Language delays and language disorders

What it is

Language is how we understand and share ideas. Speech-language pathologists usually look at two sides of it:

• Receptive language is what your child understands: words, instructions, questions, stories and lessons.
• Expressive language is how your child shares ideas: words, sentences, grammar, storytelling and explaining.

A child can have difficulty on one side or both. This is different from a speech sound difficulty, which is about how clearly sounds are pronounced. A child can speak very clearly and still have a language difficulty, or be hard to understand and have strong language.

Late talkers

Most children say their first words around their first birthday. By about age 2, most use around 50 words or more and start combining two words, such as “more juice”. A late talker is a toddler whose vocabulary is smaller than expected while other areas of development seem on track. Many late talkers catch up on their own, but a significant number do not, and it is hard to tell in advance which children will. That is why an assessment is helpful rather than simply waiting.

Developmental language disorder

When language difficulties continue over time and affect daily life and learning, and are not explained by hearing loss, a known condition or limited exposure to language, the current term is developmental language disorder, or DLD. It replaces older terms such as specific language impairment and, in French, “dysphasie”. Research suggests DLD is common, yet it is often missed because children with DLD may talk a lot and seem to understand in familiar situations. Language difficulties can also occur alongside other conditions, such as autism, ADHD or hearing loss, and we address them in the same careful way.

Who we see

We see toddlers who are late to talk, preschoolers whose sentences or understanding lag behind those of other children, school-age children with DLD or language-based learning difficulties, and teens whose language is making school or friendships harder. Families often come after a comment from a daycare educator, a teacher, a pediatrician or a school professional.

How we assess it

Our speech-language pathologists begin with your observations and your child’s history, including development, hearing, health, family history and the languages your child hears and uses. Depending on your child’s age, the assessment may include:

• play-based observation of how your child communicates, plays and interacts
• tests of vocabulary, grammar and understanding of instructions and questions
• a storytelling or retelling task to look at how your child organizes ideas
• school-age tasks such as following classroom language, making inferences and defining words
• information from daycare or school, with your permission

For young children, we often combine a first assessment with a period of support and observation, since the picture becomes clearer over time. You receive a clear explanation of your child’s strengths, needs and our recommendations. Learn more about our assessment process.

How therapy works at VoxLingue

Therapy targets the skills your child needs most, in contexts that matter to them. Sessions with young children are play-based. With older children and teens, we connect goals to schoolwork and daily life.

Toddlers and preschoolers

We coach parents to create many short, rich conversations in daily routines. Team members are trained in Hanen programs such as It Takes Two to Talk and Learning Language and Loving It, which teach strategies like following your child’s lead, waiting, and adding a word to what your child says. Read more about parent coaching and Hanen.

School-age children

We work on vocabulary, sentence structure, following and giving instructions, and storytelling. Our literacy-based approach uses children’s books to build understanding, vocabulary, story structure, inferencing and perspective-taking. A favourite book becomes a place to practise asking and answering questions, predicting what happens next and retelling the story in order.

Teens

Therapy focuses on the language of learning: understanding lessons, studying vocabulary, organizing ideas for oral presentations and written work, and using language confidently with peers. We also help teens understand their own profile and use strategies that work for them.

Your role at home

Language grows through conversation. After each session, you leave with one or two strategies to use in everyday moments:

• Get face to face and follow your child’s interest during play.
• Pause and wait, giving your child time to communicate.
• Add one or two words to what your child says (“car” becomes “red car”).
• Read together every day and talk about the pictures and the story, not only the words.
• For older children, ask open questions about their day and help them tell events in order.

Bilingual and multilingual families

Telling a language difference from a language disorder is one of the most important parts of our work. A bilingual child may know some words only in one language, mix languages in a sentence or go through a quiet period when starting school in a new language. These are normal parts of bilingual development.

A language disorder, by contrast, shows up in all of a child’s languages. That is why we look at both or all languages, consider how much exposure your child has to each, and count vocabulary across languages. Our team speaks many languages. When a clinician who speaks your home language is not available, we gather information about that language with you. We encourage you to keep speaking the languages you know best.

In person or by telepractice

Language therapy is offered in person at our Marché Central clinic in Montreal, or by telepractice anywhere in Quebec and Ontario. Online sessions work well for language goals, with shared books, games and visual supports. For young children, telepractice is often a coaching session with a parent, which helps strategies carry over to home life.

Getting started

You do not need a doctor’s referral. If you are wondering about your child’s understanding or use of language, an assessment gives you a clear picture and a plan.

Call our Marché Central clinic at 514-467-9132, or request an appointment through our contact form. Availability of specific clinicians and languages varies, and our team will match you with the right person.