New terminology for developmental language disorders

Background German speech-language professionals and linguists recommend the adoption of a nomenclature change for language-associated disorders in childhood, especially for developmental language disorders (DLD) for German-speaking countries. Objective Does the recommended terminology make sense from a medical and psychological perspective? Methods Evaluation of the arguments for and against a terminology change. Results The ICD-10 (International Statistical Classification of Diseases and Related Health Problems 10th revision) and a German guideline divide DLD into circumscribed (specific) DLD (CDLD) and DLD with other disorders (comorbidities). The CDLD as well as the future DLD definition of the ICD-11 require the exclusion of sensory impairments, neurological disorders, and intellectual limitations. This definition appears to be broad enough to include milder nonverbal impairments, does not risk depriving children of speech and other therapies, and recognizes the ICD criterion that a child's level of language development should be markedly below what would be expected given age and level of intellectual functioning. The proposed replacement of the term comorbidities by differentiating conditions, risk factors, and co-occurring conditions prefigures the omission of a decided medical differential diagnosis. Conclusion The proposed terminology risks blurring etiologically meaningful classifications and differential diagnostic boundaries and circumventing valuable medical and psychological expertise in the diagnosis and treatment of language disorders in children.