- Your child has reached 15 months of age but is still speaking in two-word sentences.
- At 2 years old, your child’s vocabulary is limited to fewer than 25 words.
- At age 3, your child often repeats your questions or does not speak in full sentences.
- At age 4, your child still regularly uses the wrong words in a sentence.
If you have a child with developmental expressive language disorder (DELD), he or she might have difficulty remembering vocabulary words or using complex sentences. A 5-year-old with DELD might speak in short, three-word sentences, for example. When you ask your young child a question, he or she might not be able to find the right words to answer you.
Unless combined with other learning disabilities, DELD is usually limited to expression and does not affect the ability to read, listen, or produce sounds. Expressive language disorder is fairly common, occurring in three to 10 percent of school-age children.
The cause of DELD is poorly understood. It is usually not related to the child’s level of intelligence. The condition may run in a family or be caused by a brain injury or malnutrition. Some language disorders are accompanied (and worsened) by other issues, such as autism and hearing impairment. If your child’s central nervous system is damaged (a condition called aphasia), he or she may be more likely to develop a language disorder.
The disorder may appear alone or with other language deficiencies. The symptoms are usually limited to vocabulary issues and faulty word memory. For example, your child may not be able to recall words he or she has just learned. The child’s vocabulary may be below average in comparison with other children in the same age group. The child may not be able to form a long sentence and might omit words or use them in the wrong order. He or she might also confuse tenses, saying, "I jump" in place of "I jumped," for example.
Commonly, children with DELD will use filler sounds such as "uh" and "um" because they cannot think of how best to express themselves. Repetition of phrases and questions is also common; your child might repeat a portion of your question back to you while thinking about how to answer.
Receptive-Expressive Language Disorder
If your child exhibits the above symptoms and also has a hard time understanding what you are saying, he or she might have receptive-expressive language disorder (RELD). In that case, your child might also struggle to understand information, organize thoughts, and follow directions.
Some children’s language skills are simply delayed, but will catch up to those of other children over time. In the case of DELD, however, your child might develop some language skills but not others. Here are some ways to tell if you should see a doctor about your child’s language development:
Your primary care doctor may recommend that you see a speech therapist, a neurologist, or a child development specialist. Your doctor will usually take down your medical history to determine if other people in your family have a language disorder or speech problems.
During a visit with a specialist, your child will undergo a standard test for expressive language disorder. Your child may also need a hearing test to rule out the possibility that hearing impairment is causing the language problem. Your child may also be tested for learning disabilities.
In order to develop language skills, children must be able to see, hear, understand, and retain information. Speech therapy focuses on testing and strengthening these skills and on helping your child increase his or her vocabulary. A speech therapist can use word repetition, images, tailored reading materials, and other tools to help nurture your child’s communication skills.
Children who have difficulty expressing themselves may feel frustrated and socially isolated. Your child might get into fights because he or she cannot find the right words during an argument. Counseling teaches children how to cope when they become frustrated by their communication struggles.
The prognosis is best for children whose expressive language disorder is not combined with other conditions, such as hearing impairment, brain injury, or learning disabilities. Through language therapy, children with DELD can usually learn how express themselves fully. Counseling also helps children to adjust socially and avoid low self-esteem. Seeking treatment early is important for minimizing the psychological challenges that your child might experience as a result of the disorder.