He Developmental Language Disorder (TDL) is a condition that affects children’s ability to understand and express themselves, with implications that go beyond language, also impacting their emotions and social skills. We talk with Virginia Estremeraspeech therapist at El Cole de Celia y Pepe, from Special Educationexplains how early diagnosis and appropriate therapies can transform the lives of children with TDL.
What exactly is Specific Language Impairment (SLI) and how is it different from other speech or language disorders?The DSM-5 eliminates the term “specific,” since recent research suggests that the disorder is not limited to language proficiency, but also presents difficulties in other areas such as memory, attention, or even motor development. From now on we will refer to this disorder as Language Disorder or Developmental Language Disorder, TL/DLD. The DSM-5 defines TL as “the presence of persistent difficulties in the acquisition and use of language, due to deficits in the understanding or production of words, phrases, structures or narration, both in spoken and written communication.” , and cannot be attributed to hearing or sensory impairment, motor dysfunction, or other medical or neurological condition, and are not better explained by an intellectual disability.” Additionally, DLD can have an impact on other areas of development, such as the child’s social, emotional, and academic skills.
Speech is defined as the production of expressive sounds, and includes articulation, fluency, voice and the quality of resonance, therefore, we would be faced with other disorders such as dysphonia, dysphemia (stuttering) or sound disorders. of speech (TSH).
What are the first signs that parents or teachers should look for to detect possible difficulties related to DLD in a child?Children with DLD often start talking later than expected. Some of them do not say their first words until they are 2 years old and/or do not say two-word phrases until they are 3. As they acquire language, it is observed that children have difficulties expressing themselves verbally and, sometimes, they help themselves of gestures and sounds so that they are understood. On the other hand, some of these children also have difficulties understanding language and have a hard time deciphering verbal messages, so they often need to look at the visual information in the context to try to understand what is being said to them. In short, children with TL will present a reduced vocabulary, a simplified or incorrect grammatical structure for their age, and altered speech, especially in narration.
When difficulties in understanding and expression begin to be suspected, a differential diagnosis should be made and any sensory, motor or cognitive alteration (hearing loss, global delay or intellectual disability) ruled out.
At what age is TDL usually diagnosed and why is early intervention important in these cases?At very young ages, if communication is severely compromised, DLD can be confused with Autism Spectrum Disorder (ASD). Furthermore, after the first few years, we could find ourselves facing a case of Simple Language Delay that will evolve favorably. Around 3 years of age, this disorder could begin to be differentiated from others and, between 4 and 5 years, a reliable diagnosis can be made. That is, it is necessary to rule out other disorders to reach the diagnosis of DLD.
An early approach to these difficulties will help the child in the language acquisition process and will provide them with tools to develop more effective communication and lay the foundations for future intervention in any other context. This does not mean that the problem disappears as children grow, but rather that with treatment the difficulties become less evident and strategies are given to solve their difficulties, since they change as they grow.
What type of evaluation and diagnosis do speech therapists perform to confirm a case of TDL?Because to confirm whether we are facing DLD, any other pathology must be ruled out, it is necessary to perform a differential diagnosis and therefore the evaluation should be carried out through a multidisciplinary team that includes doctors and psychologists, as well as speech therapists. Direct observations, interviews and questionnaires will be carried out with parents and/or teachers, in addition to standardized tests.
What impact do these difficulties have on their emotional development?Language acquisition and social and emotional development influence each other. The difficulty in communicating generates emotional problems, since human beings are social beings by nature. Children with DLD may have more worries, fears, and less self-confidence compared to their peers and may have more difficulty regulating their emotions. It is observed that these children have a greater number of tantrums and less tolerance for frustration. Therefore, the better vocabulary and language children have, the more tools they will have to regulate their emotions.
What types of therapies and strategies are most effective in helping people with TL/DLD improve their communication skills?Developmental Language Disorder may not have a definitive cure, but there are various strategies and treatments that can improve your communication and social skills. In some cases, it may be necessary to combine speech therapy sessions with other interventions, such as occupational therapy or psychology.
For school-aged children, treatment may focus on understanding classroom instructions, including helping them with problems such as: following instructions, understanding the meaning of new words, organizing and planning information, improving speaking skills , read and write. Adults may need help learning technical vocabulary or improving writing skills in the workplace.
How can a family or school environment collaborate in the treatment of DLD to enhance language development?The environment where minors grow and develop, both in childhood and adolescence, is of great relevance and therefore parents and teachers play a main role in the emotional and language development of boys and girls. Spaces should be promoted to develop language in a playful way and also emotional situations, whether through stories, tales or cartoons.
It is extremely important to work in a coordinated manner between school, home and therapists, so that the children’s development has better results. At school, those with DLD can benefit from curricular and pedagogical adaptations to facilitate their learning, such as the use of visual or auditory resources, or the implementation of school support programs.
