What to look for, and strategies to help
If your child is having difficulty communicating, you might be wondering if they have a speech and language impairment. One common one, particularly among children with neurodevelopmental differences, is expressive language disorder.
What is expressive language?
“Expressive language is everything that a child says, from their very first words, right through to long, complex sentences in conversation,” says Karen Massey, a peadiatric speech therapist and author.
“Language helps us express our thoughts, feelings and ideas with others – and without it,”life can very quickly be very frustrating and isolating”, Karen adds.
Expressive language allows a person to communicate their wants, needs and opinions. It’s the ability to make choices, ask and answer questions, and describe events. Speaking, gesturing, writing and vocalisations are all examples of expressive language.
Children with poor expressive language might find it difficult to remember words or use complex sentences. It can also make them feel frustrated when they can’t communicate their wants, such as when they’re tired, unwell or hungry.
How to tell if your child has difficulty with expressive language
The key to working out whether your child has problems with expressive language, is by observing their behaviour, Karen notes: “Often, the first signs of expressive language problems are seen in a child’s behaviour. In particular, frustration in situations where they cannot express themselves or get their message across.”
“Whether that’s them being late to start talking, or difficulties learning specific vocabulary, or problems ordering words in a stance or working out to say things in different situations.”
Some of the other signs of expressive language delay:
1. Late talking
A child who is late to begin talking may be described as having an expressive language delay – but this doesn’t always signal a problem. Keep a close eye on how their speech develops, and if in doubt, get some guidance from a speech therapist who can help determine any interventions required.
2. Jumbled sequencing
Children with expressive language delays can have trouble organising their words into a logical sentence. They can also find sequencing past events difficult, making conversation difficult to follow.
3. Pragmatic language impairments
Children with expressive language delay can have difficulty using the right words for the social situation. They may go off-topic, have a one-sided conversation, find it difficult to understand jokes, or say inappropriate things.
4. Holding a to and fro conversation
Answering and asking questions involves using lots of language. The child has to understand the question, process it, formulate an answer, and then say their answer in a logical way. Children with expressive language impairments can muddle this process up, making them sound incoherent.
What to do if you notice your child is having trouble using language
It’s not always easy to know what you’re looking for, but Karen says getting help as soon as you can is key: “It’s always a good idea to check things out as soon as you notice something might not be quite as expected.
“Sometimes you ask and receive reassurance that there’s nothing to worry about, so you can move on.
“You might be able to just add one or two small changes or ideas, then find your child makes progress again. Or you might find that additional support is the way forward. Acting early means your child will benefit quickly and therapy for expressive language is often very successful.”
Tips to help your child develop their expressive language
Difficulties with expressive language can lead to frustration, misunderstandings, and difficulties with social situations, but there are things you can do at home to help. Karen shares her top tips:
“Help a toddler by joining in his or her play and commenting. Feed him or her with new vocabulary, praise talking, and gently show new ways to expand single words into phrases and sentences. Use lots of repetition and learn in different ways, for example with songs, rhymes, and stories.”
“A great way to support expressive language skills is to make it visual. Use coloured templates to build sentences, link speaking with reading, and offer lots of space and pauses to encourage your child to take a turn.”
Children with neurodevelopment disabilities
“Be sure to include your child’s interests as they will be more motivated to learn and communicate if you do. Be prepared to teach, rehearse and repeat many times before new language is used.
“Think about how you can use different sensory ways to support learning, for example, can you clap or jump the words in the sentence? Can you colour them in or build them with bricks?”
How can a speech therapist (SALT) help a child with an expressive language impairment?
A SALT might use child-led language through play, such as the Hanen approach or parent-child interaction. They might also use colourful semantics to help them build sentences, or shape coding to add visual structure to sentences. “Other therapies that can support spoken language include signing, PECS and other symbol approaches”, Karen says.