The Language disorders In children are complete or partial difficulties that a person presents when it comes to communicating effectively in the environment. They affect important areas of cognitive, emotional, communicative and social functioning of the person.
The disorders that may occur are many and varied, affecting one or several components of language and varying in etiology, Development and forecasting and the specific educational needs they generate.
Definition
In school children who do not have genetic or neurological disorders, the prevalence of language disorders is between 2 and 3% and Prevalence of speech disorders between 3 and 6%.
In younger children, preschoolers, about 15% and also more frequent in girls than in children.
We consider that a language is normal when its use is precise in the words that are used according to its meaning, the child presents / displays a vocabulary Optimal in quality and quantity, articulates well, with an adequate rhythm and accurate and concordant intonation.
It should be noted that in children's language, since it is in development, the skills may be more imprecise and not considered pathological. Sometimes, without intervention, the apparent problem will disappear without leaving sequels.
However, there is a group of children who will have language problems and who need to know evolutionary milestones.
Classification of language disorders
1. Speech disorders
Dislalia
The Dislalia Consists in the difficulty to be able to pronounce sounds (for example, the consonants). It is a phonetic alteration and is usually a problem passenger.
There is an inability to produce phonemes of a given language and there is no organic or neurological cause that can justify it. The affectation, in this case, occurs in the phonoarticulator apparatus.
The dislalias are classified in Evolutionary (Those that appear in phonemes in evolutionary development) and Functional (when are they Alterations that should already be acquired for that age).
When a person presents dyslalia, he can omit, distort, substitute or insert phonemes and is the characteristic that would indicate that we are To that problem.
The cause of dyslalia can occur due to deficits in auditory and phonological perception or discrimination, or problems in auditory memory, Because oral motor difficulties or problems in the development environment are found.
Dysarthria
The Dysarthria Is a neuromuscular disorder that affects the articulation of the word.
It encompasses a series of motor speech disorders that result from damage to the nervous system and manifested in alterations in muscle control Of the mechanisms of speech.
Difficulties in the articulation, in the oral expression and that affect the tone and the movements in the articular muscles by injuries in the Central Nervous System.
Thus, other elements of speech such as intonation or rhythm may be involved, as well as other activities where the vocal organs They also have a function such as chewing or coughing.
One of the disorders where it occurs is in cerebral palsy, tumors and also in the Parkinson's disease .
Disglosia
A person with Dysglosia Is one that presents a disorder in the joint and that is due to organic problems in the peripheral organs of speech.
In this sense, problems arise in the phonemes in which the affected organs intervene, and the person omits, distorts or substitutes several Phonemes.
We can classify it in lips (for example, cleft lip), lingual (eg by bridle), dental (eg missing teeth), nasal (eg, Vegetations), palatal (eg, cleft palate) or jaw (eg malocclusion).
Disorders of stuttering
It is the difficulty that is presented in terms of language fluency. It is an alteration in the rhythm of speech manifesting itself in Interruptions in speech fluency.
In the Dysphoria The production of speech is interrupted by an abnormal production in the repetition of segments, syllables, words, phrases, the Air flow, there may be strange patterns of intonation. They are accompanied, in addition, of high muscular tension, anxiety, etc.
The cause is unknown, but may be due to interacting organic and environmental problems: neurological, genetic, environmental, Psychological, feedback error...
In addition, they can be classified into evolutionary dysfemia, which appears at the beginning of language and occurs because the number of ideas that the Child wants to communicate and the skills he shows to express himself. Thus, it makes repetitions to organize the speech and disappears with maturation.
On the other hand, there is chronic dysphoria, which lasts for years and can reach adulthood. It can be tonic (blockages or spasms), chronic
(By repetitions) or mixed.
Taquilalia
It is a speech with a fast pace, very fast and hasty. Deficiencies in the joint can be added, affecting intelligibility.
It is often due to inadequate speech patterns or behavioral precipitation.
Bradilalia
It is a very slow speech, and the cause is often neurological. Appears in motor or neurological disabilities.
2. Oral language disorders
Simple Language Delay (RSL)
It is a difficulty of evolutionary language, where there is a phase shift. The children do not present alterations of another type as they can be Intellectual, motor or sensory.
In general, it affects different areas of language and fundamentally affects syntax and phonology. In addition, understanding is better than expression.
Children with RSL usually present a basic grammar, with jargon, lack of nexus and prepositions, lexical delay, etc.
It is a common reason for consultation in young children. And the difference between RSL and TEL, which I'll explain below, is not clear, Generally meeting the limits of gravity.
What really confirms the diagnosis is the evolution thereof, which in this case is usually favorable, so that anticipating the prognosis is quite complicated.
Dysphasia or Specific Language Disorder (TEL)
The Dysphasia An undefined, probably multifactorial, genetic language disorder. It is a lack of language learning in a child in Absence of any organic, cognitive or environmental disorder.
The child with TEL is diagnosed after having verified that he is not hearing impaired, that he / she has intelligence within the norm, has no damage Neurological and does not develop in an environment of deprivation stimulate.
Such alteration can not be explained by problems of any kind such as intellectual, sensory, motor, neurological or psychopathological; if I had Problems such as intellectual disability, deficiencies in language should not be explained by such problem.
In practice it is difficult to distinguish it from simple language delay, and is usually diagnosed when the severity is greater, since it is acquired here Later and is more severe both phonetically and in structure.
In TEL there are difficulties in acquiring (understanding and / or expressing) spoken or written language. It may include all or any of the Components: phonological, semantic, morphological, pragmatic....
Different subtypes of TEL are described depending on the aspect to which attention is given. Thus, there are different classifications and the simplest and accepted Distinguishes between Expressive language disorder And mixed receptive-expressive disorder.
Aphasia
The aphasia S are disorders of the acquired language, where an involution of functions already acquired as a result of traumatisms takes place, Infections, ischemia or tumors.
It happens because of a Central Nervous System , In areas of the left cerebral hemisphere that intervene in the understanding and production of language. Affects language Oral and written, and we found different modalities.
We distinguish the Aphasia of Broca , Where the capacity for oral expression is lost, that of Wernicke , Where there is an inability to understand the Language, driving, with inability to repeat.
In addition, we find transcortical sensory and motor aphasia and anomic aphasia, where the person can not access the lexicon.
In older children, the types of Broca's aphasia (expressive / motor) and Wernicke's (receptive / sensory) aphasia are also distinguished, as we find the injury.
Selective mutism
A child with Selective mutism Is the one who before certain situations or people does not want to talk. However, in other situations it does.
An example might be that of the child who speaks at home, with family and friends, and yet does not speak when in school.
They have no real difficulty in understanding and speaking, it is considered more specifically an anxiety disorder.
All the articulatory or language deficits that may be behind selective mutism should be discarded.
3. Written language disorders
Dyslexia
The dyslexia A language disorder manifested by problems in learning to read in a child who is old enough to develop it.
Therefore, it is the inability to be able to learn writing in a normal way. It is possible to distinguish evolutionary dyslexia, which is related to Maturation and presents a good prognosis and the secondary, which is related to neurological problems.
Disgrafia
The Discography Are functional disorders that often affect the quality of writing. It is manifested in the lack of sufficiency to be able to assimilate and use Correctly the symbols of the language.
There are different types of syphilis with symptoms, such as:
- Acoustic discography: difficulty to acoustically perceive the phonemes and analyze and synthesize the sound composition of the words.
- Optical discography: visual representation and perception are altered, so that letters are not recognized separately and are not related to their Sounds.
- Motor Dysgraphia: There is fine motor impairment affecting motor connections with the sound of words
- Agrammatic discography: changes in the grammatical structures of writing.
Dysortography
It is a specific problem of writing, where there is a substitution or omission of letters and may have different causes. They do not occur in the
reading.
It focuses on the ability to transmit spoken and written language code and will be detected through writing.
4. Voice disorders
Dysphonia
Dysphonia is an alteration in the voice that can occur in any of its qualities. It involves a loss of voice, alterations in tone and timbre...
The cause is usually a poor technique in the voice, can be due to organic disorders or lack of muscle, vocal or respiratory coordination.
Rhinophony
It is a vocal alteration where the voice has nasal resonance. It is due to problems, for example, of nasal obstruction.
We find several types, such as the open one, where the air comes out when phonemes are emitted or closed, where the nose is obstructed and it is prevented from being emitted Nasal phonemes.
5. Psycholinguistic disorders
Autistic Spectrum Disorder (ASD)
We find in the spectrum of autism disorders different disorders of communication and language.
Children with ASD present stereotyped behaviors, problems in social interaction and also in language. In fact, this is usually one of the Most frequent reasons for consultation with a child with ASD.
Within this disorder we can find different problems in language, either complete absence of the same, echolalia, problems in prosody, Comprehension, phonology, pragmatic deficit...
There is an alteration in communication and especially in the pragmatic component of language.
Intellectual disability
Also sometimes language problems are related to intellectual disability. In addition, some of the children who Language finally present intellectual disability.
In intellectual disability there is a delay in neurological and sensorial maturation, so that deficits in perception Auditory and visual and when processing information optimally.
In the case of ID there may be delay in starting the language, which is slower or imprecise in terms of organization.
Problems also occur in conjugation, in the use of adverbs and adjectives, absence of articles, prepositions, poverty of Concepts and content and sometimes limited understanding.
In this case, the understanding and production of language will depend on the cognitive level of each individual.
Evaluation and intervention in language disorders
Early evaluation of problems or disorders in communication and language is key to being able to intervene effectively in the moment Optimal, before more complex problems develop and solution and intervention on them is much more difficult and costly.
It is necessary to know them in order to be able to act quickly and effectively at the moment in which the difficulties are detected.
For example, a child who reaches 5 years without language would have let the time where they acquire about 70% of the language spend, so it is Early stimulation is important.
It is necessary to know the normative stages of the language because it is the tool that allows us to evaluate if a child goes, linguistically, according to Their chronological age, so that they can act early in language.
In the day to day professional there are several cases of language disorders that require a multidisciplinary action (speech therapists, Psychologists, doctors, pedagogues, teachers...), where a professional response to these needs must be given.
The difficulties that can occur in language are multiple and varied, as we have said, varying in severity. And therapy should be Characteristics of the child and the language area concerned.
Language-stimulating therapies attempt, in some cases, to replace functions performed by damaged parts of the brain, such as Aphasia, so that these functions are now performed by other parts of the brain.
On many other occasions, therapy is designed to systematically and regularly stimulate and reinforce the language of children.
In addition, as we have already mentioned, in order to shape and develop language, the influence of the environment where the child is developed is very important.
Around the child there must be people who have a rich and developed language, who are affectively committed to it, who stimulate it through Play, joint activities.
If this communicative and affective relationship does not take place, the language may be altered, since language begins at the moment of birth and is Consolidated around the 6 years.
It should be noted that due to sensory deprivation, different language problems can also be included.
Deprivation often leads to delays in all aspects of development. In this way, the language appears late and develops from the same mode.
In addition, parents can work to reduce anxiety , To ensure that the child develops in the best way possible by Negative attitudes And becoming an active agent that enhances its complex development.
Behaviors of overprotection, of rejection, of maximizing their potential, of facilitating responsibility and autonomy should be avoided.
It is imperative to maximize all your achievements and to show you appropriate language models so that you can learn and develop. Is imperative Giving them rich and variable experiences, involving them and collaborating with different professionals to promote their development.
What is the language?
Human beings communicate through different forms: with gestures, icons, signs... and in addition to this, the most important means we have for To communicate is language.
Language is a system of symbols that has a social meaning and helps us to classify the experiences of the environment. Thus, it regulates our Emotions, our behaviors and organizes the thought.
Language is the general model that exists in the consciousness of all members of the same linguistic community and requires learning. Is a Social act and the child learns it as a tool to obtain and regulate contact with other people.
In order to acquire and develop language, we must have a series of biological, psychological and environmental structures. Thus, the child integrates A series of linguistic structures that are specific to their language.
In this way, if we encounter a problem or affectation in the person's personal or social skills, they can be affected, in a way More or less serious, language skills to understand and express language.
We observed in many children alterations in the development of language, as many patients with neurological damage also present problems in the language development.
It is necessary to understand how are the processes of language acquisition, its normal developmental evolution and what more common problems can occur Detect them in time and be able to contribute to their improvement.
What is the normative development of language?
The development of language is related to the maturation of the different systems in the child: sensorineural, motor, cognitive development, affective, Social... It is essential that there is no injury in the phonoarticulatory organs.
In language development there is what we call a"critical period", understood as the moment in which certain Simple and enduring way in time and where learning takes place naturally.
Once the critical period has passed, learning does not occur in the same way, it is more complicated and the skill may not be so well established and Defined.
The language consists of 4 aspects such as the phonological (speech sounds), the syntactic (language structures), the semantic (understanding the Language) and pragmatic (use of language in context).
The different stages in language acquisition are:
Prelinguistic stage
During this stage, which occurs from birth to about 12 months, the child communicates through vocal utterances, gestures, Signs...
They initiate an auditory-verbal game with babbling, first non-imitative and then yes, with phonetic and polysyllabic utterances (pseudo-conversations).
Holophonic Stage
This stage is characterized by a single word replacing a phrase. It takes place between 12 and 24 months approximately.
Telegraph Stage
It happens between the 18 and the 30 months of age approximately, where the child begins to join several words to form phrases, however these not yet Are recognized as proper sentences.
However, approximately 50% of your speech is intelligible to people who do not know the child.
They begin to use what we colloquially call"rag-language", longer broadcasts where verbs and nouns are used but are lacking Connective.
Simple sentence stage
It occurs between two and a half years and approximately three and a half years, where the emissions are characterized by being brief, context dependent and Are already recognized as prayers.
They usually elaborate sentences about 4 elements, use the pronoun I, answer simple questions, etc.
Complex sentences stage
From 3 or 4 years the child presents more complex, free, fluid and not necessarily linked to the context. They have good Understanding and obeying complex orders.
Children begin to join several simple sentences and have already acquired phonologically different sounds more complex.
It is enriching the vocabulary, it is able to define simple words and from the 6 years they are able to perfect phonetic errors.
References
- Acosta Rodríguez, V. M. (2012). Logopedic intervention in specific language disorders. Journal of Speech Therapy, Phoniatrics and Audiology , 32, 67-74.
- Aguilera Albesa, S., Busto Crespo, O. Language disorders. Integral pediatrics.
- Barragán, E., Lozano, S. (2011). Early identification of language disorders. Medical Journal Clinic Las Condes, 22 (2), 227-232.
- Bermejo Minuesa, J. More frequent language disorders. Autodidact .
- Celdrán Clares, M. I., Zamorano Buitrago, F. Disorders of communication and language.
- Godos Chocano, A. S. Classification and semiology of language disorders in children.
- Gortázar Díaz, M. (2010). Specific language development disorders.
- Hurtado Gómez, M. J. (2009). Language disorders. Innovation and educational experiences.
- Moreno-Flagge, N. (2013). Language disorders. Diagnosis and treatment. Journal of Neurology , 57, S85-S94.
- Paredes, J., González, S., Martín P., Núñez, Z. (2003). Language disorders. Suzuki Foundation Institute.
- Parrilla Muñoz, R., Sierra Córcoles, C. Language disorders.Peñafiel Puerto, M. (2015). Early indicators of language disorders. Language Intervention Center.
- Redondo Romero, A.M. (2008). Language disorders. Integral pediatrics.