as family, school, and community adapting to provide necessary resources instead of focusing solely on the individual's deficits.

Purpose: Criterion-referenced tests are recommended because they assess specific skill mastery, allowing clinicians to determine what individuals can do and what skills require support, rather than comparing to a normative group.

Test of Pragmatic Language (TOPL-2): Evaluates how children utilize language in social settings, assessing skills like:
- Making requests
- Understanding figurative language
- Adapting speech based on context
Score Interpretation: Results are based on functional ability rather than peer comparison.

Core Diagnostic Features: Students with ASD exhibit two primary characteristics:
1. Deficits in Social Communication and Interaction: Challenges may include difficulty maintaining eye contact, understanding social cues, and participating in reciprocal conversations.
2. Restricted and Repetitive Behaviors (RRBs): This may involve repetitive movements, intense interests, strict adherence to routines, or heightened sensory sensitivities.

Flexible Thinking Challenges: Difficulty shifting thoughts or adapting to new information.
Emotional Regulation Struggles: Issues managing emotions effectively, often resulting in frustration or behavioral outbursts.
Executive Functioning Difficulties: Problems with organizing tasks, planning, and managing time.

Severity Levels as per DSM-5: The DSM-5 designates three levels of severity for ASD, based on the support required.

Social Communication: Noticeable social difficulties; may experience awkwardness in conversations and struggle with making friends.
RRBs: These behaviors cause some interference with typical functioning.

Social Communication: Marked deficits in verbal and nonverbal communication; limited initiation and response from others.
RRBs: These behaviors are frequent and easily noticeable by others.

Social Communication: Severe impairments in communication; minimal social interaction is possible.
RRBs: These behaviors significantly interfere with daily life, and individuals may experience acute distress with changes.

Definition: A neurodiversity-affirming approach views neurological differences (like autism, ADHD, DLD, or ID) as natural variations of the human condition rather than disorders needing to be "fixed."

Focus on Strengths: Emphasizes individual strengths and unique needs, rather than deficits.
Encouragement of Self-Advocacy: Supports autonomy and the ability for individuals to advocate for themselves in various settings.
Inclusive Environments: Promotes respect for diverse communication styles and sensory experiences, actively working to reduce stigma associated with neurological differences.