Receptive and Expressive Language Disorders
One of a parent's greatest joys is to hear their child speak their first words or watch them take their first steps. A problem with spoken language or understanding can be a significant source of frustration for both the child and the parent. Some parents delay addressing the issue, hoping their child will eventually catch up. However, if a child's language disorder persists into the school-age years, it could lead to social and academic problems.
Creating language and communication-rich environments can foster the growth of speech and language skills in young children. However, even with a robust support system at home, children may not develop communication skills in the same time frame as their peers.
According to the American Speech-Language-Hearing Association (ASHA), almost 8% of children in the United States have language delays or disorders. Boys are nearly twice as likely as girls to have a communication disorder. Communication disorders are highest among children ages 3–6, so addressing the language problem early on is critical.
In this article, we will explain the major types of language disorders. We will provide the information you need to understand how to contribute to and actively participate in your child's language development.
If you have any questions or want to learn more, we will provide a free phone consultation with our lead speech pathologist!
What are Receptive Language Disorders?
How are Receptive Language Disorders Diagnosed?
Treatment for Receptive Language Disorder
What are Expressive Language Disorders?
How are Expressive Language Disorders Diagnosed?
Treatment for Expressive Language Disorder
Mixed Receptive-Expressive Language Disorder
Connected Speech Pathology: Helping Children with Language Disorders Succeed
What are Language Disorders?
There are two main types of language disorders. They are:
Receptive language disorder
Difficulty understanding language (written or verbal)
Expressive language disorder
Trouble speaking and expressing thoughts or feelings
Mixed receptive-expressive language disorder
A child can sometimes have both language disorders at the same time.
Causes of Language Disorders
The general causes of language disorders are not entirely clear, but they may be associated with any of the following:
Hearing impairment
Genetic disorders such as Down's Syndrome
Premature birth or low birth weight
Autism Spectrum Disorder (ASD) or Fragile X Syndrome
Brain tumor
Brain injury
According to research, there may also be a link to a family history of language problems.
What are Receptive Language Disorders?
Receptive language skills develop first. Receptive language is defined as the ability to understand language. A receptive language disorder is an impairment in the comprehension of spoken, written, and gestural language.
Children with receptive language disorders may have trouble with any of the following skills:
Following verbal instructions
Reading comprehension
Understanding complicated sentences
Answering simple or complex questions
Understanding the names of things
Taking turns during a conversation
Understanding another's perspective
A child with a receptive language disorder may exhibit trouble following directions or understanding written language. A problem understanding language can affect how the child interacts socially and may impact academic success.
A child aged 2-5 years old should respond to you when you call their name, follow directions, and engage with you when you talk to them. If you say to your child, "Let's go play with your toys," they should run to the toy bin or point to the location where the toys are kept, possibly grab your hand, and then guide you to the toys. Your child may then gather the desired toys. When a child struggles with following verbal instructions, they may be bewildered by the statement "Let's go play with your toys" and not respond or appear confused.
A school-age child with a receptive language disorder may tune people out, ask for directions to be repeated, or perhaps have trouble understanding jokes, sarcasm, or double meanings of words. The child may become easily confused and frustrated during communicative interactions at school and home. They may express that they have trouble making friends or getting along well with other children.
How are Receptive Language Disorders Diagnosed?
A speech pathologist can evaluate and diagnose a child for a receptive language disorder. Parents should also consult with the child's physician when a receptive language disorder is suspected. A doctor can compare your child's language skills to the developmental language milestones of children in similar age groups. They may also ask about the child's medical history and recommend a hearing test to rule out any hearing problems if appropriate. Your child's physician will refer your child for a speech evaluation if it is deemed appropriate.
If you have concerns about your child's receptive language, you will want to have your child evaluated by a speech pathologist as soon as possible. Early intervention is key to achieving positive outcomes in speech therapy. In other words, the earlier children acquire strong language skills, the better.
For a child's age in the range of 2-5 years old, the speech pathologist will complete a receptive language evaluation during play-based activities. For older children, the assessment may consist of a close look at the child's ability to follow verbal instructions and to read and understand sentences and paragraphs during various fun and engaging activities. Virtual assessments can be achieved successfully by a speech pathologist skilled in providing online assessments.
Treatment for Receptive Language Disorder
Children with receptive language disorders can benefit from working with a speech-language pathologist. An individualized plan should be established to meet each child's needs.
Treatment may include developing the child's receptive vocabulary (understanding words) or understanding the function of specific words. Examples of words that can be targeted in receptive language therapy are prepositions (e.g., in, of, between, on, with, by), question words (e.g., who, what, where, when), pronouns (e.g., she, they, he, it, him, her, you, me). Therapy may also include helping your child understand figurative language and how to make inferences. If needed, speech pathologists can work with the family to identify an appropriate alternative means of communication (AAC), including gestures, picture boards, or computer devices to facilitate communication.
Teaching parents about the nature of the child's disorder and how to promote language skills should be included in the treatment plan.
If you are a parent of a child developmentally younger than 6 or 7 years old and want to begin working on receptive language skills right away, you and your child can read picture books together, labeling items in the story. Receptive language activities can include playing games like Simon Says, or Red Light, Green Light. You may have to modify the rules of the game depending on your child's abilities.
If your child is developmentally older than 6 or 7 years old, you can read short stories and ask questions about the text. You will be helping your child understand the story's purpose. You also try asking your child to follow complex directions, for example, "Take your homework out of your backpack. Next, put it on the counter and go into the office and get the blue pencil." You may have to modify the complexity and length of the instruction based on your child's skills.
What are Expressive Language Disorders?
Expressive language is defined as the way your child uses words to communicate thoughts or ideas.
Children with expressive language disorders may have trouble with any of the following skills:
Use of vocabulary (uses words like "thing" or "stuff" instead)
Creating grammatically correct sentences
Telling a story in order from start to finish
Clearly conveying a concept or idea
Recalling words
Stringing together longer/complex sentences
When a child has an expressive language disorder, they may present with trouble speaking or writing. The child may understand what other people say but cannot access the right words to communicate needs or ideas. Sometimes children with expressive language disorders leave words out of sentences, have difficulty thinking of the right word, mix up word tenses, or put words into sentences in the wrong order. A child with an expressive language disorder may be frustrated or have low confidence. As with receptive language disorders, expressive language disorders can lead to social settings and academic achievement problems.
A child with an expressive language disorder may say "Mommy car" if they cannot say, "That's mommy's car." Or they may use facial expressions, body movements, gestures, or pointing instead of communicating verbally altogether. An older child with an expressive language disorder may have trouble combining sentences or using appropriate verb tenses. For example, they may say, "I goed on a trip. I climbed the mountain," instead of saying, "I went on a trip and climbed a mountain."
How are Expressive Language Disorders Diagnosed?
A speech pathologist can assess and diagnose expressive language disorders. Consulting with the child's physician regarding your concerns is recommended. A referral to an audiologist for a hearing check is often suggested. If you and your doctor suspect a problem with expressive language, you should seek a consultation from a speech-language pathologist as soon as possible. Research shows that there are substantial benefits to early intervention of speech and language disorders.
An evaluation by a speech pathologist may involve a parent interview and a recording of a child's speech sample during play, telling stories, or playing games. Children may be asked to label pictures or items in their environment. An interview with parents, caregivers, and teachers may help obtain a clear picture of the nature of the language disorder.
Treatment for Expressive Language Disorder
A speech therapist will create a treatment plan tailored to your child's needs to treat a child with an expressive language disorder. Treatment goals may involve helping your child expand their vocabulary and sentence complexity to clearly express wants, needs, and ideas. Expressive language goals may also include teaching new words and naming objects. Educating parents regarding the nature of the disorder and showing parents how to reinforce language strategies during day-to-day interactions is also an essential therapy component.
If the child cannot adequately verbalize to meet their communicative needs, the speech pathologists may work with families to develop alternative communication forms (e.g., picture systems or computer devices).
We have some suggestions for parents who want to work on expressive language-building activities right away. Reading is a great way to promote your child's expressive language skills. Families should try to set aside regular time for reading books every day. During reading time, you can encourage language skills by asking your child to describe the pictures in books. Depending on their skill level, you can help your child retell the story, label pictures, ask them to predict what will happen next, or even create their very own title for the story.
Another tip for increasing vocabulary and expressive language skills is to allow your child enough time to talk without interruptions. Provide opportunities for your child to take the lead and talk about what they observe or do or what interests them. Say, "Tell me more about that." "Is that right?". "That's very interesting." It's usually best not to correct your child by telling them that what they have said is wrong. Instead, rephrase their statement with the errors fixed so that they can hear a good example. For example, if a child says, "I goed to beach," you might say, "Yes, you went to the beach."
Mixed Receptive-Expressive Language Disorder
A mixed receptive and expressive language disorder occurs when both receptive (understanding words) and expressive language (using words) are affected. Signs of a mixed receptive-expressive language disorder include difficulty understanding spoken language or written words, limited vocabulary, grammatically incorrect sentences, and reduced sentence length.
Mixed receptive-expressive language disorder should be treated as soon as it is identified. Treatment can involve teachers, parents, and anyone else who interacts routinely with your child.
A tailor-made one-on-one treatment program that focuses on your child's specific needs is the key to improving language skills in mixed receptive-expressive language disorders.
Connected Speech Pathology: Helping Children with Language Disorders Succeed
At Connected Speech Pathology, we will work side-by-side with parents and caregivers to maximize the benefits of therapy for expressive, receptive, and mixed receptive-expressive language disorders.
Online Speech Therapy for Language Disorders
Our speech-language pathologists conveniently deliver services online using a HIPAA-compliant platform. With online speech therapy (also known as teletherapy, telepractice, or remote speech therapy), our speech-language pathologists can still provide the same effective treatment you would receive in-person but with many added benefits.
Online speech therapy encourages parental involvement. We will create an individualized treatment plan to maximize your child's language ability. Speech therapy sessions for your child may be scheduled during non-traditional hours, conveniently fitting into your busy schedule. This allows parents to be present during the sessions so that you can partner with your therapist to learn techniques to reinforce with your child at home. The convenience of working with one of our therapists online improves attendance and reduces travel time to and from appointments.
We have made effective online speech-language therapy for children our mission, and we would be delighted to help your child improve their language skills today!
About the Author
Allison Geller is a speech-language pathologist (SLP) and the owner of Connected Speech Pathology. She obtained her Bachelor’s and Master’s degrees from the University of Florida in Speech-Language Pathology. Allison has practiced speech therapy in a number of settings including telepractice, acute care, outpatient rehabilitation, and private practice. She has worked extensively with individuals across the lifespan including toddlers, preschoolers, school-aged children, and adults. She specializes in the evaluation, diagnosis, and treatment of a variety of communication disorders including receptive/expressive language disorders, articulation disorders, voice disorders, fluency disorders, brain injury, and swallowing disorders.
Allison served as the clinical coordinator of research in aphasia in the Neurological Institute at Columbia University Medical Center in New York. She is on the Board of Directors for the Corporate Speech Pathology Network (CORSPAN), a Lee Silverman Voice Treatment (LSVT) certified clinician, and a proud Family Empowerment Scholarship/Step-Up For Students provider. Allison is passionate about delivering high quality-effective treatment remotely because it’s convenient and easy to access. What sets us apart from other online speech therapy options is—Allison takes great care to hire the very best SLPs from all over the country.
Do you have questions or want to learn more about our programs? Set up a free phone consultation with our lead speech pathologist.
