The language disorders in children are full or partial difficulties of a person in communicating effectively in the environment. They affect important areas of cognitive, emotional, communicative and social functioning of the person.
Language Disorders in Children
The disorders that can occur are many and varied, affecting one or several components of the language and varying in the etiology, in the development and prognosis and in the specific educational needs that they generate.
In school children who do not present genetic or neurological disorders, the prevalence of language disorders is between 2 and 3% and the prevalence of speech disorders between 3 and 6%.
In younger children, preschool children, around 15% and it is more frequent in girls than in boys.
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 an optimal vocabulary in quality and quantity, articulates well, with an adequate rhythm and a precise and concordant intonation.
It should be noted that in the children’s language, since it is in development, skills may be more imprecise and not therefore considered pathological. Sometimes, without intervention, the apparent problem will disappear without leaving sequels.
However, there is a group of children that will present language problems and from which it is necessary to know the evolutionary milestones.
Classification of language disorders
1. Speech disorders
The dyslalia consists in the difficulty to be able to pronounce sounds (for example, the consonants). It is a phonetic alteration and is usually a temporary problem .
There is an inability to produce phonemes of a specific language and there is no organic or neurological cause to justify it. The affectation, in this case, occurs in the phonoarticulator device.
The dyslalias are classified as evolutive (those that appear in phonemes in evolutionary development) and functional (when they are alterations that should already be acquired for that age).
When a person presents dyslalia, he can omit, distort, substitute or insert phonemes and this is the characteristic that would indicate that we are facing this problem.
The cause of dyslalia can occur due to deficits in auditory and phonological perception or discrimination, or due to problems in the auditory memory, because oral motor difficulties or problems in the development environment are encountered.
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 the muscular control of speech mechanisms.
There are difficulties in the articulation, in the oral expression and that affects the tone and movements in the joint muscles due to 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 also have a function such as chewing or coughing.
One of the disorders where it occurs is in cerebral palsy, tumors and also in Parkinson’s disease.
A person with dysglossia is one who has 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 various phonemes.
We can classify it as labial (for example, cleft lip), lingual (for example: for frenulum), dental (for example: missing teeth), nasal (for example: vegetations), palatal (for example: cleft palate). ) or maxillary (eg: malocclusion).
Dysphemia or stuttering
It is the difficulty that is presented as far as language fluency is concerned. It is an alteration in the rhythm of speech manifested in interruptions in the flow of speech.
In dyspnea the production of speech is interrupted by an abnormal production in the repetition of segments, syllables, words, phrases, air flow is obstructed , there may be strange patterns of intonation. They are also accompanied by high muscle tension, anxiety, etc.
The cause is unknown, but it can be due to organic and environmental problems in interaction: neurological, genetic, environmental, psychological factors, feedback error …
In addition, they can be classified as evolutive dysphemia, which appears at the beginning of the language and takes place because the amount of ideas the child wants to communicate and the skills he shows to express himself do not match. Thus, it makes repetitions to organize the discourse and disappears with the maturation.
On the other hand, there is the chronic dysphemia, with years of duration and that can reach adulthood. It can be tonic (by blocks or spasms), chronic
(by repetitions) or mixed.
It is a speech with an accelerated rhythm, very fast and precipitate. Deficits in the joint may be added affecting intelligibility.
It is usually due to inadequate speech patterns or behavioral precipitation.
It is a speech that is too slow, and the cause is often neurological. It appears in motor or neurological disabilities.
2. Oral language disorders
Simple Language Delay (RSL)
It is a difficulty of the evolutionary language, where there is a lag. Children do not present alterations of another type such as intellectual, motor or sensory.
In general, it affects different areas of the 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 links and prepositions, lexical delay, etc.
It is usually a frequent reason for consultation in young children. And the difference between the RSL and the TEL, which I will explain to you next, is not clear, taking generally the limits of gravity.
What really confirms the diagnosis is the evolution of it, which in this case is usually favorable, so that anticipating the prognosis is quite complicated.
Dysphasia or Specific Language Disorder (TEL)
The dysphasia is a language disorder with an undefined cause, probably multifactorial and genetic. It is a lack of language learning in a child in the absence of any organic, cognitive or environmental disorder.
The child with TEL is diagnosed after having verified that he / she does not have hearing disability, that he / she has intelligence within the norm, does not have neurological damage and does not develop in an environment of deprivation to stimulate.
This alteration can not be explained by problems of any kind such as intellectual, sensory, motor, neurological or psychopathological; If there is a problem such as intellectual disability, deficiencies in the language should not be explained by this problem.
In practice it is difficult to distinguish it from the simple delay of language, and it is usually diagnosed when the severity is greater, since it is acquired here later and becomes more serious both phonetically and in structure.
In TEL there are difficulties in the acquisition (comprehension and / or expression) of spoken or written language. It can include all or some of the components: phonological, semantic, morphological, pragmatic ….
Different subtypes of TEL are described depending on the aspect to which attention is paid. Thus, there are different classifications and the simplest and most accepted distinguishes between expressive language disorder and mixed receptive-expressive disorder.
The aphasia s are acquired language disorders where an involution of functions and acquired as a result of trauma, occurs infections, ischaemia or tumors.
It happens due to a lesion of the central nervous system , in areas of the left cerebral hemisphere that intervene in the understanding and production of language. It affects oral and written language and we find different modalities.
We distinguish Broca’s aphasia, where the ability to express himself orally is lost, that of Wernicke, where there is an inability to understand language, driving, with an inability to repeat.
In addition, we found transcortical sensory and motor aphasias and anomic aphasia, where the person can not access the lexicon.
In older children, the types of Broca (expressive / motor) and Wernicke (receptive / sensory) aphasia are also distinguished, depending on the lesion.
A child with selective mutism is one who, in certain situations or people, does not want to talk. However, in other situations it does.
An example could be the child who speaks at home, with the family and with his friends and yet does not speak when he is in school.
They have no real difficulty in understanding and speaking, it is more specifically considered an anxiety disorder.
It is convenient to discard all articulatory deficits or the language that may be behind selective mutism.
3. Written language disorders
The Dyslexia disorder manifested language because problems arise in learning to read in a child who is old enough to develop it .
Therefore, it is the inability to learn to write normally. We can distinguish evolutionary dyslexia, which is related to maturation and has good prognosis and secondary, which is related to neurological problems.
The dysgraphia are functional disorders that typically affect the quality of writing. It manifests in the lack of sufficiency to assimilate and correctly use the symbols of language.
There are different types of disgraphs attending to the symptoms, such as:
– Acoustic dysgraphia: difficulty to acoustically perceive phonemes and analyze and synthesize the sound composition of words.
– Optical dysgraphia: representation and visual perception are altered, so that the letters are not recognized separately and are not related to their sounds.
– Motor dysgraphia: there is fine motor difficulty affecting the motor connections with the sound of the words
– Agrammatic dysgraphia: changes in the grammatical structures of writing.
It is a specific problem of writing, where there is a substitution or omission of letters and can have different causes. They do not occur in
It focuses on the ability to transmit the spoken and written linguistic code and will be detected through writing.
4. Voice disorders
The dysphonia is an alteration in the voice that can be given in any of its qualities. It supposes a loss of voice, alterations in the tone and the timbre …
The cause is usually a poor technique in the voice, it can be due to organic disorders or lack of muscular, vocal or respiratory coordination.
It is a vocal alteration where the voice presents nasal resonance. It is due to problems, for example, of nasal obstruction.
We found several types, such as the open one, where the air comes out when phonemes are emitted or the closed one, where the nose is blocked and the nasal phonemes are prevented from being emitted .
5. Psycholinguistic disorders
Autism Spectrum Disorder (ASD)
We found different disorders of communication and language in the spectrum of autism disorders.
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 the language, either complete absence of the same, echolalia, problems in prosody, understanding, phonology, pragmatic deficit …
There is alteration in communication and especially in the pragmatic component of language.
Sometimes language problems are also related to intellectual disability. In addition, some of the children who consult due to language delay have intellectual disabilities.
In the intellectual disability there is a delay in the neurological and sensory maturation, so that there are deficits in the auditory and visual perception and at the time of processing the information in an optimal way.
In the case of ID there may be a delay when initiating the language, which is slower or imprecise in terms of organization.
They also take place, later, problems in the conjugation, in the use of adverbs and adjectives, absence of articles, prepositions, poverty of concepts and content and sometimes limited comprehension.
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 assessment of problems or disorders in communication and language is key to being able to intervene effectively at the optimum time , before more complex problems are developed and the solution and intervention on them is much more difficult and expensive.
It is necessary to know them in order to act quickly and efficiently when the difficulties are detected.
For example, a child who reaches 5 years without language would have missed the time where about 70% of language is acquired, so 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 is linguistically speaking, according to their chronological age, so that we can act early in the language.
In the professional day to day there are various cases of language disorders that require a multidisciplinary action (speech therapists, psychologists, doctors, teachers, teachers …), where you should give a professional response to these needs.
The difficulties that can occur in the language are multiple and varied, as we have already said, varying in severity. And the therapy must be adapted to the characteristics of the child and the linguistic area affected.
The therapies that stimulate language try, in some cases, to replace functions performed by damaged parts of the brain, such as aphasias, so that now these functions are performed by other parts of the brain.
On many other occasions, the therapy is designed to systematically stimulate and reinforce the language of children.
In addition, as we have already mentioned, in order to shape and develop the language, the influence of the environment where the child develops is also very important.
Around the child there must be people who have a rich and developed language, who engage with him emotionally, who stimulate him through play, joint activities.
If this communicative and affective relationship does not take place, the language can be altered, since the language starts at the moment of birth and consolidates around 6 years.
It should be noted that due to sensory deprivation, different language problems can also be included.
The deprivation often causes a delay in all aspects of development. In this way, the language appears late and develops in the same way.
In addition, parents can work to reduce the level of anxiety, get the child to develop in the best way possible by overcoming negative attitudes and becoming an active agent that enhances their complex development.
Avoid overprotective, rejective behaviors, maximize their potential, facilitate responsibility and autonomy.
It is essential to reinforce all your achievements to the maximum and to show you adequate language models so that you can learn and develop. It is essential to give rich and variable experiences, involve them and collaborate with different professionals to promote their development.
What is the language?
Human beings communicate through different forms: with gestures, icons, signs … and besides this, the most important means we have 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 thought.
Language is the general model that exists in the consciousness of all members of the same linguistic community and that requires learning. It 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 personal or social competences of the person, the language’s abilities to understand and express the language can be affected, in a more or less serious way .
We observe alterations in language development in many children, just as many patients with neurological damage also present problems in language development.
It is necessary to understand how language acquisition processes are, their normal evolutionary development and what more common problems can occur to 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 different systems in the child: neurosensory, motor, cognitive, affective, social development … It is essential that there is no injury in the phonoarticulatory organs.
In the development of language there is what we call a “critical period”, understanding it as the moment in which certain skills are acquired in a simple and lasting way in time and where learning takes place naturally.
Once past the critical period, learning does not happen in the same way, it is more complicated and the skill may not be as well established and defined.
The language consists of 4 aspects such as phonological (sounds of speech), syntactic (language structures), semantic (understanding of language) and pragmatic (use of language in context).
The different stages in language acquisition are:
During this stage, which happens from birth until approximately 12 months, the child communicates through vowel emissions, gestures, signals …
They begin an auditory-verbal game with babbling, first not imitative and then yes, with phonetic and polysyllabic emissions (pseudo-conversions).
This stage is characterized because a single word replaces a phrase. It takes place between 12 and 24 months approximately.
Occurs between 18 and 30 months of age, where the child begins to join several words to form sentences, however these are not yet recognized as sentences themselves.
However, approximately 50% of his 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 connective are lacking .
Stage of simple sentences
It occurs between two and a half years and three and a half years, where emissions are characterized by being brief, context-dependent and already recognized as sentences.
They usually make sentences of around 4 elements, use the pronoun me, answer simple questions, etc.
Stage of complex sentences
After 3 or 4 years the child presents more complex, free, and fluid emissions and not necessarily linked to the context. They have a good level of understanding and obey complex orders.
Children begin to join several simple sentences and have already acquired phonologically different sounds more complex.
Vocabulary is enriched, is able to define simple words and from the age of 6 they are able to perfect phonetic errors.