Overview
According to DSM-5, Language Disorder, also known as Developmental Dysphasia, is characterised by issues in acquisition and expression of language. Typical symptoms include reduced vocabulary, limited sentence construction and comprehension.
It causes impairment in academic achievement, social interactions and is not explained by Intellectual Disability or Global Developmental Delay.
Children with this disorder may use incomplete sentences, have trouble comprehending grammar and morphology, have trouble explaining events, having conversations, have difficulty following instructions increasing in length, remembering new sentences and words, understanding synonyms, etc.
It may start off with delay in language processing and continue into Language Disorder as the child is substantially below their peers in language development.
Common Signs and Symptoms
Symptoms include issues in both, deficits in receptive as well as expressive language. Reception of language includes understanding, remembering and comprehending vocabulary and grammar. Expressive language includes production of vocal, gestural and verbal signs of language.
Language deficits are seen particularly in vocabulary and grammar and then affect discourse. The childโs first phrases are likely to be delayed, and as the child grows, the deficits are seen in terms of expression. For instance, speech is in the form of broken sentences, mostly in past tense. They may take help of the context, avoid using speech and tend to point towards things instead of using words.
Deficits in reception can be seen in poor instruction following, problem retaining information and lack of comprehension. There is difficulty in understanding and reproducing different sound sequences, which is important to learn a language.
The difficulty is substantially below age appropriate language development and causes impairment in academics and social life of the child. Some children may even have low self-esteem due to social stigmatisation by peers.
Risk Factors
Although there are no known causes for Language Disorder, there are several risk factors. These include genetic predisposition, cognitive and neurological factors as well as environmental factors.
Children diagnosed with Language disorder often have a family history of Language Disorder or impairments. There may be unexplained neurological issues related to language disorder. Mother-child relationship and parental neglect are also associated with development of language disorder.
In several cases, Language Disorder is associated with other specific learning disorders such as Dyslexia, or other developmental disorders such as Attention Deficit Hyperactivity Disorder.
Diagnosis
Children with Language Disorder often exhibit language delay. However, the minimum age for diagnosis is 4 years. To be diagnosed with LD, following criteria must be met:
- Persistent difficulty in reception and expression of language.
- Limited word use and poor vocabulary.
- Limited sentence structure: inability to use proper grammar and morphology.
- Impairments in discourse: inability to produce proper sentences, explain events, or have conversations.
The language difficulty may vary in severity., but is substantially below age appropriate norms.
Psychologists are required to rule out language difficulties caused due to impairments in motor functioning, medical or neurological issues, sensory deficits, global developmental delay or intellectual disability.
Treatment
Treatment for Language Disorder often starts early. A neuropsychologist often gives the diagnosis after thorough assessment of cognitive, neurological and psychological functions. A language and speech therapist is referred for help with this disorder.
The prognosis for people with difficulties in reception is poorer as compared to people with expression difficulties. Children with expressive difficulties are often given speech therapy involving morphology and phonics treatments.
They may be given additional psychotherapy for self-esteem related issues caused due to expressive language disorder.
Differential Diagnosis
1. Normal variations in language: Language disorder needs to be differentiated from normal developmental variations. This distinction may be difficult to make before 4 years of age. Regional, social, or cultural/ethnic variations of language must be considered when an individual is being assessed for language impairment.
2. Hearing or other sensory impairment: Hearing impairment needs to be excluded as the primary cause of language difficulties. Language deficits may be associated with a hearing impairment, other sensory deficit or a speech-motor deficit.
3. Intellectual disability: Language delay is often the primary feature of intellectual disability, and the definitive diagnosis may not be made until the child is able to complete standardized assessments. A separate diagnosis is not given unless the language deficits are clearly more than the intellectual limitations.ย
4. Neurological disorders: Language disorder can be acquired in association with neurological disorders such as epilepsy, acquired aphasia or Landau-Kleffner syndrome.
5. Language regression: Loss of speech and language in a child younger than 3 years may be a sign of autism spectrum disorder or a specific neurological condition, such as Landau-Kleffner syndrome. Among children older than 3 years, language loss may be a symptom of seizures, and a diagnostic assessment is necessary to exclude the presence of epilepsy.
Comorbidity
Language disorder is strongly associated with other neurodevelopmental disorders, attention-deficit/hyperactivity disorder, autism spectrum disorder, social communication disorder and developmental coordination disorder.
Specialist
A language and speech therapist and a psychologist often work together on speech related disorders.
In Conclusion
Language Disorders can be identified in childhood and adolescence. Language-disordered people have trouble communicating their ideas and understanding what others are saying. Hearing issues are unrelated to this. Although this is a major learning problem, it is very treatable, particularly if discovered early.
Intelligence is not a factor in language difficulties. They make their owners equally intelligent with everyone else. But learning new things and making friends can be difficult if you have a language issue. Early diagnosis and counseling can help reduce the symptoms.
Consult Anandaโs experts to start professional counseling.
