Current Concepts in the Understanding and Management of Developmental Language Disorder in Children

Introduction

Language disorder is the most prevalent developmental disorder in childhood (Rapin, 2006); however, it does not represent a diagnostic group that designates a uniform condition (Bishop, 1997; Laws & Bishop, 2003). It is highly established that language disorders are typically accompanied by a variety of cognitive challenges, with different types of cognitive difficulties, which manifest for example, in procedural and working memory, as well as executive functioning and motor control (Rinaldi et al., 2021). The disease can sometimes only affect language output; but, in the most severe cases, it can also affect language understanding. The form of language (phonetic, phonological, morphological, morpho-syntactic, and syntactic processing); its content (semantic-lexical and phrasal processing); and its use (pragmatic and discursive processing) can all be impacted by the disease (Roch et al., 2017; Wallace et al., 2015). It has been reported that approximately 11–18% of children aged between 18 and 36 months (Collisson et al., 2016 ; Hawa & Spanoudis, 2014) present a delay in the appearance of expressive language which mostly related to the receptive domain (Buschmann et al., 2008; Desmarais et al., 2008) in the absence of conditions such as brain injuries, intellectual disability, and cognitive impairment (Rinaldi et al., 2021).

Language disorders, according to the DSM-5, are marked problems with language learning and language use (American Psychiatric Association (APA) 2013). The term “language disorder” has recently been proposed to describe children who have severe language difficulties that are likely to persist and have a functional impact on social interaction and academic progress, while the term “developmental language disorder” (DLD) refers to language disorders without any known differentiating conditions, such as autism or brain injury (Bishop et al., 2017). Thus, DLD is a neurodevelopmental condition that emerges in early childhood and frequently persists into adulthood (McGregor, 2020). It is estimated that DLD affects approximately 7% of the population (Norbury et al., 2016). Despite having a significantly higher prevalence than autism (7% vs. 1%), DLD is seldom known, and it is thought that 60% of affected children are never diagnosed (Hall, 1997). The exact mechanisms and brain abnormalities leading to the development of DLD are not well understood. However, it is believed that several risk factors are involved including environmental, genetic, and neurological factors (Conti-Ramsden & Durkin, 2017).

For DLD children, the school years may be particularly challenging because the majority of learning is centered on language. Academically, they encounter several problems because they frequently lag behind their peers, although the real issue is frequently inadequate language abilities rather than a lack of learning capacity (Hall, 1997). The range of these issues and their detrimental effects on a child's development highlight the value of early detection of children who may be showing signs of DLD or other problems, which may can help to promote interventions at a time when significant improvement is most likely to occur (Rinaldi et al., 2021). As a result, a thorough and prompt diagnosis can also help in the formulation of focused rehabilitation therapies that are implemented before the disorder interferes with the formal educational process (Spaulding et al., 2006; Wallace et al., 2015). This chapter provides an overview on DLD in children from understanding to clinical practice.