Developmental Language Disorder (DLD) refers to a problem learning or using language that doesn’t go away and isn’t explained by other biomedical conditions. Language forms the basis of human communication. We use language all the time: we speak, write, or make gestures/signs to tell or understand messages. Given the importance of language, you might think a difficulty with language like DLD should be easy to identify. But it’s not. Why is DLD hard to recognize?
DLD Can Be Hard To Recognize for Lots of Reasons:
1. DLD looks different across people who have it.
Language is complex and made up of a number of overlapping systems:
- Phonology – the speech sounds and rules for combining that make up words
- Morphology – the rules for forming words or parts of words
- Syntax – the rules for combining words into sentences
- Semantics – the meaning of words and sentences
- Pragmatics – the rules for using language in social situations such as conversation
Some people with DLD may have particular difficulty learning phonology, while others may have greater problems in the area of syntax or pragmatics. The systems are highly integrated, so a problem in one is likely to have an impact on another system. For example, if a child with a phonological (speech sound) problem has trouble making the /d/ sound at the end of ‘pulled’, the child may go on to have difficulty learning the morphological rules for making past tense verbs or understanding the semantics (or meaning) of the marker. So, even though some struggles might be similar, people with DLD have different strengths and weaknesses across the areas of language. There’s no one language pattern that is typical for DLD. As a result, it can be difficult to recognize DLD because DLD looks different across people who have it.
2. The language of a person with DLD is similar in some ways to the language of someone who is younger.
DLD would be easy to spot if DLD language errors were unique, but that’s not the case! The language of children with DLD develops in the same way as children without DLD, but more slowly and less completely. The language errors children with DLD make, however, are the same kind that children without DLD make during their early language development. For instance, all children leave off the endings of words sometimes, but children with DLD might do this more. It takes someone with expert training like a speech-language pathologist to know whether the language errors a child is making is cause for concern or not. This overlap with typical development makes DLD hard to recognize.
3. The language of a person with DLD is similar in some ways to the language of someone who is learning a new language.
Another group who can show language struggles similar to DLD are those learning English as an additional language. In fact, it is usually hard to tell if a person learning English as an additional language has DLD or just needs more time to learn English. Parents who are concerned about their child’s language development should work closely with their child’s teacher and speech-language pathologist to develop an understanding of their child’s language learning profile. If the problem is DLD, it will affect the child’s native language as well as any other language she is learning.
Language abilities are also affected in a number of neurodevelopmental disorders, which can lead to confusion with DLD. Both children with Autism Spectrum Disorder and those with DLD, for example, can have difficulty with social communication. Assessment across a range of abilities is necessary to differentiate these conditions. Children with Attention Deficit Hyperactivity Disorder (ADHD) have trouble paying attention, which can result in these children misunderstanding messages or replying with an off-topic remark. A careful assessment is needed to determine whether such language errors are consistent with an ADHD diagnosis alone, or reflect a co-morbid DLD. DLD can be hard to recognize because DLD can look similar to others who struggle with language.
4. DLD changes over the lifespan.
Language develops and grows over time. The things being learned about language differ depending on age and stage of development. For example, young children learn how to make simple phrases whereas older children develop the ability to understand many connected sentences. Even though children with DLD need more opportunities and assistance to support their language development, learning continues as they grow. As a result, the profile of language strengths and weaknesses will differ for a child with DLD as that child grows. The learning challenges and language characteristics of a young child with DLD will not be the same as when that child becomes an adult with DLD. To be sure, DLD does not go away, but it does take on different forms over time. The changing picture of DLD over the lifespan makes DLD hard to recognize.
5. DLD is an invisible disability.
There are also no physical signs of having DLD. As a result, many who meet an individual with DLD will not even know he or she has DLD. Also, most individuals with DLD will develop the language skills necessary to communicate in daily and familiar situations. Carrying on a brief conversation with friends and family might become quite effortless, and people with DLD might sound just like other people in many ways. In this way, DLD can be an invisible or hidden disability. The more demanding the situation—explaining complex directions or writing an essay—the more likely the signs of DLD will show. All too often, people mistake un-identified DLD as laziness or lack of attention. In reality, people with DLD are working hard to meet complex language demands.
It is important to recognize the many situations in which having DLD can present challenges, and to know the signs of DLD across the lifespan. Here are a couple of examples:
The academic language of school places high demands on language. School learning involves new vocabulary, expressed in complex sentences, often presented only a few times. A student with DLD must sustain considerable effort to manage and participate in these language tasks. Is it any wonder that a student with DLD sometimes becomes fatigued and frustrated and communicates these feelings by acting out or staying silent in class?
Many social situations require sophisticated language skills as well. Friends engage in verbal banter that often involves humor or abstract language. Humorous remarks, for example, often involve stating one thing but meaning another (e.g., ‘You think so?’, said with a sarcastic tone). Abstract language forms the basis of deep discussion around issues you can’t experience with your senses like favourites, friendship, and learning.
The extent to which a person with DLD struggles with the language demands of a task can depend on so many factors. Sometimes the individual may appear to have no difficulty at all, whereas at other times, the individual may be unable to make sense of what is being said or to give a well-formed reply. DLD is an invisible disability, which can make DLD hard to recognize.
6. DLD is not well known.
Finally, DLD can be hard to recognize because people don’t know about it. In the past, DLD has been called by different names. By using the same term internationally, we can build awareness of DLD and help make DLD easier for people to recognize!
Dollaghan, C.A. (2004). Taxometric analyses of specific language impairment in 3- and 4-year-old children. Journal of Speech, Language, and Hearing Research, 42, 464-475.
Dollaghan, C.A. (2011). Taxometric analyses of specific language impairment in 6-year-old children. Journal of Speech, Language, and Hearing Research, 54, 1361-71.
Kohnert, K. (2010). Bilingual children with primary language impairment: Issues, evidence and implications for clinical actions. Journal of Communication Disorders, 43(6), 456–473.
Patchell, F., & Hand, L. (1993, December). An invisible disability: Language disorders in high school students and the implications for classroom teachers. Independent Education.
Poll, G.H., Betz, S.K., Miller, C.A. (2010). Identification of clinical markers of specific language impairment in adults. Journal of Speech, Language, and Hearing Research, 53, 414-429.
Redmond, S. (2016). Markers, models, and measurement error: Exploring the links between attention deficits and language impairments. Journal of Speech, Language, and Hearing Research, 59, 62-71.
Swineford, LB., Thurms, A., Baird, G., Wetherby, A.M., & Swedo, S. (2014). Social (pragmatic communication disorder: A research review of this new DSM-5 diagnostic category. Journal of Neurodevelopmental Disorders, 6:41.