LANGUAGE

DISORDERS
 Structure of language

- Semantics: meaning.
- Syntax: grammer.
- Phonology: articulation.
- Pragmatic: conversational rules.
Normal language development
4 months : babbling.
1 year : 1st word .
1 ½ year : 20 words ;
beginning 2 word sentence.
2 years : 200 words ;
much 2 words sentences.
3 years : 2000 words ;
3 – 4 word sentence.
4 years : basics of language are mastered.
8 years : full language development.
 Pre-requisites for Normal
Language development

 Intact brain function.

 Intact sensory channels.

 Intact psyche.

 Stimulating environment.
 Language Disorders

I. Delayed Language Development.

II. Dysphasia.
I. Delayed Language Development.
 Definition: The child is not following the
normal chart “milestones” of language
development.
 Aetiology : ( prenatal, natal, postnatal )
1- Brain damage.
2- Sensory deprivation.
3- Psychogenic disorders.
4- Environmental deprivation.
5- Specific language impairment.
 1- Brain damage

 Diffuse subcortical lesion M.R.

 Minimal brain damage ADHD,ADD.

 Localized brain damage with specific

motoric insult BDMH (CP)
 Minimal brain damage
( ADHD ; ADD )

 Definition :
- A child is “hyperactive” if his hyperactivity is
disturbing his environment and his attention.
- There is some delay in language; but it usually
recovers ; and he has learning disability.
- Core Symptoms: inattention, hyperactivity,
impulsivity.
 2- Sensory deprivation

 Hearing impairment.

 Visual impairment
 Hearing impairment and language
 What is more vital Hearing or Vision ?
 What is meant by hearing impairment?
 What are the types of hearing impairment ?
 Conductive
 Sensorineural

 Mixed

 Central

 What are the degrees of hearing

impairment?
mild/moderate/severe/profound/total
 Bilateral sensory neural hearing
loss
SNHL
 Why bilateral ?
 What is the importance of binaural hearing ?
 Sound localization

 Sound discrimination

 Hearing in background noise

Bilateral sensory-neural hearing
loss (cont.)
 Risk factors:
 Family history.

 German measles or influenza during

pregnancy.
 Diabetes.

 Small for date babies.

 Neonatal jaundice.

 Multiple congenital anomalies.

 Brain anoxia.
 Bilateral sensory-neural hearing
loss (cont.)

 What is the ideal solution ?

bilateral behind-ear digital hearing aids.

 What is the necessity of language therapy?

 What are the prognostic factors?
onset / early diagnosis / early
intervention / maintenance of therapy
program / family co-operation/ cognitive
abilities / associated deficits / schooling
and education.
 What is the role of cochlear implant?
It is indicated ONLY in those having
bilateral profound SNHL who fail to
respond to conventional hearing aids after
adequate trial of 6 months with intensive
auditory training and language therapy.
 3- Behavioral problems
“ Autism “

 Impairment in reciprocal social interaction.

 Iimpairment in verbal and non-verbal
communication.
 Restricted range of interests and activities.
 4- Environmental deprivation
 Isolation
 Foreign babysitters
 T.V. and videogames
Language
 5- Specific language impairment
(SLI)
 It is primary in origin
 It varies from mild to severe
 It includes subtypes
 Prognosis is variable :
 Excellent progress
 Learning disabilities
 Life long problems
 Assessment of D.L.D.
 I. Elementary diagnostic procedures:
 History taking
 Vocal tract and ENT examination
 Neurologic examination: simple
observation and interview with the child.
 II. Clinical diagnostic aids:
 Audiometry
 Psychometry
 Language test
 Articulation test
 III.Additional instrumental measures:

 EEG

 CAT

 MRI

 Geneticconsultation
 Endocrine consultation
 Therapy of D.L.D.
 Family counseling.
 Language therapy program is drawn and carried out according to:
 The etiology
 Language range.
 Associated deficit
 Group vs Individual therapy
 Other specialties needed:
Physiotherapist Occupational Therapist
Neurologist Child psychiatrist.
Special education Cognitive Therapist
Audiologist Nutritionist
 What is the role of drugs ?
 No place for drug therapy except in very limited scope :
 Epilepsy anti-epileptic drugs
 Hyperactivity drugs Vs behavior modification
 Brain Damage Botilinoum toxin
 II. Dysphasia
 Definition
 Etiology:
 CVA
 Traumatic
 Inflammatory
 Space occupying lesion
 Types:
 Receptive dysphasia
 Expressive dysphasia
 Mixed dysphasia
 Dysphasia (cont.)
 Prognostic factors:
 Age
 Aetiology
 Type
 Degree
 Onset of therapy
 Associated problems
 Family cooperation

 Therapy:
 Language rehabilitation program
 When to refer to SLT
Your child;
 Does not start to babble by 9 months old.
 Is non verbal or speaks few words by the age of 18 to 24
months.
 Has difficulty following simple spoken instructions by 2 years
old.
 Does not engage with peers in play or prefers to play alone.
 Has difficulty using social communication skills to interact
appropriately with peers and adults.
 Has difficulty using words together in sentences
 When to refer to SLT
 Has difficulty in producing certain speech sounds.
 Is not understood by close family even In a known context.
 Is unable to tell a story or retell daily events.
 Experiences high level of anxiety communicating in specific
settings (selective mutism).
 Has difficulty using words fluently (stuttering) or speaks to fast
(cluttering).
 Has an abnormal voice quality at any age.
 Has presence of nasal tone in his/her speech.
 Has difficulty with eating or drinking in terms of chewing and
swallowing.
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