STATEN ISLAND Expressive Language Disorder

We travel to North Shore, Mid Island, & the South Shore

Language is the foundation for speaking, listening, reading, and writing.

We evaluate, treat, and remediate underlying language skills. Underlying language skills include sound, vocabulary, and grammar development; these skills significantly affect how we talk, listen, and how we learn to read and write.

Our analysis will target where your child Pis having difficulty with his or her speech and language development. Pinpointing the underlying difficulties is critical for effective treatment. In addition to Languagerocessing Expressive & Receptive Therapy, we provide speech therapy for all ages.

School age students with oral language problems typically omit information when they speak, e.g. word or phrase, have difficulty retrieving words or ideas, convey a general message (have a hard time being specific), have a less diverse vocabulary (including verbs), speak shorter utterances, use less complex sentences, make more grammatical errors, take more time to speak, pause a lot, repeat words or phrases (e.g. “but he but he,” etc.), frequently revise what they say (“and so, um, they he and so but they couldn’t give him a name”).

We are trained to work with students who have an expressive language delay or disorder, students with a mixed expressive-receptive language delay or disorder, and students with language learning difficulties.

Students with high IQs are prone to language difficulties, particularly reading comprehension and expressive writing difficulties. We also provide reading comprehension tutoring as well as writing and speaking intervention to help students improve their language and communication skills.

Another aspect of communication we give focus on is acquiring narrative skills. Narrative development is crucial as children expand their communication skills, such as expressing and describing stories, experiences, and previous events that go beyond the present context. It is also directly correlated with a child’s success in school and academic achievement.

Young children typically acquire all grammatical morphemes by age four (see chart below). But for children struggling with narrative skills or showing other signs of an expressive language disorder, parents may notice obvious delays or missing aspects in their language skills. At Brooklyn Letters, we work with children who have narrative development difficulties.

Narrative Development in Children

According to research, narrative development can play a significant role in determining a child’s later success in school and literacy. This is because narration and relaying a previous experience allows the child to communicate and use language beyond the present context or the “here and now.” This determines the child’s grasp of linguistic structure and words chosen. But what exactly is narrative development? And how do you know your child’s progress is appropriate for his or her age?

A child’s narrative skills refer to his or her ability to use language in telling or communicating a story. As children develop their narrative skills, they learn to follow the rules of story-telling. This involves sequencing of events, organization, introducing characters, establishing the plot or main idea, and taking perspectives.

Narrative skills are first developed and introduced in very young children through storytelling or bedtime story sessions with their parents. By listening to stories and being exposed to story-telling, children begin to understand and develop narrative structure. In most cases, children with language impairments or conditions struggle with comprehending and executing narratives.

Find out more about the Stages of Narrative Development.

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.

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

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.

(Related: Find out more about language sampling in this article on the Structural Analysis of a Language Sample.)

During this phase, speech language pathologists will need to know the child’s:

full case history (including birth and medical records; history of language, speech, reading, or academic difficulties in the family; languages or dialects spoken at home; and, the family’s and teacher’s own observations and concerns)
spoken language skills (phonology and phonological awareness, semantics, morphology, syntax, and pragmatics)
level of reading and writing (if the child is school age)

How to Treat Expressive Language Disorder

Once a diagnosis is made, the SLP will conduct further analysis and observations before creating an individualized program. However, it is important to remember that therapy will not offer a permanent “cure” for the disorder. Instead, SLPs can equip children with strategies and techniques to help them manage their condition.

Therapy methods can vary, depending on the therapist and the child’s needs. Modeling target behavior is one technique where the therapist models and reinforces aspects of speech that need to be targeted, such as sounds, vocabulary, and grammatical structure.

Some areas that SLPs address are:

For elementary school children (ages 5 to 10)

enhancing phonological awareness
improving understanding and depth of vocabulary
understanding figurative language and ambiguities (words with multiple meanings, ambiguous sentence structures)
paraphrasing information and comprehension
using more advanced morphology (prefixes, suffixes)
formulating more complex sentence structures
judging and correcting grammar and morphological errors
using language to convey politeness, persuasion, and clarification
increasing knowledge and skills on a discourse level
making contributions to discussions and repairing conversational breakdowns
learning what and what not to say and when and when not to talk
Narrative Intervention: Principles to Practice
Sketch and Speak: An Expository Intervention Using Note-Taking and Oral Practice for Children With Language-Related Learning Disabilities
Looking at Expository Discourse Across the Grade Levels
Expository Discourse Intervention for Adolescents With Language Disorders