Mixed receptiveexpressive language disorder

A language disability causing problems in both understanding and expressing language. The condition was formerly called developmental receptive language disorder. Today it is generally understood that receptive language deficits do not occur all by themselves but appear together with problems expressing language as well.

Three to five percent of all children have both receptive and expressive language disorder. The cause of this disorder is unknown, but problems with receptive skills begins before the age of four. Difficulty understanding and using language can cause problems with social interaction and make it difficult to function independently as an adult.


There are a number of symptoms that indicate this condition, including problems in:

• language comprehension

• language expression

• articulation

• recalling early visual or auditory memories


Parents who are concerned about their child's acquisition of language should have the child tested, since early intervention offers the best possible outcome. 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.


Speech and language therapy are the best way to treat this type of language disorder. Psychotherapy is also recommended for children because of the possibility of emotional or behavioral problems.

MMR vaccine A vaccine designed to prevent measles, mumps, and German measles (rubella) that is given to all American infants at about 15 months of age. This live attenuated virus provides complete protection to more than 95 percent of those who receive it. MMR is not effective, however, when given to a child earlier than 12 months of age, because the baby often has maternal antibodies that will interfere with the vaccine's action.

The MMR vaccine has greatly reduced the number of cases of measles, mumps, and rubella each year, including serious side effects (death from measles, brain infection from mumps, and birth defects and mental retardation from rubella in pregnant women). Fewer than one child in one million who get this vaccine has a serious allergic reaction or other severe problem. A survey of 50 years' worth of data (more than 2,000 studies from around the world) found that there was not enough evidence to support a suspected link between the vaccine and an increased risk for autism or bowel disease in children.

A first dose is usually given at 12 to 15 months, followed by a booster at age four to six. Older children who missed these vaccines should have one dose of MMR. Children with a high fever or a severe allergy to neomycin should not be given the vaccine.

mole An area of brown pigment in the skin that may either be raised or flat. Certain types of moles can eventually become malignant. A mole that is asymmetrical, that has uneven borders, that changes color or is made up of more than one color, or that has a diameter larger than 6 mm could be a malignant lesion and should be checked by a physician. (See also birthmarks; mongolian spots; port-wine stains.)

Mongolian spots A congenital blue-black pig-mented area on the skin usually found on the lower back or buttocks. The spot, which may appear alone or in a group, may be mistaken for a bruise. It is most common in Asian or African American children and is caused by a concentration of pigment-producing cells deep within the skin. The spots usually disappear by age three or four. (See also birthmarks; port-wine stains.)

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