Language Disorder in Adults

Language disorder is characterized by persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production that include the following:

• Reduced vocabulary (word knowledge or use)
• Limited sentence structure (ability to put words and word endings together to form sentences)
• Impairments in discourse (ability to use vocabulary and connect sentences to explain or describe a topic or have a conversation)

Language learning and use is dependent on both receptive and expressive language skills. Expressive language disorders involve deficits in verbal and written expression. Deficits may involve articulation, vocabulary, sentence formation and memory. An adult’s language ability will lag behind that of his/her peers in areas such as word choice and usage, sentence formation and grammar. Receptive language disorders involve deficits in comprehension. In adults, signs of language disorder may include not listening to or following instructions and repeating words or phrases heard. A speech/language assessment is essential to determine the degree of deficits in either the expressive or receptive modalities, as these may differ in severity. For example, an adult’s expressive language may be severely impacted, while his or her receptive language is intact.

Language disorder usually affects vocabulary and grammar, which results in a limited capacity for conversation. Some of the common symptoms of language disorder include:

• Word-finding problems
• Minimal verbal vocabulary
• Poor understanding of synonyms, multiple meanings, or word play
• Problems remembering new words and sentences
• Difficulty remembering verbal information (i.e., shopping list, phone number).

In language disorders, speech and language do not develop normally. The child may have some language skills, but not others. Or, the way in which these skills develop will be different than usual.

Learning disabilities and language disorders are also closely linked, although the exact relationship between the two is not fully agreed upon. When compared with typically developing peers, fewer individuals with language impairment complete high school or receive an undergraduate degree. The majority of young adults with specific language impairment who pursue education after high school seek vocational rather than academic qualifications. In addition, individuals with speech and language impairment tend to be employed in lower-skilled jobs than their typically developing peers.

Language disorder is heritable, and family members are more likely to have a history of language disorder.  However, having a genetic vulnerability does not necessarily mean that one will develop language disorder.  Risk factors for language disorder, along with other communication disorders, include prenatal complications and premature birth. Oral-motor and feeding problems in infancy that include poor weight gain, poor suck, gagging, poor volume or quality of crying and reduced vocal play are also associated with an increased risk for communication disorders.

Under the Americans with Disabilities Act (ADA), particularly Title I, employers are required to provide workplace accommodations for individuals with learning disabilities, but only for disabilities that have been disclosed. Individuals have the right to determine whether, when, how, and to whom to disclose their disabilities, and many choose to withhold disability information. The following sources provide recommendations of workplace accommodations for adults with learning disabilities: ADA and LdAmerica.org.

Clinical research suggests the following treatments are indicated for the treatment of adults with language disorder:

• Vocational Support Services: include testing to identify vocational strengths, career counseling, vocational training, job search assistance, and job coaching
• Workplace Accommodations: Employers can provide possible solutions to remediate some of the challenges an individual with a writing impairment might experience in the workplace. Common adjustments are: allowing use of computational aids for workplace performance; assistive technology (i.e., reference sheets, digital and talking clocks, calendars and time management programs); identification of a coworker to assist with tasks involving math.

In addition, research suggests the following interventions are promising:

• Psychological therapy to address any emotional issues that stem from social isolation  
• Audiologist screening