What is a developmental language disorder (DLD)?
- It is a condition that affects language, both comprehension and expression.
- It is a condition that is present from birth and persists throughout life (unlike language delay).
- Neurotypical young children naturally learn language from the stimuli they receive. For children with DLD, learning is difficult. They will need speech therapy to develop their language. They will progress, but some difficulties will persist.
- DLD manifests itself differently from one person to another. For example, some will have only mild impairments in comprehension while for others, it will be more affected. Each person is unique in their strengths and difficulties. It is necessary to take into account their personality and the context in which they evolve (tenacious, anxious, good family support, preserved self-esteem, etc.)
How does DLD manifest?
- Difficulty understanding verbal messages, abstract words, puns, humor, figurative meaning. These difficulties persist.
- Difficulty with pronouncing words.
- Difficulty constructing sentences (word order in the sentence, gender, verb conjugation, etc.)
- Difficulty with vocabulary. Searches for words or uses vague words (that, the thing, the patent, the affair).
- Difficulty in telling or relating an event, in organizing information, in explaining.
- Can be awkward in exchanges with others (interrupting, not respecting speaking turns).
- The ability to adjust the content of a verbal message depending on the person being addressed may be affected. A person with DLD may forget that what is clear to them may not be clear to the person they are speaking to.
- Other disorders are sometimes associated (ADHD, dyslexia, dysorthography, etc.)
- DLD has nothing to do with intelligence. A person with DLD can develop compensatory strategies to overcome their difficulties.
- Fatigue can be observed in some people, because decoding verbal messages requires a lot of energy.
TDL Terminology
The name used to define this language disorder has changed a lot over time:
- We first talked aboutAudimutity (from 1960 to 1980)
- Then we talked about Dysphasia (from 1980 to 2004)
- Then he was named Primary language disorder (from 2004 to 2017)
- Finally, since 2017, we have been using the term Developmental language disorder (TDL).
The important thing to remember is that all of these terms refer to the same language difficulties.
- Make sure you have his attention before speaking to him.
- Speak slowly to give him time to decode the message.
- Give short instructions; only one instruction at a time.
- When possible, accompany the instruction with a gesture. Gestures are very powerful in facilitating understanding of the verbal message.
- Carry out demonstrations and role-plays.
- If necessary, do the task with her.
- Provide visual cues (illustrated tasks).
- Use concrete vocabulary.
- Make sure she understands. Ask her to repeat in her own words what you said. This will allow you to know exactly what she didn't understand and then fill in the blanks. Rather than repeating the entire instruction.
- If he searches for his words, use the context to help him find the word he is looking for.
- Between 1 and 2 years:
- No babbling
- No reaction when spoken to or when he hears a sound
- Little or no attempt to communicate
- Between 2 and 3 years:
- Little interaction
- No demonstration of intent to communicate
- No words
- Little reaction when spoken to
- Regression or stagnation of language development
- Between 3 and 4 years:
- Sentences with only 2 words
- Simple instructions not included
- Relatives do not understand most of what the child says.
- Between 4 and 5 years old:
- Inconsistent or abnormal interaction
- 3-word sentences
- Little understanding of spoken language
- Strangers have little understanding of children
- Relatives do not understand more than half of what the child says
- More than 5 years:
- Difficulty telling or retelling a coherent story
- Difficulty understanding what is said or read to him
- Marked difficulty understanding or remembering oral instructions
- Talks a lot, but very little engaged in reciprocal conversations
- A lot of literal interpretation
Language Delay versus Developmental Language Disorder
It is important to differentiate between a language delay and a language disorder. A diagnosis of language delay is given to a child who has not reached the expected level of language development based on their age. The child manages to catch up over time and will not suffer from the consequences of this delay. They will therefore have the same development curve as children their age, but it will only be shifted (Ellemberg, 2015).
On the other hand, a person with a developmental language disorder will also have had a language delay in preschool age. However, the appearance of irregularities in language learning and the absence of significant progress over a certain period may indicate the presence of this disorder in the child. Therefore, the language development curve of this child will be shifted and will not have the same shape (Ellemberg, 2015). If the impairment is mild, the problem may not be detected during the first years of life and the manifestations may appear only at the time of learning written language.
Causes of Developmental Language Disorder
- Research is beginning to demonstrate genetic factors. In fact, if there is a history of DLD in a family, a child is two to seven times more likely to have this disorder than other children. Boys are also three times more at risk than girls (Touzin and Leroux, 2011).
- More than 7% of the population has DLD