Mixed receptive-expressive language disorder

Mixed receptive-expressive language disorder is a language disability which causes impairment of both the understanding and the expression of language.

Causes, incidence, and risk factors 

Three to five percent of all children have either receptive or expressive language disorder, or both. These children have difficulty understanding speech (language receptivity) and using language (language expression). The cause is unknown, but there may be genetic factors, and malnutrition may play a role.

Problems with receptive language skills usually begin before the age of 4. Some mixed language disorders are caused by brain injury and these are sometimes misdiagnosed as developmental disorders.


  • impairment in language comprehension  
  • impairment in language expression  
  • speech contains many articulation errors  
  • difficulty recalling early visual or auditory memories

Signs and tests 

Standardized receptive and expressive language tests can be given to any child suspected of having this disorder. An audiogram should also be given to rule out the possibility of deafness, as it is one of the most common causes of language problems.


Speech and language therapy are the best approach to this type of language disorder. Psychotherapy is also recommended because of the possibility of associated emotional or behavioral problems.

Expectations (prognosis) 

The outcome varies based on the underlying cause. Brain injury or other structural pathology is generally associated with a poor outcome with chronic deficiencies in language, while other, more reversible causes can be treated effectively.


Difficulty understanding and using language can cause problems with social interaction and ability to function independently as an adult.

Calling your health care provider 

Parents who are concerned about their child’s acquisition of language should have the child tested. Early intervention will provide the best possible outcome.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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