Impact of developmental language disorders on mental health and well-being across the lifespan: a qualitative study including the perspectives of UK adults with DLD and Australian speech-language therapists

Objective This study aims to explore the educational, occupational and socioemotional experiences of people with developmental language disorder (DLD) across the lifespan to gain insight into risk and protective factors for mental health.Design Qualitative analysis of focus groups and written submissions. Data were combined and analysed using Braun and Clarke's reflexive thematic analysis approach within a critical realist framework.Setting Southeast England and Western Australia.Participants Six adults with DLD from England and five speech-language therapists from Western Australia participated in focus groups and/or contributed written responses to the research team.Results We developed four themes: 'perspectives on diagnosis and living with an invisible disability' explores participants' perspectives on diagnosis, the difficulty getting a diagnosis and perceptions of DLD as widely misunderstood; 'school struggles and self-esteem from past to present' details school experiences and their impact on mental health; 'DLD across the lifespan' explores DLD in adulthood with a focus on workplace difficulties, emotional well-being and mental health; 'A sense of belonging: communication, connection and support' provides a lived experience account into the social participation difficulties of adults with DLD and the importance of social support.Conclusions and implications Adults with DLD may experience poor self-esteem, anxiety and depression. These mental health concerns may result from (a) exhaustion due to masking/compensating for neurodevelopmental differences, (b) loneliness and/or disempowerment due to difficulties with social interaction and (c) adverse experiences such as bullying, discrimination and a lack of appropriate accommodation at school and in the workplace. A lack of awareness and support for people with DLD from health, education and employment providers was also seen as a contributing factor to poor mental health. Diagnosis may serve a protective function for mental health via self-understanding, self-esteem and self-advocacy.