Expressive language disorder (ELD) can be a debilitating condition for many people, especially in social settings like school or the workplace. People with this unique language disorder generally have no trouble understanding others, but when it’s time to speak up in a conversation, they struggle to make sense. 

ELD doesn’t simply affect speech: it affects someone’s use of expressive language. In this article, we cover the most important things to know about expressive language disorder, including answers to the following questions:

• What is expressive language disorder?
• What is the difference between developmental ELD and acquired ELD?
• What are the early signs and symptoms of expressive language disorder?
• What does ELD look like in adults?
• Is ELD a communication, speech, or language disorder?
• What is the difference between expressive language disorder and aphasia?
• What impact does ELD have on communication and social skills? 
• What treatments are available for ELD?
• Where can I find help for expressive language disorder? 

What is expressive language disorder?

Expressive language disorder (ELD) is a communication disorder that makes it difficult for people to share their thoughts or ideas or show they understand what others say. ELD doesn’t only affect speech; it affects expressive language, or the methods people use to communicate their thoughts.

Examples of expressive language include:

• Talking
• Writing
• Nonverbal cues, like facial expressions and body language

What is the difference between developmental ELD and acquired ELD?

Expressive language disorder can affect both children and adults but is more common in children. The two types of ELD are:

Developmental ELD. A child with developmental ELD often has normal language skills, understands verbal communication, and may have no issues reading, but they struggle to build vocabulary, say complex sentences, remember words and their meanings, and put their own thoughts down on paper. 

Acquired ELD. Someone with acquired ELD develops the condition later in life, usually following an injury or illness that impacts the brain’s language centers. Medical conditions that may cause acquired ELD include:

• Alzheimer’s disease
• Aphasia
• Brain trauma (aneurysm, concussion, surgery, etc.)
• Dementia
• Epilepsy
• Genetic disorders
• Substance abuse
• Stroke

Both forms of ELD are lifelong conditions, though symptoms can improve with treatment. Some children who show symptoms of developmental ELD catch up to their peers with time and treatment. This type of communication issue is called an expressive language delay.

What are the early signs and symptoms of expressive language disorder?

Children can show signs of developmental ELD as soon as they start talking, and their symptoms may worsen with time. Signs to look out for include:

• Learning to talk later than their peers. 
• Leaving out words.
• Using vague words like stuff or thing when they can’t find the right word to use. 
• Behavioral issues, like tantrums due to the frustration of not being understood.
• Antisocial or avoidant behavior.
• Stalling while talking (overusing words like “uh” and “um” when struggling to find the right words).

As kids enter school, ELD symptoms might become more apparent. These include:

• Difficulty taking notes.
• Poor participation in class or group activities. 
• Difficulty making friends.
• Telling stories or expressing thoughts in an illogical way.
• Speaking out of order, like saying “hungry I am” instead of “I am hungry.”

What does ELD look like in adults?

In addition to symptoms shown in childhood, adults with ELD might:

• Make up words. 
• Switch sounds within words, often without noticing. 
• Substitute related words regardless of their definition (like saying “hot dog” when they mean “hamburger”). 
• Misuse idioms and slang. 
• Struggle to make and maintain relationships.

In the workplace, adult ELD symptoms include: 

• Anxiety about public speaking, meetings, or presentations.
• Difficulty using industry/workplace jargon.
• Trouble answering direct questions.
• Problems keeping up with office conversations. 
• Feeling isolated, left out, or frustrated by coworkers. 

Is ELD a communication, speech, or language disorder?

Communication disorders are neurodevelopmental conditions involving persistent language and speech problems, like stuttering or social (pragmatic) communication disorder. Speech disorders and language disorders are two different kinds of communication disorders. 

A speech disorder involves difficulty with creating and forming speech sounds, while a language disorder involves difficulty using and understanding language. 

Speech disorders affect verbal communication, or what someone says. These disorders include:

• Aphasia/dysphasia
• Apraxia of speech
• Attention deficit/hyperactivity disorder (ADHD)
• Autism-related speech disorders
• Dysarthria
• Dyspraxia
• Orofacial myofunctional disorders
• Receptive disorders
• Resonance disorders
• Selective mutism
• Speech sound disorders/articulation disorders
• Stuttering and other fluency disorders

Meanwhile, language disorders affect what people understand and how they communicate information, not just through speech. Language disorders include:

• Expressive language disorder (ELD). Someone with ELD struggles to express themselves.
• Receptive language disorder (RLD). A person with RLD has difficulty understanding the meaning of what others say.
• Mixed receptive-expressive language disorder (MRELD). Someone with MRELD shows symptoms of both ELD and RLD.

What is the difference between expressive language disorder and aphasia?

Aphasia is an acquired language disorder caused by something like severe illness or brain injury. Damage to the brain’s language centers can make someone lose language skills they’ve had all their life. Aphasia can affect both expressive and receptive language. 

ELD and aphasia are not the same thing. Rather, aphasia can be a cause of acquired ELD in adults. There are four types of aphasia:

• Broca’s aphasia (non-fluent or expressive aphasia). Someone with Broca’s aphasia finds it extremely difficult to find and say the right words, even though they usually know what they want to say.
• Wernicke’s aphasia (fluent or receptive aphasia). Someone with Wernicke’s aphasia can speak well and use long sentences, but their words often don’t make sense.
• Anomic aphasia. Someone with anomic aphasia struggles to find precise words, particularly important nouns and verbs, often relying on vague expressions instead.
• Primary progressive aphasia (PPA). PPA is the only type of degenerative aphasia, meaning its symptoms get worse over time. Someone with PPA gradually loses the ability to write, read, and speak, as well as the ability to understand what other people say.

All four types of aphasia can cause ELD, but ELD is most commonly attached to Broca’s aphasia or anomic aphasia. Wernicke’s aphasia and PPA tend to impact receptive language skills first but can also play a role in the loss of expressive language skills.

What impact does ELD have on communication and social skills?

For both children and adults with ELD, it’s important to pay special attention to mental health. Difficulty expressing oneself can lead to feelings of depression, anxiety, embarrassment, and frustration. 

Children with ELD may act out when they feel misunderstood, struggle to make friends, or develop social anxiety. Adults with ELD may struggle in the workplace, choosing to avoid conversations with colleagues and stay away from roles that involve public speaking.

Many people with ELD benefit from accessibility features and communication apps. Check out our database of accessible mobile devices to learn more. 

What treatments are available for ELD?

Treatment for communication disorders is highly specialized to the patient. Depending on the age, lifestyle, and severity of symptoms for someone with ELD, treatment might include:

• Individual or group speech therapy.
• Private tutoring or mentoring.
• Support from school staff to manage an individualized education plan (IEP).
• Assistive technology like speech apps. 
• Home-based programs for parents and families. 
• Individual or group counseling to hope with emotional regulation issues.

Where can I find help for expressive language disorder? 

If you’ve noticed ELD symptoms in yourself or a loved one, a great place to start is with your family doctor or pediatrician.

Your doctor may refer you to an audiologist or speech-language pathologist (SLP) for further testing. These specialists test hearing, auditory processing, learning ability, and cognitive function to create personalized treatment plans. 

In addition, Ability Central maintains a database of nonprofits devoted to communications disabilities like ELD. Use our Service Locator tool to find an organization offering diagnosis, treatment, and medical/legal services near you. 

To learn more about language and speech disorders, see:

• Aphasia and Dysphasia: Why Do People Stop Using and Understanding Language?
• Receptive Language Disorder: Why Can’t I Understand What People Say?
• What Keeps Someone From Talking? Information You Should Know About Muteness