Dysphasia - a developmental speech disorder. Delayed speech development in children
Problems with speech development in children are becoming more and more common. Of course, not every failure in pronunciation, error in reading, writing or misunderstanding of verbal instructions needs to be diagnosed. But what if it is a specifically disturbed speech development manifested chronologically? In such a case, one may encounter the term dysphasia, which defines a systematic disturbance in the area of speech development. One or more areas in the development of speech may be impaired, and they manifest themselves with increasing age. Problematic speech development also affects the child's psychological profiling. Subsequently, the child's communication skills (NCS) are impaired and a complex problem arises, which can manifest itself in the overall inability to use language. How does delayed speech development manifest itself? Do exercises help with dysphasia? What is expressive dysphasia?
Author:Michelle Robinson
Updated: 07.12.2023
Did you know that approximately 4 to 7% of children suffer from impaired communication skills, i.e. developmental dysphasia? If it seems to you that your child lags significantly behind his peers in communication, speech development is slowed down, the creation of sentences or grammatical constructions is a problem, vocabulary is not increasing and there is also a problem with understanding, it is necessary to pay attention. However, the diagnosis of developmental dysphasia is a relatively complicated and complex matter. Impaired speech development - developmental dysphasia can only be diagnosed roughly between the 3rd and 4th year of life, sometimes the diagnosis takes place even later (5th - 7th year). It is also necessary to distinguish whether impaired speech development is not an accompanying symptom of another disorder in the child. How does such specifically impaired speech development manifest itself in children?
Dysphasia - a developmental speech disorder and its causes
In connection with speech disorders and speech development in children, it is sometimes very difficult for parents to determine what complication they are dealing with in a certain period of time in their child. If you notice significant speech deficits in your child, it is best to contact an expert - a pediatrician or a speech therapist, to perform an initial diagnosis and determine the procedure. In certain phases, it is natural that some children's speech development is slowed down and their communication skills are weakened. Chronologically and with the contribution of speech exercises, these deficiencies are reduced. It can be a problem if there is a systematic disruption of areas of speech development during the child's growth.
Problems (symptoms) are typical for developmental dysphasia, such as difficult sentence and sentence formation, incomprehensible words, small vocabulary, active communication and understanding of spoken speech is a problem. It can also affect other areas - worse memory, insufficient concentration, impaired motor skills.
The definition of dysphasia has several specifics. In simplicity, it could be said that dysphasia represents delayed speech development, disproportionate to the child's age. However, from a comprehensive point of view, the definition of this disorder is much broader. Primary developmental dysphasia is characterized by the fact that the child's speech development lags behind other areas and the reason is not another developmental disorder. While mental age, physical and mental development progress, the child's speech skills stagnate. Impaired speech development can also be a symptom of another health complication - diagnosis (cerebral palsy, mental retardation, autism, vision or hearing impairment, surgery or brain injury, trauma). In such a case, these are secondary symptoms of another phenomenon and other disorders may also be diagnosed.
The symptoms of dysphasia themselves are very variable, because there are several types of dysphasia. Some professional literature mentions four types, but you will also find professional sources that talk about mixed dysphasia, which can include all the other types and can present with mixed symptoms.
- Expressive dysphasia - manifests relatively inconspicuously, speech development begins relatively naturally in children, but later stagnates, the vocabulary does not expand, the child tries to communicate, but uses more gesticulation and action (non-verbal communication), verbal expressions lag behind.
- Phonological dysphasia – the child has a problem distinguishing sounds, spoken speech, there is a problem with the perception and analysis of speech, the development of speech slows down and articulation defects appear.
- Receptive dysphasia - the child perceives the acoustic signs of speech, but cannot distinguish them, so problems with understanding appear. The child finds it more difficult to orientate, does not perceive associations, simple opposites, lags behind in abstract thinking and demands repetitive rituals. Such impairment of communication skills can easily be confused with autism.
- Mixed dysphasia – diagnostically, it appears most often, because it combines expressive, phonological and receptive symptoms of impaired speech development. It is typically manifested by an insufficient ability to understand the spoken word, and at the same time it is difficult for the child to compose grammatically more complex sentence structures, the content of verbal communication is imprecise and inappropriate words are often used.
Causes of developmental dysphasia
In practice, brain dysfunction is considered the most common cause of developmental dysphasia. Developmental dysphasia is not related to direct damage to the brain, but can often involve slight abnormalities on the cerebral cortex. These subtle abnormalities affect the left hemisphere of the brain, where the speech center is located. Some experts attribute the occurrence of developmental dysphasia to insufficient oxygen supply to the brain during pregnancy or during childbirth. For example, premature babies or babies with a low birth weight are at risk.
Some opinions, in turn, refer to genetic anomalies that affect neuronal processes in the brain and cause its suboptimal activity. Thus, in case of occurrence, such specifically impaired speech development usually also appeared in parents or grandparents. Researchers also point to the lack of knowledge of parents regarding the development of speech in children and speech stimulation. Parents may neglect the interaction between them and the child and thus do not provide him with enough speech stimuli for optimal speech development. Within the framework of specific theories about the causes of the occurrence of this speech disorder, a wider dimension should be perceived, because the causes of the occurrence are usually multifactorial.
A specific category in determining the causes of dysphasia is the situation when it is a disturbance of speech development due to another primary disease. It can even be physical obstacles that complicate the child's speech and cause his delayed development.
It is important to realize that developmental dysphasia is not associated with physical damage to the speech organs or the brain, but rather to deviations in the neurological development of the brain. The occurrence of dysphasia can vary and its causes are not always clear. Therefore, it is important that children with suspected developmental dysphasia are diagnosed as soon as possible and receive appropriate therapy that will support their speech development and improve impaired communication skills.
Developmental dysphasia - symptoms
The variability of symptoms and manifestations in children with developmental dysphasia is the biggest complication for the diagnosis of this disorder in speech development. Very often, due to a large number of symptoms, it happens that it is confused with a classic delay in the development of speech. However, the symptoms of developmental dysphasia can be distinguished from classic delayed speech development by the fact that they do not only concern speech production itself, but are also related to understanding, and deficits in memory function, graphomotor and fine motor skills also appear. What signs of developmental dysphasia should be observed in a child?
- Delayed speech development.
- Worse pronunciation of words, mutilation and shortening of longer words, confuses sounds and syllables.
- Incorrect word order in a sentence, bad inflection, bad stylization of sentences.
- Significantly limited vocabulary, using the same words to express other phenomena.
- Problem with combining words and using prepositions or pronouns.
- Insufficient ability to understand speech, use of non-verbal expressions - gestures and abstract concepts.
- Deficiencies in the field of graphomotorics and fine motor skills - shaky lines, worse use of space when writing, impaired orientation in space during movement games.
- Short-term memory deficit, the child does not respond to the parent's instructions.
- A non-uniform lateral preference appears, with neither hand being preferred (less common occurrence).
- Worse ability to establish contacts in the collective, searching for family members due to the feeling of better understanding.
- The child may speak little and is unable to hold a dialogue.
Most often, the first serious symptoms appear when starting kindergarten. Manifestations of dysphasia also have a negative effect on the child's psychological development. The problem is not only creating bonds with your surroundings. Manifestations of developmental dysphasia are not only related to a lack of ability in speech production, they also affect the child's emotionality, affect the ability to learn later (note: problems with reading and writing may also appear - dyslexia, dysorthography), such children develop low self-esteem, can have a feeling of inferiority, they avoid success because they don't know how or are afraid to express themselves. However, children with developmental dysphasia usually do not have deficits in intellect or mental development, and only minor deviations may appear.
Dysphasia or autism?
A child with dysphasia is often unable to be spontaneous, is tight-lipped and unable to activate his adaptation mechanisms. He prefers repetitive rituals that give him the feeling that he knows something, understands it and can express it. It is not as frustrated by potential failure or ridicule. Such children are emotionally weakened, and the frustration of their apparent "lack" causes them to have a low level of tolerance. Such children are subsequently relational, rejecting, conflictual or even aggressive, and various behavioral and concentration disorders can be added.
Some features are typical of autism in children with developmental dysphasia. Delayed speech development is typical for autism. Autistic children require repetitive activities, they are afraid of changes and the process of adaptation and the ability to tolerate something/someone is difficult for them. Therefore, it sometimes happens that a parent indicates symptoms typical of dysphasia, but confuses them with autism. The situation can also be the opposite.
Diagnosis of dysphasia - NKS
In order to establish a diagnosis, it is necessary to seek the help of specialists. In diagnosis and subsequent therapy, it is very important that the cooperation of individual experts works. It is usually a three-leaf clover of a speech therapist, a neurologist and a child psychologist (note that a specialized phoniatrician may also be involved). The cooperation of preschool and elementary institutions that the child attends is also necessary. The above-mentioned symptoms of dysphasia can be removed or reduced to the extent that they will not cause any significant handicap to the child with early diagnosis and therapy. Accurate diagnosis can only be performed at the age of 3-4 years. Until this period, it is only a suspicion of this developmental speech disorder and it cannot be confirmed in any way. In some cases, experts can confirm dysphasia only in the higher school age of 6-7 years.
An examination by a pediatric neurologist determines whether there is an obvious neurological disorder behind such symptoms. The speech therapist's task is to diagnose the level of speech expression and speech understanding. It also focuses on articulation and grammar - the verbal part. Many experienced speech therapists also rely on their own experience, because they know several chronic symptoms from practice. The psychologist focuses on non-verbal phenomena and comparatively monitors the child's performance in the field of verbal expression. If non-verbal expressions are more dominant in communication, this is a clear manifestation of developmental dysphasia. During the diagnosis, it is important that the psychologist and the speech therapist mutually evaluate whether the child lags behind in the language and speech areas or whether other cognitive functions are also impaired. Impaired communication skills (NCS) do not automatically mean the occurrence of dysphasia.
Dysphasia - therapy and exercises
Therapy related to developmental dysphasia is long-term. Due to the fact that these children often have learning difficulties at school age, it is important to eliminate these deficiencies with appropriate therapy. Therapy, as with many other speech disorders, is complex. As a child with dysphasia is not only a problem with pronunciation, but also with comprehension or grammar, gradual goals must be set. The therapy itself is very individual. The speech therapist, in cooperation with the psychologist, determines the ideal methods of treatment. It is not true that a psychologist should be sought only if the child already has emotional difficulties.
The treatment proceeds systematically in order to achieve partial goals. It is advisable to leave the procedure to a speech therapist. Parents should follow his recommendations, which will ensure high-quality and sufficient communication. If the child attends primary school, the special pedagogue must know the entire history and details of the diagnosis in order to adapt the teaching method to the child. There are methods and exercises for dysphasia and eliminating its manifestations. However, they must have an exact sequence. The correct use of grammatical procedures, articulation and others are systematically rehearsed. The manifestations of dysphasia are gradually compensated by appropriate procedures.
Parents are recommended to read short texts with their children, look at interactive books and communicate about what the child sees, supporting his communication skills. The parent must pay attention to the correct pronunciation and sentence structure. The development of comprehension is crucial for a child to acquire spoken language. At the same time, the child concentrates more on pictures than on a long continuous text. Repeating the same texts line after line is also great for developing articulation. Learning short texts by heart is also good for the development of memory and speech. With early diagnosis, several parents decided to postpone compulsory schooling by one year, so that the subsequent schooling of the child could take place more efficiently. A suitable solution can be the zero year.
Dysphasia (delayed speech development) - experiences
The topic of dysphasia is also addressed on various forums and in several discussions. Above all, mothers and parents exchange their experiences with the symptoms, subsequent diagnosis and therapy of this speech disorder. In case of suspicion, most mothers recommend first an examination by a neurologist, who can determine with examinations whether it is a neurodevelopmental disorder. Subsequently, a visit to a speech therapist and a psychologist is necessary. Many mothers observe symptoms such as non-verbal communication with gestures, poor vocabulary or problems with reading and writing. According to them, children with dysphasia also have difficulty using extended sentences and cannot hold a dialogue. Some mothers also pointed to motor deficiencies that were related to uncoordinated movement. One of the mothers helped the child with each word with visualization, flashcards and pictures, thanks to which his understanding also developed. However, the debaters agree on one thing – that professional diagnosis and therapy are needed.
The most frequent questions - FAQ
Have you noticed a problem with your child's speech development? Do you notice a growing gap between your child's speech skills and other peers? Despite the fact that delayed speech development may not immediately mean the emergence of a serious speech disorder, deficiencies in speech development should be noted. Impaired speech development can also originate from another developmental disorder in a child - cerebral palsy, hearing impairment, vision disease, autism, or it can even be a phenomenon occurring after a brain injury. There can be a wide spectrum of causes, as well as symptoms of dysphasia. Do you have experience with impaired speech development - dysphasia? We will be happy if you share your experience, tips, advice and recommendations in the discussion below the article.
What are the symptoms of developmental dysphasia?
What is expressive dysphasia?
How do children with dysphasia read?
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