Developmental Language Disorder as a Multidimensional Neurodevelopmental Spectrum: Implications for Diagnosis

Citation

McGregor, K. K., Goffman, L., Plante, E., & Werfel, K. (2025). Developmental language disorder as a multidimensional neurodevelopmental spectrum: Implications for diagnosis. Journal of Speech, Language, and Hearing Research, 1-20. 

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Key terms that are in this paper

Developmental language disorder (DLD): a common condition that affects speaking, listening, reading, and writing.  

Neurodevelopmental condition: a condition that affects the development of the brain, with possible effects on language, motor, cognitive, and/or social-behavioural areas. DLD is a neurodevelopmental condition, but there are many others including ADHD, autism, developmental coordination disorder, dyslexia, and intellectual disability.  

Diagnosis: a decision-making process. When a speech-language professional diagnoses DLD, they have decided that the problems they observe are better categorised as DLD than some other category like typical development, dyslexia, or autism. 

Aim of the paper

DLD is too often undiagnosed or misdiagnosed. Language problems are not always obvious, and other developmental difficulties, such as in speech, attention (ADHD), or motor skill, may hide DLD. We wanted to create a thorough understanding of the dilemmas involved in the diagnosis of DLD.  

We conducted a careful review of the research literature to identify signs that define DLD and other neurodevelopmental conditions. 

What was found

	Clinical Signs	Diagnosis
Language	Executive Function
Ed	X	X	X		X		DLD
Clara		X	X				DLD
Suzi	X	X	X			X	DLD
Omar	X	X		X	X		DLD + ADHD
Ann	X			X	X	X	ADHD
X indicates that a sign is present

DLD is a spectrum. A spectrum is a collection of strengths and weaknesses that define a given condition. The spectrum will look somewhat different for one person than for another.  

In the Table, are five hypothetical profiles. Some include problems with language (potential signs of DLD); some include problems with executive function (potential signs of ADHD). By comparing the profiles, you will see that: 

• Not all people with DLD have the same language weaknesses.  

• Sometimes people with DLD have weaknesses that extend to executive function (and potentially to other areas).  

• Sometimes a person with ADHD also has some weaknesses in language (and potentially in other areas).  

• Sometimes a person will have more than one diagnosis. 

Thinking about neurodevelopmental conditions as distinct categories makes diagnosis easier. However, this is an overly simple way of defining DLD, and likely other neurodevelopmental conditions as well.  

It is important for speech-language professionals to be aware of the spectral nature of DLD. That way, they might improve diagnosis and gain a richer understanding of the needs of persons with DLD. 

What does this mean

People with DLD and their families might benefit from knowing that: 

• People with DLD have strengths as well as weaknesses.  

• People with DLD are individuals. The strengths and weaknesses of one person will be different than another. 

• People with DLD often have problems that extend beyond language. Sometimes they even have more than one diagnosis. For example, they might be diagnosed first with DLD and later with dyslexia. This does not mean that the first diagnosis was incorrect. 

• DLD is a neurodevelopmental condition. People with DLD face some of the same challenges as others who are neurodiverse.  

• You can embrace neurodiversity AND seek diagnosis and help for DLD.  

Where can I read the paper?

You can read the whole paper for free by following this link: https://doi.org/10.1044/2025_JSLHR-25-00089 

YouTube summary: https://youtu.be/RskuHU_DViM