005 Week 7 Developmental Language Disorders-DLD (1).pdf

Developmental Language
Disorders (DLD)

Developmental Language Disorders
Scinario:
• Eliza has struggled to understand and be understood since
she was very young. In first grade, her teacher noticed she
often had trouble following directions and rarely spoke
during class. When Eliza did speak up, her sentences were
hard to follow and frequently filled with “umms” as she
searched for the words she wanted. She had no trouble
pronouncing words but putting together coherent sentences
seemed to be a challenge. Her teacher recommended an
evaluation by a speech-language pathologist, who diagnosed
Eliza with a language disorder.

Developmental Language Disorder
Royal College of Speech & Language Therapists

Developmental Language Disorders
• Overview:
• Language disorders refer to a condition where a person has difficulties
learning, using, and/or understanding spoken or written language.
• They fall under the larger umbrella of communication disorders but
are distinctly different from speech disorders, like lisps or stuttering.
• Children with language disorders don’t have difficulty pronouncing words
or sounds themselves. Instead, they struggle to find the words they want
and put them together in the correct order or have problems
understanding what’s being said to them.
• Children with DLD usually have average or above average general
intelligence

Types / Categories of DLD
Language disorders are broken into three types:
• Receptive: People with receptive language disorder have problems understanding
and processing what others say to them, despite having no hearing problems.
• Expressive: Expressive language disorder causes problems with using words to
express thoughts, although the person has no physical problems in pronouncing the
words themselves.
• Mixed Receptive-Expressive: Those with this form of language disorder have
trouble with both expressing their thoughts in words and understanding what
others say to them.

DLD: Onset Age and Causes
Onset Age and Causes
• Language disorders can be acquired at any time during life
• usually caused by brain injury or illness.
• For most children, though, language disorders are developmental.
• The exact causes of developmental language disorders are unknown
• Heredity and prenatal nutrition deficiencies are both possible
suspects.
• Children with language disorders may also have related conditions,
like autism, dyslexia, ADHD, and mental health issues. They usually
have average or above-average intelligence.

DLD: Incidence – Prevalence
• About 5 to 7 percent of children in a population are believed to
have language disorders.
• That means that in a classroom of 20 students, you’re likely to have
at least one who is affected.
• Early childhood and elementary educators are more likely to
encounter undiagnosed language disorders.
• The condition is treatable but not curable, so teachers of all ages
should know what these disorders look like and how to help.

DLD: Identifying Red Flags
Red Flags Age 4:
If the child shows the following signs at age 4 consult a
speech –language therapist:
• Uses only 3-word phrases
• Speech is not understandable to parents
• Difficulty asking questions
• Difficulty finding words to express thoughts
• Boys Town National Research Hospital
- Share examples from experience

Identifying Red Flags: Age 5
If the child shows the following signs at age 5 consult a
speech –language therapist:
• Speaks only simple sentences
• Speech is not understandable to teachers
• Difficulty with complex directions
• Difficulty telling stories
• Difficulty with peer interactions
- Share Examples from experience

Identifying red Flags: School Age
If the child shows the following signs at age 5 consult a speech –language
therapist:
• Persistent difficulty with reading, writing, or math
• Difficulty following directions
• Difficulty repeating sentences
• Uses sentences with grammar errors
• expresses ideas with a limited vocabulary
• Difficulty with social interactions

DLD: Expressive Language Disorder
• Expressive language disorder is easier to identify than receptive.
• Parents usually notice when their child doesn’t begin talking by the
age of two.
• When the child does start talking, their vocabulary is usually much
more limited than others their age.
• Their sentences may be garbled or lacking key words. By school
age, expressive language disorder signs may include:

DLD: Expressive Language Disorder
Signs at school age:
• Using filler words like “um” or “stuff” frequently instead of more
specific words
• Having extreme difficulty learning and using new vocabulary
• Using only short basic sentence structures
• Often leaving out pronouns or verbs when talking, creating
incoherent sentences
• Seeming frustrated by the inability to express themselves verbally
• Simply giving up and remaining quiet, both in class and with friends

DLD: Receptive Language Disorder
Signs by School Age:
• Receptive language disorder can be harder to spot in young kids. By school
age, parents and teachers may notice persistent difficulty in following
directions. Other signs might include:
• Wandering attention during stories or lessons; tuning out because they can’t
really follow what’s happening
• Frequent interruptions on unrelated topics during lessons or casual
conversations
• Unrelated answers to questions that indicate they didn’t understand the
question itself. For example, the teacher pauses during a lesson on Abraham
Lincoln and asks “Where did Lincoln grow up?” The child might answer, “He
freed the slaves.”
• https://www.weareteachers.com/language-disorders/

DLD: Identification and Assessment
• Language Impairment
• The term language impairment is defined as a deficiency in
comprehension and/or spoken language that may also impair written
and/or other symbol systems, and negatively impacts the child’s
ability to participate in the educational environment. The impairment
involves at least one of the following components: the form of
language (phonology, morphology, and syntax), the content of
language (semantics), and/or the use of language in communication
(pragmatics) that is adversely affecting the child’s educational
performance. https://www.tn.gov/content/dam/tn/education/special-
education/eligibility/se_speech_or_language_impairment_evaluation_guidance.pdf

DLD: Distinguishing Features
• A language impairment does not include:
• Children who are in the normal stages of second language acquisition/learning and whose
• communication problems result from English being a secondary language unless it is also
• determined that they have a speech impairment in their native/primary language.
• Children who have regional, dialectic, and/or cultural differences.
• Children who have auditory processing disorders not accompanied by language
impairment, as Central Auditory Processing Disorder (CAPD) is not an eligibility category,
• Nor diagnosed with hearing problems or impairment.
• Nor diagnosed with speech impairment
https://www.tn.gov/content/dam/tn/education/special-

DLD: Technical Components
• When analyzing the definition of language impairment, the following areas
typically require clarification:
• Phonology – the speech sound system of language, and the rules for how
speech sounds are combined. Give examples in Arabic
• Morphology – the rules that govern how morphemes (the smallest
meaningful units of language) are used in a language. A morpheme can be
a single word or a word part, such as an ending, that changes its meaning.
• Example: walk; walks, walking- Give examples in Arabic
• Semantics – the meaning of words and combination of words, often
broadly described as “vocabulary.” Give examples in Arabic
• Syntax – rules in which words can be combined in language, often broadly
referenced as “grammar and sentence structure.” Give examples in Arabic

• Pragmatics – the rules that govern social communication—verbal and non-
verbal—and the use of language in various settings and people.
• Adverse effect on educational performance – An adverse effect is
determined if the student’s speech or language disorders are directly
impacting verbal or other symbolic communication, social
participation/relationships, academic performance, or vocational
performance. Give examples from cycle 1 classroom context.
• Speech disorder does not necessarily always have an adverse effect on
academic performance. However, Language disorders always have a
negative effect on academic performance

• Evaluation Procedures (Standards)
• A comprehensive evaluation performed by a multidisciplinary team using a variety of sources of information that are sensitive to cultural, linguistic,
and environmental factors or sensory impairments to include the following:
• (1) Language Impairment -significant deficiency in the student’s comprehension, form, content or use of language shall be determined by:
• (a) Hearing screening;
• (b) A minimum of one comprehensive standardized measure of receptive and expressive language (vocabulary, syntax, morphology, mean length of
utterance, syntax, semantics, morphology) that falls at least 1.5 standard deviations
• (c) An additional standardized measure to support identified areas of delay that fall at least 1.5 standard deviations below the mean with
consideration to the assessment’s standard error of measure;
• (d) Pragmatics (if identified as an area of concern);
• (e) Auditory perception: selective attention, discrimination, memory, sequencing, association, and integration;
• (f) Teacher checklist;
• (g) Parent Input; and
• (h) Documentation, including observation and/or assessment (to include the severity rating scale), of how the Language Impairment adversely affects
the child’s educational performance in his/her learning environment and the need for specialized instruction and related services (i.e., to include
academic and/or nonacademic areas).
https://www.tn.gov/content/dam/tn/education/special-education/eligibility/se_speech_or_language_impairment_evaluation_guidance.pdf

• Best Practices
• Evaluations for all disability categories require comprehensive assessment
methods that encompass multimodal, multisource, multidomain and
multisetting documentation.
• Multimodal: In addition to an extensive review of existing records, teams
should gather information from anecdotal records, unstructured or
structured interviews, rating scales (more than one; narrow in focus versus
broad scales that assess a wide range of potential issues), observations
(more than one setting; more than one activity), and work
samples/classroom performance products.

Best practices cont’d
• Multisource: Information pertaining to the referral should be
obtained from parent(s)/caregiver(s), teachers, community agencies,
medical/mental health professionals, and the student. It is important
when looking at each measurement of assessment that input is
gathered from all invested parties. For example, when obtaining
information from interviews and/or rating scales, consider all
available sources—parent(s), teachers, and the student—for each
rating scale/interview.

• Multidomain: Teams should take care to consider all affected domains
and provide a strengths-based assessment in each area. Domains to
consider include cognitive ability, academic achievement, social
relationships, adaptive functioning, response to intervention, and
medical/mental health information.

• Multisetting: Observations should occur in a variety of settings that provide
an overall
• description of the student’s functioning across:
- Environments (classroom, hallway, cafeteria, recess),
- Activities (whole group instruction, special area participation, free
movement),
- and time.
• Teams should have a 360 degree view of the student.

DLD: Identification and assessment
List of Teachers and Parents Checklists for identification of DLD:
Source: Speech or Language Impairment Evaluation Guidance,
Tennessee Department of Education, Revised 2018:
• Appendix E - Language Milestones: Play Development Scales pp. 71-
76; Levels of Play Scale p. 77.
• Appendix H – Disfluency/fluency checklist p. 83.
• Appendix I - Language Skills Checklists (by grade level) pp.84 – 88.
• Appendix J – Teacher pragmatics Checklists pp. 92 – 93.

005 Week 7 Developmental Language Disorders-DLD (1).pdf

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005 Week 7 Developmental Language Disorders-DLD (1).pdf