Expressive language disorder is difficulty expressing oneself through language, often seen in children and adults with normal intelligence who have suffered a head injury, stroke, or seizure. It is different from speech disorders and is diagnosed by a speech therapist. Treatment involves language training and counseling. Most children with expressive language delay will eventually develop normal language skills. The prognosis for adults varies depending on the severity of brain damage.
Expressive language disorder is a condition in which a person has difficulty expressing themselves with language, both speaking and writing. Usually, people with expressive language disorder have normal or near-normal intelligence and understand words they hear or read, but have difficulty using them to express themselves to others. Expressive language disorder is a fairly common developmental problem in children, but it is also seen in adults who have suffered a head injury, stroke, or seizure. If a person also has difficulty understanding what she is hearing or reading, she may actually have mixed receptive-expressive language disorder. A doctor or developmental specialist will determine if further testing is appropriate and may refer a patient to a speech pathologist for further testing.
It is important to note that expressive and receptive language disorders are different from speech problems. Speech disorders involve the physical structures of the mouth, tongue, or voice; the person with a speech disorder has difficulty physically forming words. Speech disorders involve the area of the brain that controls language processing and communication. Receptive language is the ability to interpret and make sense of the communication you receive and expressive language is the ability to express your ideas and thoughts to others. Because different areas of the brain control receptive and expressive language processing, it is possible to have difficulty in just one of these areas, but still have normal or above normal intelligence and reasoning skills in all other areas.
Expressive speech disorders are often diagnosed by a speech therapist. The tests will involve both verbal and non-verbal intelligence tests to rule out other conditions such as mental retardation or global developmental delay. Hearing tests are usually included to rule out deafness or hearing impairment, which can also interfere with normal language development. If the test shows a significant difference between receptive and expressive language skills, the pathologist will try to determine how severely the disorder is affecting the patient’s daily life before making a definitive diagnosis.
Treatment for expressive language disorders involves language training techniques adapted to the patient’s age and social settings. Patients usually receive one-on-one speech therapy to develop language and social skills. Sometimes parents and teachers are also coached, so they can incorporate language skills into the child’s daily play and school activities. In some cases, counseling may be recommended to address the associated emotional problems resulting from the child’s frustration and social isolation.
Most children who have expressive language delay without other conditions will eventually develop normal language skills. Speech therapy is very effective, especially if started early. The prognosis for adults who develop an expressive language disorder after a brain injury varies depending on the severity of the brain damage. Some patients make a full recovery after therapy, but for others, speech problems can persist for years. Anyone who suspects that he or someone he knows has expressive language disorder should contact a physician for evaluation and referral.
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