Abby Barnes, M.S., CCC-SLP
For kids who have difficulty using language and who struggle socially and in school, developmental language disorder may be the cause. Although it’s fairly common, you may not have heard of this disorder, called DLD for short. Here we cover what DLD is, how it’s diagnosed, and how speech therapy can help kids with developmental language disorder.
What is developmental language disorder?
Developmental language disorder is the new term for a condition previously called speech and language impairment (SLI). It is a communication disorder that interferes with learning, understanding, and using language.
A person with DLD has difficulty with both receptive and expressive language, and no other diagnosis is causing these language issues. Expressive language involves the way we communicate and express our thoughts and ideas. Receptive language refers to how we understand words spoken to us.
What causes DLD?
While the exact cause of DLD is not known, we do know that it’s a neurodevelopmental disorder, or a difference in the brain. There is some relation to genetics, as it tends to run in families. Children with DLD are likely to have at least one family member with DLD. In addition, other neurodevelopmental disorders, such as dyslexia and autism, are more common in the family members of a child with DLD.
Diagnosing a developmental language disorder can be tricky. So it’s important to know the signs of DLD to look for. It's estimated that DLD affects 1 in 14 kindergarten-age children. This difficulty with language negatively impacts a child’s academic performance. So if a child is having trouble in school, that’s one sign that often leads families to a DLD diagnosis.
What are the signs of DLD in children?
There are several signs and symptoms to watch for with DLD. Young children who have DLD may have the following symptoms:
Begin talking late
Difficulty learning new vocabulary
Difficulty making sentences
Difficulty understanding what’s said to them
Difficulty using grammar correctly
As children with DLD get older, they may have the following symptoms :
Use of simple sentences instead of complex ones
Difficulty choosing the right words to say
Difficulty with figurative language
Difficulty reading
Poor ability to tell stories
Spelling and grammar issues
What parents should know about developmental language disorder
It’s important to know that DLD is its own diagnosis. Other diagnoses that contribute to language difficulties, such as autism or ADHD, do not mean that a child has DLD. DLD is its own cause of language difficulties.
DLD and learning disabilities are also separate. However, if a child has DLD, this does put them at higher risk for developing a learning disability. Language processing and expression are huge factors in academic success. If language is impaired in any way, this can lead to learning disabilities. For example, difficulties in writing and reading are prominent among kids with DLD. Many children with DLD are also diagnosed with dyslexia. DLD is a lifelong condition, although the symptoms may change as a person grows. But the right kinds of therapy and support can make a big difference in a child’s communication abilities and school success.
What’s involved in a speech therapy evaluation for DLD
If a child is suspected to have DLD, they will be referred for an evaluation with a speech-language pathologist, also known as a speech therapist. Speech therapists are trained to identify and treat difficulties with receptive and expressive language.
Your pediatrician might refer your child for speech therapy, or your child’s teacher might recommend it. You can also contact a speech therapist on your own if you think your child is struggling with communication.
Before the evaluation, the speech therapist will likely ask you to complete a questionnaire. This is a series of questions about your child's medical and birth history, their daily routine, and any concerns. It’s important to be as detailed as possible. This questionnaire will help your speech therapist plan your child's evaluation.
The speech therapist may ask you questions directly as well. In particular, they may ask how your child does in school and whether they have any social concerns. Many children with DLD have a hard time communicating with other children.
During the evaluation, the speech therapist will assess a variety of things. They will test your child’s receptive and expressive language abilities. This is where any signs of DLD will be identified. The speech therapist will also assess your child’s ability to say speech sounds correctly, as well as their oral-motor abilities (their abilities to move their mouth, lips, teeth, and tongue correctly in order to form speech). The speech therapist will look for signs of stuttering and listen to your child’s voice quality as well.
The speech therapist will pay special attention to the following areas:
Conversation and telling stories
Pronouncing words
Forming sentences
Using grammar
Word-finding abilities
The speech therapist can diagnose DLD if it is identified. If needed, they may refer your child to other specialists to assess for conditions such as ADHD, dyslexia, or autism.
How speech therapy helps kids with DLD
If a child is diagnosed with developmental language disorder, the speech therapist will recommend the frequency of treatment. Some children have speech therapy sessions once or twice a week. Others may need sessions more often.
Based on the evaluation findings, the speech therapist will create a treatment plan with goals to work on in therapy. These goals will focus on the child’s specific areas that need improvement. DLD goals are often different for every child, and they also depend on the child’s age. As an example, goals may be focused on:
Improving sentence structure in conversation
Using correct verb tenses
Understanding and answering questions clearly
Following directions
Developing social communication skills
During each session, the speech therapist will guide the child toward achieving these goals in a variety of ways. This might be through games, interactive exercises, and other techniques to help kids get closer to meeting their goals independently. The speech therapist will decrease the amount of help they provide over time, so that the child learns to use language skills on their own.
The speech therapist will guide the child toward achieving their goals in a variety of ways, such as with games, interactive exercises, and other techniques.
The speech therapist will review the child’s progress with their parent or caregiver at the end of each session. They will also give the family activities to do during the week in between sessions. Parents often don’t realize the importance of home practice. When kids practice consistently, they make faster progress, and they may even graduate from speech therapy sooner!
How do I know if my child needs speech therapy?
It can be hard to know whether your child is on track with their communication skills. Being aware of communication milestones for each age can help you determine if your child should have a speech evaluation. Here are the milestones to watch for:
DLD is a lifelong condition. It isn’t something that can be cured. However, kids can make excellent progress when they have the right support from their family, speech therapist, teachers, and other specialists as needed.
If you think your child has difficulties with language, the sooner you seek support, the sooner they can be on the road to improvement. And remember, they'll benefit from your support at home, every step of the way!
