Expressive speech disorder (general underdevelopment of speech) in children

Expressive language disorder (general speech underdevelopment) is one of the forms of specific speech development disorder, in which the child's ability to use spoken language is significantly below the level corresponding to his mental development, although the understanding of speech is usually not affected.

Classification

According to the speech therapy classification, expressive speech disorder corresponds to general speech underdevelopment of levels 1-3.

With general speech underdevelopment of the first level (alalia), the child is practically silent, while specific disorders of speech understanding and intelligence may not be detected (in most cases, intelligence is below average).

Causes and pathogenesis

The basis of the disorders is a delay in the maturation of neuronal connections caused by organic damage to the speech zones of the cortex (in the postcentral and premotor zones of the left dominant hemisphere in right-handers). There is evidence of the role of genetic factors. Of certain importance is an unfavorable social environment, in which the child comes into contact with people with a low level of speech development.

Symptoms

General speech underdevelopment of levels 1-3 is manifested by varying severity of expressive speech disorders. Poor vocabulary, low level of verbal generalization, difficulties in detailed speech utterance, agrammatisms (errors in the use of word endings, violations of word formation), difficulties in the use of prepositions, verbs, conjunctions are noted. Adequate use of non-verbal remarks, gestures, and a desire to communicate are characteristic. Impairment of spoken language becomes obvious from infancy without any long phase of normal speech use. And although normal speech development is largely individualized, the absence of individual words or speech formations close to them by the age of two or simple phrases of 2-3 words by the age of three should be regarded as a sign of delay. Speech underdevelopment inhibits the development of the child's cognitive activity, which is often manifested by a delay in mental development in general.

Differential diagnostics

Differentiation from secondary disorders caused by deafness is based on audiometric examination data and the presence of qualitative pathological signs of speech pathology.

Differentiation from acquired aphasia or dysphasia caused by neurological pathology is based on the statement of the period of normal speech development before the injury or other exogenous-organic effects, manifestation of the endogenous organic process. In doubtful cases, instrumental methods (EEG, EchoEG, MRI of the brain, CT of the brain) are used to conduct differential diagnostics and establish the anatomical lesion.

Differentiation with general developmental disorders is based on such signs as the absence of imaginary play in children with general developmental disorder of the internal language, inappropriate use of gestures, disorders in the non-verbal sphere of intelligence, etc.

Treatment

Speech therapy courses, sessions with a psychologist, consultation treatment with a psychiatrist as indicated.

Forecast

The maximum possible development of speech function and compensation of mental and psychoneurological disorders.

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