Occupational Therapy in Perth & Mandurah  | Speech Pathology | Positive Behaviour Support | Psychology Assessments | Counselling  
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What Are Expressive Language Difficulties?

Expressive language refers to a person's ability to communicate their thoughts, ideas, wants, needs and feelings.

Children with expressive language difficulties may understand much of what is being said to them but have difficulty expressing themselves effectively.

​Expressive language includes:
  • Vocabulary and word knowledge
  • Sentence structure and grammar
  • Storytelling and narrative skills
  • Conversation skills
  • Explaining ideas
  • Asking and answering questions
  • Verbal problem-solving
  • Written language skills
What Do Expressive Language Difficulties Look Like?

Every child is different, but common signs may include:
  • Using fewer words than expected for their age
  • Difficulty finding the right words
  • Speaking in short or simplified sentences
  • Trouble explaining thoughts and ideas
  • Difficulty retelling events or stories
  • Frequently using words such as "thing" or "stuff"
  • Difficulty answering open-ended questions
  • Frustration when trying to communicate
  • Difficulty participating in conversations
  • Challenges with classroom discussions
Some children appear to understand language well but struggle to communicate what they know.
My Child Understands Everything but Can't Express Themselves

One of the most common concerns parents raise is:

"My child seems to understand everything, but they can't tell me what they're thinking."

​This can occur when expressive language skills are developing differently from receptive language skills (understanding language).Children may:
  • Follow instructions well
  • Understand conversations
  • Demonstrate strong knowledge
  • Appear intelligent and capable

​Yet still experience difficulties:
  • Finding words
  • Building sentences
  • Explaining events
  • Answering questions
  • Participating in conversations
This can lead to frustration, emotional dysregulation and reduced confidence.
What Causes Expressive Language Difficulties?

Expressive language difficulties can occur for many reasons.
Some children may experience expressive language challenges associated with:

Developmental Language Disorder (DLD)
DLD is a neurodevelopmental condition affecting language development. Children with DLD often experience ongoing difficulties with vocabulary, sentence structure and language organisation.

Autism Spectrum Disorder
Some autistic children communicate differently and may experience expressive language differences, social communication differences or alternative communication preferences.

ADHD
Children with ADHD may experience challenges organising thoughts, recalling words and maintaining conversational topics.

Hearing Differences
Reduced access to speech sounds may impact language development.

Learning Difficulties
Literacy, memory and processing challenges can affect expressive language development.

Childhood Apraxia of Speech
Children with apraxia may know what they want to say but have difficulty planning and coordinating the movements required for speech.

​Developmental Delays
Some children develop communication skills at a different pace and may benefit from additional support.
Expressive Language Difficulties and Autism

Expressive language difficulties and autism are not the same thing.
Some autistic children experience expressive language differences, while others have strong spoken language skills.

Communication differences in autism may involve:
  • Delayed language development
  • Different communication styles
  • Echolalia
  • Social communication differences
  • Alternative communication methods
Assessment helps identify each child's strengths and support needs.
Expressive Language Difficulties and ADHD

Many children with ADHD experience communication challenges related to attention, working memory and organisation.
​Children may:
  • Lose their train of thought
  • Jump between topics
  • Forget words
  • Provide incomplete explanations
  • Struggle to organise stories
Speech Pathology support can help children develop strategies for organising and expressing their ideas more effectively.
How Expressive Language Difficulties Can Affect School

Expressive language skills play an important role in learning.
​Children may experience challenges with:
  • Answering questions in class
  • Participating in discussions
  • Retelling information
  • Writing tasks
  • Oral presentations
  • Making and maintaining friendships
  • Explaining what they know
Without support, communication challenges can sometimes affect confidence and participation.
How Are Expressive Language Difficulties Assessed?

A Speech Pathology assessment may explore:
  • Vocabulary development
  • Sentence structure
  • Storytelling abilities
  • Social communication skills
  • Play skills
  • Language processing
  • Functional communication
Assessment findings help identify strengths, support needs and recommendations for intervention.
How Can Speech Therapy Help?

Speech therapy may support:
  • Vocabulary growth
  • Sentence development
  • Word retrieval skills
  • Narrative and storytelling skills
  • Conversation skills
  • Social communication
  • Classroom participation
  • Confidence when communicating
Intervention is individualised to the child's goals, interests and support needs.
Supporting Expressive Language Development at Home

Parents and caregivers play an important role in communication development.
​Helpful strategies may include:
  • Reading together daily
  • Talking about everyday activities
  • Giving extra time to respond
  • Expanding on your child's language
  • Encouraging storytelling
  • Following your child's interests during play
  • Creating opportunities for conversation
Your Speech Pathologist can provide personalised strategies based on your child's communication profile.
When Should I Seek Support?

It may be helpful to seek advice if your child:
  • Is difficult to understand
  • Uses fewer words than expected
  • Has difficulty forming sentences
  • Becomes frustrated when communicating
  • Struggles to explain ideas
  • Has difficulty participating in conversations
  • Is experiencing challenges at school related to communication
Early identification can help families better understand their child's communication profile and access appropriate supports.
Expressive Language Speech Therapy Across Western Australia

Belong Health provides Speech Pathology services for children experiencing expressive language difficulties across:
  • Mandurah
  • Rockingham
  • Perth Metropolitan Area
  • Peel Region
  • Regional Western Australia via Telehealth
Our team works closely with families, schools and support networks to help children build communication skills and participate more confidently in everyday life.

Have a question? or need more information

Our friendly team are happy to help call us on 08 9586 3934 or send us a message

    Contact Us
Frequently Asked Questions - Expressive Language Difficulties

What are expressive language difficulties?
Expressive language difficulties occur when a person has challenges communicating their thoughts, ideas, wants, needs or feelings. This may affect spoken language, sentence structure, vocabulary, storytelling, conversation skills, written language, gestures, signs or other communication methods.

What is an example of an expressive language difficulty?
Examples may include difficulty finding the right words, using shorter sentences than expected, trouble explaining ideas, difficulty telling stories in order, using vague words such as "thing" or "stuff", or struggling to answer questions fully.

What is the difference between expressive language and speech?
Expressive language refers to how a person communicates thoughts and ideas using words, sentences, gestures, signs, symbols, writing or AAC. Speech refers specifically to producing speech sounds. A child may have clear speech but still experience expressive language difficulties.

Does expressive language include speech?
Yes. Spoken language is one form of expressive language. Expressive language can also include gestures, signs, symbols, AAC systems, writing and other ways of communicating.

What causes expressive language difficulties?
Expressive language difficulties may occur for many reasons, including developmental language differences, autism, ADHD, intellectual disability, hearing differences, neurological conditions, genetic conditions or developmental delays. Sometimes no specific cause is identified.

Is expressive language disorder a neurological condition?
Expressive Language Disorder and Developmental Language Disorder are neurodevelopmental language conditions. They are not caused by poor parenting, lack of motivation or reduced intelligence.

What is the medical term for expressive language difficulties?
Depending on the person’s presentation, professionals may use terms such as Expressive Language Disorder, Developmental Language Disorder, Expressive Language Delay or Language Disorder. The terminology used may depend on assessment findings and diagnostic criteria.

At what age is expressive language delay a concern?
Children develop at different rates. Concerns may arise when a child is not meeting expected communication milestones, has difficulty communicating their needs, uses fewer words than expected, or is struggling to participate in everyday activities due to communication challenges.

At what age can expressive language disorder be diagnosed?
Speech Pathologists can identify expressive language difficulties during early childhood. The timing of diagnosis varies depending on the child’s developmental profile, assessment results and communication needs.

What are the signs of expressive language difficulties?
Signs may include limited vocabulary, difficulty forming sentences, trouble finding words, difficulty answering questions, challenges retelling events, difficulty explaining thoughts and ideas, frustration when communicating, or relying heavily on gestures instead of spoken language.

What is a red flag for language delay?
Potential red flags may include limited use of words compared to peers, difficulty following directions, reduced understanding of language, limited attempts to communicate, difficulty combining words into phrases or sentences, or significant frustration during communication.

Does speech delay always mean autism?
No. Speech and language delays can occur for many reasons and do not automatically mean a child is autistic. Some autistic children experience communication differences, but speech and language delays can also occur independently of autism.

What does speech delay without autism look like?
A child may have delayed speech or language development while also showing age-appropriate social interaction, play skills and social communication. A Speech Pathology assessment can help identify the factors contributing to the child’s communication challenges.

Is expressive language disorder part of autism?
Some autistic individuals experience expressive language differences, while others do not. Autism and expressive language difficulties can occur together, but they are not the same condition.

Does ADHD affect expressive language?
Yes. Some children with ADHD may experience challenges with expressive language, including organising thoughts, word retrieval, storytelling, conversational skills and maintaining attention during communication.

What are expressive language difficulties in ADHD?
Children with ADHD may lose their train of thought, have difficulty organising language, interrupt conversations, struggle to explain ideas clearly, or have difficulty recalling words quickly. These challenges can affect communication at home, school and in social situations.

What difficulties might students with expressive language challenges experience at school?
Students may experience challenges with answering questions, classroom discussions, retelling information, written tasks, giving presentations, following multi-step instructions and communicating with peers.

How are expressive language difficulties assessed?
Speech Pathologists may assess vocabulary, sentence structure, storytelling, social communication, understanding and use of language, play skills and interaction skills. Assessment recommendations are tailored to the person’s strengths, needs and goals.

How do Speech Pathologists support expressive language development?
Support may include play-based language intervention, vocabulary development, sentence-building activities, narrative and storytelling skills, parent coaching, visual supports, AAC support and social communication strategies.

How can parents support expressive language development at home?
Parents can support expressive language by reading together, expanding on their child’s language, encouraging conversation during daily activities, giving the child time to respond, following the child’s interests during play and working closely with their Speech Pathologist.

Can expressive language difficulties improve?
Many children make meaningful progress when provided with appropriate supports, regular communication opportunities and individualised intervention. Progress varies depending on each child’s strengths, support needs and circumstances.

Do children with expressive language delays catch up?
Some children naturally develop stronger communication skills over time, while others benefit from ongoing support. Early identification and intervention can help children build communication skills and participation opportunities.

Can a child overcome expressive language difficulties?
Many children develop effective communication skills with appropriate support. Outcomes vary between individuals and depend on developmental, environmental and personal factors.

Is expressive language disorder considered a disability?
For some individuals, expressive language difficulties may significantly impact learning, communication and participation in daily life. Eligibility for supports, adjustments or funding depends on the person’s individual circumstances and relevant criteria.

Do I need a Speech Pathology assessment if I have concerns?
If you have concerns about your child’s communication development, a Speech Pathology assessment can help identify strengths, support needs and recommendations for next steps.

Can expressive language difficulties be supported through telehealth?
Yes. Telehealth Speech Pathology can support many expressive language goals and may be particularly helpful for families living in regional or remote areas of Western Australia.

Is support available through the NDIS for expressive language difficulties?
Some individuals may be eligible for NDIS-funded supports depending on their circumstances and functional support needs. Eligibility is determined by the NDIS.
Related Resources

Communication & Speech Pathology
​Autism & Neurodevelopment
ADHD & Learning
Additional Supports
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​Referrals to Belong Health
We are Medicare and Private Health fund registered for Occupational Therapy and Speech Pathology.

EPC/Team care arrangements/Chronic disease (CDM) or GP management plans and self-referrals are all acceptable.

WA NDIS Registered Provider  
Medicare
You can get a referral from your/your child’s GP for OT on a Chronic Disease Management (CDM) plan this gives you 5 sessions for OT per calendar year with a $53 rebate available on each session or a Helping Children with Autism/PDD/ or an eligible disability package (20 sessions between allied health professionals, as set up by a Paediatrician/Psychiatrist) which gives your child under 16 years a $75 rebate per session for the 20 sessions, you can use up to 10 sessions per Health Professional (up to 10 for OT) and you will need a separate referral letter from your child’s Paediatrician for each Allied Health Professional you are seeking services from. 
Private Health
Your Private Health fund may cover up to 75% of the cost of OT sessions if this is included in your cover, be sure to call them or check your policy for details.

No referral or self referral
You do not require a referral for accessing OT
NDIS Registered Provider
We are an NDIS Registered Provider
Whether you or your child have NDIS funding that is NDIS Managed, Third Party Plan Managed or you are Self-Managing your funds, you are able to use your funding to cover the full cost of therapy services plus travel costs. You will need provide us with your/your child’s NDIS number and plan details ahead of your first session. Once you have booked a session or contacted us, our team will be in touch to discuss our service agreement and provide you with our services price list. 

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Phone: 08 9586 3934

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