What is the treatment for Developmental Language Disorder (DLD)?

Treatment for Developmental Language Disorder (DLD)

Speech and language therapy is the cornerstone of treatment for Developmental Language Disorder, focusing on reducing excessive musculoskeletal tension, improving articulation, and implementing structured language interventions tailored to the individual's specific deficits. 1

Core Treatment Components

Speech and Language Therapy

• Comprehensive speech/language assessments should begin at 6-18 months and continue routinely thereafter to identify specific deficits 1
• Implement symptomatic interventions focusing on:
  • Reduction of excessive musculoskeletal tension in speech and non-speech muscles 1
  • Elimination of secondary or accessory movements that interfere with normal speech 1
  • Focusing on normal movements and sounds while distracting from abnormal patterns 1
  • Using dual-tasking techniques while speaking as a form of distraction 1
  • Introducing mindfulness during oromotor tasks to maintain focus on smooth movements 1

Educational Interventions

• Early implementation of augmentative communication (e.g., sign language) is recommended to promote language use and prevent frustration 1
• Structured educational interventions should be tailored to the child's specific learning needs 2
• Collaboration between medical providers and education personnel is crucial to secure appropriate school resources and accommodations 2
• Educational accommodations may include additional time for assignments, use of computers for written work, and modified activities 2

Domain-Specific Interventions

For Vocabulary Development

• Vocabulary intervention shows the strongest evidence base among language domains for bilingual children with DLD 3
• Cross-language generalization effects are evident for vocabulary interventions, supporting the use of home language in therapy 3

For Articulation Disorders

• Focus on reducing excessive tension in head, neck, shoulders, face, and mouth 1
• Where functional facial weakness or spasm exists, collaborative treatment with physiotherapy or occupational therapy may help 1
• Use nonsense words or syllable repetitions to demonstrate potential for normal function 1
• Advance communication with higher cognitive linguistic content in a hierarchical fashion 1

Addressing Psychological Components

• Communication counseling should address predisposing, precipitating, and perpetuating issues related to language difficulties 1
• Address cognitive features related to locus of control, abnormal illness beliefs, and hypervigilance 1, 4
• Implement cognitive behavioral therapy strategies to identify and challenge maladaptive beliefs 4
• Consider treatment for comorbid psychiatric disorders such as anxiety and depression, which frequently co-occur with DLD 5
• Address potential secondary psychological impacts including anxiety, depression, and avoidance behaviors 2

Multidisciplinary Approach

• Implement a coordinated team approach including:
  • Speech-language pathologists for direct language intervention 1
  • Occupational therapists for functional activities and daily living skills 4, 2
  • Educational specialists to maximize school support and accommodations 2
  • Mental health professionals when psychological comorbidities are present 5

Important Considerations and Pitfalls

• DLD often persists into adolescence and adulthood, requiring ongoing support beyond childhood 5
• Early intervention is crucial, as delays in treatment may lead to secondary emotional and behavioral problems 6
• Avoid excessive focus on symptoms, which can reinforce abnormal patterns 4
• Recognize that DLD frequently co-occurs with other neurodevelopmental disorders, requiring comprehensive assessment 7
• The treatment approach should consider DLD as a complex neuropsychological syndrome rather than an isolated speech disorder 7
• Progress may be slow due to cognitive/learning and behavioral differences 1

Monitoring and Follow-up

• Regular reassessment is essential to track progress and adjust intervention strategies 1
• Monitor for emerging comorbidities, as symptomatology may change over time 5
• Evaluate both language skills and psychosocial functioning, as DLD is associated with increased rates of emotional and behavioral difficulties 6

Evidence Gaps

• There is limited research on interventions targeting morphosyntax, narrative skills, and literacy in DLD 3
• More research is needed on cross-language generalization effects beyond vocabulary for bilingual children 3
• The terminology used to describe DLD has evolved, with "developmental language disorder" now being the consensus term, though implementation varies across research and clinical settings 8