Expressive language disorder is a condition in which a person has difficulty expressing themselves with language, both in speech and writing. Usually, people with expressive language disorder have normal or near normal intelligence, and understand the words they hear or read, but they have difficulty in using those words to express themselves to others. Expressive language disorder is a fairly common developmental problem in children, but is also found in adults who have suffered a traumatic brain injury, stroke, or seizures. If a person also has trouble understanding what they are hearing or reading, they may actually have mixed receptive-expressive language disorder. A doctor or developmental specialist will determine if further testing is appropriate, and may refer a patient to a speech and language pathologist for further testing.
It is important to note that expressive and receptive language disorders are different from speech problems. Speech disorders involve the physical structures of the mouth, tongue, or voice; the person with a speech disorder has trouble physically forming the words. Language disorders involve the area of the brain that controls the processing of language and communication. Receptive language is the ability to interpret and make sense of communication you receive, and expressive language is the ability to express your ideas and thoughts to others. Since different areas of the brain control receptive and expressive language processing, it is possible to have difficulties in just one of these areas, but still have normal or above normal intelligence and reasoning abilities in all other areas.
Expressive language disorders are often diagnosed by a speech and language pathologist. Testing will involve both verbal and non-verbal intelligence tests to rule out other conditions such as mental retardation or global developmental delay. Hearing tests will usually be included to rule out deafness or hearing impairment, which can also interfere with normal speech development. If testing shows a significant difference between receptive and expressive language skills, the pathologist will then try to determine how severely the disorder is affecting the patient's daily life before making a final diagnosis.
Treatment for expressive language disorders involves language training techniques that are tailored to the patient's age and social settings. Patients usually receive direct, one-on-one speech therapy to develop language and social skills. Parents and teachers are sometimes educated as well, so that they can incorporate language skills into the child's daily play and school activities. In some cases, psychological counseling may be recommended to deal with the associated emotional problems stemming from the child's frustration and social isolation.
Most children who have expressive language delay without other conditions will develop normal language skills eventually. Speech therapy is very effective, especially if it is begun early. The prognosis for adults who develop expressive language disorder after a brain injury varies depending on the severity of the brain damage. Some patients recover fully after therapy, but for others the language problems may persist for years. Anyone who suspects they or someone they know has an expressive language disorder should contact a doctor for evaluation and referral.