Some children have problems with understanding, also called receptive language. They may have trouble:

• Following directions

• Answering questions

• Participating in conversations

• Participating in play sequences with peers

• Understanding new concepts

• Understanding nonverbal communication (gestures, facial expression)

Some children have problems talking, also called expressive language. They may have trouble:

• Asking questions

• Telling about events

• Providing descriptions

• Telling a story

• Using age appropriate grammar

• Using specific vocabulary

• Learning songs and rhymes

• Using correct pronouns, like "he" or "they"

• Carrying on a conversation

Many children have problems with both understanding and talking.

Children with a history of language delay (late talkers) are at higher risk for a later diagnosis of Specific Language Impairment (SLI). A child with SLI has normal nonverbal intelligence, hearing and motor development, their difficulty is specific to language. SLI affects both receptive (comprehension) and expression of language. Children with a history of delayed onset of speech and language or language delays that persist beyond the end of a child’s fourth year of age are considered to be at higher risk for a later diagnosis of SLI.

Children with SLI may speak in shorter sentences than their same aged peers. They may use nonspecific words (thing, stuff, it) so it's difficult to understand what they are talking about. Their speech may lack grammatical markers, such as tense, plural and possessive markers and they may mix up pronouns (he/she, him/his) beyond the developmentally appropriate age. They may have trouble telling a story in a sequential and organized manner and have difficulty understanding directional terms, prepositions (under, inside, between) and subtle grammatical markers can cause difficulty with comprehension. Sometimes these children appear to be inattentive as they don't seem to understand or remember what you tell them. They may have trouble paying attention and following along in a group. It is important to rule out language-based learning problems prior to diagnosing attention deficit disorders in children.