Mixed Receptive-Expressive Language Disorder

[Anonymous]

DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!

[Anonymous]

MERLD and Autism are different. Often, MERLD is intermixed with Autism as most who test are generalists and do not get the impact of MERLD, especially receptive language issues. Get a good speech evaluation and I'd go private or one of the local universities if the school has missed it over the years. MERLD can mimic autism but generally MERLD kids outgrow the concerns vs. autism they don't.

[Anonymous]

One of the exclusionary criteria for MERLD is that the child must NOT meet the criteria for PDD/ASD.

[Anonymous]

You can have autism without MERLD. My kid with ASD/Asperger's/ADHD does not and language for him is a strength.

Since his neuropsych did not find ASD, I would not worry about it.

[Anonymous]

Anonymous wrote:You can have autism without MERLD. My kid with ASD/Asperger's/ADHD does not and language for him is a strength.

Since his neuropsych did not find ASD, I would not worry about it.

Huh? Your post has nothing to do with OP comments. Aspergers is very different than MERLD. For your child, language is a strength, for her's, it is a struggle.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You can have autism without MERLD. My kid with ASD/Asperger's/ADHD does not and language for him is a strength.

Since his neuropsych did not find ASD, I would not worry about it.

Huh? Your post has nothing to do with OP comments. Aspergers is very different than MERLD. For your child, language is a strength, for her's, it is a struggle.

I was simply pointing out that MERLD is not an indication of ASD which she was concerned about. You can have ASD with or without MERLD just as you can have MERLD without ASD.

[Anonymous]

*just as you can have MERLD with or without ASD*

Since the neuropsych did not find ASD, stop worrying OP.

[Anonymous]

Anonymous wrote:DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!

OP, MERLD is not a spectrum disorder. it is a language based disorder. Was your testing done by the school system or by an actual psychologist?

[Anonymous]

Anonymous wrote:

Anonymous wrote:DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!

OP, MERLD is not a spectrum disorder. it is a language based disorder. Was your testing done by the school system or by an actual psychologist?

The testing was done by a very good SLP. He separately had neuropsych testing and the neuropsychologist recommended speech-language testing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!

OP, MERLD is not a spectrum disorder. it is a language based disorder. Was your testing done by the school system or by an actual psychologist?

The testing was done by a very good SLP. He separately had neuropsych testing and the neuropsychologist recommended speech-language testing.

OP I totally understand your confusion. If you trust your SLP and the psychologist, and neither of them used the word "autism spectrum" then you have nothing to be concerned about. Do keep in mind however that many of the therapies will be the same as what a chid on the spectrum would receive.

We are in MCPS. My DS is 13, with significant ADHD which impairs his language and social interactions because he can't focus long enough to really "catch" social queues. You can imagine the snowball effect this has! We had him tested 3 times over the years. Twice by neuropsychologist and once by a developmental pediatrician at Kennedy Kreiger (KKI). All agreed on ADHD, and early on one psychologist suspected MERLD but that was later replaced by the signifiant ADHD diagnosis. All the while MCPS kept stomping their feet, trying to shove ASD down our throats because their "quasi-psychologist" who has MAYBE a Masters degree and not a Doctorate degree felt that was the correct diagnosis. This is because they have zero idea what they're talking about. Its easier for them to just shove your kid into a neat little box so that they can just be done with it. That has disastrous outcomes, so if you're in that position please be weary of this.

FWIW we pulled DS out of MCPS and put him in private because they pretty much washed their hands of DS. They thought they had him figured out and treated him as such- as a low achieving kid who would not amount to much.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!

OP, MERLD is not a spectrum disorder. it is a language based disorder. Was your testing done by the school system or by an actual psychologist?

The testing was done by a very good SLP. He separately had neuropsych testing and the neuropsychologist recommended speech-language testing.

OP I totally understand your confusion. If you trust your SLP and the psychologist, and neither of them used the word "autism spectrum" then you have nothing to be concerned about. Do keep in mind however that many of the therapies will be the same as what a chid on the spectrum would receive.

We are in MCPS. My DS is 13, with significant ADHD which impairs his language and social interactions because he can't focus long enough to really "catch" social queues. You can imagine the snowball effect this has! We had him tested 3 times over the years. Twice by neuropsychologist and once by a developmental pediatrician at Kennedy Kreiger (KKI). All agreed on ADHD, and early on one psychologist suspected MERLD but that was later replaced by the signifiant ADHD diagnosis. All the while MCPS kept stomping their feet, trying to shove ASD down our throats because their "quasi-psychologist" who has MAYBE a Masters degree and not a Doctorate degree felt that was the correct diagnosis. This is because they have zero idea what they're talking about. Its easier for them to just shove your kid into a neat little box so that they can just be done with it. That has disastrous outcomes, so if you're in that position please be weary of this.

FWIW we pulled DS out of MCPS and put him in private because they pretty much washed their hands of DS. They thought they had him figured out and treated him as such- as a low achieving kid who would not amount to much.

Meant to say we WERE in MCPS.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!

OP, MERLD is not a spectrum disorder. it is a language based disorder. Was your testing done by the school system or by an actual psychologist?

The testing was done by a very good SLP. He separately had neuropsych testing and the neuropsychologist recommended speech-language testing.

OP I totally understand your confusion. If you trust your SLP and the psychologist, and neither of them used the word "autism spectrum" then you have nothing to be concerned about. Do keep in mind however that many of the therapies will be the same as what a chid on the spectrum would receive.

We are in MCPS. My DS is 13, with significant ADHD which impairs his language and social interactions because he can't focus long enough to really "catch" social queues. You can imagine the snowball effect this has! We had him tested 3 times over the years. Twice by neuropsychologist and once by a developmental pediatrician at Kennedy Kreiger (KKI). All agreed on ADHD, and early on one psychologist suspected MERLD but that was later replaced by the signifiant ADHD diagnosis. All the while MCPS kept stomping their feet, trying to shove ASD down our throats because their "quasi-psychologist" who has MAYBE a Masters degree and not a Doctorate degree felt that was the correct diagnosis. This is because they have zero idea what they're talking about. Its easier for them to just shove your kid into a neat little box so that they can just be done with it. That has disastrous outcomes, so if you're in that position please be weary of this.

FWIW we pulled DS out of MCPS and put him in private because they pretty much washed their hands of DS. They thought they had him figured out and treated him as such- as a low achieving kid who would not amount to much.

We are experiencing much the same thing - school district has no idea what to do with him. Awaiting receipt of the actual report from the SLP. I also want to emphasize that the question re autism was just a question as we try to figure this out. DS has had tons of testing and we would think ASD issues would have long been identified. The SLP has lots of good recommendations as to how to treat MERLD and we are actually more curious about whether services in school have helped at all with respect to this condition. Again, many thanks to all!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!

OP, MERLD is not a spectrum disorder. it is a language based disorder. Was your testing done by the school system or by an actual psychologist?

The testing was done by a very good SLP. He separately had neuropsych testing and the neuropsychologist recommended speech-language testing.

OP I totally understand your confusion. If you trust your SLP and the psychologist, and neither of them used the word "autism spectrum" then you have nothing to be concerned about. Do keep in mind however that many of the therapies will be the same as what a chid on the spectrum would receive.

We are in MCPS. My DS is 13, with significant ADHD which impairs his language and social interactions because he can't focus long enough to really "catch" social queues. You can imagine the snowball effect this has! We had him tested 3 times over the years. Twice by neuropsychologist and once by a developmental pediatrician at Kennedy Kreiger (KKI). All agreed on ADHD, and early on one psychologist suspected MERLD but that was later replaced by the signifiant ADHD diagnosis. All the while MCPS kept stomping their feet, trying to shove ASD down our throats because their "quasi-psychologist" who has MAYBE a Masters degree and not a Doctorate degree felt that was the correct diagnosis. This is because they have zero idea what they're talking about. Its easier for them to just shove your kid into a neat little box so that they can just be done with it. That has disastrous outcomes, so if you're in that position please be weary of this.

FWIW we pulled DS out of MCPS and put him in private because they pretty much washed their hands of DS. They thought they had him figured out and treated him as such- as a low achieving kid who would not amount to much.

Can you tell me how your son is doing there? Sounds like mine who was diagnosed as having a receptive delay then later we found out that it's the severe ADHD. Language is okay.

[Anonymous]

It's weird that you just received a MERLD diagnosis. It's no longer in the current DSM and is covered by these categories:

--Language Impairment
--Late Language Emergence
--Specific Language Impairment
--Social Communication Disorder
--Voice Disorder

We were diagnosed with MERLD under the previous DSM. You can definitely have it with or without being on the spectrum. Language Impairment and Specific Language Impairment are so broad and lump in a lot of things in the current DSM.


You might find reading up on Social Communication (Pragmatics) Disorder helpful:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder

and Language Disorders:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-language-disorders

My guess would be on a practical level, your kid might have trouble with back and forth conversations, particularly with peers. Kids who fit the MERLD profile have difficulty tracking what others are saying as well as simultaneously processing what they want to say. Your kid may also have difficulty with group sports, like soccer--where there are a lot of other bodies, the ball, the coach. Your kid may also have difficulty organizing his thoughts to paper, organizing paragraphs for example. (A lot of these issues are also present in kids with ADHD.)

A lot of these issues are related to executive function and processing. So if your kid has ADHD and dyslexia, it doesn't surprise me that he has MERLD. I just find it surprising that the psychologist gave this diagnosis now and wondering if it was a private or school testing.

[Anonymous]

Anonymous wrote:It's weird that you just received a MERLD diagnosis. It's no longer in the current DSM and is covered by these categories:

--Language Impairment
--Late Language Emergence
--Specific Language Impairment
--Social Communication Disorder
--Voice Disorder

We were diagnosed with MERLD under the previous DSM. You can definitely have it with or without being on the spectrum. Language Impairment and Specific Language Impairment are so broad and lump in a lot of things in the current DSM.


You might find reading up on Social Communication (Pragmatics) Disorder helpful:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder

and Language Disorders:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-language-disorders

My guess would be on a practical level, your kid might have trouble with back and forth conversations, particularly with peers. Kids who fit the MERLD profile have difficulty tracking what others are saying as well as simultaneously processing what they want to say. Your kid may also have difficulty with group sports, like soccer--where there are a lot of other bodies, the ball, the coach. Your kid may also have difficulty organizing his thoughts to paper, organizing paragraphs for example. (A lot of these issues are also present in kids with ADHD.)

A lot of these issues are related to executive function and processing. So if your kid has ADHD and dyslexia, it doesn't surprise me that he has MERLD. I just find it surprising that the psychologist gave this diagnosis now and wondering if it was a private or school testing.

It was a speech-language pathologist who gave the diagnosis. He is really struggling with the language demands of school (and social interactions are a part of that) and this DX may explain a lot (he also has LDs and ADHD). The DX really explains a lot of things that the others do not (even though there is indeed some overlap).