|Receptive-Expressive Language Disorder
Speech and language disorders refer to problems in communication and related areas such as oral motor function. These delays
and disorders range from simple sound substitutions to the inability to understand or use language or implement oral-motor for
functional speech and feeding.
Speech disorders may be problems with the way sounds are formed, called articulation or phonological disorders, or they may
be difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. People with
speech disorders have trouble using some speech sounds, which can also be a symptom of a delay. All communication
disorders may adversely affect a child's educational performance.
Developmental expressive language disorder is a disorder in which a child has a poor understanding of vocabulary, the
production of complex sentences, and recall of words. Receptive – expressive disorder is one in which both the receptive and
expressive areas of communication may be affected in any degree, from mild to severe.
There are several different types of communication disorders, including the following:
• Expressive language disorder
Expressive language disorder identifies developmental delays and difficulties in the ability to produce speech.
• Mixed receptive-expressive language disorder
Mixed receptive-expressive language disorder identifies developmental delays and difficulties in the ability to understand spoken
language and produce speech.
In a language disorder a child has the inability to understand and/or use words in context, both verbally and nonverbally. Some
characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate
grammatical patterns, reduced vocabulary and inability to follow directions. One or a combination of these characteristics may
occur in children who are affected by language learning disabilities or developmental language delay. Children may hear or see a
word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to
A child's communication is considered delayed when the child is noticeably behind his or her peers in the acquisition of speech
and/or language skills. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills,
but this is not always the case.
Signs of receptive-expressive language disorder
The following are the most common symptoms of communication disorders. However, each child may experience symptoms
• May not speak at all, or may have a limited vocabulary for their age
• Has difficulty understanding simple directions or are unable to name objects
• Shows problems with socialization
• Inability to follow directions but show comprehension with routine, repetitive directions
• Echolalia (repeating back words or phrases either immediately or at a later time.)
• Inappropriate responses to "wh" questions
• Difficulty responding appropriately to: yes/no questions, either/or questions, who/what/where questions,
• Repeats back a question first and then responds to them
• High activity level and not attending to spoken language
• Jargon (e.g. unintelligible speech)
• Uses "memorized" phrases and sentences
• They may have a problem with words or sentences, both understanding and speaking them
• Learning problems and academic difficulties
While many speech and language patterns can be called "baby talk" and are part of a young child's normal development, they can
become problems if they are not outgrown as expected. In this way an initial delay in speech and language or an initial speech
pattern can become a disorder which can cause difficulties in learning. Because of the way the brain develops, it is easier to
learn language and communication skills before the age of 5. The symptoms of communication disorders may resemble other
problems or medical conditions. Always consult your child's physician for a diagnosis.
Communication disorders may be developmental or acquired. The cause is believed to be based on biological problems such as
abnormalities of brain development, or possibly by exposure to toxins during pregnancy, such as abused substances or
environmental toxins such as lead. A genetic factor is sometimes considered a contributing cause in some cases. Some causes
of speech and language disorders include hearing loss, neurological disorders, brain injury, mental retardation, drug abuse,
physical impairments such as cleft lip or palate, and vocal abuse or misuse. Frequently, however, the cause is unknown.
For unknown reasons, boys are diagnosed with communication disorders more often than girls. Children with communication
disorders frequently have other developmental disorders as well. Most children with communication disorders are able to speak
by the time they enter school, however, they continue to have problems with communication. School-aged children often have
problems understanding and formulating words. Teens may have more difficulty with understanding or expressing abstract
Diagnosis for receptive-expressive language disorder
Most children with communication disorders are first referred for speech and language evaluations when their delays in
communicating are noted. A child psychiatrist is usually consulted, especially when emotional or behavioral problems are also
present. A comprehensive evaluation also involves psychometric testing (testing designed to assess logical reasoning abilities,
reactions to different situations, and thinking performance; not tests of general knowledge) and psychological testing of
There’s variety of language disorders for example receptive language may be mildly delayed and expressive language may be
severely delayed. Knowing the type of mixed receptive-expressive language delay is important because the split may impact
academics. For one the child may exhibit severely delayed receptive language skills and only mildly delayed expressive language.
The receptive language difficulties will most likely have a significant impact on being able to follow directions and understand
classroom instruction. This child will need extra help (written directions, one-on-one time) in order to be successful.
Many speech problems are developmental rather than physiological, and as such they respond to remedial instruction. Language
experiences are vital to a young child's development. In the past, children with communication disorders were routinely removed
from the regular class for individual speech and language therapy. This is still the case in severe instances, but the trend is
toward keeping the child in the mainstream as much as possible. In order to accomplish this goal, teamwork among the teacher,
speech and language therapist, audiologist, and parents is essential. Speech improvement and correction are blended into the
regular classroom curriculum and the child's natural environment.
Treatment for communication disorders
A coordinated effort between parents, teachers, and speech/language and mental health professionals provides the basis for
individualized treatment strategies that may include individual or group remediation, special classes, or special resources. Special
education techniques are used to increase communication skills in the areas of the deficit. A second approach helps the child
build on his/her strengths to overcome his/her communication deficit.
Specific treatment for communication disorders will be determined by your child's physician, special education teachers, and
speech/language and mental health professionals based on:
• your child's age, overall health, and medical history
• extent of the disorder
• type of disorder
• your child's tolerance for specific medications or therapies
• expectations for the course of the disorder
• your opinion or preference
Speech-language pathologists assist children who have communication disorders in various ways. They provide individual
therapy for the child; consult with the child’s teacher about the most effective ways to facilitate the child’s communication in
the class setting; and work closely with the family to develop goals and techniques for effective therapy in class and at home.
Early detection and intervention can address the developmental needs and academic difficulties to improve the quality of life
experienced by children with communication disorders. The speech-language pathologist may assist vocational teachers and
counselors in establishing communication goals related to the work experiences of students and suggest strategies that are
effective for the important transition from school to employment and adult life.
|Receptive-Expressive Language Disorder
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