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Developmental Language Disorder (Dysphasia)

Find out about the different characteristics of developmental language disorder. Developmental language disorder is different from language difficulties because it does not go away over time. Because it is difficult to recognize in toddlers, the proportion of 5-year-olds with this disorder is not known with certainty, but it could be about 7%.

What is developmental language disorder?

Developmental language disorder (DLD), formerly known as dysphasia and primary language disorder, is a neurological problem. This means that the brains of people with this disorder function differently for language learning. This disorder is present at birth and persists into adulthood. So it is not a “language delay” that the child will catch up on.

LSD is characterized by significant language difficulties that are still present at school age. This disorder affects several aspects of language. It can affect pronunciation, language comprehension, sentence construction, and vocabulary use, for example.

LDD also influences a child’s relationships because he or she has less ability to communicate. It can also interfere with academic learning (e.g., reading and writing) because language is an important part of that learning.

Signs of developmental language disorder

Generally speaking, the language of a child with developmental language disorder (DLD) is most similar to that of a younger child. They may have difficulty understanding language, expressing themselves, or both. However, there are no specific signs of DLD. The children affected may have very different profiles. For example, a child with LDD may have :

  • have difficulty understanding instructions and questions;
  • understand what is being said to him/her fairly well, but still express him/herself with incomplete or incorrect sentences at the age of 4 and 5, saying for example: “Me eat cake”, instead of : “I’m eating cake”;
  • have little vocabulary to express themselves, such as searching for words and using imprecise words;
  • make very short sentences;
  • have difficulty pronouncing certain sounds.

Of course, all children who learn to speak face certain challenges. For example, for toddlers who speak French, learning to conjugate verbs and use the right pronouns is usually not easy. However, for a child with LDD, it is even more difficult.

What causes this disorder?

The causes of developmental language disorder (DLD) are not yet well known. The causes of developmental language disorder (DLD) are not yet well understood, but there are some risk factors associated with the presence of DLD:

  • having a family history of language impairment or dyslexia
  • being a boy;
  • being the youngest in a large family;
  • have parents with low levels of education.

When a child has significant language difficulties due to a particular condition (e.g., intellectual disability, Autism Spectrum Disorder), it is called a language disorder associated with that condition, not an LDD.

These risk factors are more commonly seen in people with LDD, although the role they play in the disorder is not always well understood. A child may accumulate several risk factors and not have an LDD. Conversely, a toddler may have no risk factors at all and have an LDD.

A child with an LDD does not have language difficulties caused by another problem such as an intellectual disability. In addition, the language difficulties of a child with an LD are not caused by any other problem such as an intellectual disability, because, apart from the developmental language disorder, the child usually develops like other children his or her age . However, it is not uncommon for a child with LDD to have other difficulties such as attention, managing emotions, or controlling impulsivity.

When to see a doctor?

Before the age of 4 or 5, it is difficult to recognize developmental language disorder (DLD). It is usually when language difficulties persist at the time of school entry or shortly before the disorder can be detected by a speech-language pathologist. However, whether or not your child has an LDD, a speech-language pathologist can help your child develop language when he or she has difficulties, regardless of age.

Here are some signs of language difficulties to watch for depending on age:

  • At 18 months of age: your child does not try to communicate and does not imitate sounds or words.
  • At 2 years of age: your child has difficulty understanding instructions and everyday questions or does not use two words together (e.g., “Daddy gone”).
  • At 3 years old: your toddler does not understand several abstract words (e.g. under, red, three, after) or does not make short sentences.
  • At4 years old: he has difficulty holding a conversation or only makes short sentences containing errors.
  • At5 years old: your child cannot explain and tell something or expresses himself as a younger child.

These signs indicate language difficulties, but not necessarily developmental language disorder. If your child has these kinds of difficulties or if you have concerns about his or her language, talk to your child’s doctor. You can also contact your CLSC or the  Quebec Order of Speech-Language Pathologists and Audiologists for a referral to speech-language pathology resources.

How to intervene?

The speech-language pathologist who observes language difficulties in a child proposes an intervention plan. The speech therapist who observes language difficulties in a child proposes an intervention plan, which is composed of objectives such as “saying the first words” or “making complete sentences”. It includes ideas for strategies to be used at home and in the daycare setting to achieve these goals. The speech-language pathologist monitors the child’s progress toward the goals. For example, a child who is not yet speaking at age 2 may be able to say a few words at 2 1/2 years old with the help of his parents, his educator and his speech-language pathologist.

Later, at school, a child with a developmental language disorder generally needs help to progress well in his learning (e.g., interventions by a speech therapist and a speech therapist). The support services offered at school vary according to the child’s needs and the services available.

Points to remember

  • Developmental Language Disorder (DLI) is a neurological problem present at birth whose causes are not well known.
  • This disorder persists into adulthood and can interfere with a child’s relationships and school learning.
  • The language of a child with LDD is most similar to that of a younger toddler, but affected children may have very different language difficulties.

Resources and References

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  • ARSENAULT, Annick, and others. Au-delà des mots.2nd ed., Montreal, Éditions du CHU Sainte-Justine, 2019, 280 p.
  • BISHOP, D.V.M., and others. “CATALISE: A multinational and multidisciplinary Delphi consensus study: Identifying language impairments in children, PLOS ONE, July 2016.
  • BISHOP, D.V.M., et al. “Phase 2 of CATALISE: A multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. The Journal of Child Psychology and Psychiatry, 58(10), October 2017.
  • ORDRE DES ORTHOPHONISTES ET AUDIOLOGISTES DU QUÉBEC. Le trouble développemental du langage, 2018. ooaq.qc.ca