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Expressive language disorder

Summary

Expressive language disorder means a child has difficulty conveying information in speech, writing, sign language or gestures. The child may not use correct grammar, may produce very short phrases and sentences, and may have a small vocabulary. A speech pathologist usually assesses and treats this impairment.

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Expressive language disorder means a child has difficulty conveying or expressing information in speech, writing, sign language or gesture. For preschool children, the impairment is not evident in the written form, since they have not started formal education.

Some children are late in reaching typical language milestones in the first three years, but eventually catch up to their peers. These children are commonly referred to as ‘late-talkers’. Children who continue to have difficulty with verbal expression may be diagnosed with expressive language disorder or another language impairment.

Symptoms of expressive language disorder


Children with expressive language disorder have difficulties with the grammatical aspects of spoken language such as using the correct verb tense (they might say ‘I go’ when they mean ‘I went’) and combining words to form accurate phrases and sentences. They typically produce much shorter phrases and sentences than other children of the same age, and their vocabulary (the number of words they know and use) is smaller and more basic.

Children with expressive language disorder are usually below the average level for their age in:
  • Putting words and sentences together to express thoughts
  • Recalling the names of words
  • Using language appropriately in a variety of settings with different people (for example, at home, in school, with parents and teachers).
Specific examples of expressive language impairment include a seven-year-old child being unable to join sentences with words like ‘and’, ‘but’ or ‘if’, and a three-year-old child who speaks in two-word sentences.

Symptoms of expressive language disorder differ from one child to the next and depend on the child’s age and the degree of the impairment. Common symptoms include:
  • Making grammatical errors, leaving off words (such as helper verbs) and using poor or incomplete sentence structure (for example, ‘He going work’ instead of ‘He’s going to work’ and ‘I talk’ instead of ‘I can talk’)
  • Using noticeably fewer words and sentences than children of a similar age
  • Using shorter, simpler sentence construction than children of a similar age
  • Having a limited and more basic vocabulary than children of a similar age
  • Frequently having trouble finding the right word
  • Using non-specific vocabulary such as ‘this’ or ‘thing’
  • Using the wrong words in sentences or confusing meaning in sentences
  • Relying on standard phrases and limited content in speech
  • Sounding hesitant when attempting to converse
  • Repeating (or ‘echoing’) a speaker’s words
  • Being unable to come to the point or talking in circles
  • Having problems with retelling a story or relaying information in an organised or cohesive way
  • Being unable to start or hold a conversation and not observing general rules of communicating with others
  • Having difficulty with oral and written work, and school assignments.

Cause of expressive language disorder


For many children, the cause of expressive language disorder is not known. Children who experience difficulties in language development alone are typically diagnosed with specific language impairment. For other children, expressive language disorder is associated with known developmental difficulties or impairments (for example, Down syndrome, autism or hearing loss).

Many children with expressive language disorder will have an accompanying ‘receptive’ language disorder, meaning that they have difficulty in understanding language.

Expressive language disorder can be a developmental (from birth) or acquired impairment. An acquired impairment occurs after a period of normal development. It can be the result of trauma or a medical condition. Research suggests that in some cases expressive language disorder is a genetic impairment (found frequently in more than one family member and across generations).

Diagnosis of expressive language disorder


If your child is having difficulties with speaking or expressive language, have his or her language skills assessed by a speech pathologist (speech therapist). Do not delay an assessment, because your child may miss many months of important therapy. It is also important to have your child’s hearing assessed.

Speech pathologists perform specific assessments to identify the areas of language that a child finds difficult. These assessments are not stressful for the child, and parents are usually present during these consultations.

Speech pathologists may also recommend:
  • An auditory processing test (this is different to a standard hearing test)
  • A test for learning difficulties (for school-aged children)
  • An assessment of cognitive function (thinking and intelligence by a registered psychologist.

Treatment for expressive language disorder


Treatment options depend on the severity of the impairment. Treatment may include:
  • Group sessions with a speech pathologist
  • Individual therapy sessions with a speech pathologist
  • School-based language intervention programs
  • Assistance from special education teachers
  • Teacher’s aide support for children with severe language impairment
  • Speech pathology sessions combined with home programs that parents can use with their child.

Where to get help

  • Your doctor
  • Your maternal and child health nurse
  • A speech pathologist
  • Speech Pathology Australia Tel. (03) 9642 4899

Things to remember

  • Expressive language disorder (also referred to as expressive language impairment) means a child has difficulty with verbal and written expression.
  • For many children, the cause of expressive language disorder is unknown.
  • Treatment for expressive language disorder depends on its severity, but might include therapy with a speech pathologist.

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This page has been produced in consultation with and approved by:

La Trobe / Austin Health Clinical School of Nursing

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La Trobe / Austin Health Clinical School of Nursing

Fact sheet currently being reviewed.
Last reviewed: August 2011

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Expressive language disorder means a child has difficulty conveying information in speech, writing, sign language or gestures. The child may not use correct grammar, may produce very short phrases and sentences, and may have a small vocabulary. A speech pathologist usually assesses and treats this impairment.



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