Specific developmental disorder

• Specific developmental disorders categorizes

specific learning disabilities and
developmental disorders affecting
coordination.
The tenth revision of the ICD-10 has four categories of specific
developmental disorder
DSM-IV-TR categorizes specific
developmental disorders as
 COMPARISON B/W ICD 10 & DSM IV
ICD-10 DSM

Specific developmental disorders of speech Communication disorders:

and language:

specific speech articulation disorder (F80.0) Expressive Language Disorder (315.31)

Expressive language disorder (F80.1) mixed Receptive-Expressive Language

Disorder (315.32)

Receptive language disorder (F80.2) phonological Disorder (315.39)

Acquired aphasia with epilepsy Stuttering (307.0)

Landau-Kleffner syndrome (F80.3)

Other developmental disorders of Communication Disorder Not Otherwise

speech and language (F80.8) Specified (307.9)

Lisping
Developmental disorder of speech and
language, unspecified (F80.9)
 ICD-10 DSM IV

Specific developmental disorders of scholastic

skills (SDDSS):
Learning disorders:

Specific reading disorder (F81.0) •Reading Disorder (315.0)

specific spelling disorder (F81.1) •Mathematics Disorder (315.1)

Specific disorder of arithmetical skills (F81.2) •Disorder of Written Expression (315.2)

mixed disorder of scholastic skills (F81.3) Learning Disorder Not Otherwise Specified
(315.9)

Other disorders of scholastic skills (F81.8)

Developmental disorder of scholastic skills,

unspecified (F81.9)
 ICD-10 DSM IV

Specific developmental disorder of motor Motor skills disorders:

function:

Specific developmental disorder of motor Developmental Coordination Disorder(315.4)

function(F82)

Mixed specific developmental disorder: Mixed development disorder (315.5)

Mixed specific developmental disorder (F83)

 specific speech articulation(joining)
disorder (F80.0)
• Speech disorders are a type of
communication disorders where 'normal'
speech is disrupted.

• This can mean stuttering, lisps (a speech

defect consisting in pronouncing s  and z),
Someone who is unable to speak due to a
speech disorder is considered mute.
• Classifying speech into normal and disordered
is more problematic than it first seems.

• By a strict classification only 5% to 10% of the

population has a completely normal manner
of speaking (with respect to all parameters)
and healthy voice; all others suffer from one
disorder or another.
• Stuttering affects approximately 1% of the adult
population.

• Cluttering (to speak so rapidly and inexactly that distortions

of sound and phrasing result.), a speech disorder that has
similarities to stuttering.

• Dysprosody is the rarest neurological speech disorder. It is

characterized by alterations in intensity, in the timing of
utterance segments, and in rhythm, cadence, and
intonation of words.

• The cause of dysprosody is usually associated with

neurological pathologies such as brain vascular accidents,
cranioencephalic traumatisms, and brain tumors.

• Muteness is complete inability to speak

• Speech sound disorders involve difficulty in producing specific speech
sounds (most often certain consonants, such as /s/ or /r/), and are
subdivided into articulation disorders (also called phonetic disorders)
and phonemic disorders.

• Articulation disorders are characterized by difficulty learning to

physically produce sounds.

• Phonemic disorders are characterized by difficulty in learning the

sound distinctions of a language, so that one sound may be used in
place of many.

• However, it is not uncommon for a single person to have a mixed

speech sound disorder with both phonemic and phonetic
components.
• Voice disorders are impairments, often physical,
that involve the function of the larynx or vocal
resonance.

• Dysarthria is a weakness or paralysis of speech

muscles caused by damage to the nerves and/or
brain.

• Dysarthria is often caused by strokes,

parkinsons disease, ALS, head or neck injuries,
surgical accident, or cerebral palsy.
• Apraxia of speech may result from stroke or be
developmental, and involves inconsistent production
of speech sounds and rearranging of sounds in a word
("potato" may become "topato" and next "totapo").

• Production of words becomes more difficult with

effort, but common phrases may sometimes be spoken
spontaneously without effort.

• It is now considered unlikely that childhood apraxia of

speech and acquired apraxia of speech are the same
thing, though they share many characteristics.
 Etiology
• In many cases the cause is unknown.

• However, there are various known causes of speech impediments,

such as
• "hearing loss,
• neurological disorders,
• brain injury,
• mental retardation,
• drug abuse,
• physical impairments such as Cleft lip and palate, and
• vocal abuse or misuse."[3]

• Child abuse may also be a cause in some cases.[4]

 Rx
• Speech therapy

• Psychotheraphy

• special education programs

 Expressive language disorder (F80.1)
Expressive aphasia
• Expressive aphasia (non-fluent aphasia), also
known as Broca's aphasia in
clinical neuropsychology and

• agrammatic aphasia in
cognitive neuropsychology, is caused by
damage to or developmental issues in anterior
regions of the brain, including the left posterior
inferior frontal gyrus known as Broca's area
 Sufferers of this form of aphasia exhibit the common
problem of
• agrammatism.

• speech is difficult to initiate, non-fluent, labored,

and halting.

• writing is difficult as well.

• Intonation (the rising and falling sounds of the

voice when speaking.) and stress patterns are
deficient.
• Language is reduced to disjointed words and sentence
construction is poor, omitting function words and inflections (
bound morphemes).

• For example, in the following passage, a Broca's aphasic patient is

trying to explain how he came to the hospital for dental surgery:
Eg:
• Yes... ah... Monday... er... Dad and Peter H... (his own name), and
Dad.... er... hospital... and ah... Wednesday... Wednesday, nine
o'clock... and oh... Thursday... ten o'clock, ah doctors... two... an'
doctors... and er... teeth... yah.[2]
 Causes

• Stroke- A stroke is caused by hypoperfusion

(lack of oxygen) to an area of the brain, which
is commonly caused by thrombosis or
embolism.

• trauma to the brain, tumor,

cerebral hemorrhage, by
extradural hematoma.
 Rx
• Singing and melodic intonation therapy

• Constraint induced therapy

 Receptive aphasia
• In clinical neuropsychology and
cognitive neuropsychology, receptive aphasia,
also known as Wernicke’s aphasia, fluent
aphasia, or sensory aphasia, is a type of
aphasia traditionally associated with
neurological damage to Wernicke’s area in the
brain,[1] (Brodmann area 22, in the posterior
part of the superior temporal gyrus of the
dominant hemisphere).
 Contd…
Pharmacotherapy
• Bromocriptine – acts on Catecholamine Systems[15]
• Piracetam – mechanism not fully understood, but
most likely interacts with cholinergic and
glutamatergic receptors, among others[15]
• Cholinergic drugs (Donepezil, Aniracetam,
Bifemelane) – acts on acetylcholine systems[15]
• Amphetaminic drugs (Dexamphetamine,
Methylphenidate)[15]
 Receptive language disorder

In clinical neuropsychology and cognitive

neuropsychology
receptive aphasia, also known as
• Wernicke’s aphasia,
• fluent aphasia, or
• sensory aphasia,
is a type of aphasia traditionally associated with
neurological damage to Wernicke’s area in the brain
 Receptive aphasia
• With receptive aphasia, the person can hear a
voice or read the print, but may not
understand the meaning of the message.

• Oftentimes, someone with receptive aphasia

takes figurative language literally.
• When we want to speak, we formulate what
we are going to say in Wernicke’s area.

• which then transmits our plan of speech to

Broca’s area where the plan of speech is
carried out.
 The main symptoms of aphasia
include:
• Trouble speaking
• Struggling with finding the appropriate term
or word
• Using strange or inappropriate words in
conversation
• A person with this aphasia speaks normally,
but uses random or invented words, leaves
out key words, substitutes words or verb
tenses, pronouns or prepositions, and their
sentences don’t make sense.

• They can also have a tendency to talk

excessively.
• A person with this aphasia cannot understand the
spoken words of others or read written words.
• Speech is preserved, but language content is incorrect.

• Substitutions of one word for another (paraphasias one loses

the ability of speaking correctly, substitutes one word for another, and changes words and
sentences in an inappropriate way eg. Treen instead of Train , e.g. “telephone” for
“television”) are common.
• Comprehension(understanding) and repetition are poor.
 Rx
• Speech theraphy

Advice to
• Draw words or pictures on paper when trying to
communicate.

• Speak slowly and stay calm when talking.

• Symptomatic Rx
 Acquired aphasia with epilepsy
Landau-Kleffner syndrome
Landau–Kleffner syndrome (LKS),
also called
• infantile acquired aphasia,
• acquired epileptic aphasia or
• aphasia with convulsive disorder,

Its a rare, childhood neurological syndrome.

• It is characterized by the sudden or gradual
development of aphasia (the inability to
understand or express language) and an
abnormal electroencephalogram (EEG).

• LKS affects the parts of the brain that control

comprehension and speech (Broca's area and
Wernicke's area).
 Symptoms
• The disorder usually occurs in children
between the ages of 5 and 7 years.

• Typically, children with LKS develop normally

but then lose their language skills.
• Sometimes they also fail to recognise familiar
sounds, such as a telephone ringing or a tap
running (auditory agnosia).

• In some children language development

comes to a halt, meaning that the loss of
language skills is less apparent.
 Differential diagnosis
• The syndrome can be difficult to diagnose and may
be misdiagnosed as
• autism,
• pervasive developmental disorder, hearing
impairment, learning disability,
• auditory/verbal processing disorder,
• attention deficit disorder, mental retardation,
• childhood schizophrenia, or emotional/behavioral
problems.
 Treatment for LKS
• medications, such as
• anticonvulsants and corticosteroids (such as
prednisone),

• and speech therapy, which should be started

early.
• A controversial treatment option involves a
surgical technique called multiple subpial
transection in which multiple incisions are
made through the cortex of the affected part
of the brain beneath the pia mater, severing
the axonal tracts in the subjacent white
matter
 Thank u

Continues with Specific developmental disorders of scholastic skills