Practitioner Review: Developmental Language Disorders: A Clinical Update


Address for correspondence (Author regrets she is unable to supply reprints): Room 807 Kennedy Center, Albert Einstein College of Medicine, 1410 Pelham Parkway South, Bronx, NY 10461, U.S.A.


Non-specialists can identify three types of developmental language disorder. (1) mixed receptive/expressive disorders, which impair phonology, syntax, and semantics. Children who understand nothing are nonverbal, in others speech is sparse, nonfluent, poorly intelligible, and agrammatic; (2) expressive disorders with adequate comprehension affect phonologic production-predominantly. Children with verbal dyspraxia, the most severe variant, may also be nonverbal but comprehend well; (3) higher order processing disorders affect semantics, pragmatics, and discourse. Semantics and pragmatics are invariably affected in preschool autistic children in whom isolated expressive deficits do not occur. Etiology of developmental language disorders is predominantly genetic. Structural brain lesions detectable by neuroimaging are exceptional. Severe receptive deficits require a sleep EEG to detect subclinical epilepsy. Early educational intervention is both critical and efficacious.