Rachel Powell, Ph.D., CCC-SLP
SLP & Data Coach, Brookhaven School District, Brookhaven, MS
As a speech-language pathologist who works in schools, the most frequent comment I hear regarding Developmental Language Disorder (DLD) is “well, we don’t do that in schools.” While we don’t always label the problem as DLD, we do serve children who have DLD. In fact, according to the ASHA Schools Survey (2020), the largest proportion of our intervention caseload comprises children with language disorder.
In US schools, children with DLD qualify for services under the Individuals with Disabilities Education Act (IDEA, 2004) if their language problems have a SIGNIFICANT adverse effect limiting their access to an education. IDEA specifies broad disability categories, not the specific diagnoses that might result in a disability. In this post, we describe the disability categories that most often pertain to children whose diagnosis is DLD.
The National Center for Education Statistics and the US Department of Education Office of Special Education and Rehabilitative Services (OSEP) are responsible for tracking and reporting the incidence of special education disabilities in US schools (US Department of Education, 2021). Under IDEA, a student’s primary disability is what most adversely affects educational, social, or vocational performance. The primary disability is what is reported by OSEP. However, language challenges often accompany these other disabilities. Therefore, we are likely to find students with DLD receiving services under a number of categories. To judge by the number of children served under the speech and language impairment category alone would likely underestimate the incidence of language problems.
Speech or Language Impairment
Approximately 17% of school-age students in the US receiving special education qualify under the category of speech or language impaired. This is approximately 1.1 million students (based on the estimated 6.5 million students receiving special education in schools). Many of these students meet criteria for DLD. This category also includes children with speech sound disorders or less common conditions such as stuttering, voice disorders, and social communication disorders. In some cases, children have more than one of these conditions. For example, students with speech sound disorders are at high risk for language and learning deficits, and some research estimates that up to 60% of children with phonological disorders have co-occurring language impairments (Nelson, 2010). Therefore, it is likely that many of the 17% of US students eligible for special education supports under the category speech or language impairment are children who have DLD or DLD plus other challenges.
Specific Learning Disability
The vast majority of school-age students with special education rulings have a Specific Learning Disability (36% of students receiving special education, or 2.4 million students). Specific Learning Disability includes problems with reading (i.e., dyslexia), writing (i.e. dysgraphia), mathematics (i.e. dyscalculia), AND language (ahem, DLD!). The majority of students, up to 80%, with specific learning disability struggle with literacy and language (American Psychiatry Association, 2021). The Simple View of Reading theory (Kamhi & Catts, 2012) demonstrates how language is the foundation of reading and writing. Following the simple view, reading can be categorized by word recognition (decoding) and language comprehension:
Children with DLD (the bottom two quadrants of the simple view) will find reading and writing to be difficult. (After Bishop & Snowling, 2004)
Other Health Impairment
The third most common disability in special education is ‘Other Health Impairment’ consisting of 16% of the special education population (a little over 1 million students). Other Health Impairment comprises various medically diagnosed conditions such as specific genetic syndromes, heart conditions, leukemia, asthma, epilepsy, or diabetes. But the majority of students served under Other Health Conditions have Attention Deficit Hyperactivity Disorder (ADHD) (Project Ideal, 2021). Approximately 30% to 50% of children with ADHD also have DLD (Mueller & Tomblin, 2012). Therefore, it is highly likely that a large portion of children who receive services under Other Health Impairment also have co-occurring DLD.
Some students with DLD receive services under the category Developmental Delay, which includes 7% of the special education population (almost half a million children). The category of Developmental Delay is only applicable to students ages 3 to 10 (the maximum age varies state by state, with some states no longer using Developmental Delay at age 6, and others allowing it to continue until age 10). To qualify for services under Developmental Delay, students must have 1 deficit out of 5 areas of development, one of which is communication, aka LANGUAGE. Therefore, it is highly likely that a large portion of students receiving services under the category of Developmental Delay have DLD.
Multi-tiered Systems of Support (MTSS)
We may also find students with DLD within the Multi-Tier Instructional Support Systems (MTSS). MTSS is a general education initiative that identifies students at risk for academic (reading or math) and/or behavioral deficits. Schools implement MTSS supports by providing universal screening for all students, high quality instruction, instructional support systems individualized to meet student needs, frequent progress monitoring, and the use of data to make educational decisions. Because this is a general education initiative, there are no specific data on the number of students receiving MTSS .
Speech language pathologists play important roles in the MTSS system. They serve as members of the MTSS team where they provide input on a child’s curricular strengths and weaknesses and identify language weaknesses that are contributing to problems with reading and writing. The ASHA Schools Survey (2020) reported that speech language pathologists spent an average of 1.4 hours weekly on MTSS activities. Because eligibility criteria for receiving language supports vary from state to state, there may be students with DLD who are deemed not eligible for services, but who remain in the general education population and receive supports through MTSS.
DLD is more common than autism or hearing impairment (McGregor, n.d.), and poses a risk for academic and social/emotional behavioral concerns. Just as we’ve seen a push from the dyslexia community across the nation to “say dyslexia,” speech language pathologists in schools must “SAY DLD.” When we do, we give students, parents, and educators a means for finding information and seeking appropriate supports.
- American Psychiatry Association (2021). What is specific learning disability? Retrieved from: https://www.psychiatry.org/patients-families/specific-learning-disorder/what-is-specific-learning-disorder.
- American Speech-Language-Hearing Association (2020). 2020 Schools Survey report: SLP caseload and workload characteristics. Retrieved from: www.asha.org/Research/memberdata/Schools-Survey/.
- Bishop, D. V., & Snowling, M. J. (2004). Developmental dyslexia and specific language impairment: Same or different?. Psychological bulletin, 130(6), 858.
- Georgan, W. C. & Hogan, T. P. (n.d.). The many terms used for DLD. www.DLDandme.com. Retrieved from: https://dldandme.org/terminology/.
- Individuals with Disabilities Education Act, 20 U.S.C. § 1400 (2004). Retrieved from: https://sites.ed.gov/idea/statute-chapter-33/subchapter-i/1401/3/A.
- Kamhi, A. G. & Catts, H. W. (2012). Language and Reading Disabilities, Third Edition. Boston, MA: Pearson.
- McGregor, K. (n.d.). Diagnosing and treating developmental language disorders. www.DLDandme.com. Retrieved from: https://dldandme.org/diagnosing-and-treating-dld/.
- Mueller, K. L. & Tomblin, J. B. (2014). Examining the comorbidity of language disorders and ADHD. Topics In Language Disorders, 32(3), 228-246.
- US Department of Education (2021). Part B child count and educational environments. IDEA section 618 data products: Static Tables. Retrieved from: https://www2.ed.gov/programs/osepidea/618-data/static-tables/index.html.
- www.ProjectIDEAL.org (2021). Retrieved from: http://www.projectidealonline.org/v/health-impairments/