When a child has difficulty with language, it might also be assumed that they have an intellectual disability. But not all children who have trouble expressing or understanding spoken and written language will be diagnosed with an intellectual disability.
Read on to learn more about the difference between intellectual disabilities and language disorders, and what you can do if you suspect a child needs professional help.
Neurodevelopmental disorders are often noticed in the early years, from birth to five years. These disorders frequently co-exist. For example, children with autism spectrum disorder (ASD) often have an intellectual disability, and many children with attention-deficit/hyperactivity disorder (ADHD) also have a specific learning disorder. Communication disorders include language disorder, speech sound disorder, social (pragmatic) communication disorder, and childhood-onset fluency disorder (stuttering) (DSM-5, 2013).
What is an intellectual disability?
When compared to their peers, children with an intellectual disability have greater difficulty learning new things, understanding concepts, solving problems, concentrating, and remembering.
Many health professionals won’t officially diagnose very young children with an intellectual disability, preferring to wait and see if a child is simply a late bloomer.
However, there can be some early warning signs:
- Slow to sit, crawl, or walk
- Delayed talking
- Poor attention
- Limited planning or problem-solving abilities (e.g. a child may be unable to play in a constructive way with toy building blocks)
- Difficulty with understanding rules and instructions
- Behavioural and social problems
- Trouble with self-care tasks such as getting dressed, toileting, and feeding themselves
It’s important to note that all children develop at different rates, some may start out slower but catch up as they get older - this doesn’t necessarily mean they have an intellectual disability. However, if you’re worried about how a child’s skills are developing, it’s best to have them assessed by a professional sooner, rather than later.
What is a language disorder?
A child who experiences difficulty finding the right words or speaking in clear sentences may be diagnosed with a language disorder. You might notice that they’re having trouble putting their thoughts into words, or perhaps having trouble following conversations with their peers.
It’s important to also note that a language disorder is different from a speech disorder or a hearing impairment. Children with language disorders generally don’t have trouble hearing or pronouncing words. Their struggle is related to understanding and applying the rules of language - like using the correct grammar, and speaking in well-formed sentences. “Children with SLI [specific language impairment] may be intelligent and healthy in all regards except in the difficulty they have with language. They may, in fact, be extraordinarily bright and have high nonverbal IQs,” writes Margaret Ervin in The ASHA Leader.
There are two main types of language disorders, ranging from mild to moderate or severe.
1. Expressive language disorder: Having difficulties explaining, thinking, or expressing needs. Young children may have trouble with:
- Asking questions
- Naming objects
- Using gestures
- Putting words together into sentences
- Learning songs and rhymes
- Using correct pronouns, like "he" or "they"
- Knowing how to start a conversation and keep it going (Source: ASHA.org)
2. Receptive language disorder: Having difficulties understanding language or meaning. Young children may have trouble with:
- Understanding what gestures mean
- Following directions
- Answering questions
- Identifying objects and pictures
- Taking turns when talking with others (Source: ASHA.org)
I think a child might have language difficulties, what do I do?
If you’re concerned that a child may be experiencing language difficulties, we recommend that a referral is made (with parental approval) to the school's learning support team.
Parents and teachers will be invited to complete a checklist on the child’s development and learning abilities. The learning support teacher might also complete an initial language screening test using the CELF-5A&NZ Screener – a quick 15-minute test that accurately screens the child's oral and social language skills. The test results will recommend whether further investigation is required, in which case the child might be referred to a speech language pathologist, and/or a psychologist.
These professionals may work together to determine if the child is simply a late bloomer, or if they have a language disorder and/or an intellectual disability. Both professionals play an important role:
- A speech language pathologist assesses a child’s speech and language skills with standardised tests such as the CELF-5A&NZ
- A psychologist measures IQ, including nonverbal intelligence and adaptive behaviour, for example, is the child able to toilet, dress, or feed him/herself independently. The psychologist can obtain an overall idea of the child’s intellectual abilities with tests such as the WISC-VA&NZ and Vineland-3.
What’s next after diagnosis?
If a child is diagnosed with a language disorder, a speech language pathologist can offer intervention strategies and support for parents and teachers to assist the child in the learning and social environments.
Prevention strategies are key – the earlier a child's difficulties are identified, the greater their chance of improvement. If there are any concerns with a child's development and learning it is best to discuss these with your child's teacher; alternatively you can contact a speech language pathologist in your area.
This article is part of the Mind the Gap initiative that supports student wellbeing to improve learning outcomes. For more information about this topic, or any of the clinical assessments mentioned in this article, please feel free to contact Anisa Zulfiqar.Read more