Expressive vs Receptive Language Disorders

There are three types of language disorders in childhood: expressive, receptive and expressive-receptive disorders.

• Receptive language is comprehension. It involves the ability to process language input.
• Expressive language is outward communication. It involves the ability to communicate to others through language.
• A child with an expressive-receptive disorder has trouble both with reception and expression of language.

1. Receptive Language

Definition

Receptive language refers to a person’s ability to comprehend words and phrases that are spoken to them. It includes a child’s ability to understand a parent who makes commands or asks them questions. Children usually develop receptive language before expressive language. A child who experiences developmental delays in language comprehension may have a receptive language disorder.

Examples

Receptive communication skills include both verbal and non-verbal skills. Examples include:

• Ability to understand at a developmentally appropriate level commands, questions and conversation.
• Ability to implicitly understand routines and habits, such as knowing that cleaning teeth happens before bed time.
• Ability to understand common hand gestures and what they mean.
• Ability to read culturally appropriate signals such as red hexagons mean ‘stop’.
• At a developmentally appropriate level, ability to read both words and visual texts and comprehend their meaning.

Signs of Receptive Language Disorder

Many signs or receptive language disorder may be symptomatic of other issues such as ADD. Expert opinions are important before jumping to conclusions!

Receptive Language Disorder may exhibit itself in the following ways:

• Tuning out during conversations.
• Failure to follow simple commands.
• Inability to answer simple questions.
• Answering questions with irrelevant answers.
• Constant interruptions of conversation.

Assessment

We can measure a child’s receptive language skills by observing actions such as:

• 15 months: Should be able to point to or look at people pointed out by a parent.
• 18 months: Should be able to follow commands like “Look at the cars!”
• 2 years: Should be able to identify parts of a while when commanded, such as pointing to apples on a tree or body parts on an animal.
• 2.5 years of age: Should be able to respond to direct questions using phrases and simple sentences.
• 3 years: Should be able to follow directions that have two parts. Should be able to comprehend or respond to verbs like “get”, “take”, “run”, “walk”.

2. Expressive Language

Definition

Expressive language refers to the ability to communicate through words. This includes capacity to express wants and needs, make requests and engage in conversation. Children develop rudimentary expressive language at around 2 years of age and their language skills improve rapidly in the following years. Children whose expressive language is delayed may have an expressive language disorder.

Examples

Expressive language is not only spoken words. Expressive language includes:

• Use of spoken words, phrases and full sentences to convey meaning.
• Use of common hand signals to convey meaning.
• Use of sounds such as clapping or vocal noises to convey meaning.
• At older ages, effective use of past and future tense to convey meaning.
• At older ages, ability to create texts in writing or through pictures.

Signs of Expressive Language Disorder

Many signs of expressive language disorder are also signs of other issues, so this list is not definitive. Language abilities need to be considered in relation to the child’s developmental stage.

Children who have expressive language disorder may exhibit the following signs:

• Delayed vocabulary and inability to use common words.
• Reliance on a small range of learned phrases to self-express.
• Substitution of words in sentences with phrases like “um” or “thingy”.
• Difficulty with past and future tense when speaking.
• Frustration and outbursts of anger at inability to communicate.
• Very quiet and reserved due to lack of confidence speaking.

Assessment

We can measure a child’s expressive language skills by observing actions such as:

• 15 months: Should be able to say at least three words
• 18 months: Should be able to say names such as “Mama” and “Dada”.
• 2 years: Should know at least 25 words.
• 2.5 years: Should be able to use two-word phrases such as “pat dog” and “drink milk”.
• 3 years: Should know about 200 words, repeat phrases and questions posed to them, know the names of common objects, and use simple sentences.
• 4 years: Should be able to hold a simple conversation and make accurate word choices.

3. Language Disorders, Explained

What is a Language Disorder?

Language disorders do not necessarily have to do with faults in children’s hearing or vocal cords. Children may be able to hear or speak words perfectly fine, but are unable to process words in their brain to make meaning out of them.

The defining feature of a language disorder is difficulty in cognitive processing of language.

Developmental vs. Acquired Language Disorders

A language disorder is typically developmental, although they can also be acquired due to traumatic neurological injuries such as a traumatic head injury or stroke. The most common acquired language disorder is aphasia. Aphasia does not affect intelligence, but merely communication ability.

At what age can I Identify a Language Disorder in my Child?

Developmental language delays are usually noticeable before the age of 4 and are present in about 1 in every 20 children.

Symptoms of developmental language delays are similar to symptoms of other behavioral issues in childhood, so it is best not to make assumptions too soon. Children can be referred to speech therapists or other child specialists to get accurate diagnoses.

Language vs. Intelligence

Developmental delays in children’s language are not necessarily a reflection on a child’s intelligence. Many children who have trouble processing language have high intelligence levels, but experience difficulty in this one area of cognitive processing.

How do Language Disorders affect Children?

Difficulties in communicating have far-ranging effects. Language disorders can have negative impacts on a child’s life. They can affect:

• A child’s social life. Children whose developmental language disorders are not addressed may find themselves socially isolated. They will have trouble communicating with peers and lack friendship groups.
• Concentration. Particularly with receptive disorders, people find it hard to concentrate because not all information is being processed fast enough. They lose track of conversation or explanations and switch off from the communication process.
• Behavioral Issues. Children with poor behavior may be misbehaving due to language difficulties. They may act out if their needs and desires are not heard. Similarly, they may not understand what is expected of them due to trouble receiving messages.
• Ability to get things done and make plans. With a language difficulty, people find it more difficult to get about in life. When they reach adulthood, they may struggle to get customer service staff to help them, find it difficult in understand how to conduct everyday tasks, and struggle to find employment.
• Learning and development.
• Self-esteem. When children feel as if they are unable to perform basic communication functions, they may become withdrawn, lose motivation and lose self-confidence.
• Mental health. Children who are isolated by their language difficulties can develop stress and anxiety issues.
• Academic performance. People with language difficulties may feel frustrated with their inability to understand lessons or express themselves in class, which can lead to poor academic performance. When they cannot follow the teacher’s instructions or explanations, their performance wanes. Teachers need to differentiate instruction to support students with language difficulties.

How can I improve my Child’s Language Skills?

Sometimes developmental language disorders are intrinsic to a child – in other words, it’s not your fault or your child’s!

However, helping children’s language development is an important part of parenting any child. The most valuable strategies you can use include:

• Playing with your child: Use language when playing with your child. Phrases like “open” when a child opens a door and repetition of simple words in context will help their language development.
• Active Reading: Read to your child daily from very early on. When you read together, ensure you interact with the pictures, point out parts of the picture that relate to the story, and encourage your child to use their vocabulary during reading time.
• Making Eye Contact. Before communicating with your child, ensure you make eye contact with them and speak directly to them. Eye contact and the ability to see lips helps a child’s comprehension. Looking at the child will help ensure your voice carrier clearly to their ears.
• Avoiding Cognitive Overload. Cognitive overload is the learning theory that argues people can only hold a certain amount of information in their minds at once. This is especially important for people who have difficulty processing language. To avoid cognitive overload, try to issue short, clear instructions. Avoid complex sentences.
• Provide information in manageable chunks. Another way to avoid cognitive overload is to give commands in short chunks. Give one command, wait for it to be completed, then give the next command.
• Use signposting words. Signposting words include “then”, “if”, “now”, “next”, “here”, and “there”. These words can help children comprehend what is expected of them.
• Use visual aids. Visual aids add context that help children understand communication. A visual aid that complements spoken words will help a child triangulate the information entering their mind and understand information accurately.
• Use prompting questions. Assess your child’s comprehension by asking them to repeat what you said or ask them if they have any questions that needs clarifying.
• Be compassionate and patient. Your child wants to understand you. Try to be patient with them, even when they make mistakes based on miscommunication. It is an emotionally distressing time for your child.
• Speak Slowly. Slow speech makes information communication clearer and less ambiguous. It may also give your child more time to process the information entering their mind.
• Emphasize important words. Use your voice to place emphasis on the important words that you want your child to remember.
• Repeat yourself. Repeating yourself can give your child extra chances to pick up and retain information.
• Reduce distraction. Minimizing distractions such as background noise, cross-talking and movement in the background. Distracting information can increase cognitive load and prevent clear interpretation of information.
• Ask your teacher to change seating layouts. Your child may benefit from being seated closer to your teacher in the classroom.

4. Final Thoughts

Expressive and receptive language are both necessary for communication. Without developmentally appropriate language communication, children may experience serious difficulties academically, socially and personally.

Children who have language difficulties need specialized support that can help them overcome their challenges. It is impossible to diagnose a disorder without specialist help. However, ongoing observable symptoms of language disorders should be taken seriously by parents who can take action to help their child develop into a healthy and well-balanced person.