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Language Disorders in Children

Most infants or toddlers can understand what you're saying well before they can clearly talk. As they get older and their communication skills develop, most children learn how to put their feelings into words.

But some children have language disorders. They may have:

  • Receptive language disorder. A child has trouble understanding words that they hear and read.

  • Expressive language disorder. A child has trouble speaking with others and expressing thoughts and feelings.

A child will often have both disorders at the same time. Such disorders are often diagnosed in children between the ages of 3 and 5.

A language disorder can be frustrating for parents, teachers, and also for the child. Without diagnosis and treatment, children with a receptive-expressive disorder may not do well in school. They may also misbehave because of their frustration over not being able to communicate. But language disorders are a common problem in children, and can be treated.

What causes language disorders?

Language disorders can have many possible causes. A child's language disorder is often linked to a medical condition or disability such as:

  • A brain disorder like autism

  • A brain injury or a brain tumor

  • Birth defects such as Down syndrome, fragile X syndrome, or cerebral palsy

  • Problems in pregnancy or birth, such as poor nutrition, fetal alcohol syndrome, early (premature) birth, or low birth weight

Sometimes language disorders have a family history. In many cases, the cause is not known.

It's important to know that learning more than one language does not cause language disorders in children. But a child with language disorder will have the same problems in all languages.

What is receptive language disorder?

Children with receptive language disorder have trouble understanding language. They have trouble grasping the meaning of words they hear and see. This includes people talking to them and words they read in books or on signs. It can cause problems with learning and needs to be treated as early as possible.

A child with receptive language disorder may have trouble:

  • Understanding what people say

  • Understanding gestures

  • Understanding concepts and ideas

  • Understanding what he or she reads

  • Learning new words

  • Answering questions

  • Following directions  

  • Identifying objects

What is expressive language disorder?

A child with expressive language disorder has trouble using language. The child may be able to understand what other people say. But he or she has trouble when trying to talk, and often can’t express what he or she is feeling and thinking. This doesn’t only affect trouble speaking words. The disorder can affect both written and spoken language. And children who use sign language can still have trouble expressing themselves.

A child with expressive language disorder may have trouble:

  • Using words correctly

  • Expressing thoughts and ideas

  • Telling stories

  • Using gestures

  • Asking questions

  • Singing songs or reciting poems

  • Naming objects

Diagnosing and treating language disorders

Your child's healthcare provider will ask about your child's language use, and look at his or her medical history. Your child may have a physical exam and hearing tests. Your healthcare provider will likely refer your child to a speech-language pathologist (SLP). This is a specialist who can help diagnose and treat your child.

An SLP will evaluate your child during play. This may be done in a group setting with other children. Or it may be done one-on-one with your child. The SLP will look at how your child speaks, listens, follows directions, understands the names of things, repeats phrases or rhymes, and performs in other language activities.

To treat your child, the SLP will help him or her to learn to relax and enjoy communicating through play. The SLP will use different age-appropriate methods to help your child with language and communication. The SLP will talk with your child and may:

  • Use toys, books, objects, or pictures to help with language development

  • Have your child do activities, such as craft projects

  • Have your child practice asking and answering questions

The SLP will explain more about the methods that are best for your child's condition.

How you can help your child

If you think your child might have a language disorder, talk with his or her healthcare provider right away. Research has shown that children who begin therapy early have the best outcome. Make sure that the SLP that you choose is certified by the American Speech-Language-Hearing Association.

The SLP will guide your child's treatment. But it's important to know that parents play a critical role. You will likely need to work with your child in order to help him or her with language use and understanding. The SLP will also talk with caregivers and teachers to help them work with your child.

Ask the SLP what you should be doing at home to help the process. The SLP may advise simple activities such as:

  • Reading and talking to your child to help him or her learn words

  • Listening and responding when your child talks

  • Encouraging your child to ask and answer questions

  • Pointing out words on signs

Medical Reviewers:

  • Adler, Liora C., MD
  • Bass, Pat F. III, MD, MPH