Speech Disorders
Formation of speech is one of the basic characteristics of the general development of the child. Speech for the child is the most important means of communication with the outside world, interacting with others, as well as information for the development of cognitive activity and thinking. Therefore, the development of speech is closely connected with the formation of all other mental abilities. Signs of the backlog in the development of speech is a reason for immediate treatment and a visit to the doctor (pediatrician, child neurologist, otolaryngologist, a child psychiatrist, a speech therapist, psychologist). This is especially important, because it is best to provide treatment in the first years of life (Hawk, 1999).
For the normal development of speech a certain level of formation of brain structures, articulation apparatus, hearing safety, and full speech environment from the first days of life is required. In the speech processes participate the speech cortex, located in the dominant hemisphere (in right-handers - left, left-handed - in the right) (Trinīte, Latsone and Miėelsone, 2008).
The reasons for the lag in the development of speech can be a pathology of pregnancy and childbirth, the influence of genetic factors, violations of the articulation apparatus, the fault of the organ of hearing, the total backlog in mental development of the child, social deprivation factors (lack of communication and education). Difficulties in the development of speech are also common among children with signs of lag in physical development, undergoing early severe disease, debilitated, malnourished. A much rarer diagnose of the delay in speech development is associated with the predisposition of the child to autism or general mental retardation. In such cases, the depth is shown through the neuropsychiatric examination.
The most severe disorders of speech are alalia. They are based on an insufficient level of development of the speech centers of the cortex of the cerebral hemispheres, which can be congenital or acquired in the early stages of ontogeny in the pre-speech period.
Alalia is a full lag of speech function, caused by organic damage to the speech areas of the cerebral cortex. Alalia underdevelopment is systemic, that is all of its components are infringed - phonetic and phonemic, lexical and grammatical. Unlike aphasia, in which there is a loss of previously formed speech, alalia is characterized by the absence of the original or a sharp restriction of expressive or impressive speech. Alalia is diagnosed in approximately 1% of preschool children and 0,6-0,2% of school age children; with 2 times more often this speech disorder occurs in boys. Alalia is a clinical diagnosis, which corresponds to the speech therapy n the case of underdevelopment (NICHCY, 2011).
Factors that lead to alalia are diverse and can act in different periods of early ontogenesis. Thus, in the antenatal period the organic infringement of the speech centers of the cerebral cortex may result due to fetal hypoxia, intrauterine infection (TORCH-syndrome), the threat of spontaneous abortion, toxaemia, falling pregnant with traumatization of the fetus, chronic somatic diseases of the mother (hypotension or hypertension, cardiac or pulmonary insufficiency). A natural result of aggravated pregnancy are birth complications and perinatal pathology. Alalia may result from newborn asphyxia, prematurity, birth trauma intracranial premature, transient or prolonged childbirth, the use of instrumental obstetrical benefits (NICHCY, 2011).
Among the etiopathogenic factors that evoke alalia in the early years of a child's life, should be highlighted the encephalitis, meningitis, head trauma, physical illness, leading to depletion of the central nervous system (malnutrition). Some researchers point to hereditary, familial predisposition to alalia. Frequent and prolonged disease of children in the first years of life (ARI, pneumonia, endocrinopathy, rickets and so on.), operations under general anesthesia, adverse social conditions (pedagogical neglect, hospitalist syndrome, deficiency of voice contacts) exacerbate the leading causes of alalia (Hawk, 1999).
Typically, children with a history of alalia, are diagnosed with a whole range of factors that lead to minimal brain dysfunction. Organic brain damage is caused by the slowdown of nerve cells maturation, which remain at the stage of young immature neuroblasts. This is accompanied by a decrease in neuronal excitability, the inertia of the fundamental nervous processes, functional exhaustion of the brain cells. Lesions of the cerebral cortex during alalia are not sharply defined, but multiple and bilateral in nature, which limits the possibility of self-compensatory speech development (Trinīte, Latsone and Miėelsone, 2008).
A survey of children with alalia
Children with alalia need counseling of the child neurologist, child otolaryngologist, a speech therapist, child psychologist. Neurological examination of children with alalia is necessary to identify and assess the nature and extent of brain damage. For this purpose, the child may be recommended the procedure of EEG, echoencephalography, X-rays of the skull, MRI of the brain. To eliminate hearing loss it is necessary to carry out otoscopy, audiometry and other studies of auditory function (Trinīte, Latsone and Miėelsone, 2008).
Neuropsychological examination of a child with alalia includes the diagnosis verbal memory. The logopedic examination of alalia begins with an explanation of the perinatal history and characteristics of early child development. Particular attention is drawn to the terms of psychomotor and speech development. Diagnosis of speech (impressive speech, lexical and grammatical structure, phonetic and phonemic processes, articulation and so on) is carried out according to the scheme of general speech underdevelopment analysis.
Methods and corrective action of any form of alalia should be of a psychological, medical and pedagogical character. Children with alalia receive the necessary assistance in specialized preschools, hospitals, correctional centers, and other facilities. Work on the speech is carried against the background of medical therapy aimed at stimulating the maturation of brain structures; physiotherapy (laser therapy, magnetic therapy, electrophoresis, UHF, hydrotherapy, IRT, transcranial stimulation, electrostimulation and others). In the case of alalia it is important to work on the development of general and hand motor skills, mental functions (memory, attention, ideas, thinking) (Crosbie, Holm and Dodd, 2005).
Given the systemic nature of the infringement, speech therapy classes for correction of alalia involve work on all sides of the speech. In the event of alalia the child is stimulated by speech activity; is working on the formation of active and passive vocabulary, phrase speech, grammatical registration statement; the development of coherent speech, sound pronunciation. The outline of the speech therapy sessions include logorhythmic treatment, logopaedic treatment and massage.
The key to success of correctional work on alalia is to start to treat it as early as possible (2-3 years), provide a complex, systemic exposure to all parts of speech, speech formation processes in unity with the development of mental functions (Crosbie, Holm and Dodd, 2005). To a large extent the prognosis of alalia depend on the degree of organic brain damage. During the schooling of children with alalia may appear disorders with writing (dysgraphia and dyslexia) (Trinīte, Latsone and Miėelsone, 2008).
Prevention of alalia in children includes the provision of favorable conditions for pregnancy and childbirth, early physical development of the child. Correctional work to overcome alalia can prevent the occurrence of secondary intellectual deficiency.
Conclusion
If a child is not speaking and not pronouncing any words at the age of 2 it is important to have him checked at the doctors. In the event of alalia it is important to start the treatment immediately as hindering may lead to grave consequences. Alalia is one of the most common illnesses that are the are the causes of speech lagging among children that can be diagnosed a early as 2 years.
References
Crosbie S., Holm A. and B. Dodd. (2005). Intervention for children with severe speech disorder: A comparison of two approaches. INT. J. LANG. COMM. DIS., Vol. 40 (4). pp. 467–491
NICHCY. (2011). Speech & Language Impairments. Disability Fact Sheet #11.
Trinīte B., Latsone L. and I. Miėelsone. (2008). Speech Therapy. Liepaja Academy of Pedagogy.
Hawk, S. (1999). Speech disorders: a psychological study of the various defects of speech. London: Routledge.
