Language Disorders

Sessions Covering Language-Related Impairments and Learning Disabilities

Children or adults with language disorders have difficulty with either understanding or using language.  Click here to visit our page with information about specific linguistic areas, their impacts, and therapy approaches.

Developmental Language Disorders

Language disorders that occur developmentally (often diagnosed in childhood and persisting into adulthood), necessarily impact a child’s ability to learn and function academically and/or socially; therefore, language disorders may be referred to as language-based learning disabilities. In the absence of additional problems, they may also be referred to as specific language impairments. Despite their communicative and academic difficulties, many children with language-based learning disabilities have average to superior intelligence. Parents are often unaware and caught off-guard by their child’s learning differences, which may be difficult to identify or observe, and might not be perceptible at all until the child begins school. Following an evaluation by a neuropsychologist, a learning disability diagnosis may be given as well as additional related diagnoses. Often, a comprehensive evaluation conducted by a speech-language pathologist is necessary to identify the specific nature of a child’s linguistic difficulties. This may result in more specific language disorders such as specific reading disorder, disorder of written expression, expressive language disorder, or mixed receptive-expressive language disorder. Associated diagnoses such as attention deficit hyperactivity disorder (ADHD) are often identified concomitantly, but the exact etiology of developmental learning difficulties is often unknown. Language disorders in children may also occur due to congenital syndromes, diseases, or traumatic brain injury. While the same language disorders occur within these populations, their presentation may differ from that of a child with isolated developmental language difficulties.

Developmental language disorders may impact any combination of linguistic areas depending on the individual. Difficulties with receptive language, expressive language, reading, and writing are often present. For children with language disorders, functioning in academic and social situations may be considerably difficult, even if outward manifestations of the difficulty are not readily apparent. As a result of these skills being involved in many facets of their daily life, the emotional health of a child with language disorders may be impacted. While a child’s quality of life can certainly be impacted by their language disorder, intervention by a speech-language pathologist, beginning as early as possible, can improve their communicative skills. As a result, their quality of life, as well as their social, academic, and professional opportunities, can be enriched. It is important to address language difficulties as early as possible due to developmentally increasing linguistic demands and the potential for mounting self-esteem issues. As children age, language skills and demands in social and academic settings increase and build upon each other, which may lead to the child having increasing difficulty and frustration as the years progress. Along with this, difficulties with self-esteem may occur due to the child’s struggles with academics and communication, particularly in the presence of average or above average intelligence. Without addressing language-based learning difficulties, self-esteem issues may continue to build, leading to avoidance of academics and other emotional impacts.

In order to identify the specific linguistic aspects affected, a speech-language pathologist at Language & Learning will evaluate each linguistic area to determine if skills are developmentally typical and age-appropriate. Each impacted language area may have manifestations at the word, sentence, and/or contextual level; therefore, a speech-language pathologist must conduct a battery of tests to elicit linguistic skills in a variety of contexts. Parental and teacher reports, as well as observation in functional communication situations, are also an important part of the diagnostic process.

Treatment by a speech-language pathologist at Language & Learning will involve improving underlying skills as well as facilitating self-awareness, strategies, and supports, with the ultimate goal being improved quality of language understanding and/or use, in both written and verbal contexts. One of the speech-language pathologist’s targets is teaching the underlying language skills that are difficult for the child, and applying them in increasingly difficult contexts. Since learning these skills has proven difficult for the child, at Language & Learning we believe that alternative approaches are an important element of this aspect of therapy, with interactive methods and visual supports being incorporated whenever possible to provide multiple learning modalities. In addition to working toward improvement of underlying skills, the child’s understanding and use of compensatory strategies and supports will also be targeted. Particularly when approaching adolescence, a time when children begin to develop the metacognitive skills necessary to evaluate their own strengths and needs, strategies and supports play a critical role in keeping up with academic demands. While underlying linguistic skills may be learned in therapy, the child with a language disorder will continue to have difficulty in their areas of weakness as linguistic requirements become increasingly difficult with age. It is therefore a necessary part of therapy to support the student in understanding their own linguistic strengths and weaknesses, as well as the strategies and supports they will need. Implementation of skills and strategies within increasingly functional contexts is also an essential element of therapy. Even with many repeated exposures, children with language disorders often have difficulty independently generalizing skills, strategies, and supports to novel, functional situations.

Aphasia

Language disorders beginning later in life that are secondary to neurological damage are typically known as aphasia. While the most common cause for this damage is stroke, aphasia may also occur due to traumatic brain injury or other neurological changes (caused by disorders, tumors, etc.). Similar to developmental language disorders, aphasia may result in significant social and academic/professional impacts, with the exact area of weakness being difficult to pinpoint without the help of a professional.

Despite affecting the same general skills, the presentation and treatment approach may differ greatly depending on whether the language disorder occurs developmentally or as a result of neurological injury. For example, those with Wernicke’s aphasia often unknowingly substitute non-words for real words to make nonsensical but grammatically correct sentences, which is not a characteristic of developmental language difficulties. Treatment may also vary due to the differing communicative needs between individuals with aphasia (which typically occurs in adulthood) and those with developmental language disorders (often diagnosed in childhood).

Aphasias are most commonly diagnosed as either Wernicke’s aphasia, Broca’s aphasia, or global aphasia. Global aphasia results from widespread neurological injury, and impacts both receptive and expressive language skills. Individuals with Wernicke’s aphasia often have poor repetition abilities, use non-words, and string words/non-words together in a nonsensical, but grammatically-structured, sentence. They are also often unaware of these errors. Individuals with Broca’s aphasia typically struggle to put words together to create a grammatically correct sentence. While they may be able to recall content words, they have difficulty putting their ideas together. Broca’s aphasia is also characterized by poor repetition abilities and some comprehension difficulties caused by their grammatical weaknesses. Some of the additional types of aphasias include anomic (primarily word-finding difficulty), transcortical sensory (similar to Wernicke’s but with strong repetition skills), transcortical motor (similar to Broca’s but with strong repetition skills), and primary progressive aphasia (a disorder involving gradual language loss). Following evaluation of all major linguistic areas, a speech-language pathologist at Language & Learning will develop goals to help the client relearn impacted language skills and learn compensatory strategies. Functional applications also play an important role in treatment of this population. This often occurs through offering facilitative strategies to communicative partners and/or deliberate application of skills and strategies in a variety of functional communicative environments.

Both children and adults with language difficulties may have relative strengths and weaknesses within the area of language; therefore, it is important for the speech-language pathologist to determine and address specific areas of linguistic weakness depending upon the individual.  Visit our page about specific linguistic areas, impacts, and therapy approaches for more information.