Language Disorders Health Article

Demographics

About one in six people, or 42 million individuals in the United States, have some type of communication disorder. About 28 million have speech, voice, or language problems associated with hearing loss, and about 14 million have similar problems not associated with impaired hearing. More than one million children in special education classes are categorized as having a speech or language disability.

Causes and symptoms

Language disorders can arise at many points in the language production process such as:

• from damage to the part of the brain that produces language
• from damage to the part of the brain that understands language
• from hearing loss
• from damage to the muscles and tissues of the mouth and throat needed for speech (e.g. cleft palate)
• from neurological disorders that interrupt the transmission of information necessary to receive and produce language
• from unknown (idiopathic) causes

Symptoms of language disorders vary widely, but include:

• slow acquisition of speech and language
• inability to make the physical sounds associated with language production (mutism)
• failure to make sense of spoken or written words
• inability to speak under certain social circumstances (selective mutism)
• transformations of words or sounds when speaking
• inability to recall known words

When to call the doctor

Parents should talk to their pediatrician immediately if their child appears to have hearing impairment. They should also consult with their doctor if the child does not babble or begin to use single words within the normal time frame. Parents of older children may need a referral to a speech and language specialist if their child stutters, lisps, has difficulty forming words or producing coherent speech, or exhibits certain learning disabilities.

Diagnosis

Speech and language disorders are usually diagnosed by a speech and language pathologist, often with the help of a pediatrician, audiologist (hearing specialist), and neurologist. Many assessment tests are designed specifically for use in children, including the Clinical Evaluation of Language Fundamentals (also available in Spanish); the Preschool Language Scale (also available in Spanish); the Test of Language Development, Primary; and the Test of Language, Intermediate. There are assessments designed to evaluate speech production, such as the Goldman-Fristoe test of Articulation.

Treatment

Treatment varies, depending on the type and cause of the language disorder. However, in all language disorders and delays, early intervention is key to improvement. Many educators of the deaf now urge early compensatory programs in signed languages, because the deaf child shows no handicap in learning a visually based language. Deaf children born to signing parents begin to "babble" in sign at the same point in infancy that hearing infants babble speech, and proceed from there to learn a fully expressive language. However, only 10 percent of deaf children are born to deaf parents, so hearing parents must show a commitment and willingness to learn sign language. Furthermore, command of at least written English is still a necessity for such children to be able to function in the larger community.

Speech therapy can be a considerable aid to many children with language disorders For example, it can help to make a Down syndrome child's speech more intelligible. Despite the delay, children with Down syndrome are often quite sociable and interested in language for conversation.

Surgery, followed by speech therapy, can correct physical deformities, such as cleft palate, that interfere with speech production.

Psychotherapy can help older children whose language disorders are psychologically based.

Prognosis

Prognosis varies on an individual basis, depending on the cause, type, and severity of the language disorder. Those children who receive early intervention therapies are more likely to have a better outcome than those for whom services are delayed.

Prevention

Many language disorders are not preventable. However, those that arise from damage to the fetus due to the mother's use of drugs or alcohol during pregnancy can be prevented by avoiding these substances.

Parental concerns

Language is such a critical part of our society that parents are justly concerned when their child has a language disorder. The parents' approach to the disorder can greatly influence the child's self-image, self-esteem, and ultimately his or her success in reaching the fullest language potential.

BOOKS

Bahr, Diane Chapman. Oral Motor Assessment and Treatment: Ages and Stages. Boston: Allyn and Bacon, 2001.

Freed, Donald B. Motor Speech Disorders: Diagnosis & Treatment. San Diego: Singular Pub. Group, 2000.