Expressive Language Challenges of DLD: What Approach Shows the Most Promise?

Abstract

Developmental Language Disorder (DLD) is defined as a persistent neurodevelopmental condition that challenges individuals’ abilities to understand and express language.  Although DLD does possess distinct neurological activation patterns, it cannot solely be attributed to neurological conditions (e.g., epilepsy, cerebral palsy), neurosensory hearing impairment, any form of brain injury/lesion or environmental deprivation Children with DLD often experience deficits in both expressive and receptive language domains. DLD has pervasive implications across the lifespan and early intervention is key to changing a trajectory of lower quality of life. This analytical review compares 20 studies to consider the most promising interventions for children with DLD to improve expressive language. The results varied greatly, even amongst same-categories of Visual Supports, Narrative Interventions, Peer-Mediated, Linguistic – Specific Interventions and a combination of these approaches. Questions of bias impacted reliability and required caution for outcome results. Multi-modality or a combination of approach did not lead to the greatest success.  Larger studies did not show the effect sizes of smaller studies.  This points to a need of further research in design, longitudinal studies exploring the training of practitioners applying the interventions. Consistently explicit teaching and rehearsal was essential for larger effect size. Children with DLD did not benefit from implicit teaching or mere secondary exposure to concepts weak in their profiles.