Developmental Language Disorder

1. DLD is a neurodevelopmental condition recognized by the World Health Organization’s International Classification of Diseases, 11th Revision (ICD-11) and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as well as the U.S. Department of Education (opens in a new window) and the National Institutes of Health.
2. DLD is highly prevalent. It is estimated that, in every classroom of 30 students, two have DLD.
3. DLD is often a hidden condition. The child with DLD is typically able to carry on a basic conversation even though more complicated academic language is difficult. They may seem shy, inattentive, or naughty, and these behaviors can mask DLD.
4. Most people in the general public do not know what DLD is.
5. DLD affects children of all racial, ethnic, and socioeconomic groups, as well as all languages.
6. DLD is the result of differences in early brain development.
7. Multilingualism does not cause DLD.
8. If a child is multilingual, the DLD will be evident in all of their languages.
9. DLD is lifelong. That does not mean that children do not get better at communication, learning, and reading — they do! But it does mean that their mastery of these skills tends to remain lower than that of same-age peers.
10. About half of children with DLD also have dyslexia or ADHD.

Problems with language structure 

Languages have a characteristic structure. Sounds combine in rule-governed ways to make words; words combine in a particular order to make sentences; and sentences are organized to form coherent discourse or text. Children with DLD have difficulty mastering these structures. When they are talking or writing, they might leave off word endings, limit themselves to simple sentences, or present their ideas in a disorganized fashion. Understanding language that is spoken or written in a complex way can be difficult.

Problems with verbal working memory

To learn, comprehend, and express language, people must hold and manipulate information in working memory. Many children with DLD have limited verbal working memory capacity. They may find fast-paced conversation to be especially difficult to process and they may need extra time to formulate their messages.

Problems with academic performance

Classrooms are highly verbal environments. Children learn by listening to the teacher and other students and by asking questions. After about grade 3, their learning depends heavily on reading and writing as well. Given the breadth of their language problems, many children with DLD do not meet grade-level expectations. All content areas are language-heavy; therefore, these children have difficulty not only in language arts but also in science and math.

Problems with reading and writing

A strong foundation of spoken language skills is essential for literacy. By definition, children with DLD come to the task of learning to read and write without this foundation. Their reading problems may go undetected in the early years of reading instruction, when learning to decode is emphasized. But once the focus shifts from decoding to comprehension, they struggle. Although they might be able to spell single words, problems with writing become more obvious at the level of sentences and text structure.

DLD is not a problem with articulating speech sounds. A child with DLD may also have a speech sound disorder, but plenty of children have DLD and clear speech.

DLD is not a problem with phonological awareness and decoding. A child with DLD may also have dyslexia, but about half of all children with DLD are good at word-level reading.

DLD is not a problem with social skills. Children with DLD may have difficulty navigating social relationships because of their frequent communication breakdowns, but they demonstrate social reciprocity and prosocial behavior.

DLD is not a problem with intelligence. We often gauge intelligence through the words and sentences children use and understand. However, language and intelligence are not synonymous. Children with DLD show a range of individual differences in nonverbal and emotional intelligence. 

DLD is not a problem with motivation or emotion. Children with DLD may appear shy, hesitant, unmotivated, or distracted at times. They may appear to be frustrated, angry, or irritated. Not being able to communicate your wants and needs can be frustrating. Children with DLD deal with this frustration in a variety of ways. Some may have emotional or behavioral problems but many do not.

The terms used to refer to DLD vary greatly across contexts. In 2016, a group of DLD experts met to come to a consensus about which term to use, in hopes of lessening confusion and improving awareness of DLD. The consensus term was Developmental Language Disorder. That said, you will still come across variation in terminology. A Google Scholar Search conducted by Dorothy V.M. Bishop in 2014 yielded 33 different terms for DLD that were each used more than 600 times in the research literature. 

Some terms, like “communication problems,” are broad and include not only DLD but many other conditions. Others, like “developmental dysphasia,” can be taken as a synonym for DLD. A term not found via Dr. Bishop’s Google Scholar search, but often used for insurance billing purposes in the U.S. is “expressive-receptive language disorder.” It is useful to realize that these varied terms have all been used, and in some settings continued to be used, to refer to the condition that we now know as DLD. 

33 terms used to refer to Developmental Language Disorder (Bishop, 2014)

More than half of children with DLD can read words like their typically developing peers. These are children who may be described as “word callers” — or “hyperlexic” — because they can read words accurately and fluently, even with good intonation, and not be able to answer comprehension questions well or correctly retell the story they just read.  

This means that they can often go “under the radar” for reading difficulties. Their difficulties in comprehension are not uncovered until the later grades when reading in class is focused more on comprehension and less on word reading. Importantly, though, children with DLD have comprehension problems in the early grades. These problems are not apparent through word reading. Their language difficulties can be revealed instead, in the early grades, through tests of language comprehension that do not involve word reading — for example, retelling or answering questions about a complex, orally-presented story.

Studies that follow children with DLD from the early to late grades show that most who are eventually identified with reading comprehension problems previously had spoken language comprehension difficulties that were not discovered. These problems can only be identified if language comprehension is measured in the early grades. 

• Learn more about DLD. The more you know, the more you will understand the potential strengths and areas of struggle for children with DLD. 
• Share information about DLD with your colleagues and your students. A better sense of individual differences in language may build more acceptance in the classroom. 
• If you see a child struggling socially or academically, ensure that language testing is completed to rule DLD in or out. 
• Include language comprehension testing in your universal screening, progress monitoring, and evaluation for special education support. 
• Break down complex instructions and language and use visual supports. Provide this support in all subjects and in extra-curricular activities. 
• Ask a child with DLD to repeat instructions to ensure comprehension. Help to repair communication breakdowns. 
• Facilitate peer interactions. Provide a child with DLD the language they need to enter and continue a conversation. 
• Collaborate with other educators including speech-language pathologists, school psychologists, special educators, and support staff to ensure that everyone is providing supports for the child with DLD across the school day. 

Check out these resources to deepen your knowledge and learn more about how to help children with DLD thrive academically and socially:

• DLD and Me (opens in a new window)
• Raising Awareness of Developmental Language Disorder (opens in a new window) (RADLD)
• DLD: A Guide for Parents and Families (opens in a new window) 
• SeeHearSpeak (opens in a new window) (podcast), hosted by Tiffany P. Hogan, director of the Speech and Language (SAiL) Literacy Lab (opens in a new window) at the MGH Institute
• Understanding Dyslexia in the Context of Developmental Language Disorders (opens in a new window) (Suzanne M. Adlof and Tiffany P. Hogan)
• ASHA Voices: A Focus on Developmental Language Disorder (opens in a new window) (podcast)
• Word Learning Laboratory (opens in a new window) at the Boys Town National Research Hospital