Today is International Developmental Language Disorder Awareness Day. What is it, when and in whom is it diagnosed, and how can a person with DLD be helped? Among other things, I ask Ewa Czaplewska, dr hab. prof. UG, from the Institute of Logopaedics, is a specialist in early speech therapy intervention, especially in the field of DLD/SLI and supporting the development of bilingual children and children brought up in multilingual environments.
Elżbieta Michalak-Witkowska: - What is DLD?
dr hab. Ewa Czaplewska, prof. UG: - Developmental language disorder - DLD (some specialists and researchers still use the earlier term specific language impairment - SLI) is a dysfunction that consists of difficulties in acquiring one's mother tongue or mother tongues if more than one. It usually accompanies a person throughout his or her life and, depending on the severity, age and appropriate or not, therapy undertaken, can take different, more or less noticeable forms.
Problems can affect any aspect of language, including vocal articulation, vocabulary and the construction of grammatically correct sentences. The degree of severity of symptoms in each aspect can vary from person to person. In this respect, people with DLD are not a homogeneous group. Although most people with DLD have problems with both speech production and comprehension, the proportion of impairment in these two areas may vary.
- When and who is DLD diagnosed?
- Most global research on DLD focuses on children and adolescents. It is emphasised that children who have severe speech comprehension difficulties have a higher risk of co-occurring social disorders and lower levels of school achievement. What is particularly important is that, according to findings to date, most children with DLD have at least an average level of intelligence and no neurological or more serious somatic damage. If there are any anatomical or motor difficulties in the articulators (e.g. mouth, teeth, palate, etc.) these are definitely not the cause of such major language problems.
- What are the causes of this disorder? Does the environment in which the child grows up make a difference here?
- An unfavourable environment can of course exacerbate the problem, but it is certainly not the direct cause. DLD happens in all families, whether of high or low socio-economic status. The child's parents or guardians are therefore not directly responsible for it.
So far, the cause of this disorder has not been clearly established. Currently, the causes of this dysfunction are considered to be a complex interaction between genetics, environment and neurobiology. DLD is a relatively common developmental dysfunction. Various sources state that children with this disorder represent between 3% and 7% of the population. So we can say that statistically speaking, there are one or two children with this dysfunction in every classroom.
- How does DLD develop? When and at what age, in the context of this disorder, should a parent be concerned about something in their child's speech development?
- Individual differences in the language development of young children can be very large. Some two-year-olds are already constructing sentences and conducting dialogues, but we also observe children at 30 months whose language competence is relatively low. This does not necessarily immediately suggest serious language problems, although it should be up to the speech therapist to determine this. However, a child over the age of three should certainly be able to communicate with his or her environment like most of his or her peers, i.e. build complete sentences and have a vocabulary of at least 1,000 words in active speech. A child with DLD, on the other hand, at the same time uses single words, sometimes even just sound-modelling words, and if he or she builds sentences, they are simple and usually consist of two uncomplicated words, e.g. 'mama da', 'baba dada', etc. It can also be the case that the child uses a few words with a specific sound, or even if he or she is slightly older, utters three- to four-word sentences in which numerous dis- and agrammatism are evident.
An older, school-aged child with DLD usually already speaks. He knows a wide variety of words, puts sentences together and can tell a story. The fact that the words are simple, the story is short, and the sentences and words used by, for example, a sixth-grader resemble the speech of a first- or second-grader often goes unnoticed, unfortunately. Also, difficulties with language comprehension are not always visible to outsiders. Meanwhile, these problems do not go unnoticed in terms of schooling and social functioning. Consequently, unrecognised DLD leaves its mark on a person's entire life.
- How should DLD be treated? Where can parents go for help? And is it possible to recover completely from the disorder?
- Therapy for a child with DLD is not an easy task. The older the child, the more difficult it becomes. Adults with this disorder rarely seek help from speech therapists. Struggling with the hardships of everyday life for a person who, despite sufficient intelligence, is unable to communicate with the world to the full extent of his or her cognitive abilities, usually leaves no room or resources for adequate language therapy. Even more so if a proper diagnosis has never occurred. Adults with undiagnosed DLD wrongly attribute their professional and social failures to low intelligence, awkwardness in life, etc. This is why it is so important that DLD is diagnosed by speech therapists and psychologists as early as possible. Only then are we in a position to include the child and their family with the right therapy, which, even if it does not completely eliminate the effects of the disorder, will certainly contribute to improving the child's, and later the adult's, functioning.
Most importantly, appropriate therapy will equip not only the person with a language disorder but also their loved ones with the tools to reduce the cognitive, emotional and social effects of this serious language dysfunction that is DLD.
Parents who are concerned about their children's language development can seek help at psychological-educational counselling centres or health care facilities from early intervention speech therapists or neurologists.
Dr hab. Ewa Czaplewska, associate professor at the Institute of Logopaedics, University of Gdańsk; psychologist, speech therapist, psycholinguist, a specialist in early speech therapy intervention, especially in the field of DLD/SLI and supporting the development of bilingual children and children brought up in multilingual environments. Author of numerous publications on typical and atypical speech development, among others co-editor of the series of speech therapy textbooks 'Logopedia XXI wieku'. Co-author of the first in Poland standardised and normalized on a large representative group 'Test of Language Development' (TRJ) for children from 4 to 9 years of age. Polish representative, member of the Management Committee in the international project on children with DLD/SLI - Cost Action IS1406 - Enhancing children's oral language skills across Europe and beyond: a collaboration focusing on interventions for children with difficulties learning their first language; member of the ECHO independent international research group on children with DLD - Enhancing CHildren's Oral language skills across Europe and beyond: a collaboration focusing on interventions for children with difficulties learning their first language.