Developmental Language

Disorder
CBS4949 Child Communication Disorders and Special Education Needs
Dr. Li Sheng
[email protected]

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Overview
• Speech-language development milestones
• Theories of language acquisition (Bernstein Chapter 1)
• Developmental Language Disorder
• Genetic basis
• Neurological basis
• Characteristics of English and Chinese DLD (self study)
• DLD, late talkers, and late bloomers
• Assessment and diagnosis
• Activity

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 Developmental language milestones
o Preverbal stage;

o Infants use the earliest modes of communication

o Crying to signal their internal states
o Non-crying vowel-like sounds (first month)
o Visually search for the sound sources
o Demonstrate attention to the objects and people in their environment.
o Cooing or gooing stage (around 2-3 months)
o Babbling stage (4-6 months)
o repetitive consonant-vowel syllable sequences, bababa, dadada
o https://www.youtube.com/watch?v=a7WAfwKi88Q
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 Developmental language milestones
 Children learn to use some speech acts at this stage;
One-word stage; •Labeling  child touch the ball and says “ball”
The appearance of the first Word (12 •Repeating
months) •Answering
• Requesting action  child grabs mother’s finger
Approximately 50 words in their expressive and says “push”
vocabulary by 18 months.
•Requesting an object  child point to a book and
Larger receptive than expressive vocabulary ask the mother “book”?
•Calling  child Calling “mama” from the other
Majority of the early word are nouns room
Food, Clothing, Body parts, animals, toys
and people •Greeting  child Say “Hi” to the people
•Protesting  child Say “No” to an unpleasant
Early words are approximations of the adult action
version •Practicing  child Saying “Daddy” when he is not
Water  wawa, Cat tat, Banana 
nana present

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 Developmental language milestones

Two-word stage;
• Two-word combination appears (about 18 months)
• Expansion of semantic meanings and language functions
• The mean length of utterances (MLU) increase
• Start to use plural markers with both regular and irregular words  “cats, feets”

• Early forms of question appear:

• by rising intonation  “Daddy home?”

• Questions are mainly yes/no, what, where

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 Developmental language milestones
Preschool stage (3-5 years old);
• Utterances become longer and more complex  Mastering pragmatic skills
- Use more polite forms when
• The syntactic structures bear more resemblance to adult syntactic
speaking with adults (please,
structures
• Use more embedded clauses ->this is the one that I want thank you)
- more responsive to the Listeners’
• Mastering the key morphological forms; perspective
• Regular past tense -ed marker and irregular past tense marker
• Possessive ‘s marker and different articles
• Regular and irregular third person singular –s
• Auxiliary verbs
• Still some errors on more complex morphological structure e.g.
Mistaker, storier, unshorten

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English Morphological Development: Brown’s Morphemes

Bernstein 2009, p.174

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 Theories of language
acquisition • Behavioral approaches Skinner, 1957
Theories of • Children learn language:
• through modeling, imitation, and practice
language • by receiving a series of reinforcement and
acquisition punishments or corrections (Owens 1996)

• Syntactic approach Chomsky, 1965

• Children are born with an innate language learning
capacity for basic grammatical structure that exists in
all human languages (i.e., universal grammar)
• Children possess a hypothesis testing device ( i.e.,
Language acquisition device)
Theories of • Cognitive approach Bloom, 1970
• Children progress through stages of cognitive development in early years Piaget (1952) .
language • Highlights the importance of meaning and cognition in language development

acquisition Theories of
• Children learn meaning before they learn syntax (Bloom 1970)
• Child use the phrase “mummy sock” across two different events
language• Object permanence stage  “gone”, “away”
acquisition
• Pragmatic or social approach Bruner, 1974
• View language development within the framework of social development
• Children learn the language to socialize (communicative intention)
• Stress the role of caregiver and child interaction on language acquisition
• Children learn conversational skills (e.g. turn taking) and the roles of a speaker and a
listener
Classification of language disorders based on etiology

• Primary Language Disorder: no known cause

• Official name is Developmental Language Disorder (DLD), used to be
called Specific Language Impairment (SLI)

• Secondary Language Disorders

• Caused by another condition, such as intellectual disabilities (ID),
hearing impairment, autistic spectrum disorder, or brain injury.

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Classification of language disorders based on linguistic profile

Language can be impaired across domains and modalities :

• Different domains (components): form/content/use,
phonology/morphology/syntax/semantics/pragmatics
• Children with Down syndrome (phonology, syntax, semantics, pragmatics)
• Children with Speech Sound/Phonological disorders (phonology)
• Children with Autism spectrum disorder (pragmatics)
• Children with DLD (phonology, morpho-syntax, semantics)

• Receptive and expressive modalities

• Oral and written modalities

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 Developmental Language Disorder (DLD)

• Specific impairment of receptive and expressive language or delayed

in language development in the absence of

• Hearing impairments
• General developmental delays (e.g. motor development)
• Intellectual disabilities (IQ 70 or higher)
• Anatomical defects
• Neurological damage (e.g. perinatal bleeding, seizure disorders)
• Autism Spectrum Disorders
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 DLD
• DLD is also previously called specific language impairment (SLI),
language delay, or developmental dysphasia.

• It is one of the most common childhood learning disabilities,

affecting approximately 7 percent of children in kindergarten.

• The impact of DLD persists into adulthood.

• The cause of DLD is unknown, but recent discoveries suggest;

• A Genetic basis
• A Neurological basis of DLD
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National institute of Deafness and other communication disorders
 Genetic basis of DLD
• Having DLD in the family increases the risk of DLD by three to
four times in first degree relatives (Tomblin, 1996)

• Higher prevalence in monozygotic twins compared to dizygotic

twins (e.g. Bishop et al., 1995)

• FOXP2 mutation in three generation of a family (KE family)

• Still controversial, not observed across studies

• A gene mutation in chromosome 6, the KIAA0319 gene

• appears in DLD, dyslexia and speech sound disorders (Rice et
al., 2009).
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 Neurological basis of DLD
• Neuroimaging study on 5 Finnish family members
with DLD versus a control group

• They listened to series of isolated vowel sounds,

pseudoword, and real words.

• Individuals with DLD showed reduced activation in

brain areas that are critical for speech processing and
phonological awareness. e.g. temporal lobe and
frontal lobes (Brodman area 44).

• Other imaging data also showed structural

abnormalities in the same and neighboring areas.
From Hugdahl et al. 2004. fMRI Brain Activation in a Finnish Family With Specific Language Impairment Compared With a Normal Control Group. Journal of
Speech, Language, and Hearing Research Vol.47 162-172 15
How are language deficits manifested in DLD?

• Lexical and semantic deficits

• Morpho-syntactic deficits
• Syntactic deficits
• Phonological deficits
• Pragmatic deficits

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 Lexical and semantic deficits

• Slower rate of lexical acquisition

• Delays in the production of the first • Word finding difficulties
words and expressing the meaning a. Naming difficulty in single-word tasks as well as in
• Delays in receptive vocabulary discourse
b. Characterized by using repetition, substitution,
pauses and using fillers (stuff, thing)
• Limited vocabularies and less lexical
diversity
• Bird for ostrich • Difficulties in verb learning
• Horse for zebra a. Verbs that encode mental state (Think, understand,
believe, etc.)
b. Overuse of General-All-Purpose (GAP) verbs ( Do, go,
get, put, want)
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 Morpho-syntactic deficits

• Omission or Limited use of grammatical morphemes

• Noun morphology e.g. plural -s,

• Verb morphology (3rd person singular –s & regular past tense –ed)  She ride the horse

• Auxiliary verb forms BE, Do  Why he like me? , She were going to store

• Over-regularization of past, plurals and passive participles  he felled, two mices, got hanged up

• Problems in production of the pronouns  Me play with the doll

• Difficulties in grammatical judgment especially in sentences with more complex syntax

• He made the robot fall/fell/felled off a block

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 Syntactic deficits
• Reduced length and complexity of sentences
• MLU is shorter than age-matched children

• Difficulty in understanding longer and more complex sentences

• Passives  The man is eaten by the fish
• Center-embedded relative clause  the girl who is smiling is
pushing the boy

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Describe these grammatical errors

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From Moore, 2001
 Phonological deficits
• Lower phonological working memory
• Lower digit span or word span memory Eye tracking experiment McMurry, Samuelson, Lee & Tomblin, (2010)

• Difficulty in repeating nonword stimuli

• Poorer phonological awareness skills

• Phonological deficit should not be the only

impaired language components
Sandle-sandwich-candle
Difficulties resisting the interference of phonological distracters
could also be explained by executive function deficits.

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 Pragmatic deficits

• There is not much research about pragmatic issues in children with DLD

• Delays in development of conversational skills

• Lower performance when there are multiple communication partners
• Problem in presupposition skills
• Difficulty in asking or providing clarifications during the
communication breakdown
• Difficulty in comprehension of figurative language e.g. metaphors and
idioms

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Language deficits of Chinese DLD
• Could you think of some differences between Chinese and
English?
• Phonology
• Morphology
• Syntax
• What language difficulties are shown by Chinese children
with DLD?

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Language deficits of Chinese DLD
• Phonoligical deficits
• Tone identification
• DLD group performed worse in tone identification (Wong et al., 2019)

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Language deficits of Chinese DLD
Lexical and semantic deficits
• Classifier
• DLD children omit classfiers more often (Stoke & So, 1997)
• Frequent use of zek3 （只） as a default especially for difficult words, eg.
Glue 膠水, card卡片, bed, peanut花生
e.g. 一 張 檯
Yat1 zoeng1 toi4
a table

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Language deficits of Chinese DLD
Morpho-Syntactic deficits
• Aspect marker (Stokes & Fletcher, 2000; Chen et al., 2022)
• Poor comprehension and restricted use of aspect markers

Cantonese:
我 琴晚 寫 咗 兩 封 信
ngo5 kam4 maan5 se2 zo2 loeng5 fung1 soen3
I last-night write-AM two CL letters

Mandarin:
小 女孩 在 喝 一杯 果汁
xiao nvhai ZAI he yibei guozhi.
The little girl is drinking a cup of juice.

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Language deficits of Chinese DLD
Morpho-Syntactic deficits
• “bei” structure comprehension
• Less capable in comprehension and production of passive sentences (Yu & He, 2022; Zeng et al.,
2018; Leonard et al., 2006)

Mandarin: Cantonese:
门 被 小明 关 上 了。 貓 畀 狗 追
Men BEI Xiaoming guan shang le. mauu1 bei2 gau2 zeoi1
The door was closed by Xiaoming. The cat is chased by the dog.

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Language deficits of Chinese DLD

Morpho-Syntactic deficits
• Relative clause
• Perform worse in RCs production (Wang & Yu, 2021)
Subject RC: Object RC:
亲 妈妈 的 女孩 妈妈 亲 的 女孩
__Qin mama de nȕhai Mama qin __ de nȕhai
“the girl that kissed the mother” “the girl that the mother kissed”

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 Language deficits of Chinese DLD
Conversation Sample Analysis (Wong, 2023)
Name: CY

Age: 6 years and 4 months

Gender: female

Background information: CY was diagnosed as having a “language delay” when she was 3;6 at one
of the comprehensive assessment centers in Hong Kong. When CY was 6;4, the speech-language
therapist who had known her and her family for a few years engaged in conversation with her
while playing with a toy house.

“Understanding Development and Disorder in Cantonese Using Language Sample Analysis” is available at PolyU library
https://julac-
hkpu.primo.exlibrisgroup.com/discovery/fulldisplay?docid=alma991022802582503411&context=L&vid=852JULAC_HKPU:
HKPU&search_scope=MyInst_and_CI&tab=Everything&lang=en
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Language deficits of Chinese DLD
Example One: INV: 坐低嘅，咁呢個係 . . .
INV: 不過我哋擺好晒啲嘢先請佢出嚟啦。咦！依個係 . . . (We sit on it. And this is a . . .)
(But let’s put everything away first and then ask him to come CHI: 挨住嘅。
out. Look! This is a . . .)
lean ASP SFP
INV: {pointing to the sofa}
((We) lean on (it).)
CHI: 彈嘅。
INV: 係呀，挨住嘅。
bounce SFP
(Yes, we lean on it.)
((We) bounce on (it).)
CHI: 呢個X挨住。
INV: 哦，我知啦。你梗係平時喺度咁樣彈嘅。 (with laughter)
this CL X lean ASP
(Ah, I see. You must bounce on it here like this often.)
(This one (we) lean on.)
CHI: 坐低嘅。
sit down SFP INV: 呢個係梳化。
((We) sit on (it).) (This one is a sofa.)
CHI: 梳化。
sofa
Word finding difficulties (Sofa.) 30
Language deficits of Chinese DLD
Example Two: • What will typically developing children say?
INV: 係呀，床要嚟做咩㗎？
我哋夜晚嗰陣時要嚟瞓覺嘅。
(Yes. What is the bed for?)
ngo5dei6 je6maan5 go2zan6si4 jiu3lei4 fan3gaau3 ge3
CHI: 擺喺度。
we night that-time want-come sleep SFP
put at PRT
((When it is nighttime, we use (it) for sleeping.)
((We) put (it) here.)
INV: 好呀。咁要嚟做咩㗎，張床？
(Sure. What is it for, the bed?)
CHI:*2 我哋呢，夜晚哩，係哩，瞓覺嘅。
we PRT, night INT, be INT, sleep SFP
(At night, . . . we . . . sleep (there).
Difficulties explaining object functions and giving definitions

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Language deficits of Chinese DLD
Example Three: relative clause
Background: CY was explaining what is a fireplace (火爐 fo2lo4).
CY: 有火中間嗰個囉XX。
jau5 fo2 zung1gaan1 go2 go3 lo1 XX
have fire middle that CL SFP XX
(The one that has fire in the middle.)

Explanation: When she referred to the 火爐 fo2lo4 [fireplace], she made an attempt to produce a Relative
Clause with omission of the generic head noun 嘢 je5 [thing]. The omission of the head noun was
acceptable but the omission of the Preposition 喺hai2 [at] before the Localizer 中間 zung1gaan1 [middle]
was not. A typically developing child may say “有火喺中間嗰個嘢囉XX。”

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Language deficits of Chinese DLD
Example Four: complex sentence
*不如我哋食完呢我哋呢玩。
bat1jyu4 ngo5dei2 sik6 jyun4 le1 ngo5dei2 le1 waan2
rather we eat finish PRT we PRT play

不如我哋食完之後就玩囉。
bat1jyu4 ngo5dei2 sik6 jyun4 zi1hau6 zau6 waan2 lo3
rather we eat finish after then play SFP
(Why don’t we finish eating and then we play?)

Explanation: CY’s sentence does not include a Temporal Conjunction. It is grammatically inappropriate, with the
absence of a temporal conjunction (e.g., 之後 zi1hau6 [after]) after the verb phrase 食完 sik6 jyun4 [eat finish]. The
temporal adverb 就 zau6 [then] before the verb 玩 waan2 [play] is also omitted in the sentence.

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Language deficits of Chinese DLD
Example Five: serial verb construction
INV: 去邊度玩呀?
(Where do (we) go play?)
CHI: 我哋巴士站呀玩呀。
ngo5dei2 baa1si6zaam6 aa1 waan2 aa3
we bus-stop INT play SFP
(We go to the bus stop to play.)

Explanation: A typically developing child would use the verb 去 heoi3 [go] before 巴士站baa1si2zaam6 [bus stop]
together with the other verb 玩waan2 [play] to make a grammatically appropriate and semantically complete Serial
Verb Construction.

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Videos in Cantonese

• Experiences from a Cantonese-speaking child and parent

• 【杏林在線】有口難言
• https://news.now.com/home/local/player?newsId=306330
• https://www.youtube.com/watch?v=a1cY024fpHI (Cantonese video 發展
性語言障礙: 知多一點點
• https://www.youtube.com/watch?v=za55-2773FA發展性語言障礙: 學習句式有辦法
• https://www.youtube.com/watch?v=Z6n5hmRPjKA學習理解有辦法 (Developmental
Language Disorder (DLD): Learning to Listen and Comprehend)
• https://www.youtube.com/watch?v=7iSVo0Ti5f8是童向語還是BB話? (Child directed
speech or Baby talk​)

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DLD, late talkers, and late bloomers
Late talker

Persistent
Late language
bloomer delay

Typically
DLD
developing

• Children with delay in expressive language and vocabulary growth (Late talker)
• Some are able to compensate their language delay at later stages (late Bloomers); others will have
persistent delays and receive a diagnosis of DLD at a later age (DLD)

• Some predictive factors of language outcomes;

• Delays in development of receptive vocabulary and poor comprehension (Thal & Tobias, 1992)
• Delay in use of communicative gestures ( Thal et al., 1997)
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 How are language disorders assessed?

• The assessment process:

• is conducted for identification and diagnosis purposes

• include referral and screening procedures
• include comprehensive language assessment
• include diagnosis based on the evidence gathered
• is mainly conducted by SLPs

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Communication Sciences and Disorders: An Introduction 37
 Referral and screening

• Children under 5 years usually referred by a pediatrician

• Delayed in acquisition of the language milestones in early years
• School-age children usually referred by teacher or other school personnel

• Screening tools are used

• to determine the child’s problems in using or understanding language
• to determine the need for a comprehensive language assessment

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Communication Sciences and Disorders: An Introduction 38
 Comprehensive Language assessment

• Develops a profile of an individual’s strengths and weaknesses across different

language components i.e. form, content, & use

• Useful for the planning of intervention

• Includes the following:

• Case history and interview
• Assessment of language impairments
• Standardized tests
• Criterion-referenced measures
• Performance assessment procedures
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 Assessment of language impairments
• Standardized tests
• ranks the child’s performance against the norm (i.e., age-
matched typically developing children’s scores

• is necessary to determine the child eligibility to receive SLP

services

• is designed to assess expressive and receptive language skills

• usually have limited scope and contents

• Usually do not evaluate language use, and social

communication skills
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 Assessment of language impairments

• Criterion-referenced measures
• not comparing the child’s performance against the age-matched group
• measure the child performance against a mastery level (e.g. 90% correct)
• provide more in-depth information in specific language components

• Performance assessment procedures

• assess the language skills in more naturalistic manner
• are customized by SLP to assess form, content and use
• uses the language sampling methods
• Open ended questions, narratives (story generation, story retell)

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 42
Credit: Dr. Min Ney Wong
 Diagnosis
• Careful consideration of the evidence and the severity of the problem

• Diagnosis includes:
• Type of impairment (primary, secondary)
• Impacted domains (form, content, use; comprehension,
production)
• Severity (mild, moderate, severe, profound)
• Prognosis
• Recommended course of treatment

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