The definition involves a significant deficit relative, in part, to environmental expectations. In common-sense terms that means a deficit big enough to be noticed by ordinary people such as parents and teachers—not just language-development experts—and one that affects how the child functions socially or academically in the world in which he or she lives. The deficit, in other words, has to have some adaptive consequences. Fey (1986) refers to this as a "normativist" position.

The definition goes a step further, though. It says that the deficit also must exist relative to "norm-referenced expectations." That means that in addition to being noticeably handicapped in the ability to use language forms and meanings to communicate in everyday life, the child with a language disorder also must score significantly below expectations on some standardized or norm-referenced tests. Fey (1986) refers to this standard as a "neutralist" position. Both the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994), and the International Code of Diseases (ICD-10; World Health Organization, 1992)—the systems used by medical and mental health professionals worldwide to classify disorders—require that both these criteria (the normativist, or adaptive dysfunction criterion, and the neutralist, or standardized criterion) be met for a child language disorder to be diagnosed. In this text I adopt this position and say that a child must both score significantly low on standardized testing and be perceived as having a communication problem, as evidenced by either parent complaint or teacher referral, to be labeled as language disordered.

There are certainly reasons to quarrel with this position, and many readers no doubt will. One very legitimate reason is that standardized tests with adequate psychometric properties—such as validity; standard errors of measurement; and large, representative norming samples—are not always available for testing all the age levels, from toddlers to adolescents, or all the aspects of language, from phonology to pragmatics, that we would like (Cole, Mills, and Kelley, 1994; McCauley, 1989; McCauley and Swisher, 1984a,b; Plante and Vance, 1994). This issue is discussed more fully in Chapter 2 For now, suffice it to say that many tests in the language area are not constructed as well as they might be and that many age levels and areas of language are very sparsely covered, if at all, by standardized measures. . .

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