Thoughts of a secondary school SLT

Tag: subcategories

  • Language Disorders: Is there a difference between disadvantage and disorder?

    There has been some debate over the years around whether a language disorder should be distinguished from language disadvantage. The link between low socio-economic status (SES) and language difficulties is well established. In some deprived areas, as many as 50% of children do not have appropriate language skills for their age (Roy & Chiatt, 2013). This far exceeds the generally quoted prevalence rate of 7% across the population.

    How can this be? The environments we grow up in strongly influence our own development, and it seems reasonable that poor linguistic input from parents could lead to language difficulties in their children. Indeed, one study found that pre-schoolers’ language patterns closely mirrored that of their parents, from the range of vocabulary they used, to their interaction styles (Roy and Chiatt, 2013).

    This has led some to ask: if these children’s difficulties are down to their environments, rather than some innate difficulty with language learning, is it still appropriate to diagnose a language disorder? Could some of these children have the potential for normal language development, but have lacked the opportunity or language experience? And finally, are language difficulties caused by these kind of external factors different from those caused by internal ones?

    Surprisingly, some patterns of difference have been observed. Some studies revealed that certain areas of language, such as vocabulary and multi-clausal sentences were more affected by SES than other areas, such as basic syntax (Roy and Chiatt, 2013). Other measures, such as non-word and sentence repetition, and use of grammatical inflections also appear to be less influenced by upbringing and are sometimes considered to be more reliable predictors of language disorder.

    Some researchers have accounted for these differences by theorizing that certain aspects of language development may be more “in-built” than others. Basic syntax, and the non-word repetition tasks mentioned earlier may rely more on innate language processing abilities, and where there is no internal deficit, these skills may develop normally. On the other hand, building a rich vocabulary is a more knowledge-based endeavor, which relies on repeated exposure to a wide range of words in the environment.

    Whatever the truth, in practice it is hard to differentiate between language difficulties caused by internal versus external factors, since risk factors tend to co-occur and interact. Social deprivation may lead to poorer language outcomes through the quality of language and interactions that children are exposed to in their environments. Or it may be due to heritable aspects which have been overlooked.

    In 2016, a group of international experts concluded that there was no particular language profile associated with social disadvantage, and that the aforementioned trends are not an adequate basis on which to classify children (Bishop et al, 2017).

    For more information on the causes of language disorders, please see my post:

    https://secondaryschoolslt.wordpress.com/2026/01/05/what-causes-language-disorders/

    Notes

    Bishop DVM, Snowling MJ, Thompson PA, Greenhalgh T, CATALISE consortium (2016)

    CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children. PLoS ONE 11(7): e0158753.

    Bishop, D.V.M., Snowling, M.J., Thompson, P.A., Greenhalgh, T., and the CATALISE-2 consortium (2017). ​ Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. ​ Journal of Child Psychology and Psychiatry, 58(10), pp. ​ 1068–1080. doi:10.1111/jcpp.12721​

    Roy, P. and Chiat, S. (2013). Teasing apart disadvantage from disorder The case of poor language. In: Marshall, C. R. (Ed.), Current Issues in Developmental Disorders. Current Issues in Developmental Psychology. (pp. 125-150). PSYCHOLOGY PRESS. ISBN 9781848720848

  • Are there different subtypes of language disorder?

    Developmental Language Disorder (DLD) is a broad category that encompasses a wide range of problems (Bishop et al, 2017). Some students may struggle to formulate complex, or even simple sentences; they may miss off grammatical inflections indicating verb tense or number, or experience other grammatical difficulties. For others, a small vocabulary, alongside difficulties learning new words and understanding the connections between words seems to be the main issue.

    Other students may have trouble following instructions, or remembering and understanding large amounts of spoken information, even though they know the individual words contained within it. Some may have good understanding and sentence formulation skills but have specific difficulties in the area of pragmatics.

    I have one student, for example, with weak inference skills, who struggles to make himself understood, even though his oral sentences are basically okay. When he speaks, his thoughts come out in a jumble, and he fails to consider what his conversation partner is likely to know already, either giving too little, or too much information.

    Do all of these students have the same problem? Or is the nature, and cause of their difficulties diverse? There have been attempts over the years to identify different subgroups within the broader category of DLD. You may have used the terms “receptive language disorder” or “expressive language disorder” yourself. The term “Pragmatic Language Impairment” has also been used to describe children with social and pragmatic difficulties who do not meet the criteria for Autistic Spectrum Disorder (ASD).

    However, when a group of international experts met in 2016 to attempt to reach a consensus on a range of issues, they were unable to agree on different subgroup classifications. They observed that the categories of receptive and expressive language disorder were rather “gross” and that subcategories were not stable over time (Bishop et al, 2017).

    In some longitudinal studies, researchers attempting to classify children into different subgroups found that those children moved fluidly between those groups over time (Paul & Norbury, 2012). So a child who was originally placed into a vocabulary group or a receptive language group might have ended up in a group for children with expressive language difficulties by the end of the study. This brings into question the integrity of these subcategory classifications, and the utility of imposing them on the broader category of DLD, at least given our current understanding.

    What these results do seem to suggest, is that whilst language disorders are chronic, the way that they manifest appears to change over time. This is likely due to a mixture of internal shifts as well as external factors such as successful intervention, combined with the increasing demands of new contexts, which may reveal difficulties across other areas.

    So, a child initially identified with oral language difficulties may gradually overcome those, only for difficulties with more complex written language to emerge as they grow older. Instead of treating these as two separate difficulties, it seems more likely that they are different manifestations of the same underlying problem.

    Finally, just as language disorders do not divide neatly into different subtypes, the boundaries between different neurodevelopmental disorders such as DLD, dyslexia and ASD may be less clear-cut than is commonly assumed. Until we fully understand the underlying mechanisms beneath these conditions, we are limited to what we see on the surface.

    For more information on whether there is a difference between language disadvantage and language disorder, please see my next post: https://secondaryschoolslt.wordpress.com/2026/03/06/language-disorders-is-there-a-difference-between-disadvantage-and-disorder/

    Notes

    Bishop DVM, Snowling MJ, Thompson PA, Greenhalgh T, CATALISE consortium (2016) CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children. PLoS ONE 11(7): e0158753.

    Bishop, D.V.M., Snowling, M.J., Thompson, P.A., Greenhalgh, T., and the CATALISE-2 consortium (2017). ​ Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. ​ Journal of Child Psychology and Psychiatry, 58(10), pp. ​ 1068–1080.

    Paul, R. and Norbury, C. (2012) Language Disorders from Infancy Through Adolescence: Listening, Speaking, Reading, Writing, and Communicating. 4th edn. St. Louis, MO: Elsevier.