Spoken Language Disorders :The childhood condition we need to start talking about

Alka Raghu
BASLP, speech language pathologist
Tiny child development centre, Electronic City

A spoken language disorder represents a persistent difficulty in the acquisition and use of listening and speaking skills across any of the five language domains: phonology, morphology, syntax, semantics, and pragmatics. Language disorders may persist across the life span, and symptoms may change over time. A spoken language disorder can occur in isolation or in the presence of other conditions. Children who have experienced trauma may also exhibit language problems.

Developmental language disorder (DLD) is used when the spoken language disorder is a primary disability without a known medical cause and persisting at school age and beyond. DLD is also used when the language disorder co-occurs with other diagnoses such as attention-deficit/hyperactivity disorder or developmental coordination disorder, but the causal relationship is not as obvious.

Specific language impairment also appears in the literature. Some researchers may still use “specific language impairment” with distinctions from DLD.

Reading, Writing, and Social Communication in Spoken Language Disorders
Children with a spoken language disorder often have difficulty learning to read and write. A learning disability (i.e., reading or writing disorder) is identified when spoken language disorders negatively affect a child’s academic performance. Conversely, children with reading and writing problems tend to struggle with spoken language, particularly as it relates to higher order spoken language skills, such as expository discourse.

Language disorder associated with [condition] is used to describe a spoken language disorder that is secondary to another condition or diagnosis, such autism, Down syndrome, intellectual disability, traumatic brain injury, or sensory impairment. For example, “a language disorder associated with autism.”

Causes

Spoken language disorders have a variety of causes. In some cases, the cause is clearly environmental such as traumatic brain injury or fetal alcohol syndrome. Sometimes, the cause is due to a single affected gene, such as Down syndrome or fragile X syndrome. Most cases are due to multiple affected genes, such as autism, intellectual disability, and developmental language disorder (DLD). Genes are expressed in an environment, so environmental risks such as premature birth, exposure to tobacco smoke, or poor nutrition will increase the risk of language disorder.

Some children with language disorders may have social communication difficulty because language processing—along with social interaction, social cognition, and pragmatics—comprises social communication.

Signs and symptoms

Signs and symptoms of spoken language disorders vary across individuals, depending on

the language domain(s) affected,
the severity and level of disruption to communication,
the age of the individual, and
the stage of linguistic development.

Treatment

The goals of language intervention are to stimulate overall language development and to teach language skills in an integrated way and in context—with the aim of enhancing everyday communication and ensuring access to academic content. Goals are frequently selected with consideration for developmental appropriateness and the potential for improving the effectiveness of communication and academic and social success.

Spoken language disorders are heterogeneous in nature, and the severity of the disorder can vary. Each individual with language difficulties has a unique profile, based on their current abilities with language, hearing, cognition, and speech production. Many individuals with spoken language disorders can benefit from interventions that are family-centered. Family-centered care views speech and language services as a collaboration between the clinician, the client, and their family. Along with person- and family-centered care, individuals with spoken language disorders may also benefit from a strengths-based approach that affirms neurodiversity—including identifying the individual’s strengths, respecting the use of identity-first language, presuming competence, focusing on environmental supports, and allowing the individual to make their own choices.

Roles and responsibilities

Speech-language pathologists (SLPs) play a critical role in the screening, assessment, diagnosis, and treatment of preschool and school-age children with spoken language disorders. The professional roles and activities in speech-language pathology include prevention and education, screening and assessment, and intervention and support.