Has the UK’s exam system turned a blind eye to the most common hidden disability?

When tradition fights equity, learners lose. The assessment sector is constantly debating fairness, yet a major blind spot remains in exam halls. The Four-Nation Working Group Report from February by the Royal College of Speech and Language Therapists (RCSLT) is an eye-opener. It shines light on how current exam access arrangements are failing learners with Developmental Language Disorder (DLD) and Language Disorder associated with a biomedical condition, collectively known as (D)LD.

It’s time the sector asked itself a difficult question: are our access arrangements legally and morally fit for purpose?

(D)LD is often called the most common neurodevelopmental condition you’ve never heard of as it affects nearly 10% of children. Or two children in every classroom. It is more prevalent than autism or dyslexia. Yet, because it is a ‘hidden disability’, it remains chronically under-recognised in education policy and practice.

The academic toll is devastating. According to the report, (D)LD learners are six times more likely to struggle with reading and spelling. For high-stakes assessments within England’s schools, only 20.3% of pupils with Speech, Language and Communication Needs achieve a grade 4/C or above in GCSE English and Maths. Compare this to 63.9% of all pupils. The data isn't just about their struggle. It tells the oft-told tale that paper exams are predominantly assessing their language difficulties, not the learner’s subject knowledge and understanding.

Once again, the incumbent paper-based essay system compounds and exacerbates the struggle of affected learners

Why the system is broken Both JCQ and Qualifications Scotland heavily restrict the role of Language Modifier (LM). An LM doesn't provide answers. They reword ‘carrier language’ (the exam question's wording) into simpler terms. This helps learners understand exactly what is being asked of them. The current LM criteria focus on sensory barriers, rather than the complex cognitive-linguistic processing needs that define (D)LD.

To access an LM, JCQ criteria demand a standard score of 69 or below in a standardised reading test of comprehension or vocabulary. This is fundamentally flawed. Standardised reading tests measure decoding. This misses the broader receptive language difficulties central to (D)LD. Consequently, learners who employ compensatory strategies to decode words are denied vital and valid assistance, even though they cannot process the dense, complex language of the exam under timed conditions.

By adhering to narrow cut-offs, the system excludes learners from an arrangement explicitly designed to mitigate language barriers.

What the assessment sector must do Awarding bodies operating in the UK have legal duties under the Equality Act 2010 to make reasonable adjustments. Refusing to evolve these criteria risks indirect discrimination. To fix this, the report outlines four steps for exam owners and regulators. I’ve also included an extra for digital exam delivery.

1. Overhaul LM Eligibility Narrow reading and vocabulary cut-offs are unhelpful. Exam owners must accept comprehensive diagnostic assessments, such as the CELF-5. The report also recommends adjusting the threshold to include scores of 84 or below.

2. Acknowledge Clinical Expertise Repeated re-assessments of learners’ chronic, lifelong conditions is a scandal in plain sight. For (D)LD, the condition is unlikely to improve by age five. The exam sector must stop this, and accept existing reports from professional Speech and Language Therapists (SLTs) - clinical field experts.

3. Modify Exam Papers at Source Why wait to fix a poorly worded question in the exam hall? Another dreadful secret is that exam papers are released with inherent problems including language, syntax, missing questions, classism, and print. Part of the reason is that in England, most school exam questions are not trialled before release in a live exam. Questions and papers should undergo linguistic review and modification at source by multidisciplinary teams, including SLTs, and those who teach deaf learners.

4. Recognise (D)LD as a Distinct Category Create a specific eligibility category for (D)LD to prevent these learners from falling through the cracks of generalized frameworks.

5. Provide digitised LM help Delivery of a digital exam can enable a self-serve for (D)LD learners. Delivered over headphones or on-screen, re-wording carrier language is ripe for digitising. You can additionally have an LM off-site, able to handle multiple queries, if the software can’t offer re-wording assistance. And delivered side-by-side with other learners, the notion of being othered is greatly reduced. The technology has existed for decades.

When implemented properly, LMs and modified papers don't give an unfair advantage; they level the playing field. We now know that the rigidity of legacy paper systems (and dogmatic attitudes) is riding roughshod over equity and validity. A harmonised approach not only ensures every learner is assessed on their capability, not their neurodevelopmental barriers, but also adds to the increasing weight of evidence for deploying digital exams and digital assessment.