What is the prevalence of DLD?
- around 7% of children and young people have a profile matching DLD diagnosis
What is the definition of DLD?
- Individuals with DLD develop expressive, receptive or pragmatic language abilities (or a
combination of these) in ways that are different from the majority of age-matched
peers, in the absence of a known biomedical cause or sensory impairment. - These language differences have a functional impact on their daily living
What is the term speech, language and communication needs (SLCN) used in relation to?
- children and young people who struggle to communicate, whether this is due yo ‘social or environmental causes, neuro-developmental difficulties of sensory impairment’
What is the communication chain?
- language is complex
lots of expressive and receptive skills happening with very fast processing speed - lots of opportunities for the chain to break down
What may children with a language disorder have difficulties with?
- phonology
- syntax
- semantics
- pragmatics and social use of language
- discourse
- verbal and learning memory
- reading and writing
- processing
This differs between individuals
How do we describe a language disorder associated with a biomedical condition?
language disorder associated with X
can be….
- known genetic condition e.g down syndrome
- cerebral palsy
- acquired brain injury
- sensorineural hearing loss
- severe intellectual disability
- autism
NOT exclusionary factors
What are some general considerations for DLD?
- often not an obvious/clear cause
- not follow typical rate of speech and language development
- will not catch up: persists through the childs life
- some children will also have a significant learning disability, some will not
What are some theories of DLD?
- neuroanatomical signature of DLD is related to a brain difference involving the basil ganglia
- central learning difference
- the role of memory
- linguistic accounts (children with DLD have trouble building grammatical structures requiring ‘syntactic movement’)
What are indicators of poor prognosis between 1 and 2 years of age?
- no babbling
- not responding to speech and/or sounds
- minimal or no attempts to communicate
What are indicators of poor prognosis between 2 and 3 years of age?
- minimal interaction
- no intention to communicate
- no words
- minimal reaction to spoken language
- regression/stalling of language development
What are indicators of poor prognosis between 3 and 4 years of age?
- at most two-word utterances
- child does not understand simple commands
- close relatives cannot understand much of childs speech
What are indicators of poor prognosis between 4 and 5 years of age?
- inconsistent/abnormal interaction
- at most 3 word utterances
- poor understanding of spoken language
- strangers cannot understand much of childs speech
- close relatives cannot understand more than half of what a child says
What are indicators of poor prognosis from 5 onwards?
- difficulty in telling/re-telling a coherent story
- difficulty in understanding what is read/listened to
- marked difficulty in following/remembering spoken instructions
- talking a lot, but difficulties with engaging in reciprocal conversation
- many instances of over-literal interpretation, missing the point of what is meant
What is the impact of DLD?
- anxiety
- social frustration
- strengths as well as differences
- isolation for family due to lack of awareness
- difficulties accessing support
What are barriers and enablers of diagnosis?
SLT are the only ones who can diagnose DLD.
can feel hard if…
- theyve not been trained
- diagnostic criteria are unclear
- clients are complex
- there is anxiety about giving wrong diagnosis
- there are not clear service pathways for support
- there is concern about stigma
can feel easier if…
- colleagues provide support
- matches family needs and expectations
- there are clear benefits to a diagnosis
- there is a wider ‘medical model’ approach
How is grammar with DLD?
- potentially difficulty with verb endings
- e.g missing the regular past tense marker
- missing third person singular (‘yesterday i play with Dan’)
- difficulties with irregular past tense verbs such as i go-ed to the park (instead of went)
- may leave out ‘is’ and are’, or not put ‘s’ on the end of verbs
- auxiliary verbs
- later stage of development: words are left out
- as they get older, they may not use complex sentence/utterance structures
How is syntax with DLD?
- produces fewer instances of complex syntax and produce more grammatical errors within complex syntax utterances than same-age peers
- difficulties with comprehending object relative clauses, wh-questions, sentences with non-canonical word order, passives and other types of complex syntax
- DLD was previously characterised as a deficit in morpho-syntax but now accepted that linguistic differences go beyond this
How is vocab in DLD?
- characterised by early and persisting difficulties acquiring both breadth and depth of vocab knowledge
- learning a novel word relies on the development of: word form, meaning and the creation of an association between the two
- DLD means that establishing these foundational representations is difficult
- this means recognising and therefore further developing, word knowledge when it is heard in the future is harder
- then harder to establish syntactic, orthographic and articulatory representations all of which are required for effective use of words
- close links with memory: establishing new info in LTM
What is a lexical representation?
- how a word is stored
- in young children, a representation consists of the semantic info and the phonological info
the word apple
- semantic info: round, green, eat it
- phonological info: starts with ‘a’
- for adequate storage, this info needs to be complete
- if not, the child will find it difficult to access and say the word correctly
