What is Expressive Language Disorder?
Expressive language is how a person expresses their feelings and ideas. Expressive language disorder is characterised by a child having difficulty expressing him- or herself using speech or writing.
Children with expressive language disorder do not have problems pronouncing certain sounds or words, as with a phonological speech disorder (discussed in a previous blog post), in fact they will tend to be within the normal range for correct speech sounds. The problem is with putting sentences together, finding and using the right words, and the use of grammar.
Types of Expressive Language Disorder
Expressive language disorder can either be developmental or acquired. The acquired type is caused by damage to the brain from a head injury or stroke, but the most common type that we see here at Children’s Therapies is developmental, and generally appears when a child is learning to talk. There is no known cause for this type.
Children with expressive language disorder may have started talking later than their peers and been slower to put two words together. Once they are using whole sentences, these children may say ‘stuff’ or ‘that’ frequently instead of naming specific objects, because they are unable to remember the correct word. Children with expressive language disorder are usually of the same intelligence as their peers and can understand complex instructions and sentences, they just can’t form these complex sentences themselves. They also tend to use shorter sentences and can have difficulty holding a conversation.
Symptoms can vary widely in each child depending on their age and the severity of the disorder. A three-year-old with ELD might typically be only using two-word sentences, and a seven-year-old might miss out connective words like if,’ ‘and,’ or ‘but.’
If your child seems to be experiencing any of the following, it’s a good idea to see a speech and language therapist who can assess them for ELD:
Problems putting sentences together
Problems remembering and finding the right word for an object
Difficulty using grammar
A smaller vocabulary than peers of a similar age
Incorrect use of pronouns (me, mine, he, him)
Leaving prepositions out of sentences (at, on, but, if)
Confusing verb tenses (I go instead of I went)
Problems retelling a story or relaying information
Difficulty holding a conversation
When assessing a child for expressive language disorder, I use both verbal and non-verbal standard tests to look for the following, once I have ruled out a hearing problem:
Is the child performing below the level of their peers at tasks requiring speech communication?
Is the level of speech less developed than expected for the child’s intelligence and ability to understand spoken language?
Does this problem with level of speech create difficulties for the child in everyday life?
Therapy for expressive language disorder
To help a child with expressive language disorder, I usually recommend one-to-one therapy in clinic for improving speech and communication skills, combined with a programme to follow at home that aims to incorporate the target level of spoken language into everyday activities. At the clinic, I make use of the toys and games resources we have here to help the child practice naming everyday objects, and mimicking games to encourage them to narrate their actions and tell me about the objects they are playing with.
Therapy Activities To Try At Home
My SLT colleagues and I will always advise activities to try at home to complement the specific individual therapy we provide for each child in clinic. As general guidance though, try to be talkative when you are with your child, narrating your actions as you put clothes or toys away, prepare food, put on clothes etc. Talk about what you see when you are walking or driving, naming the specific objects. When your child speaks, don’t correct her but repeat back to her using the correct words and sentence structure.
The good news is that with therapy, we see a significant improvement in most cases of expressive language disorder.
If you have any concerns about the speech or language development of your child and would like to discuss them with a speech and language therapist, please call us on 0208 6737930.