Developmental Language Disorder (DLD): complete guide
Developmental Language Disorder (DLD), formerly called dysphasia, is a neurodevelopmental disorder that persistently affects the acquisition and use of oral language. This disorder persists despite appropriate stimulation and in the absence of intellectual disability, sensory impairment or explanatory medical condition. It affects approximately 7% of children.
📋 Contents
Definition and diagnostic criteria
According to the international CATALISE consensus (2017), DLD is defined by:
- Persistent language difficulties (beyond 5 years)
- Significant functional impact on daily communication
- Difficulties that are not explained by: intellectual disability, sensory impairment, neurological lesion, ASD, other medical condition
- Difficulties that persist despite appropriate intervention
⚠️ New terminology
The term "dysphasia" has been replaced by "Developmental Language Disorder" (DLD) in international classifications. This new designation better reflects the neurodevelopmental and persistent nature of the disorder.
Manifestations of DLD
DLD can affect different components of language, with varied profiles:
| Component | Possible difficulties |
|---|---|
| Phonology | Sound disorders, persistent phonological simplifications |
| Vocabulary | Reduced lexicon, word-finding difficulties, slow lexical access |
| Morphosyntax | Short sentences, omissions, persistent grammatical errors |
| Discourse/narrative | Difficulties organizing ideas, poor narratives |
| Pragmatics | Sometimes conversational difficulties |
| Comprehension | Variable: sometimes preserved, sometimes impaired |
Clinical profiles
- Expressive DLD: comprehension preserved, expression impaired
- Mixed DLD: BOTH expression AND comprehension impaired
- Some profiles primarily affect phonology, others morphosyntax...
Diagnosis
Warning signs
- First words after 18-24 months
- Late word combinations (after 30-36 months)
- Language poorly intelligible after 4 years
- Persistent difficulties despite intervention
- School difficulties related to language
Diagnostic assessment
- Complete speech therapy assessment: all language components
- Psychological assessment: rule out intellectual disability, assess non-verbal reasoning
- Auditory assessment: rule out sensory impairment
- Neuropediatric consultation if necessary
💡 Differentiating delay and disorder
A language delay resolves with time and stimulation. A DLD persists despite intervention. The diagnosis of DLD is generally made with certainty only after 5 years, when the persistent nature is established.
Daily impact
- Communication: frustration, difficulties being understood
- Schooling: learning difficulties, reading, writing
- Social: relationships with peers sometimes difficult
- Emotional: risk of low self-esteem, anxiety
- Behavior: sometimes behavioral problems (frustration)
Speech therapy treatment
Principles
- Early: from the identification of difficulties
- Intensive: several sessions per week if possible
- Extended: over several years
- Comprehensive: all language components
- Functional: aiming for effective communication
Working areas
- Vocabulary development with visual aids
- Morphosyntax work: sentence construction
- Phonological work if necessary
- Narrative development
- Written language preparation
- Parental guidance: family involvement
Schooling and accommodations
Students with DLD are entitled to accommodations (PAP or PPS):
- Systematic visual aids
- Reformulated, simplified instructions
- Additional time
- Adapted oral assessments
- Writing assistance (secretary, computer)
- AESH if necessary (with PPS)
- Possible orientation to ULIS TFM (Motor Function Disorders) or UEE
Our downloadable tools
Frequently asked questions
DLD is a persistent disorder: it does not "cure" in the medical sense. However, with appropriate treatment, people with DLD make significant progress and can develop functional communication. Difficulties may diminish but sequelae often persist (written language, elaborate expression). Support may be necessary throughout life.
DLD primarily affects oral language. Dyslexia specifically affects written language learning (reading). However, many children with DLD also develop dyslexia because oral language is the foundation of written language. Both disorders can therefore coexist.
Many children with DLD follow mainstream schooling with accommodations (PAP/PPS). For severe cases, orientation to specialized classes (ULIS) may be proposed, with possibility of return to mainstream settings. The important thing is to adapt schooling to the child's needs. With appropriate support, many succeed in their academic and professional journey.
