Disorder of speech and language development in a child

Speech and language development disorders are a group of disorders in which normal speech development is disrupted from an early age and is in significant discrepancy with the overall level of cognitive functioning.

ICD-10 code

• F80.0 Specific disorder of speech articulation.
• F80.1 Expressive language disorder.
• F80.2 Receptive language disorder.
• F80.8 Other developmental speech disorders.

Epidemiology

There is no precise data on the prevalence of specific disorders of speech and language development, since there are no clearly defined boundaries with extreme variants of the norm. The fact that these conditions predominate in boys has been established.

Causes and pathogenesis of speech and language development disorders

The cause of specific speech and language disorders is complex and not fully understood. Presumably, the disorders are based on a delay in the maturation of neuronal connections caused by organic damage to the speech zones of the cortex. Environmental factors may influence the disruption of the developing speech function, but they are not of primary importance. There is evidence of a significant role of genetic factors.

Symptoms of speech and language development disorders

The main clinical characteristic of specific disorders of speech and language development is the late acquisition of spoken language (in comparison with age norms), which, unlike mental retardation, does not correspond to the general level of cognitive functioning of the child.

Diagnosis of speech and language development disorders

The course of ontogenetic development, including the development of speech and language, is genetically programmed. The degree to which this program is implemented largely depends on the surrounding conditions - the characteristics of upbringing, emotional and sensory deprivation, additional exogenous-organic effects on the developing brain. Each child has individualized rates and timing of speech development. Speech development is assessed by comparing the timing of the formation of individual speech functions with the development standards typical for most children.

Stages of speech development in a normal child (G.V. Kozlovskaya et al., 2007).

• By 8 months, expressive speech is characterized by active babbling, speech imitation, syllabic speech; receptive speech is characterized by understanding the first verbal instructions: “give”, “where”, “on”.
• By 10 months, expressive speech is characterized by paired babbling words, copying the intonation of an adult, and receptive speech is characterized by understanding permission, prohibition, and a number of other verbal instructions.
• By 12 months, expressive speech is characterized by a vocabulary of 8-10 words; receptive speech is characterized by the subject-matter correlation of words and specific situations, understanding of addressed speech, and individual instructions.
• At the age of 1 year 3 months, expressive speech is characterized by the presence of a vocabulary of 10-30 words; receptive speech is characterized by understanding the image of individual objects and situations.
• By 1 year 9 months, the vocabulary increases to 60, the first phrases appear; the child follows simple instructions, recognizes objects in the picture.
• A rapid leap is noted by two years. Vocabulary is 200-300 words, the first questions appear. For impressive speech by this age, understanding the name of actions in various situations, two-stage instructions is characteristic.
• By the age of three, most children have developed phrasal, emotionally expressive speech. The child retells simple poems and fairy tales. Understands and uses the question "why?" in speech, understands the meaning of the prepositions "under", "from", "on", "in", etc.

Treatment of speech and language disorders

Correction of specific speech development disorders requires a professional approach with the participation of a speech therapist, defectologist, psychologist, psychiatrist, depending on the severity and type of disorders, the presence of concomitant psychological problems and psychopathological disorders.

The complex of treatment and rehabilitation measures includes a combination of speech therapy, psychotherapy and symptomatic drug treatment. The educational system provides the following forms of assistance to this group of children:

• speech therapy kindergartens and preschool educational and training complexes for children with speech impairments;
• special (correctional) general education schools for children with speech pathology (“speech” schools);
• centers for psychological, medical and social support.

The healthcare system includes specialized children's speech pathology centers in the form of structural divisions of research institutes, large hospitals and outpatient facilities.

Forecast

A tendency for the manifestations of speech disorders to decrease as the child grows older.

Prevention

Creation of social and psychological conditions for normal speech development for a child from an early age. Early detection of congenital or acquired forms of speech pathology with the implementation of adequate treatment, rehabilitation and pedagogical measures.