Max is 6 years old. He’s been at school for an entire term, and he’s uttered just a few words. Ask his teacher to describe Max, and she’ll say he’s inattentive, “away with the fairies” and a bit naughty. He’s labelled, early on, as an underachiever.
But actually, Max has a condition that explains all of the above - developmental language disorder (DLD).
Put crudely, DLD is to spoken language what dyslexia is to written language. It requires constant effort and attention for Max to understand what is going on in lessons. He might, for example, pick up on his teacher saying “dog”, “chase” or “boy”, and understand that there had been a chase involving a boy and a dog, but not whether it was the boy chasing the dog, or vice versa. This is exhausting for Max, and it’s easier for him to tune out entirely.
You might think that Max’s circumstances are unusual, but you would be wrong. In fact, DLD is very common in the classroom. In 2018, researchers predicted that around 7.5 per cent of children begin school with a language disorder unexplained by any other condition, with DLD the likely cause. In a class of 30 children, an average of two will need therapeutic intervention for their language difficulties.
Dorothy Bishop, professor of developmental neuropsychology at the University of Oxford, is an expert on DLD. She believes it’s the most prevalent special educational need that most teachers have never heard of.
Why? Bishop says part of the problem is around language choices. Until recently, the preferred term for the condition was “specific language impairment”. “Developmental language disorder” was settled on only after considerable debate and research. “All these choices of words are very loaded,” Bishop says. “If I say ‘impairment’ or ‘disorder’ or ‘disability’, it makes a big difference.”
The symptoms of DLD are also difficult to spot as they can be written off as behaviour or attention issues, says Courtenay Norbury, professor of developmental language and communication disorders at University College London. She adds: “People with DLD often come across as not listening or not paying attention. And so, people don’t recognise language disorder as much as dyslexia or autism.”
Because of widespread ignorance about the challenges they face, students with DLD can have an extremely difficult time in education. What can be done? First, teachers need to be aware of the symptoms, and the disorder itself. But once they have identified a child with DLD, what should they do next?
Pupils need visual support within a classroom to help them to access what the teacher is saying, says Bishop. If a teacher is talking about windmills, for example, an image of a windmill should be on display.
Sometimes diagnosis itself can lead to improvements. As a result, pupils often have weekly sessions with a speech and language therapist, as well as daily activities with a teaching assistant trained in dealing with speech and language difficulties.
However, speech and language therapy must be specifically developed to target the needs of pupils with DLD, says Bishop: “With speech and language therapy, a lot of what’s done isn’t being subjected adequately to good trials. Therefore, lots of what’s going on in schools is people making it up as they go along.”
But still, if pupils do have targeted intervention at school, they are one of the lucky ones, says Bishop. The sad reality is that too many children with DLD remain undiagnosed and are condemned to a life of underachievement simply because people are unaware that the condition exists.
Adi Bloom is a writer and editor, and is former comment editor at Tes
Commentary: ‘There is still much work to be done’
Courtenay Norbury is professor of developmental language and communication disorders at University College London. She says:
In May 2022, it will be 10 years since my colleagues launched a campaign to raise awareness of DLD. As described in Adi Bloom’s article, the origins were rooted in our frustration that, despite being very common, the disorder was so poorly recognised.
Indeed, my own research from the Surrey Communication and Language in Education Study (SCALES) in 2016 found that DLD affects 7 per cent of the primary school population, which is approximately two children in every classroom.
We knew that teachers would be crucial to the success of this campaign: they are often among the first to recognise that something is not quite right about a child’s development or participation in the classroom. But all too often, without the knowledge of DLD, they may attribute difficulties with language to bad behaviour or trouble with reading.
However, things are slowly improving. Our campaign has realised huge success, and we launched an International DLD Day that is celebrated across the globe every October. We have produced films that have had more than 1.3 million views, providing unique insights into the impact of DLD on school success, friendships and mental health. Language is now firmly on the political agenda: the government has committed more than £17 billion to support the delivery of early language interventions such as the Nuffield Early Language Intervention (NELI).
We shouldn’t, however, get ahead of ourselves: there is still much work to be done. Speech, language and communication needs are the most commonly identified special educational needs, and yet, only 17 per cent of identified children receive an education, health and care plan.
Getting the right services for children with language disorders remains a challenge and parents face a postcode lottery to secure specialist services. SCALES data shows that language disorder at school entry persists into secondary, with little evidence that the language gap is closed for these children. There is also mounting evidence that short-term intervention gains “fade out” over time and rarely transfer to other academic skills such as reading.
Over the next 10 years, I hope that teachers, clinicians and researchers will work together to find the solutions and support children with DLD needs over the longer term. Ultimately, DLD needs to be the condition that teachers have heard the most about, not the least.
