top of page

What is Mixed Receptive-Expressive Language Disorder in Children?

Mixed receptive-expressive language disorder occurs in children more often than you may think. The symptoms may take a while to appear. And the sooner you start treatment, the better the results will be.

Children need to develop physical, cognitive, social and emotional skills in order to speak. When one or more of these isn't properly developed, it can cause a language disorder. The disorder can be receptive, expressive or mixed.

In this article we will discuss:

Child plays with old pink rotary phone pretending to be talking, similar to mixed receptive expressive language disorder, that child may have trouble understanding.

What is a mixed receptive-expressive language disorder?

Mixed receptive-expressive language disorder is a condition that commonly affects children. Currently, specialists estimate that 1 in 20 kids have some type of language disorder. Generally, you can start to see symptoms after age 3. You should treat it with the help of a professional speech therapist for kids.

What is "receptive" language disorder?

Receptive language disorder is where there is a problem interpreting spoken language, i.e., with receiving the language. You may see children with receptive language disorder appear to "tune out" when people are talking, or have trouble following directions. However, this doesn't stop children from learning to communicate. They often learn to communicate in their own way.

What is "expressive" language disorder?

Expressive language disorder is where it's hard sending or expressing a message and making yourself understood. This doesn't necessarily mean that you can't understand what someone else is saying. This is not to be confused with selective mutism, as speech therapy for selective mutism is not typically necessary because selective mutism is thought to be more of a psychological response to language rather than an inability to produce language.

A mixed receptive-expressive language disorder is both of these.

Mixed receptive-expressive language disorder is the sum of both of these disorders. Children with this disorder have difficulty in both understanding messages, plus difficulty expressing themselves through language. This can make communication very difficult. As you know, communicating is based on understanding and being understood.

Help your child overcome communication difficulties

Speech therapy for child and adult

Language disorders vs developmental issues.

Sometimes it's common to confuse language disorders with developmental problems. However, these are two different things. Although it's true that these disorders can be associated with some developmental problems, they aren't the only cause.

Often, it's not possible to identify the specific cause of mixed language disorder in kids. In these cases, you need to talk with your doctor. Usually, these symptoms start in childhood. This is when kids' bodies are growing physically and mentally. Most kids learn language completely naturally.

Children learning how to use their words in an activity

Mixed Receptive-Expressive Language Disorder Symptoms

As we've mentioned, the first signs of language disorders usually appear around age 3. When we talk about mixed disorders, these may include one or more symptoms:

  • Learning difficulties. Children with mixed language disorders usually have learning problems. This is because learning is based mostly on communication.

  • Issues with following directions. The main difficulty is though oral language.

  • Problems organizing and summarizing thoughts or emotions. It's difficult to form coherent sentences.

  • Social disfunction. A child who has trouble communicating may also experience trouble playing with other kids. In some cases, researchers see that social problems lead to behavioral problems or depression.

  • Difficulties forming sentences. Some children can make very short and incomplete sentences to try and express themselves. However, others can make sentences that don't connect words well. These are difficult to understand.

  • Challenges in school. The consequences of learning difficulties are low school performance and not wanting to go to school. Also, their intellectual progress is lower than in other children.

Treating mixed receptive-expressive language disorder requires professional help from a speech therapist and speech therapy is one of the best ways to treat it.

What Causes Mixed Receptive-Expressive Language Disorder?

The exact cause of mixed receptive-expressive language disorder is unknown. There is no one thing that researchers have pinpointed that causes a child to have a language disorder. However, there are a few factors that can increase an individual's chances of developing a mixed receptive-expressive language disorder. Some of these factors include:

  • Premature birth

  • Mixed receptive-expressive language disorder secondary to a primary diagnosis (i.e. Autism, Down Syndrome, etc.)

  • Chronic illnesses such as ear infections can occasionally (but not always) increase the chances of developing a language disorder

  • Family history of language disorders

  • Accidents resulting in TBI or other injury

What Are The Treatment Options for Mixed Receptive-Expressive Language Disorder?

Fortunately, there are several treatment options for a mixed receptive-expressive language disorder. Speech therapy for children can range from toddlers, preschoolers, and adolescents. The first thing a parent/caregiver may think to do is speak to their child's pediatrician about their concerns. Or if the child is school age, possibly to the child's teacher. A pediatrician can offer a referral to a specialist, such as a speech-language pathologist so the child can receive an in-depth language evaluation and if needed, treatment. A diagnosis from a speech-language pathologist can also assist in setting up accommodations for school-age children. So treatment overall might include:

  • Speech-Language Intervention: Intervention from a speech-language pathologist might involve therapy once a week, to a few times a week, depending on the individual's needs.

  • School Accommodations: After a diagnosis is made (in this case, a diagnosis of a mixed receptive-expressive language disorder) accommodations in the school environment can be requested. This way, the individual is not falling behind in the school setting and is able to keep pace with their same-age peers while receiving help from other education professionals.

How is Mixed Receptive-Expressive Language Disorder diagnosed?

If a family is concerned about their child’s communication development, a consultation with a speech–language pathologist is recommended. General guidelines for when to schedule an evaluation include when a child:

  • Does not use single words by 15 months

  • Does not use 50 words or 2-word phrases (ex. “more cookie”) by 24 months

  • Does not follow two-step directions (ex. “Get your coat and shoes”) by two years of age

  • Is not understood 90% of the time when speaking by four years old or is easily frustrated because others cannot understand him/her

  • Has difficulty interacting with kids their age

  • Has difficulty with memory or problem-solving

What to expect during a language evaluation

During a language evaluation, the speech-language pathologist will collect information about your child’s medical history, developmental milestones, and your current concerns. Depending on your child’s age and communication skills, the speech-language pathologist may also:

  • Engage your child in conversation

  • Collect a language sample while your child is playing

  • Administer standardized language testing which typically involves identifying pictures, following directions, answering questions, and describing pictures

  • Ask your child to follow directions of increasing complexity

  • Ask your child to answer questions about stories he/she read or was read to him/her

Results and recommendations will be discussed at the end of the evaluation. If appropriate, language therapy will be recommended and home activities will be discussed and demonstrated. At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.

Frequently Asked Questions

Is mixed receptive-expressive language disorder common?

Mixed receptive-expressive language disorder is most commonly diagnosed in children. Typically, a mixed receptive-expressive language disorder is diagnosed when a child has trouble expressing themselves utilizing language as well as receptively understanding/comprehending language (following directions, etc.) However, it is not only found in children. It can also occur as a result of a stroke, TBI, or some other accident or illness in both children and adults.

Can you grow out of mixed receptive-expressive language disorder?

How can I help my child if they have Mixed Receptive-Expressive Language Disorder?

What are the long-term effects of Mixed Receptive-Expressive Language Disorder?


About the Author

Cheri Gipson

I am a speech-language pathologist who specializes in language skills and pronunciation. I obtained my Master’s of Science degree in Speech-Language Pathology from Western Illinois University and I have worked in the field of speech pathology for over 20 years. One of the things I enjoy most is helping people learn.

In my spare time, I enjoy writing tips on how to improve online teaching for both the larger language schools and also as a private ESL teacher. Teaching is my passion, and I love seeing students make progress. Every day is a new adventure, and I am grateful for the opportunity to help people learn and grow!


Commenting has been turned off.

Get Free Guide to Improve Speech

Improve your
communication skills

18 copy.png

Improve your
child’s speech

17 copy.png
TrustPilot Beter Speech copy.jpg

by Patricia D. Myers

I'm not an English native speaker and I wanted to improve my speech. Better Speech onboarding process is AWESOME, I met with different people before being matched with an AMAZING Therapist, Christina. My assigned therapist created a safe place for me to be vulnerable and made all the sessions fun and helpful. Thanks to her, I received great feedback from my clients.

by John L. Wilson

Better Speech is a great program that is easy to use from home and anywhere online. Shannon was amazing at engaging our shy son - and building on their relationship each session! Her commitment to knowing him improved his confidence to speak and practice more. Truly appreciate her dedication. She cares for her clients.

by Christy O. King

Better Speech is an excellent opportunity to improve your speech in the convenience of your home with flexible scheduling options. Our therapist Miss Lynda was nothing short of amazing! We have greatly appreciated and enjoyed the time spent together in speech therapy. Her kind, engaging and entertaining spirit has been well received. She will surely be missed.

by Patricia W. Lopez

This service is so easy, i signed up, got a therapist and got to set up an appointment right away that worked with my schedule. so glad to see that services like speech therapy are finally catching up to the rest of the convenience age! therapy is great, i can't believe how many good tips, exercises and methods in just the first session. really recommend it!

bottom of page