Developmental Language Disorder (DLD)

Overview

Developmental language disorder is one of the most common developmental disorders. The disorder can interfere with learning, understanding, and using language. The disorder’s language difficulties are not explained by other conditions, such as hearing loss or autism, or by circumstances such as lack of exposure to language.

Developmental language disorder is a developmental disorder, which means its symptoms first appear in childhood. This does not mean children grow out of the problem. Instead, the condition appears in early childhood and will likely continue but change as they get older.

For example, a young child with developmental language disorder might use ungrammatical sentences in conversation, while a young adult with developmental language disorder might avoid complex sentences and struggle to produce clear, well-organized, grammatically accurate writing.

Early treatment during the preschool years can improve the skills of many children with language delays, including those with developmental language disorder. Children who enter kindergarten with significant language delays are likely to continue having problems, but they can still benefit from treatment. Even older children can still benefit from treatment.

Related Terms: Developmental language disorder has also been called:

• Specific language impairment
• Language delay
• Developmental dysphasia

Signs and Symptoms

A child with developmental language disorder often has a history of being a late talker, reaching spoken language milestones later than peers. Although some late talkers eventually catch up, children with developmental language disorder have persistent language difficulties.

Developmental language disorder can be difficult to recognize, as the signs aren’t the same for every child.

Younger children with developmental language disorder may:

• Be late to put words together into sentences
• Struggle to learn new words and make conversation
• Have difficulty following directions, not because they are stubborn, but because they do not fully understand the words spoken to them
• Make frequent grammatical errors when speaking

Older children and adults with developmental language disorder may experience:

• Limited use of complex sentences
• Difficulty finding the right words
• Difficulty understanding figurative language
• Reading problems
• Disorganized storytelling and writing
• Frequent grammatical and spelling errors

Language difficulties may be misinterpreted as a behavioral issue. A child who struggles with language may avoid interactions, leading others to think the child is shy. A child may not follow directions because they don’t understand the instructions, but others may interpret this as misbehavior. A child who struggles to communicate may become frustrated and act out. When a child struggles at home or in school, it is important to determine if language difficulties may be part of the problem.

Related Health Effects

Developmental language disorder is not the same thing as a learning disability. Instead, developmental language disorder is a risk factor for learning disabilities, since problems with basic language skills affect classroom performance. Children with developmental language disorder are more likely to be diagnosed with a learning disability than children who do not have developmental language disorder.

Specific academic challenges associated with developmental language disorder include:

• Difficulty translating letters into sounds for reading
• Writing weakened by grammatical errors, limited vocabulary, and problems with comprehension and organizing thoughts into coherent sentences
• Difficulty with mathematical word problems due to language comprehension challenges
• Signs of dyslexia in some children

By the time they reach adulthood, people with developmental language disorder are six times more likely to be diagnosed with reading and spelling disabilities and four times more likely to be diagnosed with math disabilities than those who do not have developmental language disorder.

Voice, speech, and language disorders more broadly often affect a person’s emotional and social life and can compromise educational and job opportunities.

Causes and Risk Factors

Developmental language disorder is a neurodevelopmental disorder. Neurodevelopmental disorders result from complex interactions between genes and the environment that change brain development. The exact causes of the brain differences that lead to developmental language disorder are unknown.

Family History

Family history plays a role. Neurodevelopmental disorders tend to run in families. Children with developmental language disorder are more likely than those without developmental language disorder to have parents and siblings who have also had difficulties and delays in language development. In fact, 50–70% of children with developmental language disorder have at least one family member with the disorder. Other potentially related neurodevelopmental disorders, such as dyslexia or autism, are more common in the family members of a child with developmental language disorder.

Multilingualism Does Not Cause Developmental Language Disorder

Learning more than one language at a time does not cause developmental language disorder. The disorder can, however, affect both multilingual children and children who speak only one language. For multilingual children, developmental language disorder will affect all languages the child speaks. Importantly, learning multiple languages is not harmful for a child with developmental language disorder. A multilingual child with developmental language disorder will not struggle more than a child with developmental language disorder who speaks only one language.

Diagnosis

If a doctor, teacher, or parent suspects that a child has developmental language disorder, a speech-language pathologist (a professional trained to assess and treat people with speech or language problems) can evaluate the child’s language skills. The type of evaluation depends on the child’s age and the concerns that led to the evaluation.

In general, an evaluation includes:

• Direct observation of the child
• Interviews and questionnaires completed by parents and teachers
• Assessments of the child’s learning ability
• Standardized tests of current language performance

These tools allow the speech-language pathologist to compare the child’s language skills to those of same-age peers, identify specific difficulties, and plan for potential treatment targets.

A hearing test is often included in the evaluation because a hearing problem can affect speech and language development. Depending on the results, the speech-language pathologist may suggest activities to do at home, recommend group or individual therapy, or suggest further evaluation by an audiologist or a developmental psychologist.

Language assessment may also involve formalized questionnaires, direct observation, and testing of vocabulary, understanding, the production of words and sentences, and the use of language in social situations. Given the diversity of the U.S. population, interpretation of findings from language assessment measures must take into account the native language of the speaker.

Treatment and Management

Building stronger language skills is key for children with developmental language disorder. Scientists are developing ways to boost their learning. They’re also trying to identify children with the disorder earlier to get them support sooner.

Treatment services for developmental language disorder are typically provided or overseen by a licensed speech-language pathologist. Treatment may be provided in homes, schools, university programs for speech-language pathology, private clinics, or outpatient hospital settings.

Identifying and treating children with developmental language disorder early in life is ideal, but people can benefit from treatment regardless of when it begins. Treatment depends on the age and needs of the person.

Starting treatment early can help young children to:

• Acquire missing elements of grammar
• Expand their understanding and use of words
• Develop social communication skills

For school-age children, treatment may focus on:

• Following directions
• Understanding the meaning of words that teachers use
• Organizing information
• Improving speaking, reading, and writing skills

Adults entering new jobs, vocational programs, or higher education may need help learning technical vocabulary or improving workplace writing skills.

Living With DLD

Many adults develop strategies for managing developmental language disorder symptoms. This can improve their daily social, family, and work lives.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on developmental language disorder.

Find Treatment

Talk to your child’s doctor or teacher if you have any concerns. Your doctor or teacher may refer you to a speech-language pathologist, a health professional trained to evaluate and treat people with speech or language disorders.

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.  

NIH supports a wide variety of research on the causes, symptoms, diagnosis, and treatment of developmental language disorder. Current research areas include:

• Understanding how brain and learning patterns differ for children with developmental language disorder compared to children with typical language development
• Determining how to accurately diagnose developmental language disorder, especially in children who speak a variety of dialects or languages
• Identifying the best ways to teach language to children with developmental language disorder, including how many times a language structure should be practiced, how instructional sessions should be organized, and how often teaching should occur
• Researching how to coach parents or peers of children with developmental language disorder to support language growth at home or school

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.