Who are Adults with Developmental Language Disorder? Profiles from the Engage with Developmental Language Disorder...

Although developmental language disorder (DLD) is a lifelong, neurodevelopmental condition, its presentation in adulthood has received scant research and clinical attention. Several longitudinal studies have demonstrated that poor language ability may be negatively associated with wider life factors in adulthood. Moreover, although a growing body of qualitative evidence illustrates the lived experience of adults with DLD, more quantitative research on this subject is needed, which may guide evidence-informed assessment and support practices for adults. In this short report, we aim to explore the presentation of DLD in adulthood. We share the demographic characteristics, language difficulties, and mental health profile of a sample of adults with DLD based on self-report data.

We collected data from 92 adult participants recruited via Engage with Developmental Language Disorder (E-DLD), an international database set up to facilitate DLD research. Participants completed a DLD screening questionnaire, a set of demographic questions, and measures of emotional health including anxiety, depression, and self-esteem. We used the resulting data to construct an overview of the characteristics and profiles of two subgroups in the database: (a) adults who self-reported a clinical diagnosis of DLD (n = 30); and (b) adults who scored highly on the screening questionnaire ("possible DLD," n = 62) but who did not have a formal diagnosis. For some measures, we also include a comparative sample of typical adults with no confirmed or suspected DLD (n = 91).

More women than men completed the survey, with the average age of the DLD participants being just under 37 years of age, whereas the controls were on average 43 years of age. About 70% of the DLD participants were UK residents, while 30% were from countries across the world. Participants with DLD tended to be lower earners than controls but were represented in all income bands. In total, 43% (39) were parents and 43% (39) were living with a partner. Word finding and expressive language were the most reported areas of language difficulty, and the clinically diagnosed sample reported significantly more pragmatic language challenges than the "possible DLD" group. Respondents across both DLD groups had higher levels of emotional challenges including anxiety, depression, alexithymia, and low self-efficacy compared to the comparison sample.

Adults with DLD are a diverse group, with potentially more women than men seeking diagnosis or recognition in adulthood. It is possible that the high rates of emotional difficulties may indicate notable levels of need in those with DLD in adulthood.

Our findings show that there are many adults with likely DLD without a formal diagnosis. As such, they are unlikely to qualify for support. We recommend that services providing for adults with DLD should make every effort to be accessible to those on lower incomes, given our income findings, and services could usefully collaborate with mental health services to understand the complexities of co-occurring needs. Speech and language services should also consider how to work alongside other advocates to increase recognition of DLD in adulthood, given the lifelong impact of DLD, whether diagnosed or not.