Problems with narrative development is a tell-tale sign of an expressive language disorder. Unlike speech sound disorders, which involve difficulties in producing spoken sounds, language disorders refer to problems using spoken language compared to peers. These expressive problems manifest in at least one of these areas: spoken vocabulary, complexity of what the child is saying (grammar), and social use of words (pragmatics). These issues become more apparent when children, older than 4 years of age, have difficulties telling stories and making friends.
Expressive Language Disorder are classified as two types:
Mixed Receptive-Expressive Language Disorder – Difficulty with comprehension or understanding the words or complexity of what the individual understands compared to peers and has an expressive language disorder.
Expressive Language Disorder – Receptively, the individual is age appropriate but there are significant issues expressing oneself compared to peers.
There is no such thing as just a receptive language disorder. If a child is misdiagnosed with this label, either the child has significant attentional difficulties or the child’s expressive language skills were not thoroughly assessed. Speech language pathologists are the best professionals to thoroughly assess expressive language skills.
Spoken or expressive language disorder is a lifelong condition and appears in early childhood. It is often developmental in nature but may also be caused by traumatic brain injury. An individual with expressive language disorder exhibits normal comprehension skills but has difficulty with written and/or verbal expression. This can impair academic achievement and make it more difficult to socialize in groups with peers.
Signs of an Expressive Language Disorder
Depending on the age, linguistic development, and affected language domains, the signs of an expressive language disorder can vary among individuals. In children, these symptoms can manifest in a variety of ways and affect the following language domains:
Phonology – The ability to recognize and work with sounds in spoken language, e.g. rhyming or playing around with sounds.
Syntax – Another word for grammar.
Morphology – A specific type of grammar dealing with units of words called morphemes.
Semantics – Vocabulary.
Pragmatics – Using appropriate language (including nonverbal communication) in social situations and daily interactions. Learn more about social communication disorder.
In many cases, signs of an expressive language disorder may not be obvious to parents and teachers. In some cases, signs and behaviors may not directly imply a language problem. Children with an expressive language disorder may:
- have less developed vocabulary than their peers
- often say fillers like “um,” “uh,” and “huh”
- have no problems with understanding, but struggle with speaking, asking questions, or answering
- use short phrases or sentences or say the same words or phrases over and over;
- struggle with telling stories
- for toddlers, relies on using gestures
- lack intonation and modulation when talking
- shy away from conversation and avoid social situations or group interactions
- may say a lot but not make much sense
Signs of a child who needs expressive language therapy:
- Difficulty naming items and objects.
- Does not link words together or may use sentences that are shorter than those used by children of the same age.
- Uses sentences that are not grammatically correct and, therefore, can sound immature.
- May use jargon (made-up words) when talking.
- Speaks in sentences that are ‘jumbled’ (i.e., words are in the wrong order, lots of stopping and starting, creating a lack of flow).
- Can be misunderstood by unfamiliar people.
- May have difficulty finding the correct words to use when describing something or having a conversation. The child may use techniques such as ‘circumlocution’ (talking around the word) or a word with a similar meaning to help them express themselves.
Diagnosing Expressive Language Disorder
As with all speech or language disorders, it is always important to first ensure that there are no hearing issues affecting language development. A hearing assessment by an audiologist is necessary to rule out any issues with hearing (ears). Even undetected ear infections can interfere with acquiring language in younger children.
To get your child diagnosed with an expressive language disorder, a speech-language pathologist (SLP) must do a thorough evaluation. A comprehensive assessment must be conducted with the help of the child’s family and teachers. This evaluation process includes both informal and formal assessments. Formal evaluation comes in the form of standardized tests, while informal evaluation involves interviews, observations, checklists, and language samples.
While both types are essential in providing accurate diagnosis and appropriate treatment goals, it is the language sample that provides a clearer picture of the child’s language abilities and conversational skills. Through language sampling, an SLP is able to gain better understanding of the child’s strengths and weaknesses with regards to the key language areas or domains mentioned above.
Our SLPs at Brooklyn Letters conduct language sampling in order to accurately diagnose and assess the needs of your child using the Systematic Analysis of Language Transcripts or SALT program. The typical expressive language development in young children, aged 12 months to 47 months onwards, is outlined in the Acquisition of Sentence Forms Within Brown’s Stages of Development. This framework is an invaluable tool used by SLPs in conducting a structural analysis of a language sample.