Developmental Language Disorder
Lasting difficulty understanding or using language in children
Quick Facts
- Type: Neurodevelopmental condition
- Affects: Understanding and using language
- Onset: Apparent in early childhood
- Main treatment: Speech and language therapy
Overview
Developmental language disorder (DLD) is a condition in which a child has lasting difficulty learning and using language, despite otherwise typical development and no obvious cause such as hearing loss or another medical condition. The difficulties are significant enough to affect everyday communication, learning, and social interaction.
DLD is a common but often under-recognized condition. Children with DLD may struggle to understand what others say, to put words and sentences together, or both. The disorder is not caused by lack of effort or intelligence, and it is different from the temporary language differences seen in children learning more than one language. With early identification and ongoing support, children with DLD can make meaningful progress.
Symptoms
Signs of DLD vary with age but generally involve difficulty understanding or using language. They may include:
- Starting to talk later than peers
- A smaller vocabulary and trouble learning new words
- Difficulty putting words together into sentences
- Using short, simple, or grammatically incorrect sentences
- Trouble following directions or understanding questions
- Difficulty telling or following stories
- Frustration when trying to communicate
These difficulties persist over time and are more than would be expected for the child's age. They can affect learning to read and write and can lead to social and behavioral challenges if not supported.
Causes
The exact cause of DLD is not fully understood. It is considered a neurodevelopmental condition, meaning it relates to how the brain develops the ability to process and use language. Several factors are thought to contribute:
- Genetics: DLD often runs in families, suggesting inherited factors.
- Brain development: Differences in how language networks in the brain develop.
Importantly, DLD is not caused by poor parenting, lack of stimulation, or learning more than one language. It is also distinct from language difficulties that are part of another condition, such as hearing loss, autism, or intellectual disability.
Risk Factors
- A family history of language or learning difficulties
- Being male, as DLD is somewhat more common in boys
- Other developmental or learning difficulties
- A history of speech or language delay in early childhood
DLD occurs across all backgrounds and is not related to a family's language environment or how many languages a child is learning.
Diagnosis
DLD is diagnosed by a speech-language pathologist, often as part of a broader team:
- Language assessment: Standardized tests and observation of how the child understands and uses language.
- Developmental history: Reviewing milestones, family history, and concerns from parents and teachers.
- Hearing test: To rule out hearing loss as a cause.
- Evaluation for other conditions: Checking for autism, intellectual disability, or other conditions that can affect language, since DLD is diagnosed when language difficulty is not explained by another condition.
Treatment
The main treatment for DLD is speech and language therapy, tailored to the child's needs:
- Speech-language therapy: Targeted activities to build vocabulary, grammar, understanding, and conversation skills.
- School support: Individualized education plans, classroom accommodations, and support for reading and writing.
- Parent and teacher strategies: Techniques to support communication at home and in the classroom, such as simplifying language and giving extra time.
- Ongoing support: Therapy and accommodations may continue for years, adjusting as the child grows.
Early and consistent support leads to the best outcomes, and many children make strong progress.
When to See a Doctor
Talk to your child's doctor or a speech-language pathologist if you have concerns about your child's language development, such as talking much later than peers, a limited vocabulary, difficulty putting sentences together, or trouble understanding what is said. Early evaluation is important because earlier support tends to lead to better outcomes.
It is also worth seeking advice if language difficulties are affecting your child's learning, friendships, or behavior. A hearing test is usually recommended to rule out hearing problems as a cause.
Frequently Asked Questions
What is developmental language disorder?
DLD is a condition in which a child has lasting difficulty understanding or using spoken language that is not explained by another condition such as hearing loss or autism. The difficulties affect everyday communication, learning, and social interaction.
How is DLD different from a speech delay?
A speech delay often refers to producing sounds and words later than expected, which some children outgrow. DLD involves persistent difficulty with the deeper aspects of language, such as understanding, grammar, and putting sentences together, and it does not simply resolve on its own.
Is DLD caused by learning two languages?
No. Learning more than one language does not cause DLD. Bilingual children with DLD have difficulty in all the languages they are learning. DLD is a neurodevelopmental condition and is not related to a child's language environment.
Can DLD be treated?
Yes. Speech and language therapy is the main treatment, along with school support and strategies for parents and teachers. While DLD is usually a long-term condition, early and consistent support helps children make meaningful progress.
When should I seek help for my child's language?
Seek an evaluation if your child talks much later than peers, has a limited vocabulary, struggles to form sentences, or has trouble understanding what is said, especially if it affects learning or friendships. Earlier support tends to lead to better outcomes.
References
- National Institute on Deafness and Other Communication Disorders (NIDCD).
- American Speech-Language-Hearing Association (ASHA).
- MedlinePlus, U.S. National Library of Medicine.
- Centers for Disease Control and Prevention (CDC). Child Development.