DLD and other disorders

Some speech or language problems may resemble DLD. For example, speech problems can be due to a cleft palate or speech motor issuesMoving the muscles of the mouth, tongue, lips and jaw to speak (developmental verbal dyspraxia or childhood apraxia of speech). Some children with DLD also have problems with fluency (stuttering, stammering or cluttering). 

Some children only speak to family members or people they know, while they remain silent in school or at parties. If this problem is persistent it might be selective mutism. This is a form of social anxiety, and not a language disorder. 

Some syndromes are associated with speech and language problems, such as Down syndrome or 22q11.2 deletion syndrome. Children with general developmental delays or intellectual disabilities often struggle with language as well. If the language problems are (better) explained by a general developmental delay, they are not classified as DLD. However, children with DLD may have lower non-verbal intelligenceScores on an intelligence test that requires little or no language. For example, placing pictures in a logical order. scores. 

Approximately half of the children with DLD also have dyslexia: severe and persistent problems with learning how to read and/or spell (decodingThe ability to read words fluently by sounding out the letters, in Dutch: technisch lezen). Children who have both DLD and dyslexia have more severe reading problems than children who only have dyslexia. Does your child with DLD struggle with decoding? Ask the teacher about a dyslexia assessment. 

Not all children with DLD have dyslexia. However, most children with DLD have difficulties with reading comprehension. They may not always grasp the meaning of a text. Reading comprehension requires both decoding and language skills: understanding words, sentences, and the connections between sentences. For more information on DLD and reading, see DLD at school. 

Children with DLD and/or dyslexia also have a higher risk of dyscalculia: problems with arithmetic and spatial awareness. Dyslexia and dyscalculia are considered to be specific learning disorders. 

For more information on learning disorders, visit the site of the British Dyslexia Association. 

The websites of the NKD (Dutch institute for dyslexia) and RID (Regional institute for Dyslexia) provide information on diagnosis and treatment options in the Netherlands (in Dutch). Parent associations like Balans and Impuls & Woortblind also provide valuable information (in Dutch). 

Many children occasionally have trouble with paying attention or sitting still. Young children in particular can be distracted, dreamy or forgetful. They may have difficulties concentrating on a task, planning or organising. All children can be energetic or impulsive at times, or act without thinking. For example, they may speak up in class without raising their hand first. 

For some children, this behaviour does not match their age. This might indicate attention problems (inattention and/or impulsivity). This could potentially be ADHD. Children with ADHD can also have language and/or reading problems. For example, they may have difficulties telling a coherent story. Some have trouble focusing while reading.  

Children with DLD can also have attention problems. They may feel distracted or easily overwhelmed. Not being able to keep up in class can make them act out. Their language or reading problems can (partly) be due to attention problems. Or the other way around: attention problems can be due to problems with language or reading. However, children can also have both DLD and ADHD (or dyslexia and ADHD). 

If you suspect that your child has (traits of) ADHD, find out more at the ADHD foundation. Information about getting help in the Netherlands is available from Druk & Dwars (in Dutch).

DLD and Autism Spectrum Disorder (ASD) can look similar. In ASD, language development can also be delayed. Children with ASD often struggle to make contact. They may show less interest in communicating and interacting with others. They can also have difficulty empathising or putting themselves in someone else’s shoes (Theory of Mind). They also often have special interests (like train routes, for example). 

Children with ASD mainly struggle with social communication. This includes the ‘unwritten’ rules of conversation, like taking turns, not talking too long about your own topic, or considering the other person’s knowledge on a topic. They may also take language too literally. 

Children with DLD can have difficulties in social communication as well. For example, the stories they tell might sound illogical. Your child may leave out certain information or jump from one topic to another. However, this could also be due to other language problems (such as difficulties finding words or forming sentences). 

Children with ASD often have sensory issues. They may be more sensitive to tastes and sounds, for example. Sensory issues are sometimes also present in children with DLD. 

Especially in young children, it is often challenging to determine which diagnosis is most suitable: DLD or ASD. If the language difficulties are better explained by ASD, DLD is not diagnosed. However, children with DLD may still show ASD traits. 

Do you think your young child shows signs of ASD? Consider completing this questionnaire (in English). Information on ASD and the system in the Netherlands (in Dutch) is provided by the NVA (Dutch association for Autism) or the platform autismejongekind (Platform for ASD in young children). You can find more information on ASD on the website of the American National Institute of Mental Health. 

Some children struggle with motor skills like running, cycling, swimming, catching a ball or writing. Are the motor problems severe? Then it can be DCD (Developmental Coordination Disorder). This English term is also used in Dutch. Another term for DCD is (developmental) dyspraxia (in Dutch: dyspraxie.  

Children with DCD move ‘clumsily’. For example, they often drop things or bump into something. Children with DCD are more likely to have speech and language difficulties. Severe motor speech issues are called developmental verbal dyspraxia or childhood apraxia of speech (CAS). Children with these issues have difficulties with moving the muscles needed to speak. For more information on motor speech disorders, see the British National Health Service or Apraxia Kids.   

Children with DLD are more likely to have motor problems than children without DLD. They are also more frequently diagnosed with DCD or verbal dyspraxia. In severe cases of DCD or  motor speech issues, referral to a rehabilitation doctor or paediatrician is necessary. For more information about DLD in Dutch, see parent association Balans. For information in English, consult this NHS website. 

Many children with developmental problems experience difficulties with executive functions: brain functions that help to manage and regulate behaviour in everyday life. For instance, focusing your attention on a task, making plans or solving problems. For more information, see How the brain works. 

Children with DLD are also more likely to experience social-emotional problems. For example, they often feel insecure They may also have difficulty recognising or naming emotions. For more information, see Social-emotional development. 

Are you looking for more information about other emotional, behavioural or mental health problems in children? Such as eating disorders, health complaints, anxiety, obsessive-compulsive disorder (OCD) or depression? NIMH provides information in English and Spanish. 

Information in Dutch is provided by the expertise centre for child and adolescent psychiatry. There is also expert information on how to help children with different developmental difficulties at school (in Dutch). Information for young people is available on brainwiki (in Dutch).

English language resources on DLD are available from these websites:

• RADLD (UK)
• DLDandMe (UK)
• DLDandMe (US)
• TheDLDProject (Australia)

The UK-based charity Afasic provides a parent helpline.