Navigating Mixed Receptive-Expressive Language Disorder in Children
- Sounderic
- Aug 17, 2023
- 6 min read
Updated: Jul 28
Mixed Receptive-Expressive Language Disorder (MRELD) is a communication disorder that affects a child’s ability to both understand and express language. Children with MRELD may struggle to follow directions, comprehend questions, form sentences, or share thoughts clearly.
Understanding MRELD is crucial because language is the foundation for learning, social interaction, and emotional regulation. In this blog, we'll dive into what MRELD entails, recognize the signs, understand the causes, the diagnostic process, and the therapeutic journey to help these young minds flourish.
What is Mixed Receptive-Expressive Language Disorder?
MRELD is a condition where a child has significant difficulty in both:
Receptive language – understanding words, questions, and instructions
Expressive language – using words, grammar, and sentences to express ideas
This differs from:
Pure expressive language disorder – where the child understands language but struggles to express it
Pure receptive language disorder – where the child mainly has trouble understanding spoken or written language
Causes of Mixed Receptive-Expressive Language Disorder:
The origins of MRELD are complex and multifaceted. While pinpointing a singular cause is often difficult, research suggests a blend of various factors like :
Genetic, Neurological, and Environmental factors
A family history of language disorders
Children with co-occurring conditions like autism, hearing loss, or ADHD
Premature birth, exposure to toxins during pregnancy,
And, limited early language exposure can also contribute to the disorder's development.
Receptive vs. Expressive Language: Understanding the Two Sides
Feature | Receptive Language | Expressive Language |
Definition | Understanding words, questions, or directions | Using words, phrases, and sentences to express thoughts |
Examples | Following instructions like “Give me the ball” | Saying, “I want the ball” |
Impact | May appear inattentive or confused | May use short or incorrect sentences |
Signs and Symptoms of MRELD
General Signs:
Difficulty understanding spoken or written words
Trouble expressing thoughts clearly or forming sentences
Challenges in both school and social settings
Age-Specific Signs:
Age Group | Receptive Signs | Expressive Signs |
Toddlers | Doesn’t respond to name, limited gestures | Few or no words, delayed babbling |
Preschoolers | Difficulty following instructions | Short, incomplete sentences; limited vocabulary |
School-age | Struggles with reading/listening comprehension | Difficulty retelling stories, avoids speaking in groups |
Diagnosis of Mixed Receptive-Expressive Language Disorder:
The journey of diagnosing MRELD requires a team effort involving:
speech-language pathologists, medical professionals, educators, and parents.
It often involves a battery of language tests to assess the child's receptive and expressive language abilities. Observing the child's interactions and communication patterns in various contexts is equally important. A thorough medical history review helps us understand any underlying conditions contributing to the disorder.
Diagnosing MRELD requires a comprehensive evaluation involving:
Speech-language assessment: Using tools like CELF, PLS-5, or REEL
Hearing tests: To rule out hearing loss
Medical and developmental history
Observations across environments: At home, school, and during play
Differential Diagnosis
MRELD can resemble other conditions. It's important to distinguish it from:
Specific Language Impairment (SLI): Similar expressive difficulties but receptive skills are often stronger
Intellectual Disability: Involves global developmental delays, not just language
Selective Mutism: The child can speak but chooses not to in specific settings
Sensory Deficits: Such as unaddressed hearing or visual impairments
Treatment of Mixed Receptive-Expressive Language Disorder:
One of the most important factor in overcoming MRELD is early intervention. Customized speech-language therapy sessions for the gist of treatment. Drawing from various therapeutic techniques, we help children build their vocabulary, enhance sentence structure, refine listening skills, and improve social communication abilities. These sessions are tailored to suit each child's unique needs, gradually helping them overcome the language barriers that once hindered them.
Treatment and Intervention
Importance of Early Intervention
Early diagnosis and therapy significantly improve outcomes. The brain’s plasticity is highest in early childhood, making this the ideal time for intervention.
Speech-Language Therapy
Individualized sessions tailored to the child’s specific needs
Focus on:
Receptive skills (e.g., following directions, vocabulary understanding)
Expressive skills (e.g., sentence building, grammar, storytelling)
Use of visuals, gestures, and multisensory techniques
Parental and Caregiver Involvement
Talk to your child throughout the day using clear, simple language
Read books together and ask open-ended questions
Use play-based learning: pretend play, role play, and games
Collaborate with your child’s therapist to reinforce goals at home
School and Social Supports
Individualized Education Plans (IEPs) with accommodations
Speech therapy within school settings
Social skills groups and peer support programs
Collaboration is the essence of effective treatment. We provide parents and caregivers with tools to continue language development at home, as is equally essential.
How Can You Help?
The good news is, you're not alone on this journey. Here are some steps you can take to support your child:
1. Early Intervention
Like fixing a puzzle as soon as you see a missing piece, early help is important. The earlier we start working together, the better. Reach out to a speech therapist who can create a plan tailored to your child's needs.
2. Patience and Encouragement
Imagine if the puzzle pieces were hard to fit together. Your child might need more time to find words or understand what's being said. Be patient and encourage them to communicate, even if it's a bit tough.
3. Talk, Talk, Talk
Just like practicing a sport or playing an instrument, practicing language is key. Talk to your child about everyday things. Describe what you're doing, ask them questions, and listen actively to their responses.
4. Reading Time
Reading together is like adding colorful pieces to the puzzle. Choose books with simple words and bright pictures. Let your child point to things in the pictures and talk about them.
5. Play and Games
Playtime is learning time! Simple games like "I Spy" or building with blocks can help develop language skills while having fun.
6. Be Their Biggest Cheerleader
Every small step your child takes toward better communication is a victory. Celebrate their efforts, no matter how small.
Remember, no one understands your child better than you. If something doesn't feel right or if you have concerns, don't hesitate to talk to a speech therapist for your child.
Prognosis and Long-Term Outlook
Children with MRELD often make significant progress with consistent, targeted therapy and home support. The earlier therapy begins, the better the long-term outcomes in language, academics, and social development. Some children may continue to need support through school years, while others catch up to peers over time.
Everyday Tips for Supporting Children with MRELD
Use visual aids and gestures alongside verbal instructions
Break down tasks into small, manageable steps
Give extra time to respond—don’t rush the child
Praise all efforts to communicate, even small ones
Play games like “Simon Says” or “I Spy” to strengthen comprehension
Establish a reading routine with engaging, picture-based books
Frequently Asked Questions (FAQs)
🔹 What does MRELD look like in a classroom?
Children may seem inattentive, avoid speaking, struggle with instructions, and have difficulty participating in group work.
🔹 Is MRELD the same as Developmental Language Disorder (DLD)?
They overlap, but MRELD specifically refers to impairments in both receptive and expressive language, while DLD is a broader term for language difficulties not caused by other conditions.
🔹 How can parents support a child with MRELD at home?
Engage in daily conversations, read books together, reduce screen time, use visuals, and play communication-based games.
🔹 Can children “outgrow” MRELD with help?
With consistent therapy and home support, many children make significant progress. However, they may continue to need accommodations in school settings.
🔹 Is bilingualism a cause of MRELD?
No. Bilingualism does not cause MRELD, although it may temporarily mask or complicate its diagnosis if not assessed properly.
How Sounderic Can Help
At Sounderic, we offer online speech therapy for children with Mixed Receptive-Expressive Language Disorder and other communication challenges. Our licensed speech-language pathologists provide personalized, engaging, and evidence-based interventions to help your child grow in confidence and communication.
📞 Book a consultation:👉 Schedule here
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Reference:
1. Johnson C, Brown L. "Understanding the Etiology of Mixed Receptive-Expressive Language Disorder: A Multidisciplinary Approach." Child Development Perspectives.
2. American Speech-Language-Hearing Association (ASHA). "Diagnosis and Treatment of Childhood Language Disorders."
3. Rice M, Smith S. "Children with Specific Language Impairment: An Overview of Research on Genetics, Neurobiology, and Pathophysiology." Journal of Communication Disorders.
4. National Institute on Deafness and Other Communication Disorders (NIDCD). "Mixed Receptive-Expressive Language Disorder: Information for Parents."
5. Bishop D. "Genetic and Environmental Influences on Language Development in Children with Neurodevelopmental Disorders." Frontiers in Psychology.
