SLPSurveyInternational journal of language & communication disorders2017

Why is it so hard to reach agreement on terminology? The case of developmental language disorder (DLD).

Dorothy V M Bishop

PMID 28714100

WHAT IT FOUND

Speech-language therapists may use developmental language disorder as a broad label for children with persistent language problems, not a sharp diagnosis.

It should not depend on a gap between language and non-verbal ability, and functional impact must be shown.

Key findings

01The CATALISE panel recommended replacing specific language impairment with developmental language disorder as a broad term.

02The panel concluded that DLD diagnosis should not require a mismatch between verbal and non-verbal ability.

03The panel agreed that test scores should not be the sole criterion for identifying language disorder; evidence of functional impairment is needed.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The paper is based on expert consensus and panel comments, not on direct measurement of patient outcomes or treatment effects. The supplied text does not state how many experts were on the panel or how many comments were analysed. Consensus was defined as at least 75% agreement, but the paper notes that agreement among experts does not prove that a label is true or clinically valid. The panel identified major gaps in evidence for prognosis, standardized assessment, and intervention efficacy for children with co-existing conditions. The paper discusses allocation of services, but it does not report how any new criteria changed access to therapy in real patients.

Declared interests

No funding source or conflict-of-interest declaration is included in the supplied text.

The easy way to misread this

Do not read developmental language disorder as a proven syndrome or as proof that therapy works. It is an expert consensus label for children with poor-prognosis language problems, and this paper reports no treatment outcomes.

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