Receptive and Expressive Language Delays

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What is a language disorder?

An expressive language disorder is one in which the child struggles to get their meaning or messages across to other people. A receptive language disorder is one in which a child struggles to understand and process the messages and information they receive from others. Some children have a mixed receptive-expressive language disorder in which they have symptoms of both types of disorders.

Types of language delays

There are two major types of language disorders: receptive language disorders and expressive language disorders.

A receptive language delay happens when your child has difficulty understanding language. An expressive language disorder happens when your child has difficulty communicating verbally.

What causes language disorders or delays?

Frequently, a cause for a child’s developmental language disorder cannot be identified. Other times, it can be a symptom of an underlying developmental delay or disorder.

What are the symptoms of a language delay or disorder?

Children with language delays and disorders can struggle in social and academic situations. Those struggles can result in problems with behavior and acting out. It is important for caregivers to discuss any concerns regarding a child’s language development with the pediatrician. Caregivers who suspect a child has a language delay should refer to the speech and language milestones development chart by clicking here. While not all children will develop at the same rate, it serves as a good guide as to the development caregivers should see in children as they grow. Additionally, children with a receptive language disorder may have some or all of the following symptoms:

  • Difficulty understanding what people have said to them.
  • Struggle to follow directions that are spoken to them.
  • Problems organizing their thoughts for speaking or writing.

Children with an expressive language disorder may have some or all of the following symptoms:

  • Struggle to put words together into a sentence or may not string together words correctly in their sentences.
  • Have difficulties finding the right words while speaking and use placeholder words like “um.”
  • Have a low vocabulary level compared to other children the same age.
  • Leave words out of sentences when talking.
  • Use tenses (past, present, future) incorrectly.

These are some signs of language delay by age:

  • 12 months: isn’t using gestures, such as pointing or waving bye-bye
  • 18 months: prefers gestures over vocalizations to communicate, has trouble imitating sounds, has trouble understanding simple verbal requests
  • by 2 years: can only imitate speech or actions and doesn’t produce words or phrases spontaneously, says only some sounds or words repeatedly and can’t use oral language to communicate more than their immediate needs, can’t follow simple directions, has an unusual tone of voice (such as raspy or nasal sounding)

How is a language disorder diagnosed?

Children with a suspected language disorder undergo a comprehensive assessment to identify the specific delay and disorder. The assessments may include an interview with the parent or caregiver regarding the child’s medical history, unstructured play with the child to see how the child uses and understands language in a natural environment, and several standardized tests. These tests help the child’s treatment team determine the presence or severity of a child’s language disorder.

How is a receptive or expressive language delay treated?

Specific treatment for dysphagia will be determined by the child’s health care team based on the following:

  • The child’s age, overall health, and medical history.
  • The extent of the swallowing disorder.
  • The child’s tolerance for specific medications, procedures, or therapies.
  • Expectations for the course of the swallowing disorder.
  • The family’s opinion or preference.

The child’s therapist will put together an individualized treatment plan based upon the results of the child’s assessments. Through books, games and play, components of language are taught and practiced. A therapist will continue to work with a child until the child is able to produce and understand language naturally in a conversation without cues or until the child reaches their best potential for language.

How can I help if my child has a language disorder?

  • Parents are an important part of helping kids who have a speech or language problem. Here are a few ways to encourage speech development at home:
  • Focus on communication. Talk with your baby, sing, and encourage imitation of sounds and gestures.
  • Read to your child. Start reading when your child is a baby. Look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures.
  • Use everyday situations. To build on your child’s speech and language, talk your way through the day. Name foods at the grocery store, explain what you’re doing as you cook a meal or clean a room, and point out objects around the house. Keep things simple, but avoid “baby talk.”

Recognizing and treating speech and language delays early on is the best approach. Call your doctor if you have any concerns about your child’s speech or language development.