What is developmental language disorder (DLD)?

Development language disorder (DLD) is a brain difference that can present challenges in understanding or using language (or both). Surprisingly, DLD is quite common, affecting approximately 1 in 14 individuals, or 7% of the population. To put it into perspective, this prevalence is comparable to ADHD, three times more common than autism, and 45 times more common than hearing impairment.  Despite its prevalence, DLD often goes unrecognized and undiagnosed. I’m here to contribute to the efforts to change that!

Parents play a vital role in identifying and intervening with children who may have DLD. By understanding what DLD is, risk factors for DLD, and the signs of DLD, parents can actively seek out necessary support if they notice signs in their own child. Together, we can absolutely make a difference in improving understanding of DLD and the uptake of intervention for language disorders.

What challenges might individuals with developmental language disorder encounter?

• Acquiring new vocabulary

• Being labeled a “late talker”

• Understanding and following instructions

• Answering questions

• Constructing coherent sentences

• Having a weak vocabulary; often uses general words like “that”, “thing”, or “stuff”

• Mixing up words and using them incorrectly

• Struggling with grammar rules, resulting in numerous grammar errors in their speech

• Difficulty learning to read

• Difficulty writing

• Difficulty understanding spoken and written language

• Engaging in social play

• Excessively using filler words like “um” or “uh” when speaking

• Struggling to understand the main ideas of stories or conversations

• Having difficulties understanding figurative language (e.g., idioms, metaphors)

DLD is quite complex, and it’s considered both a developmental and a spectrum disorder. You see, spectrum disorders affect a whole range of interconnected skills. It’s important to keep in mind that the severity of DLD and the specific combination of skills involved can vary a lot from person to person. Because DLD is also developmental, symptoms will also evolve as language skills grow and change, and the demands of school (and life) increase.

Stories of Three Children With DLD

From a young age, Xavier faced challenges with language. His parents observed that he didn’t consistently respond to his name by the time he turned 1, prompting them to seek early intervention. With the support he received, Xavier made remarkable progress, eventually being discharged from speech therapy at the age of 3. Although he still faced difficulties in certain areas of language, he was communicative and his family felt comfortable stopping therapy. Xavier continued without intervention until his family and teacher noticed he was really struggling with reading and writing. It was then that he had a comprehensive assessment completed at his school and he was found to be eligible under both speech or language impairment (SLI) and to have a specific learning disability (dyslexia). Remember, SLI describes the eligibility category for kids with DLD. With the right interventions, Xavier made steady progress with reading.

Kim did not experience delayed speech development/late language emergence. While she spoke many single words at a young age, her parents observed that her articulation and grammar skills were lacking as she grew older. She was an active and social kid who loved to play with her friends and never showed signs of frustration with her communication weaknesses. Kim’s kindergarten teacher expressed concern with how Kim’s speech sounded, so the school’s speech-language pathologist completed an assessment. During this assessment, the SLP also noted the grammar challenges and completed additional assessments in language. She was found to have DLD and was eligible to receive speech and language support at school through an eligibility category of speech or language impairment. She worked on grammar and articulation with her SLP. Kim continued to receive speech therapy throughout her schooling.

Kiaan was a late talker, struggling with communication throughout his early childhood. He seemed to not understand other people and he unfortunately often withdrew from interactions with others. He was unjustly labeled as “lazy” by his parents, rarely doing what they wanted him to do. He did not receive early intervention because his family was unaware that getting support through the school district at 3 years old was even an option. As he progressed to kindergarten, his behavior became more problematic, and he faced numerous challenges in articulating and organizing his thoughts. With a diagnosis of DLD and targeted and intense interventions, his language improved and so did the problem behaviors. Kiaan was never lazy, but how he understood and interacted with the world around him was unique and required specific interventions to help him succeed.

While all of these children have DLD, they demonstrate various patterns of development, strengths, and weaknesses. Some children encounter challenges in following directions or using complex sentence structures, while others struggle with active participation in conversations or responding to questions. Children with DLD will have a variety of skills and it will look different depending on the child.

Risk Factors for DLD

We can’t say for sure what causes DLD (I wish I knew!), but it’s important for parents to be aware of certain risk factors. Just remember, these things are beyond our control, and having DLD or a child with DLD is nothing to feel guilty about. We don’t know all of the risk factors linked to DLD yet, so even people without the known risk factors may still have DLD:

• Family history of speech, language, or learning disorders
• Male (1.3:1 male to female with DLD, but late talking is much more common in males 2.5-3:1)
• Being the younger sibling in a large family
• Having parents with few years of education
• Having dyslexia

Sansavini et al. did a thorough review of existing research about early predictors for DLD and found that the majority of research focuses on English-speaking children, so caution should be exercised when generalizing these findings. Despite this limitation, the identified predictors offer valuable insights into the early detection of DLD between the ages of 2 and 3:

• Delayed gesture production (e.g., pointing with an extended index finger)
• Receptive and/or expressive vocabulary weaknesses
• Poor syntactic comprehension (e.g., who is eating? / who ate?)
• Absence of two-word combinations up to 30 months
• Family history of language impairment
• Other notable factors but with a lower predictive power: low socioeconomic status, poor communicative interactions in the child’s environment

Sex-Linked Differences in DLD

A mother recently asked me about the truth behind the notion that boys tend to develop language skills at a slower pace compared to girls. It is true that girls often exhibit a stronger vocabulary and more advanced communicative gestures at a young age. Additionally, boys are more likely to be late talkers, with a ratio of 2.5-3 boys to every 1 girl. Although these differences tend to diminish by the time children reach school age, some studies suggest that girls continue to outperform boys in narrative and storytelling tasks, even throughout high school. The exact reasons for these disparities remain unclear, but they may be attributed to a combination of social factors, such as peer influence and the way adults communicate with each gender, as well as potential biological, neurological, or hormonal variations that affect language development.

We have observed sex-linked differences in the behavior of children with DLD. Boys tend to exhibit more external responses, such as acting out or seeking attention, while girls often withdraw and may be perceived as shy (often going unnoticed). We believe this is why boys receive services at a higher rate compared to girls, with a male-to-female ratio of 1.7:1. It is worth noting that although the prevalence of DLD is similar between boys and girls at 1.3:1, there appears to be no difference in the severity of symptoms.

Impacts of DLD

DLD can have far-reaching impacts on a child’s development and long-term outcomes. In educational settings, children with DLD frequently face challenges with reading comprehension and writing. This is why it is so important to have a diagnosis and seek the right support in school. When we diagnose early, we can support children with specific and targeted interventions. Skills build on each other, so the earlier we can support academics, the stronger academic outcomes are.

Socially, these children might find it challenging to maintain conversations, interpret non-verbal cues, or understand the complex language used by their peers, leading to social isolation or exclusion.

In the long term, DLD can impact a person’s career prospects and overall quality of life. Difficulty with verbal communication may limit job opportunities, especially in roles that require extensive interpersonal interaction. Additionally, individuals with DLD may experience lowered self-esteem and an increased risk of mental health issues, such as anxiety and depression.

It’s important to remember that early intervention and the right intervention throughout the school years can make a significant difference, and many individuals with DLD are able to lead successful and fulfilling lives with the right support and resources. If you would like to learn about how you can support your child with language difficulties please join our newsletter and bookmark this blog! There are a few wonderful groups working on expanding awareness of DLD, you can find more information about DLD on any one of these sites:

Raising Awareness of Developmental Language Disorder

DLD and Me

The DLD Project