Mind Your Language: Developmental Language Disorder

5 December 2016

Sometimes a study is published that makes you stop and think. Often it is a study that is subtle in its message and yet could have profound implications. I recently read one such study by Dr Susan Ebbels and her team at Moor House Schools and College HERE.

The study looked at the effectiveness of direct 1:1 intervention by Speech and Language Therapists working with children with severe Developmental Language Disorders. This study concluded that 1:1 intervention with very highly trained therapists, working on programmes directly designed to support the needs of the child, was extremely effective and “direct SLT services should be available for school-aged children with (D)LD, including older children and adolescents with pervasive difficulties” (Ebbels et al, 2016)

Yes,” I thought as I read the conclusions, “That is really obviouswhy doesn’t that happen for all children with speech language and communication difficulites?” But, the research suggests that these children who were involved in the trial are the lucky ones – they received the support they needed.

It sounds like a no brainer, doesn’t it. Children with a language development difficulty should receive the appropriate support. And yet, does it happen?

Since 2011 Professor Courtenay Norbury and her team have been leading a longitudinal population study to explore language ability and risk for language impairment at school entry age in the UK. After an initial screening of over 7000 children, the SCALES study (2016) invited 600 children, randomly selected to take part in more in-depth research assessments of their language, communication and learning skills over time. Some of the initial analysis of the trial data published earlier this year have been shocking. The analysis suggests that on average two children every class of thirty will have a language impairment or delay that should receive specialist clinician intervention. Yet within the sample, less than half of the children who met the criteria for language impariment had been referred to specialist clinical services. This included the 1% of the sample who started school being described as ‘non-verbal’ – put simply they had no clear intelligble speech at all. Often it was the youngest children on entry to school who were most rated as having language development deficits and these deficits were highly correlated to behaviour problems.

It is easy to understand why a child may have behaviour difficulites if they don’t understand, or aren’t able to express themselves clearly. Equally, there is considerable evidence to suggest that children who have received speech and language therapy at some point are at far greater risk of having difficulties learning to read and write. Putting that into a national context, in 2006, the Bercow Review concluded that up to 80% of children in some primary schools (typically those in areas of high social and economic disadvantage) have either delayed or impaired language development. The Communication Trust is more conservative in their estimates – they only suggest 50%.

So, in real terms, what does this mean for us in the classroom. Quite simply, it means that up to 50 % of the children in front of you may understand very little of what you say. Even if they do have some sense of understanding, they could find it extraordinarily difficult to contruct speech in order to respond and share thoughts, ideas, feelings, wishes and desires.

Is this a case of schools and teachers simply not acting on the research evidence in front of us? Do we go chasing for more complex and difficult explanations for some of the barriers to learning children seem to have? Is the answer, inconveniently, much simpler, but more profound in its implications? Professor Dorothy Bishop is clear- language impairments and delay are far more common that either dsylexia or ASD and yet it is the least identified Special Educational Need for children, and the least researched.

So maybe before we leap to other conclusions, maybe we should be asking…. How will we know if a child is having difficulty with language? What will that mean for the child? And finally, how can we help?

Find out more about Developmental Language Delay and specific language impairments HERE.


Megan Dixon, Director of Aspirer Research School

Posted on 5 December 2016
Posted in: Evidence
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