Understanding Language Disorders: Causes and Characteristics

Language forms the basis of communication. Language allows you to express your thoughts, whether verbally or nonverbally. We tend to teach our children to express their needs and wants through a language which is mostly their mother tongue. If the child is unable to express in accordance with the age, it is definitely going to be a concern for the parent. Language disorder is the difficulty of getting meanings through speech, writing, or even gestures.

It refers to a number of conditions where speaking or understanding words and language is difficult. If someone is unable to derive meaning from verbal or non-verbal language, it is evident that such an individual has a language disorder. Let us get an understanding of such language disorders.

Types of Language Disorders

Language disorders can be congenital or acquired. It can be caused by various organic, structural, psychological, or environmental factors. Developmental language disorders can be seen in children with Hearing loss, Autism, Mental retardation, Specific language impairment/ developmental dysphasia, dyslexia, etc. There are varieties of ways in which speech and language disorders can be classified. One way is as follows:
a) Developmental
b) Acquired

Language development can be arrested/ hindered by several factors, such as brain damage caused during the prenatal, natal, and postnatal periods leading to conditions like mental retardation, cerebral palsy, and dysphasia/aphasia in childhood. It could also be affected due to sensory defects such as congenital hearing impairment and oral structural defects such as cleft palate.

Developmental vs Acquired Language Disorders

Developmental/congenital and acquired language disorders are two broad categories of language disorders, and they differ in terms of their causes, onset, and characteristics. Here’s an overview of each.

	Developmental/congenital language disorders/congenital	Acquired language disorders
Definition	Acquired language disorders, also known as secondary language disorders, are language impairments that develop after a period of typical language development.  Acquired language disorders are deficits that occur due to traumatic brain injury, stroke, neurological conditions such as epilepsy or brain tumors, seizures, or medical conditions.	Acquired language disorders are linked to specific neurological or medical causes. Common causes include strokes, traumatic brain injuries, brain tumors, infections, neurodegenerative diseases, and other brain-related conditions.
Examples	Developmental language disorders occur during a child’s early developmental period, typically before the age of three. Symptoms become apparent as the child begins to acquire and use language.	Traumatic brain injury, Seizure disorders, Brain tumors, Autoimmune disorders, lead poisoning, metabolic disorders
Onset	Acquired language disorders are linked to specific neurological or medical causes. Common causes include strokes, traumatic brain injuries, brain tumors, infections, neurodegenerative diseases  and other brain-related conditions.	Acquired language disorders can occur at any age and are typically associated with a specific event or condition, such as a stroke, brain injury, neurodegenerative disease, or other medical conditions.
Causes	The exact causes of developmental/congenital language disorders are not always clear, but they are believed to have a strong genetic and hereditary component. Environmental factors and early language exposure can also play a role.	Acquired language disorders are linked to specific neurological or medical causes. Common causes include strokes, traumatic brain injuries, brain tumors, infections, neurodegenerative diseases and other brain-related conditions.
Nature	Individuals with developmental language disorders may have difficulties with various aspects of language, including vocabulary development, grammar, comprehension, and social communication skills. These difficulties persist into adulthood, although with appropriate intervention, some improvement can be made.	Acquired language disorders can manifest in various ways, depending on the underlying cause and location of brain damage. Aphasia is a well-known example of an acquired language disorder that affects language comprehension and expression. The nature and severity of the language impairment vary based on the specific condition.
Intervention	Speech therapy and language intervention are the primary modes of treatment for developmental language disorders. Early intervention is essential for helping affected children develop effective language skills.	The treatment and management of acquired language disorders often involve rehabilitation services, including speech and language therapy, as well as other forms of medical and therapeutic intervention, depending on the underlying condition. The goal is to help individuals regain or compensate for lost language abilities.

Developmental language disorders are present from early childhood, have unclear etiologies, and typically involve difficulties in language development. Acquired language disorders are linked to specific neurological or medical conditions, often occur later in life, and result in language impairments due to brain damage. The assessment, diagnosis, and treatment of these disorders differ based on their nature and underlying causes.

How to identify Language disorders?

With delayed onset, if speech is developed, abnormal, inadequate, and/or deviant language behavior is evidenced, such as any of the following:

• Incorrect/inappropriate speech characteristics, including voice, articulation, and prosodic abnormalities.
• Limited speech output, progress with age in terms of stages of language development, length, and complexity, variety of utterances, inadequate mastery of grammatical inflections, inadequate acquisition of grammatical categories of nouns, verbs, adjectives, adverbs, prepositions, etc.
• Typical vocabulary and grammatical development are seen as the patchy acquisition of vocabulary on a single or a few selected topics. Only nouns such as names of objects, interest /fascination with numbers, alphabet, dates, etc
• Stereotyped and repetitive use of language such as echolalia, use of stock utterances of few topics only, and repeated questions and others.
• Use of neologisms (new and non-existent words in the language of exposure) whose meaning is obscure to others.
• Lack of spontaneous and responsive speech is seen as an inability/ failure to initiate and sustain conversations, indicating problems with interpersonal communication or two-way communication in any given situation.
• Difficulties with speech comprehension are seen in the failure to comply with requests, questions, etc… an inability to derive meaning from others’ speech/failure to understand others’ speech, etc.
• Abnormalities in the use of nonverbal aspects involved in communication, such as the poverty of facial expressions and gestures such as pointing, showing, impaired emotion recognition and expression, failure to understand basic gestures and facial expression, etc
  • Difficulties with reading and/or writing.
  • Poor scholastic achievement.
• Observation of any of these features by parents/teachers, doctors, or any other professionals warrants a consultation with a speech-language pathologist and audiologist. Several of these atypical features of language manifestations are found in specific combinations in the different clinical conditions of disabilities.
• One needs to understand the multi-faceted, complex language disorders and their highly varying nature.
• The term language disorder, therefore, applies to a heterogeneous group of individuals who show diverse problems in the acquisition (developing)/ comprehension (understanding)/ production (expression), and use of various aspects of language singly or in different permutations and combinations.
• Language-disordered individuals (children and adults) have major problems in a language like:
  • Poor listening skills
  • Limited skills in understanding spoken language
  • Limited expressive language skills
  • Limited or lack of use of morphological elements of language
  • Limited use of sentence structures
  • Inappropriate use of language
  • Deficient use of language
  • Limited conversational skills and limited skills in narrating experiences.

In addition, certain language-disordered children and adults might also manifest

• Some abnormal patterns of language
• Limited cognitive skills· Later problems with reading and writing 
• Later problems with reading and writing

Assessment of Language Disorders

Assessing a language disorder typically involves a comprehensive process that includes various steps to determine the nature and severity of the disorder. The assessment procedure for a language disorder is typically conducted by speech-language pathologists (SLPs) or other qualified professionals. It involves a systematic and thorough evaluation of an individual’s language and communication skills. Here is a step-by-step breakdown of how the assessment procedure is typically done

Assessment Step	Description
Referral	Initiated by health care provider, teacher, or parent.
Case History	Gather information about individual background, medical history, development milestones, and family history of language disorders.
Interview	Conduct an interview with caregivers or parents to gather information about their communication skills.
Standardized Assessment	1. Administer formal tests to evaluate different aspects of language. 2. Receptive Language: Assess understanding of spoken language, following instructions, and comprehending language concepts. 3. Expressive Language: Assess vocabulary, grammar, and sentence structure. 4. Social Communication Skills: Assess conversation skills, turn-taking, use of nonverbal cues, and interpretation of social context.
Observation	Assess language and communication skills in real-life situations, such as structured tasks, free play, and conversation.
Language Samples	Assess language production through spontaneous conversations, storytelling, and describing pictures.
Parent/Caregiver and Teacher’s Input	Gather input from individuals in different settings to assess language skills.
Hearing Assessment	Rule out hearing impairment as a potential cause of language difficulties.
Additional Assessments	Conduct additional assessments based on specific concerns and suspected language disorders (e.g., cognitive abilities, auditory processing, motor skills).
Analysis	Analyze assessment results to determine the presence and nature of the language disorder.
Conduct regular follow-up assessments to track progress and adjust the treatment plan.	Specify the type and severity of the language disorder based on assessment findings. The diagnosis helps guide treatment planning.
Treatment Planning	1. Develop individualized treatment plans tailored to the individual’s needs and goals. 2. Treatment may include speech therapy, language therapy, and strategies to support language development
Progress Monitoring	Conduct regular follow-up assessments to track progress and adjust the treatment plan as needed.
Variability	The assessment procedure may vary based on age, the nature of the language disorder, and individual factors.
Goal	Provide a comprehensive understanding of the language disorder to guide appropriate interventions and support.

The assessment procedure may vary depending on the individual’s age, the nature of their language disorder, and other individual factors. The ultimate goal of the assessment is to provide a comprehensive understanding of the language disorder and to guide appropriate interventions and support.

Language Delay Vs Language Disorder

	Language delay	Language disorder
Definition	Language delay refers to a situation where an individual’s language development is behind the expected milestones for their age. It is a temporary lag in language development	A language disorder is a more persistent and specific impairment in the development of language skills. It involves deficits in language comprehension, expression, and use, and it is not a temporary delay.
Onset	Language delay typically occurs in children during their early years. It is often observed in children who are late talkers but eventually catch up with their peers.	Language disorders can be identified in children or adults, and they are often present from an early age. They may persist throughout an individual’s life.
Causes	Language delay can be caused by various factors, including environmental factors, limited exposure to language, hearing impairment, or a family history of late language development	Language disorders can have various causes, including neurological or genetic factors. They are not typically a result of environmental or temporary factors.
Nature	Early intervention is essential for language-delayed children, and many catch up to their peers with speech therapy and language-rich environments.	Individuals with a language disorder may struggle with one or more aspects of language, such as vocabulary, grammar, comprehension, and social communication. Their difficulties are often more persistent and not limited to a temporary delay.
Intervention	Individuals with a language disorder may require ongoing speech therapy or language intervention to improve their language skills. The focus of intervention is to help individuals compensate for or overcome their language difficulties.	Individuals with a language disorder may require ongoing speech therapy or language intervention to improve their language skills. The focus of intervention is to help individuals compensate for or overcome their language difficulties

Is it Speech delay or Language delay?

Speech delay and language delay are mostly used interchangeably. In fact, speech delay indicates the delay in producing certain speech sounds. Individuals who find it difficult to articulate certain speech sounds are identified as having speech delays. Language delay indicates the inability to use correct words and pronunciations to express something they want to. The language skills of such individuals, though they have a typical sequence, are not age-appropriate.

Other disorders in childhood, like autism, could also bring about delayed and deviant language development. Some children also exhibit learning disabilities during schooling. Lack of onset of speech or delay in the onset of speech is seen as partition /total mutism with limited vocalization or total lack of speech.

Treating language disorder

Any Speech issue or language issue can be treated using speech therapy techniques. Language disorders should be addressed as early as possible.

Speech therapy

The speech therapist works with your child to develop vocabulary and grammar. Speech therapists also suggest home-based activities and tips for improvement for children.

Psychotherapy

If the child faces emotional difficulties due to language concerns, then psychotherapy is suggested depending on the child’s age and cognition.

A parent or caregiver should communicate with the child and understand their difficulties even when they cannot express their needs. It helps if the parent or caregiver can take the suggestions of a speech therapist in communicating with their child and helping them deal with their difficulties.