Language literacy disorders: It's important to have an understanding of the similarities and differences between reading disorder, language disorder, and reading comprehension difficulty to make an accurate differential diagnosis. This page provides an overview of several common language learning disabilities that feature prominently on school-based clinicians' case-loads.
What are key characteristics of Language Disorder?
Children with language disorder generally have deficits in core language areas such as morphology, syntax and semantics. The difficulty may range from mild to severe and affect oral receptive and expressive language and written language.
Children with language disorder will most always have difficulty with phonological awareness, which is a vital early reading skill, and working memory a key skill which relates to holding onto newly learnt information just long enough to manipulate it meaningfully.
What is Dyslexia?
Dyslexia, or reading disorder, is a specific learning disability that affects decoding, reading fluency, word recognition and spelling. Children with dyslexia will most likely have deficits in phonological awareness, working memory and rapid automatic naming, which impacts their ability to access text. This problem is compounded when children with dyslexia reach grade 3-4 when they are expected to read to learn.
Unlike children with language disorder, children with dyslexia generally have good morpho-syntax skills and adequate vocabularies. Comprehension of text is mostly solid, but these children's primary difficulty is that they struggle to access age appropriate text. This populations' oral language and social language skills are generally strong, but children with reading disorder find it difficult to access the curriculum due to poor decoding skills, which, of course, can significantly affect their academic progress.
Children with Reading Comprehension Difficulty
Some children are very good decoders and have excellent reading fluency but struggle to process the meaning of what they read. Children with reading comprehension difficulty have good phonemic awareness skills, average oral language skills with appropriate social language skills, but may have weak vocabularies. Working memory is often below average and there is also some deficiency in grammar skills. When working with this population, it's not unusual to see a child read from an age appropriate book beautifully and seemingly effortlessly.
The clinician once worked with a 10 year old girl who was reading chapter books with quite complex language. She read from a book to the clinician a passage that vividly described a child protagonist's fear and excitement as the light aircraft he was a passenger in took off, with some difficulty, into the air. The girl's reading was fluent and essentially flawless. Her pitch and intonation matched the rhythm of the text at an almost adult level.
When the clinician questioned the student about the passage, it was revealed that the student hadn't comprehended that the child in the story was in an aircraft, let alone grasped that the aircraft in the story had difficulty lifting into the sky. None of the essential language and events in the text had been comprehended. The text, though beautifully decoded, had not been understood by the student at all.
Summing Up - Language Literacy Disorders
An essential clinical skill is to be able to confidently make a differential diagnosis of children who have language literacy disorder to ensure that appropriate interventions and recommendations are selected.
Children with language disorder have difficulty with most aspects of learning. These children's low language, phonemic awareness and working memory skills impact all aspects of academic learning. Children with this disability are generally poor readers and have poor comprehension skills.
Children with reading disorder (dyslexia) have good oral language skills and adequate comprehension. These children most often have difficulty with phonological awareness and phonological working memory which limits their ability to make the sound-letter link, necessary for accurate decoding and when learning new words.
Children with reading comprehension difficulty often fail to comprehend the complexity of written language due to problems with syntactical awareness and below average vocabularies. These children can read fluently which often masks their reading difficulty.
Much of the information on this page about differential diagnosis of language literacy disorders has been condensed onto a handy chart which can be accessed below.
References - Language Literacy Disorders
Kamhi, A.G. & Catts, H.W. (2012) Language and Reading Disabilities Allyn & Bacon
Paul, R. (2007) Language Disorders from Infancy Through Adolescence Assessment and Intervention Mosby Elsevier
Stein-Rubin, C. & Fabus, R (2012) A Guide to Clinical Assessment
and Professional Report Writing in Speech-Language Pathology Delmar/Cengage Learning
Wagner, R.K. Muse, A.E. & Tannenbaum, K.R (2007) Vocabulary Acquisition: Implications for Reading Comprehension The Guilford Press