What is Mixed Receptive-Expressive Language Disorder in Children?

Language serves as the cornerstone for learning and human interaction. For some children, accessing educational content in the classroom and navigating the nuances of social relationships can be challenging. This can be due to differences or weaknesses in language development that affect their ability to learn and communicate with ease.

One such condition is known as mixed receptive-expressive language disorder. In this article, we will examine how mixed receptive-expressive language delays and disorders impact activities of daily living. We will discuss its causes, symptoms, and review effective speech therapy exercises that will strengthen and optimize overall language development and learning.

Defining Mixed Receptive-Expressive Language Disorder

When children struggle to understand information or use language to express themselves, this is referred to as a receptive-expressive language delay or disorder. Mixed receptive-expressive language disorders are characterized by difficulties in both understanding language (receptive language) and using language to express thoughts, ideas, and needs (expressive language).

Children with mixed receptive-expressive language disorder struggle with processing and comprehending spoken and written language. They also struggle with formulating cohesive grammatical sentences that effectively convey their thoughts verbally. Both receptive and expressive language skills are considered foundational to proficiency in reading comprehension and written expression. Thus, early intervention is recommended to support overall language and literacy development.

Understanding the Challenges

Children who struggle to process verbal information may listen attentively to instructions but have trouble holding on to all the details or understanding their meaning. They may ask for multiple repetitions of information, carry out part of a series of directions, or complete tasks incorrectly.

These children may find it hard to recall specific words or link and sequence their ideas, even if they wish to share their thoughts and ideas. This can result in disorganized messages that contain multiple reformulations, pauses, and hesitations, as well as missing details and vague terminology. In some cases, they may rely on simple sentence forms when speaking even though they possess a strong understanding of a concept. Consequently, listeners may have a hard time interpreting their intended meaning.

Symptoms and Signs of Mixed Receptive-Expressive Language Disorder

Every child is unique and possesses several personal strengths and areas of challenge. Therefore, symptoms of mixed receptive-expressive language disorders can vary amongst individuals. Some common indicators include:

• Difficulty following instructions
• Trouble responding appropriately or accurately to questions
• Difficulty pointing to or identifying objects
• Limited vocabulary and difficulty recalling words or names
• Challenges in organizing thoughts and constructing sentences with age-appropriate grammar
• Difficulty engaging and participating in conversations
• Frustration or anxiety during communication attempts
• Delayed language development compared to peers

Causes and Risk Factors

While scientists’ understanding of the neurological processes underlying these difficulties is evolving, several factors may contribute to its development:

• Genetic predisposition: A family history of language disorders or developmental delays may increase the likelihood of mixed receptive-expressive language disorders.
• Neurological factors: Structural or biochemical brain differences, or, disruptions in brain development can impact how language centers in the brain function.
• Environmental influences: Lack of exposure to rich language experiences or early childhood trauma may hinder language acquisition.
• Co-occurring conditions: Mixed receptive-expressive language disorder often coexists with other developmental disorders such as autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD).

Evaluation and Diagnosis

While a diagnosis of a mixed receptive-expressive language disorder may cause you to feel a deep sense of worry and uncertainty about your child’s future, we want to assure you that speech therapy for kids offers effective solutions for addressing language difficulties in children. With the guidance of a licensed speech-language pathologist (SLP) and targeted speech therapy exercises, your child can develop the necessary tools to excel in language learning and experience social and academic success.

At Open Lines®, our team of specialized pediatric speech therapists provides compassionate, evidence-based speech therapy for kids. Our approach starts with a comprehensive evaluation conducted by experienced and expertly trained therapists to pinpoint your child’s specific communication strengths and challenges.

This will include a thorough case history where we will gather details about relevant medical history, symptom progression and frequency, speech and language development, academic performance, and the impact challenges are having on daily functioning and confidence.

Your child will then be guided through a series of assessments by your clinician to gather baseline data which will help us to better understand their unique set of needs and goals. For preschoolers, testing will include a mix of standardized measures integrated with play. Parent and caregiver involvement is sometimes encouraged during testing to facilitate comfort and ease and to elicit skills most naturally.

For school-aged children, testing will more closely mimic school-based skill sets that teachers use with students in the classroom. This will include the administration of standardized measures and participation in functional activities. Activities include reading and telling stories, answering inference questions, and following directions and procedures.

Reading comprehension and written language may also be examined to provide a more detailed profile of your child’s speech, language, and literacy skills. This evaluation also determines how those skills are integrated to help the child communicate and learn.

Treatment and Intervention

Drawing on the latest research and techniques, we work closely with you and other professionals. At your request, we design a personalized treatment plan tailored to your child’s unique goals and needs. Our interventions focus on improving language skills and bolstering positive self-concepts through interactive multisensory speech therapy exercises.

We aim to foster better comprehension, effective communication, and enhanced confidence through these activities. Through collaboration with parents, educators, and care partners, we create a nurturing environment for children to succeed academically and socially.

Treatment strategies may encompass:

• Speech and language therapy: Tailored interventions focusing on improving receptive and expressive language skills through structured activities and exercises.
• Parent/Caregiver education: Equipping families with strategies to facilitate language development at home and promote improved communication and connection with your child.
• Collaborative approach: Engaging multidisciplinary teams including speech therapists, educators, psychologists, and pediatricians to address the diverse needs of children with mixed receptive-expressive language disorder.

Treatment Targets for Different Age Ranges

Preschoolers (Ages 3–5 years):

• Target areas may include phonology, semantics, morphology, syntax, pragmatics, and literacy.
• Activities focus on enhancing phonological awareness, expanding vocabulary, improving sentence structure, and fostering conversational skills through play-based and interactive exercises.

Elementary School Children (Ages 5–10 years):

• Interventions integrate curriculum-based content, addressing language needs relevant to success in classroom, social, and home contexts.
• Activities aim to improve comprehension, build vocabulary and use of complex sentence structures, narrative development, reading fluency, writing skills, and metalinguistic awareness through structured tasks and exercises.

Adolescent Students (Ages 11 years through High School):

• Instructional strategies focus on teaching students how to acquire and use information across various settings.
• Target areas may include context-based comprehension, morphological analysis, academic vocabulary, writing strategies, and metacognitive skills.
• Activities involve using context clues, deciphering complex vocabulary, creating organizational tools, utilizing technology for research and collaboration, and direct vocabulary instruction to bridge any existing gaps in academic language proficiency.

If you have any concerns about your child’s language learning and development, don’t wait! We recommend seeking the support of a licensed pediatric speech therapist who will listen to your concerns and provide expert guidance based on scientific evidence. They can determine if your child’s language development is progressing typically or if additional assistance is needed to enhance their growth. Acting promptly ensures that your child can begin making strides and achieving success as quickly as possible.

For more ideas on strategies parents can integrate into their daily communication and play routines, see our blog on developmental milestones.

Source: ASHA.org