What is childhood or evolutionary dysphasia?

The Childhood dysphasia Is a language disorder characterized by difficulty in both speaking and understanding speech.

People affected by this disorder may not be able to speak using coherent phrases, have difficulty finding the correct words, show difficulty in understanding the message that their interlocutor wants to convey, or they may make use of words that have no meaning in That particular moment.

Characteristics of childhood dysphasia

Evolutionary or infantile dysphasia is a Specific language disorder , Both in comprehension and expression, which affects a child of intelligence within the mean and who has no other disorder. This disorder affects a greater proportion of children compared to girls, reaching within the 2/1 - 5/1 margins.

Language disability in childhood dysphasia is not secondary to other clinical conditions such as deafness, autism , the cerebral palsy , Emotional alterations , Mental retardation Or environmental deprivation.

Difficulties in the development of language are, to this day, a fairly common problem. Preschool age ranges from 3% to 8%.

In addition to evolutionary or infantile dysphasia, there are currently other terms to denominate this disorder, some of them are Language Specific Disorder (TEL) (Aguado, 1999, Mendoza, 2001), or Specific Language Development Disorder (TEDL) , Although the latter less often considerably.

Children with academic delay, although some of them usually present other problems that may affect this, the most commonly relevant is the disability in language development.

There is a high percentage of probability that the relatives of children with evolutionary dysphasia have presented delayed speech learning and difficulty learning to spell and read. In addition, a high percentage of these relatives are left-handed or ambidextrous compared to the rest of the population.

Possible causes

While there is no single theory regarding the origin of dysphasias, there are several postures that have as their cause various biological issues.

Some authors argue that it is brain damage or lack of oxygen at birth, while for others the main cause would be in a delayed maturation. There are also some theories that point specifically to a Traumatic brain injury At the right time of delivery.

Finally, other authors point out as possible causes of infectious diseases such as meningitis or encephalitis , Which affect the Central Nervous System .

In any case, if it was a maturational delay, dysphasia would have a better prognosis, since over time it could be compensated. In case it was due to brain damage, the prognosis would be less positive. If brain damage occurs, the pattern of development will continue to be altered over time.

Although the main causes seem to be biological, it is true that there are other environmental factors that may aggravate the disorder. These factors can be a bad family environment or long periods of hospitalization.

Types of childhood dysphasia

Within the childhood or evolutionary dysphasia, we find two types:

Expressive dysphasia

In this dysphasia are errors that specifically affect speech production with large differences in intensity. Children who have this type of dysphasia have less emotional and behavioral problems than those who are affected by receptive dysphasia.

They have a greater desire for communication, than they demonstrate with their non-verbal communication (gestures and eye contact) and their vocalizations.

Receptive dysphasia

In receptive dysphasia, on the other hand, defects occur in the reception of speech, that is, in the understanding of the message that the interlocutor wants to transmit.

This is not caused by a hearing loss. The sounds are not differentiated correctly and a good attribution of the meanings of these sounds is not made. These children, in addition to presenting more emotional and behavioral problems, are generally less communicative.

In relation to phonological development, there is a delay in relation to children with normal development but in no case appears deviant.

Semantic development is a considerable delay in relation to the development of early vocabulary.

Childhood dysphasia

Within infantile dysphasia, we found acquired childhood dysphasia. A special case that occupies a very low percentage within the dysphasias. S Characterized by a loss in the language already acquired, due to a brain injury or a progressive loss concomitant to the appearance of a Compulsive disorder .

Unlike evolutionary or infantile dysphasia (which has more cases of occurrence in males), in acquired dysphasia there are hardly any differences of occurrence between sexes.

The age at which dysphasia appears is crucial to consider it acquired or infantile (or evolutionary). It would be from the age of 3 when it would be considered acquired. Thus, authors Kolb and Whishaw (1986) have already stated that in the age range of 3 to 10 years, brain lesions may be the cause of dysphasia.

However, recovery can take place over an acceptable period of time since the hemisphere that has not suffered the injury is intact and can take over the functions of language.

Although language recovery may occur, children who have suffered an injury at these ages may suffer some other sequelae in language such as hypoproductivity, a significant reduction in language use.

The consequences of hypoproductivity can be a total absence of speech, suppression of the gestual communication or the use of the written language during periods of time that can last between several weeks to years.

In relation to language comprehension disorders, they are rare and long lasting in acquired childhood dysphasia. On the other hand, written language disorders often occur when diffuse lesions occur in children aged 7 years and over.

In contrast, if the injury occurs from 10 years of age onwards, the disorder will be similar to that occurring in the adult. This is because The hemisphere Who has not suffered the injury becomes more specialized the greater the individual, and is more incapable of adaptation and reorganization to the deficit suffered in the hemisphere of the brain injury.

In addition, if the lesion occurs in the dominant hemisphere, there is a better prognosis for speech recovery provided that the non-dominant hemisphere has good abilities to assume linguistic functions.

Therefore, the probability of recovery of a brain lesion will depend on two factors: the ontogenetic characteristics of brain dominance and The plasticity of the brain In developing to cope with the consequent changes of the injury.

Acquired dysphasia may also appear because of Epileptic seizures . Symptoms that Occur in this case are a sudden and progressive loss, in which a EEG Abnormal at the same time as a compulsive disorder.

symptom

Next, I'll go on to define what are the most common symptoms of childhood or evolutionary dysphasia:

• There is a constant repetition of words which the child does not know their real meaning.
• There is a notable difficulty in making use of personal pronouns (eg, I, you, he, we, etc.).
• Vocabulary is often poor.
• When organizing a sentence, there are often omissions of grammatical elements.
• Since they have deficits in both comprehension and expression of words, they often communicate with non-verbal communication using gestures to express themselves with others. These children do not have a special communication motivation.
• They have special difficulty remembering and repeating long phrases.
• They have altered both the understanding and the expression of the messages transmitted to them by their interlocutors, not getting to understand well.
• Difficulty in the acquisition of gender, number and verbal morphemes.
• Deficit in the conjugation of the various verbal forms, usually using the infinitive generalized. In addition, they usually make little use of prepositions and conjunctions.

Although these are the symptoms that occur more frequently in those affected by dysphasia, there are also some symptoms that although they are not the most commonly occurring, they can go hand in hand with the previous ones. These are some:

• Alterations of rhythm in speech.
• Difficulty to retain and reproduce verbally emitted elements.
• Some delay in motor skills, laterality acquired late or not defined.
• Frequent cases of attention deficit and Hyperactivity .
• Deficit in the discrimination of sounds that are known to be familiar to the individual.

Consequences

All the factors I have already discussed that significantly affect the child in his socio-emotional development have a number of consequences in his life.

The difficulty in communicating (at both the expressive and the understanding level) in these individuals is notorious, so their motivation to have social relationships is scarce. At the same time, when they see so many difficulties in relating to them, their peers lose interest in doing so on many occasions.

For all this, there is a social isolation. A child with these characteristics and socially isolated can be misdiagnosed of other disorders such as autism or deafness.

This, undoubtedly, affects your emotional state. These children, and consequently of all the problems that drag, usually present affective disorders, Anxiety states , Or the deficit of self-esteem. And in the worst cases being victims of bullying .

Due to all these complications that they suffer in the various areas of their lives, their academic level is also affected, reducing their ability to learn, especially in relation to reading and writing.

Treatments

Childhood dysphasia may have a good prognosis. For this, it is important to know that the earlier the disorder is diagnosed the better the child's development.

Also, in order to mark the appropriate goals for those who are prepared in the treatment, it is essential to be clear the evolutionary stage in which it is. The stage in which the individual is found will identify the biological and psychological maturity available to the child.

When establishing the different tools that will belong to the treatment, it is necessary to take into account the individuality of each case. All of them must always be carried out by a specialized professional, in addition to working together with the family and the school.

Generally speaking, these are some of the working tools that are quite effective when working with dysphasia:

Auditory Discrimination Exercises

As I mentioned before, these children have a deficit in the discrimination of different sounds that, previously, we know that knows. The function of these exercises is that they learn to differentiate them and for this they are made recordings and, later, the child is asked to try to guess what sound each one is.

Some of these sounds known to the child and that can be used are, for example, sounds of animals common to him, or sounds of nature such as rain.

Exercises to increase vocabulary

Another convenient exercise in this case to increase their vocabulary is to make known a priori words known to the child and to repeat them for assimilation.

Once these are assimilated, the difficulty level of the words will be increased progressively until the child has already obtained an adequate number. Then, these categories are classified into categories so that the child can use them optimally in their daily communication.

Buco-focal exercises

The pronunciation of the phonemes is also affected. An effective tool is to perform buco-facial exercises to strengthen and exercise the organs involved in the pronunciation of phonemes.

Organs such as mouth, tongue, or breathing are essential in the formation of phonemes so if you exercise consistently this pronunciation may be improved.

References

1. Newman, S., and R. Epstein (eds). Current Perspectives in Dysphasia. New York: Churchill Livingstone, 1985.
2. Berrios, G.E. (2002). The history of Mental Symptoms. Descriptive psychopathology since the ninetenenth century. Cambridge University Press. United Kingdom.
3. Brookshire, R. Introduction to Neurogenic Communication Disorders (6th edition) St. Louis, MO: Mosby, 2003.
4. Darley, F. Aphasia. Philadelphia, PA: WB Saunders, 1982.
5. NJIOKIKTJIEN, Ch, 2006: Developmental Language Disorders and Behavioral Disorders, Language: normal and pathological development, D. Riva, I. Rappin and G. Zardini (eds.), John Libbey Eurotext, pp1-1.
6. NJIOKIKTJIEN, Ch., 1998: Pediatric Behavioral Neurology, Clinical Principles, Vol. 1 Amsterdam, Suyi Publikaties.