Published on April 25th, 20190
Developmental Language Disorder: Updates on an International Consensus
The CATALISE Project
Did you see that Speech-Language & Audiology Canada recently published an official statement supporting the promotion and implementation of the consensus statements established by the CATALISE consortium? As a second year speech-language pathology Master’s student at the University of Western Ontario, I had the opportunity to learn about the consensus statements from my professor Dr. Lisa Archibald during our Developmental Language Disorders 2 course.
If you aren’t familiar with CATALISE, it stands for Criteria and Terminology Applied to Language Impairments: Synthesising the Evidence. In 2015-2016, the CATALISE consortium assembled an international panel of 59 English-speaking experts in child language disorders to participate in a two-phase study. The Delphi method was then used to establish consensus regarding identification criteria (phase 1) and terminology (phase 2) for child language difficulties (Bishop, Snowling, Thompson, & Greenhalgh, 2016, 2017). Ultimately, the umbrella term Language Disorder was chosen to describe “a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis” (p. 1). The term Developmental Language Disorder (DLD), more specifically, was used to describe a language disorder with no known biomedical cause (Bishop et al., 2017).
DLD in Other Languages
Being bilingual in French and English, and having completed my undergraduate degree in a bilingual setting at Laurentian University, I was curious to know how the consensus statements were being applied in other languages. As stated in Phase 1 of the study, the CATALISE consensus statements were restricted to the majority English-speaking countries of the United Kingdom, Australia, Canada, Ireland, New Zealand and the United States. The authors agreed that it would be impossible to examine all of the estimated 6,500 languages of the world in one study. As a result, the CATALISE studies were completed in English only, with the intention of creating a model to be used in other languages and countries (Bishop et al., 2016).
During a class discussion about the CATALISE studies, I indicated my interest in the status of DLD terminology in other languages. Dr. Archibald recommended that I address this question through my final project for the DLD2 course and she put out a call on Twitter for her bilingual colleagues to collaborate with me for this project. From there, I was able to get in touch with S-LPs around the world and ask them about what terminology is being used in their language and region.
The French-Canadian Context
I was first interested in learning about how the consensus statements were being applied in the French-Canadian context. To learn more about this, Dr. Archibald put me in touch with Dr. Chantal Mayer-Crittenden and Dr. Roxanne Bélanger of Laurentian University (Ontario), Dr. Elin Thordardottir of McGill University (Québec) and Dr. Chantal Desmarais of the Université Laval (Québec).
Through my research and conversations with these francophone S-LPs, I found that many terms have been used to describe language difficulties in French over the years, such as “audimutité,” “dysphasie,” “retard de langage” and “trouble spécifique du langage.” I also found that efforts to determine common terminology in French pre-date the CATALISE consensus statements and have been led by researchers and S-LPs from various regions around the world, including Ontario, Québec, Belgium, France, Switzerland and Algeria. In fact, in 2004 the Ordre des orthophonistes et audiologistes du Québec (OOAQ), with the help of many researchers and clinicians such as Dr. Thordardottir, reached agreement on the term “trouble primaire du langage” (“En Définition,” n.d.). However, with the consensus on Developmental Language Disorder by the CATALISE consortium, OOAQ decided to adopt a term that corresponds more closely to the English term: “trouble développemental du langage” (TDL) (Gingras, 2017; Maillart, 2018; OOAQ, 2018). Other French-speaking regions, including Ontario, France and Belgium, have also begun to adopt this terminology (Archibald, Cunningham, & Oram Cardy, 2019).
The road to the adoption of “trouble développemental du langage” has proven to be more difficult than it would seem, however, as the order of the words and the prepositions used in the French translation can entail a change of meaning. To better understand why this seemingly simple translation can lead to confusion, let’s explore two of the terms that were initially proposed. The settled-upon term “trouble développemental du langage” may be directly translated to “developmental disorder of language,” with some S-LPs interpreting this as describing a disorder of human development with subsequent impact on language abilities. Some suggest that this might cause confusion between language difficulties associated with known biomedical aetiologies such as Down Syndrome. Contrarily, the similar term “trouble du développement du langage,” which can be translated to “disorder of the development of language,” might be interpreted as a disorder specific to language development. Ultimately, however, the term “trouble développemental du langage” was chosen, as the majority of S-LPs agreed that the specifics of the term are less important than the use of consistent terminology.
The Big Picture
After many years of hard work on the part of francophone clinicians and researchers worldwide, it appears that the international consensus is moving towards the term “trouble développemental du langage.” While the technicalities of reaching this consensus may seem cumbersome to clinicians, achieving agreement on the use of consistent terminology ultimately benefits our clients in many ways. The consistent use of a label allows us to ensure equity of access to services, accurately identify individuals with DLD, access research funding, gather and synthesize information from the literature, improve communication among researchers, clinicians and families, and increase awareness of DLD both in the public and academic spheres (Bishop, 2014; Bishop et al., 2017; Ebbels, 2014; OOAQ, 2018).
What Can You Do?
Step 1: Inform yourself! Whether you work in an English- or French-language setting, take a look at the CATALISE resources to better understand the project’s methods and results.
Step 2: If you work in a French-language setting, you may need to do some research to learn more about the decisions regarding terminology in your region. Consider getting in touch with the experts in your area. You may even be able to help contribute to the efforts in your region!
Step 3: Use the agreed-upon term of your language and region, share and discuss it with your colleagues, and help spread awareness to others, whether in person or on social media. We all have a part to play in increasing awareness of DLD!
CATALISE Phase 1 paper: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158753
CATALISE Phase 2 paper: https://onlinelibrary.wiley.com/doi/full/10.1111/jcpp.12721
CATALISE Summary paper: https://www.rcslt.org/clinical_resources/docs/revised_catalise2017
RADLD video (5min): https://www.youtube.com/watch?v=OZ1dHS1X8jg&t=154s
Dorothy Bishop IJLCD Lecture video (60min): https://www.youtube.com/watch?v=uBehC82whh0
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. (2014). Ten questions about terminology for children with unexplained language problems. International Journal of Language and Communication Disorders 49(4), 381-415.
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.
En Définition. (n.d.). Retrieved February 7, 2019, from https://www.dysphasie-quebec.com/en-definition/
Ebbels, S. (2014, July/August). Introducing the SLI debate [Editorial]. International Journal of Language & Communication Disorders, 49(4), 377-380.
Maillart, C. (2018) L’apprentissage du langage chez les enfants présentant un trouble développemental du langage (TDL). In A. Roy et al. (Eds.), Neuropsychologie de l’enfant (pp.68-81). Paris, France; De Boeck Supérieur.
Gingras, M. (2017, July 23). Le nouveau « Trouble développemental du langage » : 57 experts se prononcent sur la terminologie entourant les troubles du langage [Blog post]. Retrieved from https://cuitdanslebec.wordpress.com/2017/07/23/le-nouveau-trouble-du-langage-developpemental-57-experts-se-prononcent-sur-la-terminologie-entourant-les-troubles-du-langage/
Ordre des orthophonistes et audiologistes du Québec (2018). Le trouble développemental du langage pour les professionnels de la santé et de l’éducation. Retrieved from: http://www.ooaq.qc.ca/actualites/OOAQ_deIpliant_professionnels_pour%20le%20web_v007.pdf
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.