Expressive Language Disorder Defined

From the moment of birth, children begin to learn and express themselves through language. As they grow, their capacity to communicate their needs and ideas through words and understanding the spoken message of others improve as well.

Your child may have missed certain language milestones by age three, but caught up with their peers later on. Missing these milestones isn’t necessarily a sign of an expressive language disorder. Your child could just be a “late talker.”

However, if your child’s struggle with expression persists, he/she will probably be diagnosed with an expressive language disorder. Such a disorder can cause social problems in school, increase your child’s risk for developing learning problems, and lead to low self-esteem.

Signs and Symptoms

Explicit Signs and Symptoms

Children with expressive language disorder have trouble talking and making other people understand them. These are some of the more obvious symptoms:

  • trouble finding the right word, and using placeholders like “uh.”

  • uses the incorrect verb tense

  • uses the wrong pronouns (such as him/he, her/she, them/they)

  • omits pronouns or verbs

  • stumbles over words

  • difficulty asking and answering questions

  • repeats words back when asked a question

  • struggles learning songs or rhymes

  • difficulty expressing thoughts and ideas

  • uses noticeably fewer words and sentences than children of a similar age

  • uses shorter, simpler sentence construction than children of a similar age

  • has a limited and more basic vocabulary than children of a similar age

  • uses the wrong words in sentences or confuses meaning in sentences

  • relies on standard phrases and limited content in speech

  • hesitates when attempting to converse

  • talks “in circles”

  • fails to observe general rules of communicating with others

  • has difficulty with oral and written school assignments

  • uses vague words, like “thing” or “stuff”

  • uses vocabulary incorrectly

  • speaks quietly

  • exhibits selective mutism

  • demonstrates incorrect usage of grammar

Subtle Signs and Symptoms

1. Sequencing

Children with expressive language disorder often have difficulty putting language together logically, such as when they recount a story. Or they struggle to correctly order the steps of an activity. Conversations with these children can be frustrating.

2. Correctly Using Adjectives, Multiple Meanings, and Figurative Language

These children also struggle to use descriptors correctly. Adverbs, adjectives, and other language features are designed to make the conversation more interesting and clear. However, children with a language delay will often use these words incorrectly, if they use them at all. They struggle with metaphors, similes, and idioms, as well as multiple-meaning words, which can make humor difficult for them to understand.

3. Social Skills

Many children with expressive language disorder have difficulty with social skills. Their language deficit becomes a significant handicap when interacting with other kids. And it can be the source of other problems as well, such as depression, aggression, and anxiety.

4. Inferences

Children with this disorder usually have a hard time drawing inferences from events that they witness, or from what they read. Due to this deficit, they seem simpler and more linear in their understanding and thinking, oblivious to what’s written: “between the lines.”

5. Lack of Intonation and Modulation

When we speak, we unconsciously vary our pitch, cadence, and intonation according to the situation and subject we are talking about. Children with this disorder often struggle with these elements that come naturally to others. Consequently, their speech will often sound stilted and awkward.

Causes

For many children, the cause of expressive language disorder is unknown. While some kids experience difficulties in language development alone, unrelated to other areas of their development that are progressing normally, for others, the disorder is integrated with known developmental difficulties or impairments (for example, Down syndrome, autism, or hearing loss).

A preponderance of children with expressive language disorder will have an accompanying receptive language disorder, (difficulty in understanding language).  Another factor in their expressive language disorder could be hearing loss, whether temporary or permanent. For a child who suffers from ongoing ear infections, this on/off hearing loss could also become the cause of problems with expressive language.

Expressive language disorder can be a congenital impairment (from birth) or acquired (occurring after a period of normal development). Alternatively, it can result from trauma (such as a brain injury) or an underlying medical condition. And then again, an expressive language disorder could be due to genetic factors, poor nutrition, or a deficiency in needed vitamins.

Treatments

Is Treatment Necessary?

You may feel that your child’s expressive language disorder is somehow charming or believe that if it’s naturally who he is then it would be improper to force him to speak or communicate differently. Unfortunately, since expressive language disorder can cause your child to experience social problems, it can often lay the foundation for serious behavioral problems if left untreated.

Types of Treatment

If your child is diagnosed with expressive language disorder, speech and language therapy is generally the optimal way to treat the problem. The therapist will help your child become more comfortable talking by helping him/her to use language more appropriately. When there is an emotional or behavioral component, psychotherapy or cognitive behavioral therapy may be prescribed for your child as well.

If necessary, a speech therapist can teach your child alternative ways to communicate, such as through gestures/sign language. Developing the capacity to communicate may precede talking, and become the catalyst to growing adept at using language.

The specific methods that the therapist uses will depend solely on the diagnosis and suitability of your child to that particular treatment. However, you can rest assured that the therapy will be tailored to the age and aptitude of your son or daughter.

Some therapists use a technique known as “modeling target behaviors.” Play is often used as a natural, relaxed setting for these activities. The therapist will model specific aspects of speech for your child such as sounds, vocabulary, and grammatical structures, and then use techniques and games to reinforce these.

Regarding older children, speech therapy may include teaching the child to make judgments about what to say in different social contexts and reinforcing these judgments by role-playing different day-to-day scenarios.

Although expressive language disorder can be devastating for a child if left unattended, intervention is a real game-changer for many children and can be the catalyst to living a successful, productive, and happy life.