Developmental Language Disorder: Concept, Confusion and Critique

Difficulties in learning a language are quite natural. Language disability is also a common phenomenon. Many terms and concepts have been used synonymously to define and explain some related concepts. However, the term developmental language disorder (DLD) was recently coined in 2017 [1]. The word developmental refers to an unknown condition. One usually tries to diagnose DLD when a child fails to acquire their own language for no obvious reason. This results in children who have difficulty understanding what people say to them, and struggle to articulate their ideas and feelings. Recent trend showed that on average, around 7-8% children in every class experience DLD which may be found at the level that severity that hinder academic progress (Figure 1).

Figure 1:

Studies have been attempted in response to concerns that a wide range of terminology was used to deal with lack of communication, poor public acceptance, and also denied service access in some cases. Developmental language disorder is nothing new, but a sub division of a broader term ‘language disorder’ which is initially related to the field of speech, language and communication (Figure 2).

Figure 2:

Communication channel

Figure 3:

There are different phases of sub process through which communication takes place. The diagram showed below exhibits it clearly (Figure 3).

Types of language difficulty or disability

It is essential to differentiate the two terms-difficulty and disability. Broadly speaking, a difficulty is a learning condition which a learner may face, which can be minimized and even removed. On the other hand, a disability may be related to inborn condition, physical challenges which can be removed, however a teaching/learning strategy can be evolved to combat the challenge. DLD can be associated with a range of areas of language: phonology, morphology, semantics, lexicon or even skills such as listening, reading, writing and speaking.

Phonology: The branch of linguistics that is concerned with the way sounds are produced at letter (phoneme) or morpheme (word) level. Children with difficulties with phonology may fail to distinguish between certain resembling sounds like ‘t’, ‘d’. They may understand the difference but may not be able to produce the exact sound due to some disabilities. Inability to produce some crucial sounds may lead to lack of accurate communicate (orally), but the disable child may express via writing if he is able to write. It is important to note that some learners are fit orally but can’t write due to physical handicap in general and hearing disorder in particular.

Morphology (Study of grammar): Morphology involves the ability to combine words/phrases into correct morphological structure popularly known as syntax. Generally speaking a correct structure includes subject-predicate or subject-verb-object. In most cases, subjects are either nouns or pronouns. In this case, the user of the language is supposed to know the gender and number of the nouns or pronouns because the verb will accordingly be used in a sentence. In most cases, such issues are related to difficulties rather than disability unless the child is confused with the number itself. A child is born with universal grammar, according to Chomsky. If we agree with the researcher, we should agree to the notion that one can be born with some genetic issues which is inborn.

Lexicon (words): It is very important part of language. It is perhaps the basis. A lexicon is nothing but the collection of words that a user of a specific language possesses. It is also termed as ‘lexis’. Lexicon may also include the whole stock of terms used in a particular subject or context.

A. Examples of lexicon: All the associated words or groups of words related to soccer or ‘football’ includes terms such as players, referee, linesman, match, yellow card, penalty shootout, goalkeeper, right out, foul play etc. This is the lexicon of football. These words can be displayed in a form of a group so that a linguistic and logical connection can be tested and accordingly developed. Following is the word web example of the word, Football (Figure 4 & 5). Similarly, lexicon of teaching includes students, teacher (s), table, chair, classroom, board, computer, projector, test/exam etc. A student having difficulties in learning may not be able to learn all associated words for different reasons, but a disabled child may have other reasons.

Figure 4:

Figure 5:

Semantics (study of meaning): This refers to children’s ability to understand the meaning of words and how meanings are expressed by combining words together. Children with DLD often have limited vocabulary and may make heavy use of a small set of words with rather general meanings [2].

DLD & speech disorder

Speech is the act of articulating or producing sounds which may negatively be affected for multiple reasons such as a structural/ physiological factor, a neurological problem affecting motor control of the speech or inability to perceive distinctions between sounds because of hearing impairment. Some distortions of speech sounds are usually found among children [3] (Figure 6).

Figure 6:

Relationship with other neuro-developmental disorders

DLD often co-occurs with milder neuro-developmental disorders of unknown origin, such as attention-deficit hyperactivity disorder, developmental dyslexia or developmental co-ordination disorder [4].

Diagnosis

DLD is purely a behavioural condition, therefore an attempt of any biological testing may not be a foolproof activity. There are three points that need to be met for a diagnosis of DLD [1]

a) The child’s language difficulties create obstacles to communication,

b) The child’s language problems are unlikely to resolve by five years of age, and

c) The problems are not associated with any known biomedical conditions such as brain injury, neurodegenerative conditions, genetic conditions or similar disorders.

Treatment/strategies

Treatment is usually carried out by speech and language therapists/pathologists, who use a wide range of techniques to stimulate language learning [5]. The language instructor might be equipped with some therapy knowledge or training and he plays a dual role. According to Ebbels [6] & Bryan [7], at this point of time when everything is getting ultra-modern and digital, interventions for older children, may be more explicit, telling the children what areas are being targeted and giving explanations regarding the rules and structures they are learning, often with visual supports. Furthermore, here has been a move away from a focus solely on grammar and phonology toward interventions that develop children’s social use of language that emerges out of skill-based teaching strategies [8, 9-16].

1. Bishop DVM, Snowling J, Thompson PA, Greenhalgh T, CATALISE Consortium (2017) Phase 2 of catalise: A multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. Journal of Child Psychology & Psychiatry 58(10): 1068-1080.
2. Rice ML, Bode JV (1993) GAPS in the verb lexicons of children with specific language impairment. 13(37): 113-131.
3. Shriberg LD, Tomblin JB, McSweeny JL (1999) Prevalence of speech delay in 6-year-old children and comorbidity with language impairment. Journal of Speech, Language and Hearing Research 42(6): 1461-1481.
4. Bishop DVM, Snowling MJ, Thompson PA, Greenhalgh T, CATALISE Consortium (2016) CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children. PLOS One 11(7): e0158753.
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10. Bishop DVM, North T, Donlan C (1995) Genetic basis of specific language impairment: evidence from a twin study. Developmental Medicine and Child Neurology 37(1): 56-71.
11. Bishop DVM, Edmundson A (1987) Language-impaired four-year-olds: distinguishing transient from persistent impairment. Journal of Speech and Hearing Disorders 52(2): 156-173.
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13. Conti-Ramsden G, Botting N (2004) Social difficulties and victimization in children with SLI at 11 years of age. Journal of Speech, Language, and Hearing Research 47(1): 145-161.
14. Clegg J, Hollis C, Mawhood L, Rutter M (2005) Developmental language disorders - a follow-up in later life. Cognitive, language and psychosocial outcomes. Journal of Child Psychology and Psychiatry 46(2): 128-149.
15. Paul R (2006) Language disorders from infancy through adolescence: Assessment and intervention, (3rd edn). Mosby-Year Book, St. Louis, USA.
16. Snowling MJ, Bishop DVM, Stothard SE, Chipchase B, Kaplan C (2006) Psychosocial outcomes at 15 years of children with a preschool history of speech-language impairment. Journal of Child Psychology and Psychiatry 47(8): 759-765.