Speech and language pathologists' diagnostic approaches to developmental language disorders in German-speaking children with intellectual disability

Abstract

Introduction:

Children with an intellectual disability (ID) often manifest a developmental language disorder (DLD). However, conventional standardized DLD diagnostic tools often prove unsuitable for this population. Furthermore, no guidelines are provided on how speech and language pathologists (SLPs) should conduct the assessment. This study investigated how practitioners in German-speaking countries assess DLD in children with ID, including the role of multilingualism and practitioners’ self-perceived competence.

Methods:

A cross-sectional online survey was conducted with 102 practitioners in German-speaking countries. The questionnaire examined diagnostic timing and goals, use of assessment tools, consideration of non-linguistic abilities, handling of norm values, adaptations for different levels of cognitive functioning, multilingual assessment practices, and perceived diagnostic competence regarding children with ID. Data were analyzed using descriptive statistics, qualitative content analysis for open responses, and multiple linear regression to identify predictors of self-perceived competence.

Results:

The Results showed that practitioners mainly use language assessment at the beginning of an intervention and for monitoring progress, with a focus on identifying specific language difficulties and planning intervention rather than categorical diagnosis. Most SLPs relied on tools developed for typically developing children, while adapting procedures for children with ID through observational and qualitative approaches. Non-linguistic factors such as attention, memory, and executive functions were frequently integrated into assessment. Norm-referenced testing was used variably, often for orientation rather than diagnosis. Multilingualism rarely led to different diagnostic procedures, although uncertainty among practitioners regarding its impact on language development was evident. Self-perceived competence was moderate overall and was significantly predicted by professional experience and working in specialized therapy settings.

Discussion:

In conclusion, assessment practices are highly heterogeneous and characterized by a combination of standardized tools and individualized adaptations. The findings highlight the need for more suitable diagnostic instruments, clearer guidelines, and targeted professional training to support consistent and confident DLD assessment of children with ID.