Developmental Language Disorder (DLD) affects around 1 in 15 people, yet many parents, carers and professionals have never heard of it. It can quietly shape a child’s experience of the world, making it harder to follow conversations, express ideas, or keep up in class.
To make things more confusing, the signs of DLD can often look similar to those seen in Autism. So how do we tell the difference? And how can we make sure children with DLD receive the support they need? We spoke to Karen Bernstein, Specialist Speech and Language Therapist at CAYP Psychology, to unpack what DLD is, how it differs from Autism and other language difficulties, and what support is most helpful.
What is Developmental Language Disorder?
“Developmental Language Disorder is a lifelong condition that affects a child’s ability to understand, learn and use language,” explains Karen. “It can impact speaking, listening, reading and writing.”
It is different from a language delay, where a child is learning language at a slower rate but still following a typical developmental path. “With DLD, the child’s language development is not just slower, it’s following an unusual pattern, and the difficulties persist beyond the age of five.”Importantly, a diagnosis of DLD is only made when a child has no other condition that is also known to have an impact on language development. “If a child also has Autism, hearing loss or a learning difficulty, the diagnosis will be ‘Language Disorder associated with [additional diagnosis],” explains Karen.
Where is the overlap between DLD and Autism?
Children with both DLD and Autism can experience challenges in communication and social interaction. “Both groups may struggle to express themselves clearly, and both may find social relationships difficult,” Karen says.
However, the nature of these difficulties is different. Children with DLD typically have trouble with grammar and sentence structure, such as using incorrect tenses, or substituting words they can’t retrieve. “You might hear them say things like ‘thingy’ or rely on pointing if they don’t know the word,” Karen explains. By contrast, Autistic children may have a strong vocabulary, but struggle with the pragmatics of language, how to use language socially, flexibly and appropriately in different contexts.
How are the social communication difficulties different?
“A child with DLD may know the rules of conversation, like taking turns or being aware of their listener’s existing knowledge about a topic or interest in it. They just aren’t always able to express themselves fully,” says Karen. “A child with Autism may not naturally pick up on these rules at all.”
Restricted interests or sensory-seeking behaviours are also key differences. “These are more typical of Autism, and are not generally present in children with DLD,” she adds.
Why is it so hard to tell them apart in younger children?
One reason DLD is usually diagnosed after age five is because the signs can be difficult to interpret in younger children. “It’s difficult to be certain which children will catch up, which ones definitely have DLD, and which ones may have social communication difficulties.” Karen explains. As a child gets older, the tests used to assess language are more reliable and the differences between a child and their peers becomes more marked.
An early sign of DLD is that a child understands far more than they can say. “Whilst this is also the case with typically developing children, when this gap is wider than we would expect, it may be a sign of DLD” says Karen. In Autism, the opposite can sometimes be true: “An Autistic child may use advanced language without fully understanding what they’re saying.”
Another difference is the way children use language socially. “From an early age, Autistic children may repeat words or phrases without clear communicative intent or show less interest in social interaction. These are not typical features of DLD.”
How do support needs differ in school?
Children with DLD may need help accessing the language of learning. “They might struggle with understanding instructions, keeping up with discussion, or learning new vocabulary, especially technical topic words,” says Karen. “A child with Autism may need more support engaging with the learning in the first place, such as with managing transitions, understanding group work, or staying emotionally regulated.” Karen explains that while children with DLD can often work independently once a task is understood, a child with Autism might need more consistent adult support throughout.
What interventions are most effective?
Karen recommends the following strategies for children with DLD:
- Pre-teaching key vocabulary before new topics
- Simplifying instructions and breaking them down into steps
- Using visual supports such as symbols, diagrams or story maps
- Repetition and overlearning to consolidate understanding
- Narrative support, helping children build more complex sentences
- Explicit teaching of emotions and traits, supporting social understanding
“These strategies can also help some children with Autism,” she says. “But Autistic children may also need support with emotional regulation and finding ways to stay motivated and engaged, especially if they’re not intrinsically interested in the topic.”
How can parents support children at home?
The home environment plays a big role in supporting communication development. “Parents can help by using visuals, simplifying their language, giving children time to respond, and repeating key words in different contexts,” says Karen. For children with Autism, support at home may also include helping with emotional regulation and providing predictable routines. “It’s about supporting their understanding of social situations, not just their language,” Karen adds.
What does the future look like?
Both DLD and Autism can have a lasting impact into adolescence and adulthood. “Children with DLD are at higher risk of anxiety and depression,” says Karen. “They may struggle to form friendships or feel misunderstood by peers.” This is also true for many Autistic children. “Both groups may need workplace adjustments or ongoing support to help them thrive.”
Karen stresses the importance of early recognition and the right support. “With the right understanding and intervention, children with DLD or Autism can build confidence, communication and meaningful relationships. These skills can grow over time, especially when support starts early.”
Useful resources for families
If you’re looking for more information about DLD, these websites offer excellent support:
https://radld.org/
https://www.dldandme.org/
https://www.rcslt.org/speech-and-language-therapy/clinical-information/developmental-language-disorder/
About Karen Bernstein
Karen is a Specialist Speech and Language Therapist, having graduated from City University in 2008. She has worked in NHS and independent settings, supporting children with DLD, Autism, social communication difficulties, and speech sound disorders. She is trained in SCERTS and is a qualified ADOS assessor. Karen is a registered member of the Royal College of Speech and Language Therapists (RC0029484), the Association of Speech and Language Therapists in Independent Practice (4201), and the Health and Care Professions Council (SL37604).
Concerned about your child’s communication or social development?
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