Mixed Receptive and Expressive Language Disorder. What Can Parents Do?

Mixed Receptive and Expressive Language Disorder. What Can Parents Do?


When a child says their first words it is one of the greatest joys of being a parent. So when there is a problem with understanding or speaking, parents are worried or frustrated. The child may often feel the same. Some parents put off dealing with the problem in the hopes that their child would catch up later. This has already been shown by researchers to be a bad idea. Even if a child does catch up on their own, there could be academic and social issues that persist throughout the school years. When a child does not understand or speak at an appropriate level, it may be a delay or a mixed receptive and expressive language disorder (sometimes labeled as MERLD).


The speech therapists at Therapy Works Together have included some information below on receptive and expressive language disorder below that parents may find helpful.


The American Speech-Language-Hearing Association (ASHA) reports that about 8% of children in the United States have language delays or disorders, with boys twice as likely to have a disorder. Moreover, communication disorders are highest in children between the ages of 3–6 years old. Parents should not adopt a wait and see approach but instead should consider seeing a speech therapist if they are wondering if their child needs speech therapy.


What is a Mixed Receptive and Expressive Language Disorder?


There are two different types of language disorders:

  1. Receptive language disorder: difficulty understanding or comprehending language which is spoken or written. It’s possible that the child shows confusion and misunderstanding in school, fails to follow verbal directions at home, struggles to get along with friends, or just problems processing speech in direct conversation. They may heavily rely on facial expressions and struggle with complicated language.
  2. Expressive language disorder: difficulty with speaking or expressing one’s thoughts, ideas, feelings. People with expressive language disorder may make confusing remarks with poor grammar and improper or general vocabulary. Their speech may have false starts, lack cohesion, or tail off, and they may rely on simpler messages.


It is possible for a child to have both language problems at the same time. This is when they may have a mixed receptive expressive language.

What is the Cause of a Mixed Receptive and Expressive Language Disorder?


Unfortunately, the cause of a mixed receptive and expressive language disorder is not known. There are some contributing factors or related issues that have been identified:

  • Hearing impairments
  • Premature birth and/or low birth weight
  • Genetic disorders like Down’s Syndrome
  • Autism Spectrum Disorder (ASD), Fragile X Syndrome or other disorders
  • Brain tumors
  • Brain injuries (strokes or other trauma)


Research has also shown that there may be a family relationship associated with mixed receptive and expressive language disorder. So if there are other people in the family with a similar diagnosis, parents should take note.


RELATED: Speech delay in children.

Emotional and Social Consequences of Mixed Receptive and Expressive Language Disorder


Since people are social creatures, when a child’s receptive or expressive language skills are not at a developmentally appropriate level, it can have ramifications in many areas of their lives, ranging from straining relationships with parents and teachers to affecting their ability to make friends at school and/or participate in group activities.


For example, not following directions can get a child in trouble, or it might make them look like you’re willfully refusing to follow instructions. In fact, failure to follow verbal directions might be due to an issue with comprehension or understanding rather than deliberate opposition. The same concerns may be seen on the playground, where misunderstandings are more likely to lead to confrontations with other kids, and children may be bullied as a result of poor language comprehension or difficulty responding appropriately.


Untreated mixed receptive and expressive language disorders can lead to low self-esteem and behavioral issues over time. Frustration, emotional outbursts, and acting out might result from not being able to articulate demands and needs. Children may retreat and lose confidence in themselves as a result of embarrassment over perceived speech impairments.


Some children may assume they are inferior to their classmates or friends in terms of intelligence or skills. They may feel less motivated in school and have depression issues. That is why it is critical to provide emotional support and to get assistance from a professional.


Mixed Receptive and Expressive language disorder and the Impact at School


Learning takes place as a result of our communicating with each other. Communication problems can contribute to poor academic performance. A child’s capacity to deal with verbal and written language is at the heart of most of schooling. If a student is unable to digest the information presented by a teacher, they may struggle to take notes and may perform badly on homework tasks. In addition, working in a group might be very difficult.


A child may be hesitant to join in classroom conversations if they can’t explain themselves, or their contributions may be dismissed due to irrelevant remarks or wrong answers. It might be difficult or scary to stand up to present oral reports. Furthermore, a student’s capacity to understand new vocabulary when reading and use that vocabulary when writing. So poor language skills affect literacy as well.


What Can Parents Do?


When parents find out their child has a receptive and expressive language disorder they become very concerned and are very eager to help. We encourage parents to take steps at home and at school to help their child. Speech therapy is very helpful for kids with mixed receptive and expressive language disorder. Parents should speak to their doctor or contact a speech therapist for a screening. 


Here are some suggestions for what parents of younger children (toddlers or preschoolers) can do at home :


  • Talk to your child a lot. This will help your child learn new words.
  • Reading every day helps a lot. Point out words and repeat books your child likes.
  • Point to signs in the grocery store, at school, and outside.
  • Speak to your child in the language you know best. Being bilingual does not harm children’s language skills.
  • Take a moment to pause to listen and answer your child
  • Give your child time to ank, answer questions and speak; try not to finish their sentences


Some children qualify for speech therapy at school. Yet unfortunately with decreasing budgets, more and more kids don’t qualify to get the help they deserve. And with more kids being screened and tested for services at school, special needs teams are maxed out. So kids receiving services get less focused time with a school-based intervention team. Parents need to be their child’s biggest advocate.

Here are some suggestions for what parents of school age children can do to help their child:


  • To support material presented verbally, request visual prompts (images, movies).
  • Ask a teacher to provide overview notes before a lesson to be prepared
  • Record classroom discussions; use speech-to-text technology for transcripts to review later at home
  • Request vocabulary lists for new texts in advance to review at home


Speech Therapy for Mixed Receptive and Expressive Language Disorder


Speech therapists can assist children in developing more complex receptive and expressive language skills including. They can also teach you how to work at home with your child and what accommodations to request for your child at school.


In speech therapy, the SLP will create a treatment plan that is specific to your child’s strengths and weaknesses. Treatment goals may focus on:


  • Enriching your child’s vocabulary
  • Increasing sentence complexity to age appropriate levels
  • Helping your child clearly express wants, needs, and ideas
  • Providing strategies on how to figure out what a new word means when reading
  • Improving story retell by teaching story grammar
  • Working on executive function skills which help a child organize themselves for learning


All in all, there are many strategies that parents can learn at home to help their child with a mixed receptive and expressive language disorder. Therapy Works Together provides you with the expertise you need to help your child succeed socially and academically.


Therapy Works Together – Online Speech Therapy for Children and Adults


We care about every child and adult achieving their speech, language and communication goals. You can start speech therapy online now with a certified speech language therapist. We’ll discuss your personal needs, develop an individualized treatment plan, and schedule affordable online therapy sessions online at your convenience.

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