Speech of a child with alalia

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

Features and characteristics of the speech of children with alalia

Early identification 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 age of the child. The assessment may include any combination of standardized tests, as well as direct observation of the child's play, interactions with parents, etc. By a psychologist. 

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

The most difficult situation is with the defeat of both zones, which leads to an impressive-expressive or sensorimotor alalia. Lesions can 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 the age of five or more, or speech cannot be understood).

With different views on the essence of the perception and reproduction of speech and a variety 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 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 due to a deep systemic disruption of the synchronization of various levels of the motor-speech system, although the majority of children have cognitive capabilities for its normal development (i.e., there are no hearing and speech pathologies in children). Obviously, the whole point is the impossibility or violations of language operations in the process of recognizing sounds (as phonemic communicative units), identifying sensory information and forming a speech statement as a combination of lexical, grammatical and syntactic components.

According to experts, impressive speech with alalia means that the child has problems with the perception and understanding of the meaning of what they say (that is, the lack of connections between words and the objects they denote). And expressive speech in alalia indicates an underdevelopment of the mechanisms of speech utterance at the level of the motor speech analyzer of the cerebral cortex - in Broca's motor speech area, where algorithms for using all language systems are formed and fixed.

Speech of a child with motor alalia

Among the features of the speech of children with motor alalia - against the background of an adequate understanding of what was said by others - the following are noted:

• limited vocabulary;
• omissions of initial or final sounds in words;
• omissions and / or permutation of syllables in words;
• inventing your own "words" or using onomatopoeic substitutions instead of words;
• inability to spontaneously pronounce phrases, connecting two or three words;
• gross violations of the grammatical structure of the language (for example, gender, number and case of nouns or tenses of verbs);
• errors in the use of prepositions, etc.

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

Also read - Expressive speech disorder (general underdevelopment of speech) 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 someone else's speech.

In addition to the increased sensitivity of children to quiet sounds, among the characteristics of their speech: the inability to memorize individual words, extremely limited vocabulary, incoherent repetition of heard words and phrases (echolalia) - with omissions and substitutions, without understanding their meaning, with gestures and intonation changes. 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 a child is often combined with personality disorders and secondary cognitive deficits. [4]

Speech of a child with sensorimotor alalia

With a deep underdevelopment of the speech function, which is defined as sensorimotor alalia, the child does not have the opportunity to speak and understand someone else's speech. And a speech defect affecting all levels of speech organization is accompanied by impaired motor skills, attention, and hyperactivity syndrome.

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

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

Development of speech in autism

According to some studies, 64% of children may have impaired language development in autism and autism spectrum disorders - in the form of language delay. And nearly two-thirds of children with autism may have 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, but 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 - the strength, rhythm, tonality and articulation of spoken sounds), echolalia, permutation of words, grammatical inconsistency of sentences (the simplest in construction), clutter of speech with unnecessary and clearly inappropriate words. [6]