Speech of a child with alalia

In children, a systemic delay in speech development, as one of the higher mental functions of the brain, is called alalia, which can be motor (expressive), sensory (impressive) or mixed - sensorimotor. How does the speech of children with alalia differ? [ 1 ]

Features and characteristics of speech in children with alalia

Early detection of this problem increases the chances of improving the child's communication skills. And the examination of the speech of children with alalia is carried out during the study of the neuropsychic sphere - in accordance with the child's age. The assessment may include any combination of standardized tests, as well as direct observation of the child's play, interaction with parents, etc. by a psychologist.

The functional neuroanatomy of speech processing – despite decades of research – is not fully understood. And from a neuroanatomy perspective, in children with alalia, the functions of the speech centers of the cerebral cortex, localized in the temporal gyri of the left hemisphere, are impaired. In motor alalia, dysfunction is associated with Broca's area (responsible for the algorithms of the language systems used in oral speech), and in sensory alalia, with Wernicke's area, responsible for the perception and understanding of speech, closely associated with the primary auditory cortex of the temporal lobe, which processes and codes auditory information. [ 2 ]

The most difficult situation is when both zones are damaged, which leads to impressive-expressive or sensorimotor alalia. Damage may also affect the lower primary motor cortex of the brain, the cortex and subcortex of the frontotemporal lobes, the angular gyrus of the parietal lobe, areas of white matter, etc.

Speech impairments can be mild, moderate, or severe (when a child may not speak until age five or older, or their speech cannot be understood).

With different views on the essence of speech perception and reproduction and a multitude of concepts of its sensorimotor integration that exist today (in particular, the model of two-stream phonological, orthographic and semantic processing of speech signals, according to which the ventral stream processes these signals for understanding, and the dorsal stream sends them to the articulatory networks of the frontal lobes), the neuropsychological mechanisms of speech impairment in children with alalia are still explained in different ways.

However, everyone agrees that alalia in a child is caused by a profound systemic disruption of synchronization of various levels of the motor-speech system, although most children have the cognitive capabilities for its normal development (i.e., there are no pathologies of hearing and speech apparatus in children). Obviously, the whole point is in the impossibility or disruption of language operations in the process of recognizing sounds (as phonemic communicative units), identifying sensory information and forming a speech utterance as a set of lexical, grammatical and syntactic components.

As experts note, repressive speech in alalia means that the child has problems with perceiving and understanding the meaning of what is being said (that is, the lack of connections between words and the objects they denote). And expressive speech in alalia indicates underdevelopment of the mechanisms of speech utterance at the level of the speech motor analyzer of the cerebral cortex - in the speech motor area of Broca, where the algorithms for using all language systems are formed and consolidated.

Speech of a child with motor alalia

Among the speech characteristics of children with motor alalia - against the background of adequate understanding of what others say - the following are noted:

• limited vocabulary;
• omissions of initial or final sounds in words;
• omissions and/or transposition of syllables in words;
• making up your own "words" or using onomatopoeic substitutes for words;
• inability to spontaneously pronounce phrases by combining two or three words;
• gross violations of the grammatical structure of the language (for example, gender, number and case of nouns or verb tenses);
• errors in the use of prepositions, etc.

A child with motor alalia cannot say what he wants or needs and often resorts to gestures or onomatopoeia. [ 3 ]

Also read - Expressive language disorder (general speech underdevelopment) in children

Speech of a child with sensory alalia

As already noted, the main problem of children with sensory alalia is the gap between the sound of words and their meanings, as a result of which they simply do not understand either their own or other people's speech.

In addition to the increased sensitivity of children to quiet sounds, their speech characteristics include: inability to remember individual words, extremely limited vocabulary, incoherent repetition of words and phrases heard (echolalia) - with omissions and substitutions, without understanding their meaning, with gesticulation and changes in intonation. This once again emphasizes the presence of dissonance in the verbal and non-verbal structures of mental activity.

According to experts, this type of speech and language development disorder in children is often combined with personality disorders and secondary cognitive deficits. [ 4 ]

Speech of a child with sensorimotor alalia

With profound underdevelopment of speech function, which is defined as sensorimotor alalia, the child lacks the ability to speak and understand someone else's speech. And the speech defect, affecting all levels of speech organization, is accompanied by a violation of motor skills, attention, and hyperactivity syndrome.

With sensorimotor alalia, children initially lack speech; such a child does not respond to the mother's voice or his name; does not remember the names of objects, does not show them in a picture, does not follow the simplest verbal instructions. The sounds produced are similar to incoherent babble and have no meaning.

As speech therapists say, correction, that is, the initiation and development of speech in alalia associated with damage to both cerebral speech areas (Broca and Wernicke) is often impossible. [ 5 ]

Speech development in autism

According to some studies, 64% of children with autism and autism spectrum disorders may have impaired speech development – in the form of delayed language acquisition. And almost two-thirds of children with autism may suffer from apraxia – a speech disorder in which it is difficult to coordinate the use of the tongue, lips, mouth and jaw to articulate speech.

And although at the initial diagnosis children with autism are often silent, this is not a lesion of the speech zones and not alalia in autism. Violations are noted in the form of monotony of speech (due to problems with prosody - strength, rhythm, tonality and articulation of sounds), echolalia, word transposition, grammatical inconsistency of sentences (the simplest in structure), cluttering of speech with unnecessary and clearly inappropriate words. [ 6 ]