NIH News in Health · Source article

Many kids start talking later than expected. Most eventually catch up with other kids their age. But some kids have language difficulties that persist. This can be a sign of a condition called developmental language disorder, or DLD.

DLD is a communication disorder that persists into adulthood. It can interfere with learning, understanding, and using language.

“DLD is incredibly prevalent, but many people don’t know about it,” says Dr. Mary Alt, a speech and language expert at The University of Arizona.

It’s one of the most common developmental disorders. DLD can affect a child’s speaking, listening, reading, and writing.

The exact causes of DLD aren’t known. It tends to run in families. But both genes and other factors are thought to play a role in changing how the brain develops.

Building stronger language skills is key for kids with DLD. Scientists are developing ways to boost their learning. They’re also trying to identify kids with DLD earlier to get them support sooner.

Noticing Signs

Late talking can be one of the earliest signs of DLD. Young kids with DLD may struggle learning words. They might have difficulty talking.

“If you have a young child who isn’t using a language to communicate, but is more using body language and gestures, that’s a sign that they’re having difficulty with learning language,” says Dr. Jim Montgomery, a professor of communication sciences at Ohio University.

Another early sign of DLD is using simple language. By the time they reach preschool, most kids start using sentences.

“The sentences that a child with DLD might use are much simpler,” says Alt. “Instead of saying, ‘Look, the dog is running,’ the child with DLD might say, ‘Him run.’”

Alt’s team recently tracked the progress of kids who were late talkers at ages 2 to 3 years. Her study showed that late talking can be a red flag for language and reading struggles later on.

Over one-half of the late-talking kids in her study were diagnosed with a learning disability once they reached school. DLD is a risk factor for developing a learning disability, but it’s not the same.

DLD affects basic language skills, which can affect a child’s school performance. Kids with DLD may struggle to learn vocabulary. They may have difficulty structuring sentences. Or they may not be able to tell or write stories in an organized way.

“Signs of DLD fall along a continuum, from quite mild to pretty profound,” Montgomery explains.

Kids with a learning disability struggle with skills, such as reading, writing, or math. Dyslexia is one example. Kids with dyslexia struggle with linking speech sounds to letters and words. They have difficulty with sounding out letters and spelling or recognizing words.

“Dyslexia and DLD often go hand in hand because both involve language,” Alt explains. “Dyslexia is the problem with written language. DLD is a problem with oral language. Often, once a child gets the dyslexia label, they’re never tested for oral language. There is a difference between kids who have dyslexia only and kids who have dyslexia and DLD.”

Many kids show signs of both DLD and dyslexia. People with DLD are six times more likely to be diagnosed with reading and spelling disabilities by the time they’re adults. Difficulties with understanding language can make math more challenging, too. Kids with DLD are four times more likely to have a math disability.

Screening for Differences

DLD can be difficult to recognize, as the signs aren’t the same for every child.

“A very mild case of DLD might be something that may not affect a child that much in their everyday conversation or in everyday functioning,” Alt explains.

But it may become apparent as reading and writing get more complex in school. “More severe DLD could mean having difficulty getting your basic needs met because you can’t express them,” she adds.

“Language differences can be subtle to notice for those with mild DLD,” says Dr. Suzanne Adlof, a speech-language researcher at the University of South Carolina.

“But school is a place the impact of DLD is going to be noticed. Right now, schools don’t have systems that assess oral language before the academic impacts are noticed.”

Adlof’s team is developing oral language screening tests for schools. To do so, her group is first tracking how language typically develops across school-aged children. They’re looking at kids from kindergarten through 3rd grade.

The team will use their findings to develop standards to design a screening test. Such a test could identify kids whose language skills are falling behind their peers. The test could also be used to measure if treatments are helping kids catch up with their peers.

Personalizing Progress

Certain specialists can help kids with DLD improve their language skills. Speech-language pathologists are experts in communication. They can test for DLD and provide treatment. Interventions are tailored to support a child’s individual challenges.

“The nature of the treatment is going to change as kids get older because their language changes and their deficits change,” Montgomery says.

Montgomery’s group is testing ways to teach complex sentences to school-aged kids with DLD. They’re comparing two strategies. One explicitly teaches kids about grammar. The kids learn specific rules about the different parts of a sentence. The other gives lots of examples of complex sentences verbally. This taps into the kids’ natural ability to learn the sentence structures. Montgomery is testing which teaching strategy works better for kids with DLD.

“Typically, kids learn grammar without trying. You don’t have to teach them,” Alt says. “Kids with DLD aren’t always going to pick up on that naturally.”

Alt’s team is studying which treatment strategies work best for kids aged 2 to 5. And they’re trying to understand why some kids don’t respond to current interventions.

Researchers are continuing to develop better ways to support kids with DLD. But there are many interventions a child can get right now. If you have concerns about your child’s speaking or language abilities, talk with their doctor.

“Anytime a child is showing difficulty with reading and writing in the classroom, it is important to check how their oral language skills are progressing,” Adlof advises. “It could be a sign of DLD.”

Further reading and research references

• Decoding Dyslexia: Helping Kids Who Struggle With Reading
• Keeping Up in School? Identifying Learning Problems
• Developmental Language Disorder (DLD)
• Speech and Language Developmental Milestones
• Early Learning
• What Are Some Signs of Learning Disabilities?
• How Can Parents and Caregivers Promote Early Learning?
• Child Development (CDC)
• Enhancing syntactic knowledge in school-age children with developmental language disorder: The promise of syntactic priming.
• Beyond toddlerhood: Rates of impairment, strengths, and challenges in the communication outcomes of former late talkers
• Reading and math achievement in children with dyslexia, developmental language disorder, or typical development: Achievement gaps persist from second through fourth grades
• Examining the associations between parent concerns and school-age children’s language and reading abilities: A comparison of samples recruited for in-school versus online participation.

Illustrative archival photograph: National Cancer Institute / Unsplash, used under the Unsplash License. The people or equipment shown are not identified as participants in the research or interviews described here.