Developmental language disorder (DLD) is a condition which can first be diagnosed in childhood. It affects how people understand and express language. There is no known single cause, although evidence suggests that biological, genetic and environmental risk factors play a part. Left unidentified and unsupported, DLD can reduce access to education, employment and social interaction. Speech and language therapists have a crucial role to play in the diagnosis of DLD and in supporting people with DLD, along with their families and the professionals working with them, to understand their diagnosis, achieve their potential and reduce the impact of their difficulties.
What Is Developmental Language Disorder?
DLD is a condition characterized by difficulties with understanding and/or using spoken language. DLD has no single known cause and is likely a result of a number of biological, genetic and environmental risk factors. DLD was previously known as specific language impairment (SLI). DLD, while not identical, is now the agreed term and people with an SLI diagnosis will qualify for a diagnosis of DLD. DLD may be diagnosed if a child’s language difficulties are likely to persist throughout childhood and into adolescence and adulthood. DLD affects every individual differently and there are a wide variety of ways in which language problems may present and evolve over time.
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• Listening, attention, memory and language processing, particularly when lots of information is being given orally;
• Following instructions, understanding questions and narratives;
• Understanding and using vocabulary;
• Expressing what they want to say, including difficulties with word finding, grammar and sequencing their thoughts;
• Social interaction, including having difficulties joining in conversations, understanding jokes, and non-literal language;
and
• Using language to express their thoughts and feelings and to regulate their behavior and their interactions with other
people.
Individuals with DLD are also at risk of difficulties with reading and writing, and with discriminating between different
sounds, either on their own or within words. For example, knowing that ‘cat’ and ‘bat’ are different words because the first
sound is different. This is known as phonological awareness. Individuals with DLD may have difficulties with producing
speech sounds, although not always.
The Potential Impact Of Developmental Language Disorder
The impact of DLD can be mitigated if people with DLD have their needs identified and appropriately supported. Without that support, people may face challenges with their mental health and wellbeing, relationships, personal development, education, employment, and quality of life. DLD also puts children at risk of victimization and has been found to have an economic and financial impact on individuals, their families, and society.
Mental health and wellbeing
Children with language disorders are at risk of psychological and social wellbeing difficulties. Adolescents and young adults with DLD are more likely to experience anxiety and depression than their peers. Young adults with DLD face greater challenges to their wellbeing. This vulnerability is related to a range of factors, including social relationships, health and employment.
Relationships
Adolescents and young adults with DLD are more likely than their peers to have difficulties forming and maintaining relationships.
Personal development
People with DLD often have lower self-esteem in adolescence and adulthood. They also have lower social confidence.
Education
Children and young people with DLD obtain lower academic and vocational qualifications and were found to have left education significantly earlier than their peers.
Employment
People with DLD have been found to be much more likely to be in non-professional occupations. Young adults with DLD have been found to be unemployed four times longer than their peers. A higher proportion of people with DLD were in part-time employment and more of their peers were in full-time employment
Quality of life
Children with DLD have a lower quality of life than their typical peers at age nine. Co-occurring social-emotional problems appear to play an important role in contributing to this lower quality of life.
Economic
DLD can also have an economic impact on individuals, families and society. Research has found that DLD is likely to place an increasing burden on the health and welfare system as children move through school and after they leave education. It has also found that DLD impacts on future earning potential, as a result of low levels of literacy and numeracy. In addition, carers of children with DLD have been found to substitute paid for unpaid work by working fewer hours. When their child’s condition is severe or persistent, mothers are less likely to be employed.
Financial
DLD has an impact on people’s ability to organize and manage their finances. Compared to their typically developing peers, young people with DLD have less extensive engagement with financial products and lower competence in organizing and managing their finances.
The Role Of Speech And Language Therapy
With their knowledge and expertise in speech, language and communication, speech and language therapists have a
crucial role to play in the diagnosis and management of DLD. This includes providing direct therapy to people with DLD
who need it, tailored to their individual needs.
It also includes supporting their families and, through multidisciplinary team working, supporting professionals who work
with people with DLD to recognize and respond appropriately to their difficulties.
The role of speech and language therapy includes:
• Identifying and diagnosing DLD and those at risk of it;
• Devising and delivering needs-led programs of individual or small group therapy;
• Overseeing therapy programs delivered by others, including ensuring that individuals are adequately trained and
supported, and progress is regularly monitored;
• Supporting people with DLD, their families and those who work with them, including to understand their diagnosis and
how it can impact on their lives, so they can respond appropriately and advocate for themselves;
• Supporting schools to integrate strategies into the curriculum in order to foster children’s language learning and use;
and
• Maximizing communication potential by skilling others in the use of facilitative strategies and/or use of augmentative
communication aids.
Comprehensive assessments are needed to identify how DLD is affecting an individual’s:
• Communication;
• Social participation;
• Wellbeing; and
• Learning.
Regular monitoring of progress and modifications to management is required to identify needs at each stage in
development, and particularly at transition points - for example from nursery to primary school, from primary to secondary
school.
The Aim Of Speech And Language Therapy Is To:
• Develop the language abilities of people with DLD to their maximum potential; and
• Teach people with DLD and those around them strategies to reduce the impact of their difficulties on communication
and their access to education, employment, public services and social activities.
Speech and language therapy help people with DLD to maximize their language potential. This helps to reduce some of
the negative consequences of their disorder.