Expressive Language Disorder in Children

What is Expressive Language in Childhood?

Expressive language in childhood is the ability to express one’s own thoughts and ideas. 

Simply put, “expressive language is saying what you want to say.” Expressive language skills involve language development, speech skills, and vocabulary. 

Some children have trouble sharing ideas, getting their points across, and telling stories. Expressive language problems can be common in children and can impact self-esteem. Problems at school may occur in speeches, debates, group work, and oral presentations.

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Symptoms of Expressive Language Issues in Children

• Comprehension issues: your child says, “I don’t know,” “I don’t remember,” or “I can’t say it!”
• Expression problems: your child has a hard time explaining what they want to say
• Incomplete thoughts: your child struggles to express their thoughts in complete sentences that make sense
• Odd sentence structure: your child demonstrates challenges with verb tense, grammar, or pronouns
• Unclear descriptions: your child finds it challenging to come up with words or describe objects or events
• Word-finding issues: your child becomes frustrated because they can’t remember vocabulary words or think of the word they are trying to say. You may hear your child say, “I just can’t find my words”
• Delayed language: your child started speaking a bit late. A good rule of thumb is that kids should have 18 words by 18 months. If your child is not speaking in two-word phrases by 24 months, expressive language concerns are evident
• Frustration: your child has lots of ideas that they just can’t get out and becomes frustrated in trying so hard to communicate 

Types of Expressive Language Issues In Children

If your child seems to have expressive language issues, exploring what type of challenge they are experiencing can be helpful. 

Using a list like the one below can help you talk to your child’s teacher or speech therapist about the concerns you are seeing in your child’s language development.

• Verbal expression: if verbal expression is an issue, your child may frequently say, “I don’t know” or “I don’t remember” when trying to express their thoughts
• Formulating sentences: if your child understands what you are asking but cannot come up with an appropriate response, sentence formation may be the issue. Your child may have difficulty identifying the correct vocabulary to create long and complex sentences. 
• Word-finding: your child may struggle with word-finding if you hear something like, “I can think of it, but I don’t know the word” or “I can’t find my words.” They may not appropriately use verb tenses, such as past, present, and future. Due to problems with verb tenses, they may have difficulty writing stories and describing an event that happened.
• Frustration over word choice: your child may not use the correct words and may get frustrated. This frustration could result in behavioral problems or low self-esteem. Children with expressive language problems sometimes misuse words because they don’t understand what they mean. 
• Social challenges: your child may be very conscious of their language difficulties and may even be hesitant to make new friends or engage in social activities due to their communication skills.

The issues described above are not necessarily signs of an actual language disorder. Instead, they are clues about where your child is struggling. Knowing the specifics can help you target the right school-based or community-based interventions. 

“A child with these challenges may limit conversation with others or cry easily when constantly misunderstood. Some children may use a sibling to communicate their ideas. It might appear that a child doesn’t care about something, but in reality, they are just intimidated by the language required to participate.”

Causes of Expressive Language Difficulties in Childhood

English language learner

If your child is new to the cultural environment, it is normal to see some difficulties with expressive language. It could be that your child is assimilating to a new group of kids with cultural norms and expectations. There could be slang language that your child is slowly learning with peers. This process takes time.

Autism

Autism can be a cause of expressive language problems. Many autistic children are developmentally behind peers in terms of expressive language. Sometimes an autistic child starts talking very late, at 3 years old or older. Other times an autistic child can speak clearly but may struggle to express thoughts and ideas, particularly about oneself. Autistic children may have trouble telling stories, sharing experiences, or communicating during conversations.

Expressive language disorder

The most common cause for expressive language issues is a language delay or a language disorder. Expressive Language Disorder is somewhat common in childhood and is amenable to treatment. It is characterized by a limited or decreased vocabulary for the person’s age, difficulty using pronouns, and trouble with verb forms, plurals, and the rules of language. 

Expressive language disorder signs 

• Limited vocabulary: they may know fewer vocabulary words to express their thoughts or feelings
• Difficulties with plurals: they may misuse words, saying “childs” for children or “gooses” for geese
• Trouble expressing thoughts clearly: they might say things in a jumbled-up order, making it sound confusing for the listener
• Challenges getting ideas from head to paper: they may have difficulty expressing themselves in written language
• Socially hesitant: they may appear to be shy or not speak much because it is difficult to get their ideas out clearly

What to Do About Expressive Language Issues or Expressive Language Disorder

If you are concerned about your child’s expressive language, take these steps. 

• Talk with your pediatrician: for a referral to see a speech-language pathologist. You may discuss family history with your doctor because children can inherit some language issues
• Talk to your child’s teacher or counselor: for help at school. Consider a meeting with the school speech-language pathologist, who can determine if an evaluation is necessary. The school special education team may be able to determine if further testing is required to rule out learning issues or disorders. The school team may include a speech language pathologist, a learning specialist, a school psychologist, or a school counselor.
• Practice at home: for improved language skills. You can make a lot of progress with your child in verbal expression by practicing skills at home. You can model the following skills: choosing a topic, commenting on someone else’s comment, asking questions, answering questions, and telling a story. 
  • Story cubes strategy: You might try Story Cubes to teach your child to tell stories. The parent would roll the dice and look at the pictures on top. Using one of the pictures, the parent starts the story. The parent stops after a few sentences. Now it is the child’s turn to roll the dice and add to the story. 
  • Index card strategy: Another way to practice telling stories is to use index cards. Parents can put topic ideas on the card. The topics might be shown in pictures cut out of magazines, emojis, or words. Just as discussed above, this can be a fun interactive activity. You start by choosing a card and beginning the story. Then, turn it over to your child to add to the story. It is okay for stories to get silly or goofy. The point is to have fun in a storytelling activity.

When to Seek Help For Expressive Language Challenges

When your child has a lot of trouble communicating clearly… If your child struggles with coming up with the words they want to say, sharing ideas with others, and telling stories, it is probably time to get help.

The good news is that these language challenges are readily amenable to treatment. Speech therapy can do wonders for a child struggling to express their thoughts at school, at home, or in the community.

When your child is not socializing well with peers… If your child seems to be choosing not to socialize much with other children their age, it could be because of difficulties communicating. They may prefer to play alone or with family members who understand them. If your child is experiencing these challenges at school, consult with the teacher early and often.

When your child is struggling academically… If your child is falling behind in school, it could be time to get help. Expressive language can affect all academic areas. These challenges can impact written language tasks, speaking in class, and social communication. Your child may struggle with various subjects that require public speaking or writing. 

If this is the case, it is wise to inform the school. Often interventions are available through the school’s Response to Intervention (RtI) program. The school may have an interventionist who can provide support for your child’s expressive language or academic challenges. 

Further Resources on Expressive Language

• Speech-language pathologists: to provide speech therapy in expressive language and communication skills if special needs there are identified
• Special education teacher: to help with reading and writing that may be impacted by expressive language or a speech disorder
• Psychologist: to help with any emotional or social challenges associated with the expressive language problem
• Pediatrician: to provide a referral for therapy or diagnose any related medical conditions
• Geneticist: to evaluate if genetic issues are suspected

Related Conditions to Expressive Language Disorder

• Receptive language problems: it may be that deficits in language comprehension are impacting communication skills in general
• Social skills challenges: it may be that social skills are impaired due to difficulty with language skills
• Learning concerns: it may be that deficits in language skills impact schoolwork or grades in terms of completing homework tasks, projects, and tests
• Tantrums: it may be that deficits in language skills lead to tantrums or acting out
• Executive functioning: it may be that deficits in language skills are related to problems with planning out what to say and controlling impulses
• Auditory processing: it may be that language deficits occur due to problems with processing auditory information

Resources for Expressive Language Challenges In Children

Apel, Kenn & Masterson, Julie (2012). Beyond Baby Talk: From Speaking to Spelling: A Guide to Language and Literacy Development for Parents and Caregivers.

American Speech-Language Hearing Association. http://www.asha.org/

Bernstein, Deena K. &   Tiegermann-Farber, Ellenmorris (2017). Language and Communication Disorders in Children, Third-Sixth Editions.

Law, James; Garrett, Zoe & Nye, Chad. (2003). Speech and language therapy interventions for children with primary speech and language delay or disorder.

Lewis, Ph.D., Jeanne, Calvery, Ph.D., Margaret, & Lewis, Ph.D., Hal (2002). Brainstars. Brain Injury: Strategies for Teams and Re-education for Students. US Department of Education: Office of Special Programs.

Speech Language Milestones: http://www.asha.org/public/speech/development/chart.htm