IJLCD: 'It depends who I'm with' - How young people with developmental language disorder describe their experiences of language and communication in school

In this podcast we speak with Anna Ekström and Olof Sandgren about their study of experiences of young people with DLD, which focused on language and communication in a school context. The study is guided by the following research question: How do young people diagnosed with DLD describe their experiences of language and communication in school?

The paper is:

'It depends on who I'm with': How young people with developmental language disorder describe their experiences of language and communication in school https://pubmed.ncbi.nlm.nih.gov/36703539/

Anna Ekström , Olof Sandgren , Birgitta Sahlén , Christina Samuelsson

First published: 26 January 2023

This paper was nominated in the top five for the 2023 IJLCD Editors' Prize.

Resources:

What is Developmental Language Disorder: a discussion for DLD awareness day 2023 https://open.spotify.com/episode/70V0Qqnjf1Y1jH98unrN3Y (Podcast Oct 2023)

IJLCD - The impact of DLD on jury perceptions: https://open.spotify.com/episode/7zQNjYxju2EwuEKxiswSN6 (Podcast May 2023)

IJLCD - collaborative working with parents to support children with Developmental Language Disorder https://open.spotify.com/episode/1Kvyx0tiNZ6CgIQmv2DCan (Podcast Sept 2024)

Please be aware that the views expressed are those of the guests and not the RCSLT.

Please do take a few moments to respond to our podcast survey: uk.surveymonkey.com/r/LG5HC3R

Transcript

Transcript Date: 
8 October 2025

Speaker Key (delete/anonymise if not required): 
HOST: JACQUES STRAUSS
AE: ANNA EKSTRÖM 
OS: OLOF SANDGREN


 

MUSIC PLAYS: 0:00:00-0:00:09 

HOST: 0:00:09 Welcome to an IJLCD edition of the RCSLT podcast, in which we talk to authors of papers in the International Journal of Language and Communication Disorders that we think would be of interest to the SLT community and beyond. My name is Jacques Strauss. 

In this episode, we are talking about a paper entitled, It depends on who I'm with: How young people with developmental language disorder describe their experiences of language and communication in school. As a reminder, in a classroom of 30, you're likely to have two or three children with DLD, so the prevalence is quite high. We were joined by two of the authors, Anna Ekström and Olof Sandgren. Links of interest, including to this paper, are in the show notes. 

I started by asking our guests to introduce themselves.

AE: 0:00:55 My name is Anna Ekström, and I’m a senior lecturer at Linköping University in Sweden. I’m not a trained SLT, I have a background in cognitive science and I have a PhD in educational science, so that’s my way into the SLT programme here at Linköping University.

OS: Hello, my name is Olof Sandgren. I’m also a senior lecturer in the speech-language pathology area at Lund University in the south of Sweden. I had my training in speech-language pathology and a PhD in speech-language pathology.

HOST: 0:01:29 Anna, what clinical question were you trying to answer?

AE: 0:01:33 This study is part of a project focusing on education for students with DLD and we received funding from the Swedish Research Council responsible for educational questions and we’re very grateful, of course. Really, our way into the study wasn’t really trying to answer a clinical question but we want to know more about the education for students with DLD in Sweden and this project is focused both on experiences of going to school with DLD, as this paper is about, but we are also investigating goal attainment and participation in learning activities for students with DLD in our project. But this doesn’t mean that we don’t think that this is of clinical relevance, of course, I mean, students with DLD are part of… it’s a group that receives interventions from SLTs, and knowing more about how a language disorder or DLD play out in the everyday lives of students and young people I would presume is, of course, of clinical relevance.

HOST: 0:02:37 What does the existing literature say about this?

OS: 0:02:42 Well, we know from many studies that children with DLD, they struggle in school. They have an increased risk of lower academic results or lower academic performance and fewer go on to employment and they have an increased risk of some psychiatric problems, such as anxiety and depression and maintaining friendships, so these are all areas that are very important to address. And although these problems are quite well known, also among teachers in many cases, there is perhaps a general knowledge that is lacking, and, as a consequence, these symptoms are perhaps misinterpreted by teachers and by schools. These children are not given the interventions that they deserve or that would help them better. 

We wanted to listen to these children themselves, listen to them directly. What do they have to say? How do they describe these difficulties that they have? What are their experiences of school, of being in the classroom? What works well and what are the problems that they have encountered? And there are actually not many studies that have done this, listened to the children directly. There are a few examples, from the UK in particular, that we’ve been inspired by, that have found that children may not have the same idea of these problems as their parents do. They have different perspectives that they will convey if we allow them to talk about them. We were interested in finding these firsthand experiences of living with a developmental language disorder and listening to what the children find important themselves.

HOST: 0:04:30 I wonder if you could tell us a little more about the design of your study?

AE: 0:04:35 Yeah, of course. As I said, this was part of a larger project, where we started out with a broad invitation to a survey, where we wanted to investigate how students would deal with the experience, their educational support and what kind of difficulties they have in school. And at the end of this survey, we also invited them to express interest in participating in our next study, interview study. This is how we recruited individuals to this study, so it was self-selection, if you want to be part of this project, you can contact us. 

And it was a quite broad interest I think, this survey was directed also to parents, so I think we had over 80 answers, we want to know more about this interview study. At the end, there were 23 participants that wanted to participate in the interviews, so this is quite a large interview study. But this was also done during COVID, COVID restrictions. We interviewed the students over Zoom, then we transcribed the interviews and we analysed them and we constructed some themes that we think convey the overall or underlying meaning with the students’ experiences of school.

HOST: 0:05:48 Okay, so another big question, what were the main findings?

OS: 0:05:52 As Anna said, when we transcribed and analysed this data, we were able to identify four main themes. And the first one was feelings of inadequacy or comparisons with others, many saw themselves as lacking competences, both in terms of understanding others and in being able to express themselves. And some were quite specific in what they felt that they were lacking, they mentioned things like word finding difficulties or pronunciation of grammar. And others were less specific, they talked about overarching problems with social difficulties or pragmatic difficulties, as we sometimes call them. For example, they mentioned that they felt nervous when talking in front of others or talking to others, and that it was challenging to raise your hand in classroom to answer the question, for example. That was one theme. 

And another theme was about feelings of being misunderstood. These children, they portrayed themselves as being misjudged by others and that their communicative problems could be mistaken for other types of problems. And they described a wish of being better understood, or that the problems that they had were better understood by the teachers and others in school, and that they hoped that others would better understand their situation and know more about language disorders and that that would have helped them. 

Our third and fourth themes were quite similar. It was the importance of feeling safe and feeling comfortable, for example, knowing that there were situations in school where things worked a lot better, where they felt safe talking to friends or talking to specific teachers that were better at understanding these things, that made them feel more safe and more at ease. 

And the last theme was the significance of the social and communicative context and more or less they gave examples of types of situations where they felt that they were better understood, so to speak. And that’s also to remember that although many things that they mentioned were perhaps on the negative side, where schools had problems understanding them, and they felt they didn’t get the same opportunity as others, this last theme also contained some positive aspects, that they had positive things to share as well. Certain teachers that were excellent in dealing with these problems, or certain aspects of the school day that worked better, not the least talking to other friends, for example, that they all gave examples of having easier communication with the friends that they were close to.

AE: 0:08:52 What I found very interesting is that many of the things that these students told us wasn’t specific about communicative difficulties, it was more secondary problems or things around these communicative difficulties. Fears of being interpreted as stupid, as one of the students say, or even a student that doesn’t want to learn things in school. And I think these are things that they shouldn’t really have to experience. We, as a society, should be able to address these kind of problems, but they shouldn’t feel scared for being misinterpreted or misunderstood in school due to their language difficulties. I think that is one thing. It wasn’t mainly about communicative difficulties, it was very much about other things as well in school, so I thought that was something that really, really touched me. 

But I also think it is important to remember that, and maybe we can come into this regarding the limitations of the study, most of our participants, they could talk about their difficulties, they had quite good expressive abilities, but even so, they experienced quite a lot of educational problems or educational difficulties in schools. Perhaps this is not surprising for SLTs, but it is important to remember for teachers, for example, that even if you don’t really see any or hear any difficulties with the student, maybe you don’t experience that this is a student with this pronounced communicative difficulties, they can still experience this as a very challenging situation in school, so I think that is also very important to remember.

HOST: 0:10:30 What does the study tell us about what therapists should be doing?

AE: 0:10:36 Maybe this study wasn’t designed to give advice in that kind of way, but I think it is an important reminder that language abilities and communicative function can vary, depending on situational and contextual factors. And, therefore, I’m sure many people already considered this, but it’s of course important too to continue to assess language using several methods, not only relaying on a norm-based test in a clinical setting, but also trying to explore other areas of communication. And, of course, a reminder to actually pose questions to the person that is at the centre of the problem. Our study shows that at least our participants had quite a lot to tell us about how language problems is felt, the consequences, but also what could be something that addresses these problems or make them easier for the students themselves, yeah.

OS: 0:11:35 Well, I think, just as Anna said, this is a way to better assess the functional impact of the disorder in a way. Perhaps we’re, in a clinical setting, as you said, Anna, we’re looking at the results of clinical tests or norm-based tests, but we have a harder time assessing what the consequence of these problems will actually be in school. By talking to these children, we will get a sense of what will actually happen, how do these problems that we will find in our tests, how would they actually impact during a school day? Where do the problems arise? What will work better and what won't? I think it’s a good tool for clinicians or for therapists to add to their toolbox, to have these sorts of conversations, if they don’t already, I know many do, but also many don’t.

HOST: 0:12:35 What about any limitations that listeners should be aware of?

OS: 0:12:40 Well, there are, of course, a few limitations that we’ve thought about ourselves. As Anna said, we had many people wanting to participate in this interview, and there were 23 interviews that the results are based on. And it’s hard for us to tell if these were representative of all possible participants, perhaps they all felt a need to convey something about their problems that they felt they hadn’t had the chance to say before, so there could be a sample bias, or some sort of a selection bias in the study that we can’t control for. 

And then regarding the themes that we identified, of course, these are subjective interpretations, we follow a framework, of course, and we do it by the book. But in some sense, these are subjective interpretations, and, of course, they could be interpreted in other ways by other people looking at the data in another way, but we felt quite certain about the themes that we identified at least.

AE: 0:13:45 But I think it is important of course that this is the stories from 23 individuals, it’s based on these, so that is of course important to have in mind, you cannot generalise on any kind of statistical grounds. But, of course, Olof said that we couldn’t find that many interview studies with students with DLD, but the ones that we have taken part of, I think there are similarities in what our participants have been saying and what has been portrayed in previous, and also later studies. Perhaps there is something about this that these stories are important to have in mind when you meet a student with DLD. It’s a small sample. 

But I also think, as I said in the beginning, being an interview study, this is quite a large sample, so maybe I can feel sometimes I have been working closely with these interviews, having 23 participants could be a limitation in the sense that this is very general themes, we couldn’t really go into depth of trying to convey the stories that they shared with us. The journal had a limitation of 8,000 words, so we had to be very brief in our descriptions, maybe that is some kind of limitation as well. And, as Olof said, I think it is important to know that these participants have self-selected to be part of our study, they wanted to tell their stories. Maybe that says something about they are a subgroup of students with DLD, perhaps, and I would presume, that many of them assess themselves as being, having expressive abilities good enough to participate in a research interview. So, maybe because we say things seem to actually work out quite well for our participants, so maybe that’s not the case for all students with DLD. That could be something to have in mind. 

We have some participants that participated together with a parent, and in some of these cases it’s actually mainly the parent doing the talking. But we still wanted to include them in our study, because I assume then that those students wouldn’t have participated in the study if they weren’t able to bring their parents. And this is one way to trying to also include students and participants with more pronounced expressive problems in research. But, of course, one thing, we have had questions about this, how do you know that this is the student’s views being expressed, isn't it the parent? Maybe those are things that you can have in mind reading the study.

HOST: 0:16:24 And, finally, do you have any take home messages for the audience?

AE: 0:16:29 Maybe I’m still lingering on these things that aren’t about specific language difficulties. Judging from the stories from our participants, it seems that just showing a little bit of understanding and showing that you are aware of the student’s difficulties, that you know about them, seems to be able to make a difference in these persons lives. If I want to say something to a broader audience I think maybe this is a small thing that we all can do, so maybe that would be actually my take home message, not specific to SLTs, but to society.

OS: 0:17:05 Well, I think Anna said it quite well there, ending on a need for the society. But looking specifically at the take home message for SLTs, I think we should take the time to talk to our clients or patients, to remember that they have important information to add, that adds to what we know from test results, for example. More important is how these problems come across when we’re looking at where these children are every day, they are in school, and that’s where their language is put to the test, and on listening to them we will get a better picture of that.

HOST: 0:17:47 A very big thank you to Anna and Olof for their time today. RCSLT has produced a number of different podcasts about DLD, including research about how curricula can be adjusted for children with DLD, as well as interviews with adults with DLD. Please see the show notes for links. As always, we ask that you share and rate the podcast, so that we can reach a wider audience and advocate for SLTs and service users in the UK and beyond. Until next time, keep well. 

MUSIC PLAYS: 0:18:15-0:18:22 
END OF TRANSCRIPT: 0:18:24