Language Disorder

Language Disorder is a communication disorder that affects a child’s ability to understand and express language. This can include difficulties with spoken, written, or signed language. Children with a language disorder may have trouble learning new words, forming sentences, or using correct grammar. They might also find it hard to follow conversations or tell stories in the right order. These challenges can make it difficult for them to communicate effectively at home, in school, and with friends. Unlike speech sound disorders, which involve problems making sounds, language disorders involve issues with understanding and using language. This disorder usually appears in early childhood and is not caused by other conditions like hearing loss or intellectual disabilities.

What are the symptoms of Language Disorder?

Children with language disorder show a variety of symptoms that affect how they learn and use language.

Core symptoms of language disorder

– Difficulty learning new words: They may struggle to remember and use new vocabulary.

– Difficulty using a wide range of words: Their vocabulary might be limited, making it hard to express themselves.

– Difficulty making sentences: They might have trouble putting words together to form sentences.

– Difficulty using correct grammar in sentences: They may use incorrect verb tenses or leave out important words.

– Difficulty explaining or describing things clearly: They might find it hard to describe events or explain their thoughts.

– Difficulty connecting sentences when talking about a topic: Their speech may lack flow or coherence.

– Difficulty having conversations with others: They might struggle to keep a conversation going or respond appropriately.

– Difficulty telling a story in order: They may tell stories out of sequence, making them hard to follow.

– Difficulty communicating their thoughts with words: They might find it challenging to express what they are thinking.

– Difficulty talking in social situations: They may avoid talking to others, especially in unfamiliar settings.

Associated symptoms of language disorder

– Behavior problems: Frustration from communication difficulties can lead to acting out.

– Social withdrawal: They might avoid social interactions due to embarrassment or fear of misunderstanding.

– Low self-esteem: Struggling with language can affect their confidence.

– Academic challenges: Language difficulties can impact learning and school performance.

How is Language Disorder diagnosed?

Language disorder is typically diagnosed by a speech and language pathologist, but a psychologist, psychiatrist, or pediatrician may also be involved. The diagnosis process includes various tests to assess a child’s vocabulary, grammar, and ability to use language for learning and communication. A child is diagnosed if they show significant impairments in these areas compared to what is expected for their age. The evaluation often occurs as part of a broader assessment that looks at the child’s overall cognitive development, including intellectual abilities, academic skills, and attention. After the evaluation, families receive recommendations that may include speech or language therapy and other supportive services.

Language Disorder facts

Worldwide prevalence:

Estimates of language impairment range from 0.4% to 25.2% of the global population, with significant variation across groups and studies. Currently, there is no nationally representative data available in Brazil.

Gender ratio:

Data indicate that language disorders are diagnosed more frequently in boys than in girls, with ratios between 1.5:1 and 1.8:1.

Most common age of onset:

The peak age for onset of language disorder is estimated to be between 2 and 3 years of age, earlier than the average onset of neurodevelopmental disorders in general, which is 5.5 years.

Proportion of cases arising before age 18:

Although there are no recent estimates specific to Language Disorder, approximately 83.2% of people with a neurodevelopmental disorder will have been diagnosed by age 18.

What are the associated factors for language disorder?

Some common factors linked with language disorder are:

– Genetic and familial factors: Language disorders often run in families. A child is more likely to have a language disorder if a parent or sibling also has it. Studies show that language disorders are highly heritable, with multiple genes involved.

– Environmental factors: Bilingualism does not cause language disorder, but children who are bilingual may show delays in both languages. Assessment should consider both languages. Other factors include low maternal education, low income, and not attending preschool.

– Biological factors: Being male, having a family history of language difficulties, and certain birth-related factors like low birth weight or preterm birth increase the risk. Hearing problems and a reactive temperament are also risk factors.

What other disorders co-occur with language disorder?

Language disorder can co-occur with other neurodevelopmental disorders, such as specific learning disorders, intellectual developmental disorder, attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder, and developmental coordination disorder. It is also associated with social (pragmatic) communication disorder. Children with language disorder may have difficulty making friends, which can lead to feelings of depression or social anxiety. Understanding these co-occurring conditions is important for providing comprehensive support and intervention.

How is language disorder treated?

Language disorder is best treated with speech and language therapy. A specialist works with the child to improve their ability to understand and use language. This therapy helps develop vocabulary, grammar, and sentence construction, and teaches the child how to use language to learn and communicate.

Therapy is tailored to each child’s needs and may include individual sessions, parent training, and interventions to improve social communication. Parent involvement is crucial, as they can help reinforce language skills at home. Therapy may also address any secondary challenges, such as social interactions or self-esteem issues.

While medication is not typically used to treat language disorder directly, it may be prescribed if the child has co-occurring conditions like ADHD or anxiety. In such cases, medications can help manage symptoms that interfere with language therapy. It is important for caregivers to work closely with healthcare providers to monitor the child’s progress and adjust treatment as needed. Combining therapy with supportive home and school environments can lead to the best outcomes for children with language disorder.

References

Clinical description, symptoms, and diagnostic information

– American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: Fifth edition text revision DSM-5-TR. American Psychiatric Association Publishing.

– World Health Organization. (2025a, January). ICD-11 for mortality and morbidity statistics. 6A01.20 developmental language disorder with impairment of receptive and expressive language. https://icd.who.int/browse/2025-01/mms/en#822134099

– World Health Organization. (2025b, January). ICD-11 for mortality and morbidity statistics. 6A01.2 developmental language disorder. https://icd.who.int/browse/2025-01/mms/en#862918022

– Child Mind Institute. (2023, October 30). Quick facts on language disorder: A brief overview of the signs and symptoms of language disorder, and how it’s treated in children and adolescents. https://childmind.org/article/quick-facts-on-language-disorder/

– Child Mind Institute. (2025, February 6). Language disorder in children: A quick guide. https://childmind.org/guide/quick-guide-to-language-disorder/

– Child Mind Institute. (n.d.). Speech and language therapy. Retrieved March 8, 2025, from https://childmind.org/care/areas-of-expertise/autism-clinical-center/speech-and-language-therapy/

Facts

– American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: Fifth edition text revision DSM-5-TR. American Psychiatric Association Publishing.

– Chilosi, A. M., Brovedani, P., Cipriani, P., & Casalini, C. (2023). Sex differences in early language delay and in developmental language disorder. Journal of Neuroscience Research, 101(5), 654–667. https://doi.org/10.1002/jnr.24976

– De Bree, E., Wiefferink, K., & Gerrits, E. (2024). Characteristics of children and youth referred for language assessment at different ages. Journal of Speech, Language, and Hearing Research, 67(8), 2653–2668. https://doi.org/10.1044/2024_JSLHR-23-00540

– Etchell, A., Adhikari, A., Weinberg, L. S., Choo, A. L., Garnett, E. O., Chow, H. M., & Chang, S.-E. (2018). A systematic literature review of sex differences in childhood language and brain development. Neuropsychologia, 114, 19–31. https://doi.org/10.1016/j.neuropsychologia.2018.04.011

– Hill, E., Calder, S., Candy, C., Truscott, G., Kaur, J., Savage, B., & Reilly, S. (2024). Low language capacity in childhood: A systematic review of prevalence estimates. International Journal of Language & Communication Disorders, 59(1), 124–142. https://doi.org/10.1111/1460-6984.12944

– Institute for Health Metrics and Evaluation (IHME). (2019). GBD compare data visualization. Seattle, WA: IHME, University of Washington. Available from http://vizhub.healthdata.org/gbd-compare. (Accessed 11/15/2022)

– McLeod, S., & Harrison, L. J. (2009). Epidemiology of speech and language impairment in a nationally representative sample of 4- to 5-year-old children. Journal of Speech, Language, and Hearing Research, 52(5), 1213–1229. https://doi.org/10.1044/1092-4388(2009/08-0085))

– Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., Il Shin, J., Kirkbride, J. B., Jones, P., Kim, J. H., Kim, J. Y., Carvalho, A. F., Seeman, M. V., Correll, C. U., & Fusar-Poli, P. (2022). Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry, 27(1), 281–295. https://doi.org/10.1038/s41380-021-01161-7

– Whitehouse, A. J. O. (2010). Is there a sex ratio difference in the familial aggregation of specific language impairment? A meta-analysis. Journal of Speech, Language, and Hearing Research, 53(4), 1015–1025. https://doi.org/10.1044/1092-4388(2009/09-0078))

Associated factors

– American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: Fifth edition text revision DSM-5-TR. American Psychiatric Association Publishing.

– De Bree, E., Wiefferink, K., & Gerrits, E. (2024). Characteristics of children and youth referred for language assessment at different ages. Journal of Speech, Language, and Hearing Research, 67(8), 2653–2668. https://doi.org/10.1044/2024_JSLHR-23-00540

– Harrison, L. J., & McLeod, S.(2010). Risk and protective factors associated with speech and language impairment in a nationally representative sample of 4- to 5-year-old children. Journal of Speech, Language, and Hearing Research, 53(2), 508–529. https://doi.org/10.1044/1092-4388(2009/08-0086))

– Rudolph, J. M. (2017). Case history risk factors for specific language impairment: A systematic review and meta-analysis. American Journal of Speech-Language Pathology, 26(3), 991–1010. https://doi.org/10.1044/2016_AJSLP-15-0181

– Uzun Çiçek, A., Akdag, E., & Celebi Erdivanli, O. (2020). Sociodemographic characteristics associated with speech and language delay and disorders. Journal of Nervous & Mental Disease, 208(2), 143–146. https://doi.org/10.1097/NMD.0000000000001120

– Zambrana, I. M., Pons, F., Eadie, P., & Ystrom, E. (2014). Trajectories of language delay from age 3 to 5: Persistence, recovery and late onset. International Journal of Language & Communication Disorders, 49(3), 304–316. https://doi.org/10.1111/1460-6984.12073

Co-occurring disorders

– American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: Fifth edition text revision DSM-5-TR. American Psychiatric Association Publishing.

– Donolato, E., Cardillo, R., Mammarella, I. C., & Melby‐Lervåg, M. (2022). Research review: Language and specific learning disorders in children and their co‐occurrence with internalizing and externalizing problems: A systematic review and meta‐analysis. Journal of Child Psychology and Psychiatry, 63(5), 507–518. https://doi.org/10.1111/jcpp.13536

– Zupan, B., Hutchings, S. M., Everitt, L. E., & Gupta, C. (2022). Language disorder and internalizing mental health problems in youth offenders: A systematic review. International Journal of Language & Communication Disorders, 57(6), 1207–1228. https://doi.org/10.1111/1460-6984.12759

Interventions

– Child Mind Institute. (n.d.). Speech and language therapy. Retrieved March 8, 2025, from https://childmind.org/care/areas-of-expertise/autism-clinical-center/speech-and-language-therapy/

– Child Mind Institute. (2025, February 6). Language disorder in children: A quick guide. https://childmind.org/guide/quick-guide-to-language-disorder/

– Frizelle, P., Tolonen, A.-K., Tulip, J., Murphy, C.-A., Saldana, D., & McKean, C. (2021). The influence of quantitative intervention dosage on oral language outcomes for children with developmental language disorder: A systematic review and narrative synthesis. Language, Speech, and Hearing Services in Schools, 52(2), 738–754. https://doi.org/10.1044/2020_LSHSS-20-00058

– Jensen De López, K. M., Kraljević, J. K., & Struntze, E. L. B. (2022). Efficacy, model of delivery, intensity and targets of pragmatic interventions for children with developmental language disorder: A systematic review. International Journal of Language & Communication Disorders, 57(4), 764–781. https://doi.org/10.1111/1460-6984.12716

– Kk Nair, V., Clark, G. T., Siyambalapitiya, S., & Reuterskiöld, C. (2023). Language intervention in bilingual children with developmental language disorder: A systematic review. International Journal of Language & Communication Disorders, 58(2), 576–600. https://doi.org/10.1111/1460-6984.12803

– Law, J., Garrett, Z., & Nye, C. (2003). Speech and language therapy interventions for children with primary speech and language delay or disorder. Cochrane Database of Systematic Reviews, 2015(5). https://doi.org/10.1002/14651858.CD004110

– Roberts, M. Y., Curtis, P. R., Sone, B. J., & Hampton, L. H. (2019). Association of parent training with child language development: A systematic review and meta-analysis. JAMA Pediatrics, 173(7), 671. https://doi.org/10.1001/jamapediatrics.2019.1197