Learning Problems-The-

Speech disorders

definition

If children cannot develop normal speech or language development, later disorders occur. In addition to delayed language development, language and speech disorders in Stammering, rumbling and stutter express.

In order to be able to give an assessment of the language development, paediatricians, ear, nose and throat doctors, psychologists, pedagogues and speech therapists orient themselves on language development stages that have arisen from experience.

Language development

Language is an important means of communication for us humans. Normal language development begins around the second month of life with "babbling" and is completed with language acquisition at the age of seven.
Vocabulary, style, pronunciation and sentence length are of course expanded and refined as you grow up. The table gives an overview of the children's language development. It is the result of years of observation. Deviations vary from person to person and do not have to represent an abnormality!

You might also be interested in: Language disorder in children

From the 2nd month: Lallen = first vowels, screams
From the 8th month: repeat attempts and some language comprehension
From the 1st year: First words
At the age of 1.5: two-word sentences "da Mama"
At the age of 3: multi-word sentences "go to grandma today"
From 4 years: grammatically correct sentences, pronunciation sometimes still incorrect
At the age of 7: language acquisition completed, elementary school entrance qualification

Normal language development requires a functioning system of several organs. Facial muscles, tongue, jaw and teeth, larynx and vocal cords, brain, breathing and abdominal muscles must work together in a coordinated manner to ensure normal language development.

Is there damage in one of these organs (e.g. Macroglossia = tongue too big; Paraplegia in spina bifida), speech development can be more difficult and delayed.
Due to the many causes inherent in delayed or defective language development, various specialists are also involved in finding the cause (etiology). These include above all paediatricians, child and adolescent psychiatrists, ENT doctors, neurologists and speech therapists (speech therapists).

What forms are there?

Strictly speaking, there must be speech disorders and speech disorders independently be defined from each other.

One speaks of a language disorder when the ability to form language is impaired on the neurological level. This means that a person with a language disorder is mentally incapable of language formation. Speech disorders can be differentiated between different manifestations. The development of language can be delayed or absent, and a person can lose the ability to speak and understand language. This phenomenon is called aphasia and occurs, for example, in Alzheimer's dementia or after a stroke. In addition to the inability to generate speech, it also happens that only speech understanding is disturbed. So people can still hear, but they don't understand what is being said.

In contrast to the speech disorder, it is not the neurological level of language formation that is disturbed in a speech disorder, but the motor level. The speech disorder leads to the fact that speech understanding and the development of language are normal, but articulation is disturbed. In the case of speech disorder, a distinction can be made between disorders of the flow of speech, such as stuttering, and a disorder of speech motor skills, for example lisp.

What is an expressive language disorder?

An expressive language disorder is understood to be a language development disorder that affects the use of language. This means that the person concerned understands language, but is not able to express himself adequately. So children are not able to express themselves according to their intelligence quotient.

The range of expressive language disorders is large, there may be a lack of language or a complete lack of language. Those affected try to compensate for the linguistic deficit through facial expressions and gestures. Speech understanding, on the other hand, is not affected in an expressive language disorder. In contrast to expressive language disorder, the receptive language disorder impaired speech understanding.

Subforms of language and speech disorders

What is stammering?

Stammering, dyslalia, dyslalia, engl. Stammer
These are sound formation errors and articulation disorders. Up to the age of 4, sound formation errors are considered normal. The most common form of stammering is lisp, whereby the S-sounds are formed incorrectly.

What is rumbling?

Rumble, engl. Battarism

Rumbling is a speech disorder in which people speak very quickly or the pace of speech fluctuates. In addition to this irregular speaking pace, parts of the sentence are also partially omitted. This can be expressed in that Merging words together or Parts left out become. A person with a rumbling speech disorder can be very difficult to understand. Sometimes what is said is completely incomprehensible. It is difficult for those affected to control their language.

The fact that interlocutors often do not understand what is being said and do not have to ask questions can lead to a fear of speaking among those affected. Another characteristic of rumbling speech disorder is that those affected have difficulty in structuring what is being said. A problem that is directly related to this is that it is very difficult for those affected to formulate a sentence differently if the interlocutor has not understood it and asks.

Sufferers can learn to speak more slowly and with emphasis through various techniques. If you speak slowly and carefully, the language becomes more understandable and the speech disorder takes a back seat.

What is stutter?

Stuttering, Balbuties, engl. Stutter

Stuttering is a disturbance of the flow of speech caused by a disturbance of the coordination of the speech muscles. There are frequent interruptions and repetitions of sounds. One can distinguish two forms of stuttering, on the one hand the clonic form, where sounds are repeated at the beginning of a word, e.g. "B-B-B-uch“And on the other hand the tonic formin which a sound is drawn out within a word, e.g. "Ko-f-f-f-fer“.

Stuttering often occurs for no apparent reason, and there is no evidence that stuttering is caused by nervousness. However, stuttering increases nervousness and can cause anxiety. Stuttering can be treated by various techniques, so the symptoms can be alleviated and the stuttering is less pronounced. However, stuttering is not curable.

More information can be found here: stutter

General causes of speech and language disorders

The exact cause of the various language disorders is sometimes not known. Rather, a disruption to various influences on language development is suspected.
Scientists call this a "multifactorial genesis“.

So what factors can influence a language disorder? The following points should above all prepare parents for an initial discussion with the pediatrician. Parents will initially deal with these or similar questions and explanations:

Genetic factors
A fault is preprogrammed from the start. Is there an intellectual disability? Is there an autism (pathological self-centeredness, inability to make contact)?
Social factors
Is the language and speaking of the parents wrong? Is speech only perceived through the television? Is there a lot of arguments and is language used in the family to fight?
Cultural factors
Is there hardly any talk in the family? Does the child grow up bilingual? Have you often changed schools and spent time abroad?
Psychological factors
Does the child have any drive to speak at all? Are there any inhibitions about linguistic expression? Is it stimulated to speak? Does the child have an audience?
Sensory factors
Does the child hear correctly? Is it interested in its environment? Are there appropriate reactions to the situation? Do you have autism?
Motor and physiological factors
Does the Facial muscles, Chewing, screaming? Has the tooth development been normal? Could there be brain damage? Are there any known accidents or falls?

How do I recognize a language disorder in my child?

There are different forms of speech disorders, so they can express themselves very differently. The so-called speech disorders, such as Stammer, stutter or Rumble. With these forms you can see that the way you speak is unusual and does not correspond to the language you are used to. It is more difficult for parents to recognize when children start speaking too late and understand language.

There are guidelines as to what children should be able to do at what age, but it is difficult as a parent without professional support to see whether the child is only able to speak a little late or whether there is a really manifest language disorder. It is therefore advisable to attend the routine examinations at the pediatrician, as this can also reveal abnormalities in language development.

Learn more about this under: Speech disorder in children

Diagnosis of language and speech disorders

Parents usually notice a speech or language disorder. Parents may only notice a disorder incidentally or assume that it will subside with age. In doubt parents should be first inform the educating teachers.
Kindergarten teachers and elementary school teachers often have a good feeling for the linguistic performance that a certain age group should actually achieve.

However, an exact consultation and diagnosis takes place with a specialist. In the first place, a pediatrician should be consulted. If necessary, he or she will arrange a referral to an ENT doctor or a speech therapist. All will put the child's language ability in relation to age and stage of development.

Bumpy and unclear language can e.g. should still be quite normal and should not be a cause for concern for parents.

Some ENT doctors have the additional designation "Phoniatrics and Pedaudiology". These ENT specialists are usually familiar with the diagnosis and treatment of speech and speech disorders.

Medication

There are not yet any drugs against stuttering itself. However, drugs against states of tension and anxiety (anxiety) can alleviate certain situations and thereby improve the symptoms.

Child and youth psychiatrists can give the best advice on this. You have a wealth of experience in anxiety therapy and know the spectrum of anti-anxiety drugs (Anxiolytics).

Find out more at: Overview of anxiety disorders

When does the stutterer feel relief?
What should accompany every therapy?
What can parents and teachers do?

When the caregivers stutter listen patiently, let him finish and respond with understanding, this usually leads to a joy in speaking for the stutterer and makes it easier for him to control his own flow of speech.

Stuttering should not be considered in the family. On the contrary, corrective interventions by others, impatience and unacceptance promote a stressful situation and make it difficult for the person concerned to speak.

The latter mainly takes place in school. Children quickly recognize that they can weaken and offend their stuttering classmate, are happy to correct them and annoy them with smiles and ignorance. Parents and teachers should therefore not be afraid to openly address the situation in the class in order to appeal to the understanding of their classmates!

The person concerned usually does not like to talk about such teasing and skilfully hides his shame from the educators and parents.
Here, too, open discussions should be held every now and then in order to assess the child's situation and, if necessary, take action.

Supportive forms of therapy

Speech therapy

Speech therapy is a specialty in medicine that deals with impairments of speech, voice, speaking, hearing and swallowing. Speech therapists are particularly important for the early diagnosis of impairments in children that would lead to a disturbance in language development in the child. So it has to be recognized when a child speaks too late.

In addition, the cause of the delayed language development must be found. Often the reason for this is the child's hearing loss, which must be recognized and treated as early as possible in order to enable the child to communicate with the environment as normally as possible. Often speech therapists not only deal with the spoken word, they are also consulted if one Written language acquisition disorders present that earlier Reading and spelling weakness was called.

The age of speech therapy patients is broad and includes all age groups. In addition to children with language and speech disorders, adults are also treated who have developed problems with speech due to various illnesses. Swallowing therapy is also important in this group of patients, as there are often swallowing disorders.

Occupational therapy

Occupational therapy is a form of therapy in which targeted occupation is achieved that makes more sense for the individual, strengthening the person concerned so that he can cope with everyday life and thus improve the quality of life. Occupational therapy can support a lengthy speech therapy treatment and support the development of language. The motor skills of the child can thus be consolidated in a playful way.

Speech disorders due to stress

Speech disorders can be triggered by stress. Under certain circumstances, stress can lead to aphasia, which means that the person concerned can suddenly no longer speak. This aphasia can occur especially in acute stressful situations, such as after a car accident or the loss of a loved one. This aphasia can be temporary or, in very severe cases, permanent.

With speech disorders one has to differentiate. While stuttering is not triggered by stress, stuttering itself does trigger stress in those affected. Rumbling can be triggered by stressful situations if it can be deliberately suppressed under normal conditions.