How would you know if a child has MERLD?

MERLD (Mixed receptive-expressive language disorder) is a communication disorder that affects both understanding and speaking to varying degrees. Children with this disorder struggle to understand words and sentences and to express themselves through language. Sensory deficits, intellectual deficits, neurological conditions, environmental deprivation, or psychiatric impairments do not cause this disorder. Those with MERLD have a normal left-right anatomical asymmetry of the planum temporale and parietal but a reduced left hemisphere functional specialization for language. 

MERLD is also known as receptive-expressive language impairment (RELI).

You have MERLD if all of these DSM IV – TR Criteria are met: 

• Mixed receptive-expressive language disorder is a communication disorder characterized by below-average scores on standardized tests measuring receptive and expressive language development, as well as difficulties with understanding words and sentences and expressing themselves. 
• These difficulties can significantly interfere with academic or occupational achievement and social communication. 
• The disorder is not a pervasive developmental disorder.
• Suppose MERLD is associated with mental retardation, speech-motor or sensory deficit, or environmental deprivation. In that case, the language difficulties are more severe than what is usually observed in individuals with these issues.

Common Signs for Cant Express Well

Children with a mixed receptive-expressive language disorder may struggle with various symptoms that impact their ability to communicate effectively. These symptoms include a limited ability to form sentences, which can manifest as incomplete or short sentences. For example, instead of saying, “I am going to the store,” they may say, “going store.”

Another symptom is leaving words out of sentences, which can make it difficult for others to understand what the child is trying to communicate. For instance, instead of saying, “I am hungry and want some food,” they may say, “hungry want food.”

Children with a MERLD may also have difficulty saying words in the correct order, which can further hinder their ability to communicate effectively. For example, they may say “cup blue” instead of “blue cup.”

Finally, these children may exhibit a reduced vocabulary compared to other children of the same age. They may struggle to find the right words to express themselves or may use simpler words than their peers. For instance, they may use “thing” instead of a more specific word like “toy” or “book.”

Common Signs for Can’t Understand Well

In addition to difficulties with expressive language, children with a MERLD may also struggle with understanding what others are saying to them. This can manifest as difficulty understanding spoken language, including conversations or instructions from others. For example, they may have trouble understanding when someone asks them a question or gives them directions on how to complete a task.

Similarly, they may have difficulty following directions that are spoken, which can make it challenging for them to complete tasks or participate in activities that require following verbal instructions. For instance, they may struggle with following directions such as “put the red block on top of the blue one.”

Another MERLD symptom is confusion surrounding abstract nouns or spatial terms. Children with this disorder may struggle to understand concepts that are not concrete or tangible, such as “love” or “honesty.” They may also have difficulty understanding spatial terms like “over,” “under,” “behind,” or “in front of,” which can make it difficult for them to understand directions, follow conversations, or participate in activities that require spatial awareness.

Conclusion

If children have difficulty understanding what others are saying, struggle to express themselves through language, have a limited ability to form sentences, leave words out of sentences, say words in the wrong order, or have a reduced vocabulary in comparison to other children of the same age, they may have MERLD. This disorder is a communication disorder that significantly interferes with academic or occupational achievement and social communication. However, it is not associated with sensory deficits, intellectual deficits, neurological conditions, environmental deprivation, or psychiatric impairments. If parents suspect that their child may have MERLD, it is essential to seek professional evaluation and diagnosis.