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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