MANHATTAN, NYC, RECEPTIVE LANGUAGE DELAY DISORDER

We travel to Battery Park City, Central Midtown, Chelsea, Chinatown, Clinton, East Village, Financial District, Flatiron District, Garment District, Gramercy Park, Greenwich Village, Harlem, Hell's Kitchen, Hudson Square, Kips Bay, Little Italy, Lower East Side, Midtown, Murray Hill, SOHO, Sutton Place, Theatre District, Times Square, TriBeCa, Turtle Bay, Union Square, Upper East Side, Upper West Side, West Village

A language disorder or delay is a type of communication disorder that involves difficulties in using and understanding spoken language. There are two types of language disorders: expressive and mixed expressive-receptive language disorders. These disorders can be due to inherited conditions, developmental disorders, or traumatic brain injuries. In most cases, language issues fall under expressive language disorder. This refers to problems in expression or putting words together to form coherent sentences and to get the message across to listeners.

However, there are cases wherein a child struggles with both expression and comprehension. Problems with understanding and comprehension are referred to as a receptive language disorder. This involves difficulties in processing messages and information that one receives, whether through listening or reading. It is not a disorder of hearing, e.g. hearing loss.

Before an individual can use language to communicate (expressive language), one must first understand and grasp spoken language. That is why most children with a receptive language disorder also struggle with expressive language. This is called mixed receptive-expressive language disorder.

When language disorders or delays are not quickly addressed, they cause children to fall behind in school. According to research, around 5% of pre-school age children and 3% of those in grade school are found to have mixed receptive-expressive language delays or disorders.

Read about Listening Milestones and Questions Answering and Asking Milestones.

Signs and Symptoms of Mixed Receptive-Expressive Language Disorder

Signs of language disorders do not become noticeable until it is time for a child to start talking. Organizing thoughts while trying to process what others are saying can be a struggle for children with a receptive language disorder. They often find it difficult to connect words and the ideas behind them. In some cases, they may also have trouble with pronunciation and speech sound production.

Possible causes of receptive language disorder:

Family history. A child is more likely to have a language disorder if a mother, father, sister, or brother also has one.
Language disorders and with learning disabilities.
An audiologist should evaluate anyone suspected of having difficulties processing spoken words to rule in or out any hearing issues.
Pediatricians typically do not perform full audiological evaluations.

Symptoms of mixed receptive-expressive language disorder include:

low vocabulary and comprehension levels compared to their peers
issues with pragmatics or the social use of language in social contexts
difficulty inferring meaning
trouble with spontaneous language production, hence, unable to ask questions
problems understanding more complex questions and directions
difficulty understanding and applying grammatical rules (tenses in verbs, singular or plural verbs, determiners, pronouns, etc.)
problems with completing two cognitive operations at the same time, called working memory, and learning new words or morphemes

For pre-school and school-age children, these symptoms can manifest in various ways and affect one’s behavior, interactions, and performance at home and in school. A child with a receptive language disorder may exhibit the following:

seems uninterested in conversations or when other people are speaking
infrequently asks questions when someone is speaking or sharing a story
does not seem to be listening or understanding lessons in school
has difficulty in following directions
often copies what other children are doing before acting on a task
misunderstands what is asked, said, or written
gives off base responses to questions
has trouble getting along or communicating with peers
Trouble following directions
May respond to your questions by repeating back what you have said.
Asking people to repeat what they say
Giving answers that are “off”
Misunderstanding what’s said
Not getting jokes
Difficulties answering questions such as Who? What? Where? When? Why? How?
Struggles to understand changes to a routine
Difficulty understanding different concepts such as place, size, and colors
Difficulties comprehending abstract language
Does not recognize the meaning of grammatical markers in speech such as’s’ or ‘es’ indicating plurals and ‘ing’ and ‘ed’ indicating tense

Read about Early Childhood Developmental Milestones.

Likewise, research identifies late talking as one of the early signs of a language disorder. The Hanen Centre defines a late talker as a child between 18 and 30 months with a good understanding of language and typical development in other areas (hearing, vision, motor, and cognitive skills) but has a limited spoken vocabulary compared to peers for their age. However, late talking becomes a more serious concern for children who also exhibit other risk factors, such as:

Quiet or little babbling as an infant
Has a history of ear infections
Limited consonant sounds
Does not link pretend ideas and actions together during play
Does not imitate words or sounds
Uses mostly nouns and few verbs
Difficulty interacting or playing with peers
A family history of communication, learning, and academic difficulties
Mild comprehension delay for their age
Uses few gestures to communicate

According to experts, children with a limited vocabulary for their age and show any of the above risk factors should seek the help of a speech and language pathologist (SLP). In particular, studies suggest that the last three risk factors listed are indicators that a child could have continuing language delay or showing signs of a language disorder (expressive or expressive/receptive language). This is also known as a Developmental Language Disorder (DLD) or language impairment, as referred to in research.

(Related: Know more about the relationship between language and learning disabilities.)

(You may also download our FREE pamphlet on Late Talking!)

Get Started

Diagnosing Expressive Language Disorders

As with all speech and language delays or disorders, it is always important to first ensure that there are no hearing issues affecting language development. A hearing assessment by an audiologist is necessary to rule out any issues with hearing (ears). Even undetected ear infections can interfere with acquiring language in younger children.

To get your child diagnosed with an expressive language disorder, a speech-language pathologist must do a thorough evaluation. A comprehensive assessment must be conducted with the help of the child’s family and teachers.

During this phase, speech-language pathologists will need to know the child’s:

full case history (including birth and medical records; history of language, speech, reading, or academic difficulties in the family; languages or dialects spoken at home; and, the family’s and teacher’s own observations and concerns)
spoken language skills (phonology and phonological awareness, semantics, morphology, syntax, and pragmatics)
level of literacy and language development (reading and writing, if the child is school age)

(Related: Find out more about language sampling in this article on the Structural Analysis of a Language Sample.)

Assessing and Managing a Receptive Language Disorder

What is receptive language therapy? Receptive language therapy is used to support children who have difficulties understanding what others are saying.

If your child shows signs of having a receptive language disorder, it is crucial to have an assessment conducted by a speech language pathologist/speech language therapist. This can be done privately or with the help of your school principal, counselor, school district office, and through Early Intervention. It is also recommended to have your child tested for hearing problems by an audiologist, which can be a common cause of why the child is having difficulties acquiring language.

Because children with receptive language issues are most likely struggling with expressive language problems as well, a speech-language pathologist will test both your child’s speaking and comprehension skills. During the assessment, the SLP will want to know if the child:

knows what to do with toys or uses pretend play
follows directions and simple instructions
names everyday objects and actions
identifies colors, numbers, and letters
follows simple routines
sings songs or recites rhymes
changes his or her manner of speaking when talking to different people in different places
is easy to understand or speaks coherently

Once it is established that your child is struggling with acquiring and using language compared to his or her peers, the speech and language pathologist will then design an individualized program to help you and your child improve their language skills. These strategies typically involve:

developing important connections between letters, sounds, and words
vocabulary development
practicing the use of language in social situations
multisensory techniques

Parents and teachers also play critical roles in managing language disorders. Particularly when it comes to language monitoring and stimulation. Some of the therapy goals that SLPs may set with parents and teachers are:

increasing the child’s understanding
improving how the child uses words to express feelings and ideas
teaching parents, family members, and teachers how to speak with the child and encourage conversation
helping the child use other ways of communicating (also known as augmentative or alternative communication), if necessary, such as using simple gestures, picture boards, or text-to-speech apps and software
learning early reading and writing skills

Read SPELLTalk questions and answers about the language literacy network– which represents normal reading and writing processes.

Helping Your Child at Home

Aside from speech language therapy, there are other ways you can help your child improve their language skills. Some of the things you can do at home include:

talking and engaging with your child in conversation to improve their vocabulary
reading aloud to your child and pointing out words
speaking to your child in the language of which you are both most familiar and comfortable
listening and answering your child’s questions
encouraging your child to ask questions
allowing your child enough time to process and answer questions
setting limits on the use of gadgets, computers, and watching television
Increase time with toys and imaginary play.

Likewise, a receptive language disorder can interfere with reading comprehension, particularly for school-aged children. To know more about how you can help your child improve their comprehension skills, please click here