Language Disorders in Children

Most infants or toddlers can understand what you are saying well before they can clearly talk. As they mature and their communication skills develop, most children learn how to put their thoughts into words.

Children with a language disorder, however, may have trouble understanding words they hear or read. This is called a receptive language disorder. Other children may have trouble speaking with others and expressing their thoughts and feelings. This is called an expressive language disorder. Often, children will have both disorders at the same time.

Language disorders are a common problem in children and can be treated. Still, having a language disorder can be frustrating, not only for the children who have them, but for their parents and teachers, too. Without diagnosis and treatment, children with a receptive-expressive language disorder may experience poor performance in school. They may also misbehave because of frustration over not being able to communicate. Getting an accurate diagnosis and beginning treatment as soon as possible is important.

If you suspect your child might have a language disorder, talk with your child’s healthcare provider right away. Research has shown that children who begin therapy early have the best outcomes. Make sure the speech-language pathologist (SLP) you choose to work with your child is certified by the American Speech-Language-Hearing Association.

Language disorders can have many possible causes. Although your child's language disorder may be the primary concern, it is often secondary to another condition.

Causes of language disorders include:

• Medical conditions or disabilities, such as autism, a brain injury, stroke or tumor
• Birth defects such as Down syndrome (trisomy 21), fragile X syndrome, or cerebral palsy
• Problems in pregnancy or birth, such as poor nutrition, fetal alcohol syndrome, early birth or low birth weight

Sometimes, language disorders have a family history. In many other cases, the cause is not known.

It is important to know that learning more than one language does not cause language disorders in children; however, a child with a language disorder will have the same issues in all languages.

Children with a receptive language disorder have difficulty 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. Receptive language disorders can cause problems with learning and need to be treated as early as possible.

A child with a receptive language disorder may have difficulty:

• Understanding gestures
• Understanding what people say
• Following directions
• Identifying body parts or objects
• Identifying pictures of objects or actions
• Understanding concepts and ideas
• Learning new words
• Understanding questions he is asked
• Understanding what he reads
• Understanding jokes or indirect language

Children with an expressive language disorder have trouble using language. They may be able to understand what other people say, but have difficulty expressing what they are feeling and thinking. The disorder can affect both spoken and written language.

A child with an expressive language disorder may have difficulty:

• Using gestures
• Naming objects
• Using words correctly
• Expressing thoughts and ideas
• Using appropriate grammar
• Telling stories
• Asking and answering questions
• Singing songs or reciting poems

Your child's healthcare provider will ask about your child's language use and look at her medical history. Your child may have a physical exam and hearing test. He may see a psychologist. Your child’s healthcare provider will also likely refer your child to a speech-language pathologist (SLP), a specialist who can help diagnose and treat your child.

The SLP will talk to you about your child’s communication skills. She will look at how your child speaks, listens, follows directions, understands the names of things, repeats phrases or rhymes, and performs other language and play-based activities.

To treat your child, the SLP will help him learn to relax and enjoy communicating through play. The speech-language pathologist will use various age-appropriate methods to help your child with language and communication. She will also talk with your child and may use toys, books, objects or pictures to help with language development. The SLP may practice asking and answering questions with your child and will explain more about the techniques that are best for your child's type of language disorder.

Various forms of augmentative and alternative communication (AAC) may be introduced during a speech-language evaluation or therapy, depending on your child’s specific communication needs and abilities. AAC includes any type of communication that enhances or replaces natural speech. This includes technology-free systems, such as manual sign language and picture communication boards, and high technology systems, including computerized devices with large vocabulary sets and synthesized speech output. These tools can be used by children whose speech is insufficient to meet their daily communication needs and to decrease frustration when communicating.

Your child’s speech-language pathologist will guide his treatment, but parents also play a critical role in treating language disorders. You will need to participate in therapy and work with your child — outside of the therapy room — to help him with his language use and understanding. Your child’s SLP may also discuss your child’s communication challenges and needs with other caregivers and teachers who will be working with your child.

Ask your child’s SLP what you should be doing at home to help your child. The SLP may recommend activities such as:

• Reading and talking to your child to help him learn words
• Listening and responding when your child talks
• Encouraging your child to ask and answer questions