Most infants or toddlers can understand what you’re saying well before they can clearly talk. As they get older and their communication skills develop, most children learn how to put their feelings into words.
But some children have language disorders. They may have:
- Receptive language disorder. A child has trouble understanding words that he or she hears and reads.
- Expressive language disorder. A child has trouble speaking with others and expressing thoughts and feelings.
A child will often have both disorders at the same time. Such disorders are often diagnosed in children between the ages of 3 and 5.
Language disorders can have many possible causes. A child’s language disorder is often linked to a health problem or disability such as:
- A brain disorder such as autism
- A brain injury or a brain tumor
- Birth defects such as Down syndrome, fragile X syndrome, or cerebral palsy
- Problems in pregnancy or birth, such as poor nutrition, fetal alcohol syndrome, early (premature) birth, or low birth weight
Sometimes language disorders have a family history. In many cases, the cause is not known.
It’s important to know that learning more than one language does not cause language disorders in children. But a child with language disorder will have the same problems in all languages.
The cause often is not known, but children at risk for a language disorder include those with:
- A family history of language disorders
- Premature birth
- Low birth weight
- Hearing loss
- Thinking disabilities
- Genetic disorders such as Down syndrome
- Fetal alcohol spectrum disorder
- Brain injury
- Cerebral palsy
- Poor nutrition
- Failure to thrive
Children with receptive language disorder have trouble understanding language. They have trouble grasping the meaning of words they hear and see. This includes people talking to them and words they read in books or on signs. It can cause problems with learning. It needs to be treated as early as possible.
A child with receptive language disorder may have trouble:
- Understanding what people say
- Understanding gestures
- Understanding concepts and ideas
- Understanding what he or she reads
- Learning new words
- Answering questions
- Following directions
- Identifying objects
A child with expressive language disorder has trouble using language. The child may be able to understand what other people say. But he or she has trouble when trying to talk, and often can’t express what he or she is feeling and thinking. The disorder can affect both written and spoken language. And children who use sign language can still have trouble expressing themselves.
A child with expressive language disorder may have trouble:
- Using words correctly
- Expressing thoughts and ideas
- Telling stories
- Using gestures
- Asking questions
- Singing songs or reciting poems
- Naming objects
Your child’s healthcare provider will ask about your child’s language use. He or she will also look at your child’s health history. Your child may have a physical exam and hearing tests. Your child’s healthcare provider will likely refer your child to a speech-language pathologist (SLP). This specialist can help diagnose and treat your child.
An SLP will evaluate your child during play. This may be done in a group setting with other children. Or it may be done one-on-one with your child. The SLP will look at how your child:
- Follows directions
- Understands the names of things
- Repeats phrases or rhymes
- Does in other language activities
To treat your child, the speech-language pathologist (SLP) will help him or her to learn to relax and enjoy communicating through play. The SLP will use different age-appropriate methods to help your child with language and communication. The SLP will talk with your child and may:
- Use toys, books, objects, or pictures to help with language development
- Have your child do activities, such as craft projects
- Have your child practice asking and answering questions
The SLP will explain more about the methods that are best for your child’s condition.
A language disorder can be frustrating for parents and teachers, and also for the child. Without diagnosis and treatment, children with such a disorder may not do well in school. They may also misbehave because of their frustration over not being able to communicate. But language disorders are a common problem in children. And they can be treated.
If you think your child might have a language disorder, talk with your child’s healthcare provider right away. Research has shown that children who start therapy early have the best outcome. Make sure that the SLP you choose is certified by the American Speech-Language-Hearing Association.
The SLP will guide your child’s treatment. But it’s important to know that parents play a critical role. You will likely need to work with your child to help him or her with language use and understanding. The SLP will also talk with caregivers and teachers to help them work with your child.
Ask the SLP what you should be doing at home to help the process. The SLP may advise simple activities such as:
- Reading and talking to your child to help him or her learn words
- Listening and responding when your child talks
- Encouraging your child to ask and answer questions
- Pointing out words on signs
Call your child’s healthcare provider if your child has:
- Symptoms that don’t get better, or get worse
- New symptoms
- Children who have a language disorder have trouble understanding language and communicating.
- There are 2 kinds of language disorders: receptive and expressive. Children often have both at the same time.
- A child with a receptive language disorder has trouble understanding words that they hear and read.
- A child with an expressive language disorder has trouble speaking with others and expressing thoughts and feelings.
- Language disorders can have many possible causes, such as a brain injury or birth defect.
- A speech-language pathologist can help diagnose and treat a language disorder.
- Parents can help their child with language use and understanding through simple activities.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
September 29, 2017
Leonard LB. Is Expressive Language Disorder an Accurate Diagnostic Category? American Journal of Speech-Language Pathology. 2009;18;(2):115-23.
Watson, L Renee, MSN, RN,Adler, Liora C, MD,Bass, Pat F III, MD, MPH