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Developmental Language Disorder (DLD) by Stephen Parsons, Speech and language therapist

By Stephen Parsons, @WordAware, Chair, NAPLIC, Speech and language therapist

Developmental Language Disorder (DLD) is the term used when a person has difficulty with talking and/or understanding language, and for which there is no known cause. The condition starts in childhood and affects all languages spoken.

Perhaps surprisingly for a condition that relates to language, until recently there was no agreed terminology to describe this condition. This confusion has resulted in DLD being unrecognised and misunderstood.  International consensus was agreed in 2016 (REF1), but still, most people do not know about DLD.

Developmental Language Disorder is common

DLD has been called the ‘most common neurodisability that most people have never heard of.’ With an incidence of 7.6%, this equates to two children in a class of 30. (REF2)

Think about how much talk children need to understand to access learning in the classroom. The discussion of a shared book and the learning of new mathematical or scientific concepts all require language. It is hardly surprising to hear then that DLD has serious impacts on students’ literacy, wider academic achievement and mental health (REF3).

Identifying DLD in the classroom

DLD has been referred to as a ‘hidden disability’ (REF4) as it is impossible to tell by looking at someone if they have the condition. This is compounded by its variability. Confusingly, some students with DLD may even talk a lot. The most obvious signs of DLD will be students who cannot express themselves as well as their peers, using simpler vocabulary and shorter sentences.

Of those with this hidden disability, the most hidden are the students who have a poor understanding. Their expressive language may give some clues, but the severity of their needs may not be obvious. You may need to undertake some detective work to identify them as they rarely say ‘excuse me miss, but I don’t understand.’

If a student presents with any of the following it is worth taking a closer look, as they may have underlying difficulties with understanding language.

  • ‘Poor listening’: many with DLD struggle with listening, but when they are paying attention do they understand what is said to them?
  • ‘Off-topic’: in class discussion, they may pick up on the general gist and respond to that, rather than specifics
  • ‘Reading difficulties’: some students with DLD may struggle with phonics, but even once they can decode do they understand what they read?
  • ‘Behaviour issues’: difficulties understanding language impact on behaviour in many different ways and research studies show 60-90% of all students with behaviour difficulties have a language disorder (REF5).

Supporting DLD in the classroom

Diagnosis of DLD can only be made by a specialist, such as a Speech and Language Therapist, conducting a thorough assessment. There is no cure, and short term interventions will have limited effect, so the focus needs to be about long term support, strategies, self-management and awareness. (REF6) Because DLD presents in many different ways a personalised programme is essential, but these classroom strategies are a starting point.

  • Relationship: as with all vulnerable learners students with DLD need to feel they are understood and supported. They need trusted people to go to when they need to. They need people who know about DLD and how to support students with the condition.
  • Reduce the language load: differentiating whole class talk is a challenging skill to master, but a few modifications will make it more accessible for all learners. Use short, simple sentences. Use words you know they understand. Do not talk too long at any one time. Pause to allow processing time. Repeat key points. Summarise what you have said, especially if it has been longer or more complex.
  • Check their understanding: not all students who struggle with understanding language are aware of their needs or how much they are missing, so when asked ‘do you understand?’ they may answer ‘yes’, even when they do not. A better alternative is ‘tell me what you need to do’, or ‘explain the process to a peer.’ A strong relationship will make it easier for students to admit when they do not understand.
  • Non-verbal supports: when students struggle to extract meaning from language then alternative methods of conveying meaning need to be found. Use objects or hands-on learning where possible. A well-chosen image or photograph can act as a focus. Pictograms or symbols can be used to visually represent more abstract concepts. Free symbols are available from arasaac.org

Find out more about DLD go to naplic.org.uk/dld or follow us @NAPLIC on Twitter.

Stephen Parsons (@WordAware)

Chair, NAPLIC

 

References

  1. Bishop DVM, Snowling MJ, Thompson PA, Greenhalgh T, CATALISE consortium (2016) CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children. PLoS ONE 11(7): e0158753. pmid:27392128
  2. Norbury, C. F., Gooch, D. , Wray, C. , Baird, G. , Charman, T. , Simonoff, E. , Vamvakas, G. and Pickles, A. (2016), The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study. J Child Psychol Psychiatr, 57: 1247-1257. doi:10.1111/jcpp.12573
  3. Conti-Ramsden, G., Durkin, K., Toseeb, U., Botting, N. & Pickles, A. (2017). Education and employment outcomes of young adults with a history of developmental language disorder.International Journal of Language and Communication Disorders, 53(2),237-255
  4. Norbury, Courtenay. Guardian (2017): https://www.theguardian.com/science/head-quarters/2017/sep/22/developmental-language-disorder-the-most-common-childhood-condition-youve-never-heard-of
  5. Clegg, J., Stackhouse, J., Finch, K., Murphy, C., & Nicholls, S. (2009). Language abilities of secondary age pupils at risk of school exclusion: A preliminary report. Child Language Teaching and Therapy25(1), 123–139.  https://doi.org/10.1177/0265659008098664
  6. Ebbels, S. H., McCartney, E. , Slonims, V. , Dockrell, J. E. and Norbury, C. F. (2019), Evidence‐based pathways to intervention for children with language disorders. International Journal of Language & Communication Disorders, 54: 3-19. doi:10.1111/1460-6984.12387

 

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