Published on October 4th, 20190
Developmental Language Disorder: Updates on an International Consensus (Part 2)
This is part 2 of a 2-part series on the translation of the new CATALISE terminology. To read part 1, click here.
In Part 1 of this post I explain how a discussion in my Developmental Language Disorders 2 course with Dr. Lisa Archibald sparked my interest in the CATALISE consensus and how terminology surrounding Developmental Language Disorder (DLD) is being used in other languages. This led me to get in touch with some notable French-Canadian speech-language pathology researchers, with the help of Dr. Archibald, to find out more about the strides that are being made towards using consistent terminology to describe child language difficulties both in English and in French.
DLD Around the World
After learning more about DLD in the French-Canadian context, I also wondered about its status from an international perspective. Dr. Archibald was able to put me in touch with clinicians and researchers who provided me with information on the terminology used in Brazilian Portuguese, Gaelic, Georgian, German, Greek, Italian and Swedish. Through many exchanges with these individuals, I had the opportunity to learn about how various countries have attained different levels of agreement regarding DLD terminology.
Some countries have created advocacy groups, similar to the UK’s RADLD (Raising Awareness of Developmental Language Disorder). One such example is TDL Brasil, which consists of five S-LPs who completed their doctoral degree at the University of São Paulo. I got in touch with Dr. Juliana Perina Gândara, one of the founding members of TDL Brasil, who expressed that she and her team have long been interested in improving awareness of DLD. The results of the CATALISE consensus set the stage for them to create their own advocacy group. They first began by translating DLD to the Brazilian Portuguese term “Transtorno do Desenvolvimento da Linguagem” (TDL). Since then, their group has been working tirelessly to raise awareness of DLD across Brazil.
Other countries have attained at least some level of agreement on terminology through a less formal process, such as Sweden and Italy. Ida Rosqvist and Signe Tonér, S-LPs and PhD candidates at Lund University and Stockholm University (respectively) informed me that the Swedish term “språkstörning” (language disorder) had already begun to be commonly used prior to the CATALISE consensus. The term “utvecklingsrelaterad språkstörning” (developmental language disorder) was recommended after the CATALISE consensus, though it is not yet commonly used. As for Italian, Dr. Ludovica Serratrice, professor at the University of Reading, reports use of the term “disturbo specifico del linguaggio” as per the most recent congress of the Federazione Logopedisti Italiani, the Italian S-LP professional body.
In contrast, some countries have not yet established consistent use of any term to describe DLD. Consider the country of Georgia, located at the crossroads of Western Europe and Asia where they speak a Kartvelian language. According to Tamara Kalandadze, a Georgia native completing her PhD at the University of Oslo, a Georgian equivalent of the previously-used term “Specific Language Impairment” had been created, though it has not been widely adopted across the country. As for an appropriate translation of DLD, she has suggested „ ენის განვითარების დარღვევა“ (disorder of language development) in a recent interview for a Georgian e-journal.
Finally, other countries have had to additionally take into consideration the minority status of the languages under study. Similar to French in Canada (outside of Québec), Gaelic is a minority language of Scotland and has recently been undergoing many revitalization efforts, such as Gaelic-medium education. Morna Butcher, research assistant at the University of Edinburgh and native Gaelic speaker, describes how she and Dr. Vicky Chondrogianni selected the term “mi-rian cànain” (disorder of language) while completing the first research study to examine DLD in Gaelic.
One of the first things I learned in speaking to these international clinicians and researchers was that, in any language or region, there are many variables that may contribute to a lack of unified, consistently-used terminology.
For example, similar to the creation of DLD’s French equivalent described in part 1, a slight barrier to selecting an appropriate term relates to the specific linguistic features of each language. For example, Katerina Drakoulaki, S-LP and PhD candidate at the National and Kapodistrian University of Athens, reports “Αναπτυξιακή Γλωσσική Διαταραχή” (developmental linguistic disorder) as the Greek term corresponding to DLD. She notes that the word “language” was changed to “linguistic” as a phrase cannot contain two nouns in such a way in Greek.
However, these linguistic differences represent only a small portion of the challenges encountered in adopting a unified term. In Sweden, for example, while many researchers and clinicians have agreed on the use of “språkstörning” (language disorder), there has been a movement led by teachers, parents and people with DLD against the use of this term due to the stigma associated with “störning” (disorder). They propose instead “språknedsättning” (language impairment).
Similarly, Dr. Wiebke Scharff Rethfeldt, S-LP and professor at the City University of Applied Sciences Bremen, describes some differences between the terminology used in the medical and the speech-language pathology fields in Germany. At the moment, the medical term “Sprachentwicklungsstörung” (SES) is preferred as the umbrella term corresponding to “language disorder,” though it directly translates to “developmental language disorder” (de Langen-Müller, Kauschke, Kiese-Himmel, Neumann, & Noterdaeme, 2011). However, following the CATALISE consensus, S-LPs are in discussions to describe “language disorder” using “Sprachstörung” and to denote DLD using SES, as it is a more direct translation of the English term (Scharff Rethfeldt & Ebbels, in prep).
Another challenge relates less to the terminology used to denote DLD, and more to the criteria used to identify it, as determined in Phase 1 of the CATALISE consensus. For example, Eiman Nilsson, Ahlfont & Hansson (2018) surveyed 184 Swedish S-LPs and S-LP students to examine their degree of agreement with the criteria reported in CATALISE Phase 1. They found that, of the 27 statements, 14 attained consensus (at least 80% of the respondents rating the statement as a 4 or 5 on a five-point Likert scale). This study demonstrates that, while the majority of Swedish clinicians largely agree with the CATALISE consensus statements, there still remains work to be done to achieve agreement for certain criteria.
The Big Picture
These are only some examples of the efforts being led by clinicians and researchers around the world to reach consensus on the criteria and terminology used to describe DLD. Just as steps towards consensus have been going on in the English-speaking realm long before the CATALISE studies, many other regions of the world have been working to reach agreement on these issues for many years. In many cases, however, the CATALISE consensus has helped bring these international efforts to the forefront, or has even created opportunities for clinicians and researchers to make substantial progress on longstanding issues.
If you have any more information to add in regards to DLD in other languages, please contact Dr. Lisa Archibald at email@example.com. Help contribute to the progress made by the many childhood language experts working to improve the lives of those affected by DLD by continuing to educate yourself on this disorder, contributing to the consensus and research efforts when possible, and raising awareness of DLD in your community, in whatever language(s) you speak!
References (Part 2)
Archibald, L.M.D., Cunningham, B.J., & Oram Cardy, J. (2019). Developmental language disorder: Steps toward implementation in Ontario. (An OSLA working paper). Retrieved from uwo.ca/fhs/lwm/OSLA
Bishop, D. V., Snowling, M. J., Thompson, P. A., & Greenhalgh, T. (2016). CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children. PLoS One, 11(7), e0158753.
Bishop, D. V., Snowling, M. J., Thompson, P. A., Greenhalgh, T., Catalise‐2 Consortium (2017). Phase 2 of CATALISE: A multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. Journal of Child Psychology and Psychiatry, 58(10), 1068-1080.
Eiman Nilsson, L., Ahlfont, A. & Hansson, K. (2018, May 10-12). Swedish Speech-Language Therapists’ Views on Criteria for DLD: A Comparison with CATALISE. Paper presented at 10th European Conference of Speech and Language Therapy, Cascais, Portugal.
de Langen-Müller, U., Kauschke, C., Kiese-Himmel, C., Neumann, K., & Noterdaeme, M. (2011). Diagnostik von Sprachentwicklungsstörungen (SES), unter Berücksichtigung umschriebener Sprachentwicklungsstörungen (USES). Düsseldorf: Arbeitsgemeinschaft Medizinisch Wissenschaftlicher Fachgesellschaften e. V, 049-006. Date: 12/16/2011. Expired. Retrieved from: https://www.awmf.org/uploads/tx_szleitlinien/049-006l_S2k_Sprachentwicklungsstoerungen_Diagnostik_2013-06-abgelaufen_01.pdf
Scharff Rethfeldt, W., & Ebbels, S. (in prep). Sprachentwicklungsstörung (SES) – Auf dem Weg zu einem internationalen terminologischen Konsens. Forum Logopädie, 33, 4.
Marika Robillard is a graduate student in her final year of the speech-language pathology program at Western University. Prior to her studies at Western, Marika completed a Bachelor of Health Sciences degree in speech-language pathology at Laurentian University. In 2018-2019, she was the recipient of an SAC Elks & Royal Purple Fund for Children Gordon Leslie Memorial Scholarship, as well as an OSLA Student Peer Award. She also volunteers on the Western Student Council as a Health & Wellness Committee representative, and is as an executive member of CSD Smile, a student initiative to raise money for Operation Smile, a non-profit organization that provides cleft lip and palate repair surgeries worldwide.
This blog post was completed under the guidance of Dr. Lisa Archibald and was submitted as a final project in the Developmental Language Disorders 2 graduate course in the speech-language pathology program at Western University. You can view more final projects for this course at http://www.uwo.ca/fhs/lwm/teaching/dld2.html.