Definition and Components of Language and Speech

• Language: A communication system acquired through use, involving symbols sequenced to share attention and ideas.
• Speech: One mechanism for expressing language, but other methods like gestures, sign language, and iconic symbols can also be used.

Pre-linguistic Skills and Joint Attention

• Joint attention, the ability to share focus with another, is crucial for language acquisition.

Disorders Affecting Speech and Language Acquisition

• Defined by inclusionary (specific deficits) and exclusionary (absence of other explanations) criteria.
• Common conditions disrupt the typical progression of speech and language in children, measured relative to peers.

Diagnostic Criteria

• ICD-10 (WHO) and DSM-5 (APA) provide classifications:
  • ICD-10 distinguishes receptive, expressive, and mixed disorders.
  • DSM-5 groups these under "communication disorders" with subcategories:
    • Language disorder
    • Speech sound disorder
    • Childhood-onset fluency disorder (stuttering)
    • Social (pragmatic) communication disorder
    • Unspecified communication disorder

    Speech Disorders

    • Speech sound disorder: Persistent difficulty with speech sound production affecting intelligibility.
    • Dysfluency (e.g., stuttering):
      • Repetition of sounds, syllables, or words; silent blocks; and associated physical movements.
      • Often resolves between ages 3-5 but can become chronic with risk factors like family history.

      Pragmatic Language Impairment

      • Affects everyday language use without the social and behavioral features of ASD.

      Severe and Rare Conditions

      • Childhood Apraxia of Speech (CAS)/Verbal Dyspraxia: Impaired motor planning for speech, debated underlying mechanisms.
      • Dysarthria: Weakness or involuntary movements affecting articulation, often in acquired disorders.
      • Phonation Issues: Problems with voice projection and breath control, worsening intelligibility.

      Neurological Paroxysmal Disorders

      • DSM-5 includes speech and language disorders linked to epilepsy, affecting development and acquired abilities.
      • Certain anticonvulsants may exacerbate speech issues.

      Prevalence and Demographics

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      Information

      Published:04 January 2025 Last Updated:04 January 2025