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  • Empowering People with Developmental Language Disorder: A Push for Greater Inclusion

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    A graphic with a lady holding a clipboard with the words: Developmental Language Disorder Day #DLD Day, speak up for DLD, Friday, 18 October 2024.

    Imagine you’re traveling in a country where you don’t speak the language and you order a coffee. You might get a bit tongue tied or can’t quite remember what the barista said to you. These language difficulties occur every single day for the 2 million Australians with Developmental Language Disorder (DLD).

    DLD is a common but often overlooked disability, affecting 1 in 14 people globally (Norbury et al., 2016). In Australia, recent studies estimate that approximately 6.4% of children aged 10 have DLD (Calder et al., 2022). Despite its prevalence, DLD remains largely invisible, with less than 20% of Australians aware of the condition (Kim et al., 2022). This lack of awareness contributes to stigma, leaving many with DLD feeling isolated and unsupported.

    DLD is a lifelong, neurodevelopmental condition that impacts the ability to understand and use language, often hindering educational and employment opportunities (Cronin, 2017). Unlike some other conditions, people with DLD do not look different to their peers, which can make it challenging to diagnose and even harder to advocate for necessary support.

    A Call for Greater Awareness and Support

    The international consensus on DLD, established by the CATALISE consortium, emphasises the need for unified terminology and greater public awareness (Bishop et al., 2016; Bishop et al., 2017). While DLD is recognised as a neurodevelopmental disorder in the World Health Organization's ICD-11, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) still uses the outdated term "Language Disorder," with narrower criteria. This inconsistency complicates public understanding and hampers efforts to secure appropriate support for individuals with DLD (McGregor, 2020).

    In Australia, Speech Pathology Australia has endorsed the term DLD, but challenges remain in ensuring individuals receive the intervention and support they need. Diagnosis often occurs only when children reach school age, and inconsistent access to speech pathology services across states makes it difficult for families to get timely help (Calder et al., 2022).

    Challenges in Education and Employment

    For children with DLD, early and consistent intervention is crucial. Without it, they are at higher risk of experiencing difficulties in reading, spelling, and mathematics. Statistics reveal that students with DLD are six times more likely to struggle with these skills, putting them at a disadvantage in the classroom (Young et al., 2002).

    Dr Shaun Ziegenfusz (Lecturer, School of Health Sciences and Social Work) has investigated the educational needs and supports of school-aged students with DLD in Australia during his recently completed doctorate. He found students with DLD face challenges across the entire school curriculum, particularly in literacy and numeracy (Ziegenfusz et al., 2022). A national survey involving teachers, allied health professionals, and parents/caregivers highlighted that literacy, behaviour, and communication were the most significant areas of need for students with DLD. To address these challenges, participants suggested that additional time, visual supports, and individualised approaches would be beneficial. Teenagers with DLD echoed these sentiments, identifying literacy and numeracy as their biggest areas of need. They also agreed with the suggested supports from adults but emphasised the potential benefits of integrating technology into their learning experience. In response to teacher feedback, Shaun developed a 90-minute webinar which enhanced teachers’ knowledge, promoted supportive attitudes, and encouraged the use of evidence-based educational practices when working with students with DLD.

    The long-term impacts of DLD extend beyond education. Adults with DLD are twice as likely to go over a year without employment compared to their peers (Law et al., 2009). This disparity highlights the need for better support systems that provide targeted skills development and workplace accommodations to ensure that people with DLD can thrive in professional environments.

    The Push for National Support

    Currently, DLD is not included on the National Disability Insurance Scheme (NDIS) lists, which makes it challenging for individuals with DLD to access comprehensive support. For example, more than 200,000 Autistic individuals (<1% of the population) access the NDIS compared to 150 DLD individuals. Advocates argue that inclusion in the NDIS would streamline access to resources, reducing the burden on families and ensuring those with DLD receive the necessary support to reach their potential.

    Speech pathologists, psychologists, and educators stress the importance of a multidisciplinary approach to intervention, particularly for children in school settings (Toseeb et al., 2017). Adjustments and accommodations to learning and assessment in the classroom are essential for helping students with DLD succeed academically. For adults, ongoing access to speech pathology services and other therapies can improve communication skills, enhance employability, and reduce social isolation often associated with DLD.

    Looking to the Future

    Advocates and researchers recommend several steps to improve outcomes for those with DLD:

    1. Increased Awareness Campaigns: Public health initiatives should aim to educate the public about DLD to reduce stigma and increase understanding.
    2. Improved Access to Support Services: A unified funding approach in Australia would help ensure individuals with DLD receive adequate speech pathology services, exceeding the current limit of five subsidised sessions under the Chronic Disease Management plan.
    3. Education and Training for Professionals: Training educators, GPs, and NDIS planners in recognizing and supporting DLD is vital to creating a more inclusive environment for those affected.
    4. Research Funding: More funding is needed to understand the long-term impacts of DLD and to develop effective interventions that can be implemented across different stages of life (McGregor et al., 2020).

    Conclusion

    DLD is a hidden disability that affects many Australians, yet awareness and support remain insufficient. By addressing these gaps through education, improved access to services, and policy changes, Australia can foster a more inclusive society where individuals with DLD are empowered to achieve their goals. Positive disability inclusion is about recognizing invisible challenges like DLD and ensuring that those affected are given every opportunity to thrive.

    Getting involved in DLD this 18 October and “Speak Up for DLD”. Visit TheDLDProject.com and RADLD.org to find out more. By participating, you can empower people with DLD to live a life of their own choosing.

    DLD - Fast Facts

    A graphic with a lady pointing to icons of 14 white people icons, one is shaded in yellow to represent the text. Developmental Language Disorder is a hidden but common disability that affects 1 in 14 people causing difficulties understanding and using language for no known reason.

    A graphic showing two women with speech bubbles and a head with clouds and question marks, visually representing the text. DLD is a diagnosis given to a person who has difficulty talking and/or understanding language. Diagnosis is made by a speech pathologist however, a person with DLD may need support from other health professionals.

    A graphic with two people communicating, one is a person of colour and the other a wheelchair user with speech bubbles between them and a map of the world in the background. The words read: DLD affects an individual’s life, regardless of their nationality and language. Speaking more than one language does not cause DLD.

    A graphic with a male speaking with a young girl with speech bubbles between them and question and exclamation marks. DLD has a genetic and biological basis, but there is not a single known cause. DLD is not caused by how parents verbally interact with their children.

    A graphic with a man standing with question marks above his head, he looks visibly worried accompanied with the text: DLD – The Facts. Children with DLD are 4 times more likely to have math disability and 6 times more likely to have reading disability. DLD is 50 times more prevalent than hearing impairment and 5 times more prevalent than autism.

    A graphic with a head with squiggly line surrounded by words in bubbles. Co-occuring conditions can include Dyslexia, ADHD, Mental Health Issues and Learning Difficulties.

    A graphic representing signs of DLD. People with DLD will often have difficulty paying attention; struggle to remember what they have been told; struggle to find the words to express ideas; find it hard to understand words, follow instructions or answer questions; experience challenges with reading and writing; and have trouble saying words in the right order, engaging in conversations or telling a story.

    Graphic with diverse people with the words: A DLD diagnosis can lead to an individual accessing supports and highlight their man strengths such as being: compassionate, thinkers, creative, social, unique.

    Graphic with a large group of diverse people with the text: DLD is a common neurodevelopmental condition impacting 2 million Australians. People with DLD can succeed in life, with the right supports that meet their unique strengths and areas of need. If you are concerned, see a speech pathologist.

    More information: The DLD Project is an impact focused social enterprise founded to elevate awareness and understanding of DLD in Australia. Connect with us Natalie Turner, Co-CEO and Co-Founder, Dr Shaun Ziegenfusz, Lecturer, Griffith University, Co-CEO and Co-Founder, The DLD Project. Email: connect@thedldproject.com or visit the website: TheDLDproject.com. Visit us on social media: Facebook, LinkedIn and Twitter.

    References

    Bishop, D. V. M., Snowling, M. J., Thompson, P. A., Greenhalgh, T., & Schiller, N. O. (2016). CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children. PLOS ONE, 11(7).

    Bishop, D. V. M., Snowling, M. J., Thompson, P. A., & Greenhalgh, T. (2017). Phase 2 of CATALISE: a Multinational and multidisciplinary Delphi consensus study of problems with language development: terminology. Journal of Child Psychology and Psychiatry, 58(10), 1068-1080. https://doi.org/10.1111/jcpp.12721

    Calder, S. D., Brennan‐Jones, C. G., Robinson, M., Whitehouse, A., & Hill, E. (2022). The prevalence of and potential risk factors for developmental language disorder at 10 years in the Raine Study. Journal of Paediatrics and Child Health, 58(11), 2044-2050. https://doi.org/10.1111/jpc.16149

    Conti‐Ramsden, G., Durkin, K., Toseeb, U., Botting, N., & Pickles, A. (2018). Education and employment outcomes of young adults with a history of developmental language disorder. International Journal of Language & Communication Disorders, 53(2), 237-255. https://doi.org/10.1111/1460-6984.12338

    Cronin, P., Reeve, R., McCabe, P., Viney, R., & Goodall, S. (2017). The impact of childhood language difficulties on healthcare costs from 4 to 13 years: Australian longitudinal study. International Journal of Speech-Language Pathology, 19(4), 381-391. https://doi.org/10.1080/17549507.2016.1216599

    Kim, J.-H., Davies, B., & Xu Rattanasone, N. (2023). Have You Heard of Developmental Language Disorder? An Online Survey. Communication Disorders Quarterly, 44(4), 228-238. https://doi.org/10.1177/15257401221115822

    Law, J., Dennis, J. A., & Charlton, J. J. V. (2017). Speech and language therapy interventions for children with primary speech and/or language disorders. Cochrane Database of Systematic Reviews(1).https://doi.org/10.1002/14651858.CD012490

    Law, J., Rush, R., Schoon, I., & Parsons, S. (2009). Modeling developmental language difficulties from school entry into adulthood: Literacy, mental health, and employment outcomes. Journal of Speech, Language, and Hearing Research, 52(6), 1401-1416. https://doi.org/10.1044/1092-4388(2009/08-0142)

    McGregor, K. K. (2020). How we fail children with developmental language disorder. Language, Speech, and Hearing Services in Schools, 51(4), 981-992. https://doi.org/10.1044/2020_LSHSS-20-00003

    Norbury, C. F., Gooch, D., Wray, C., Baird, G., Charman, T., Simonoff, E., Vamvakas, G., & Pickles, A. (2016). The impact of nonverbal ability on prevalence and clinical presentation of language disorder: Evidence from a population study. Journal of Child Psychology and Psychiatry, 57(11), 1247-1257. https://doi.org/10.1111/jcpp.12573

    Toseeb, U., Pickles, A., Durkin, K., Botting, N., & Conti-Ramsden, G. (2017). Prosociality from early adolescence to young adulthood: A longitudinal study of individuals with a history of language impairment. Research in Developmental Disabilities, 62, 148–159. https://doi.org/10.1016/j.ridd.2017.01.018

    Young, A. R., Beitchman, J. H., Johnson, C., Douglas, L., Atkinson, L., Escobar, M., & Wilson, B. (2002). Young adult academic outcomes in a longitudinal sample of early identified language impaired and control children. Journal of Child Psychology and Psychiatry, 43(5), 635-645. https://doi.org/10.1111/1469-7610.00052

    Ziegenfusz, S., Paynter, J., Flückiger, B., & Westerveld, M. F. (2022). A systematic review of the academic achievement of primary and secondary school-aged students with developmental language disorder. Autism & developmental language impairments, 7, 1-33. https://doi.org/10.1177/23969415221099397