Language Disorders

An expressive language disorder refers to difficulty producing language while a receptive language disorder refers to difficulty understanding language. 

 Expressive language disorders manifest through widely varying symptoms such as a young child having difficulty producing first words or older children and adolescents having difficulty contributing to a conversation.  Likewise, symptoms of a receptive language disorder can range from a child who has difficulty following directions, to someone who has difficulty understanding humor or sarcasm. In addition, a receptive language disorder often results in an expressive language disorder.

The areas of language that are impaired can be categorized as follows: ​  difficulty with the sound system of language (phonology), difficulty understanding meanings of words or groups of words (semantics), difficulty understanding and putting  sentences together in grammatically correct ways (syntax and morphology), or difficulty with the social use of language (pragmatics).

 Effects of language disorders are far-reaching and impact academic and social participation as well as an individual's self-concept. Adults with a history of a childhood language disorder tend to have lower income and education outcomes and have more difficulty developing social relationships. Peterson et.al., (2013) found that language disorders predicted attentional and behavioral problems in children. This has long been observed by caregivers who notice that when children have difficulty expressing themselves verbally, they are more likely to tantrum or exhibit other maladaptive behaviors.  Academically, a language disorder negatively impacts a child’s ability to understand and learn material that is presented verbally or written. 

In addition, language disorders and cognition go hand-in-hand as language is a type of cognition. Evidence-based practice directed at intervening on cognition and executive function require meta-cognitive development. Graham (1998) states that “meta-cognitive strategies, by and large, consist of routines that are mediated with language. Students must learn how to talk to themselves about what they are doing and how they are doing it.” This is an important phenomenon when the goal is to improve the child’s overall functioning and long-term outcomes. 

A comprehensive  assessment of language, cognition and academic achievement begins the process.  All areas  of language must be assessed and include receptive and expressive  language with regard to:  grammar, phonology (speech sounds), vocabulary and language use.  The assessment of cognition includes attention, memory, executive  function and problem solving.  If the child is school-aged, academic achievement based on standardized school testing and teacher reports are analyzed.  In addition, the child (when appropriate) and  caregiver undergo an interview to provide information about areas in which difficulty with language impede participation  in life events such as school or social groups.  After a thorough assessment, intervention is designed to accelerate and correct language development.  Treatment includes methods to scaffold literacy development to mitigate the increased likelihood of future reading challenges.