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Disorder of expressive speech (general speech underdevelopment) in children
Last reviewed: 23.04.2024
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The disorder of expressive speech (general hypoplasia of speech) is one of the forms of a specific violation of speech development, in which the child's ability to use colloquial speech is noticeably below the level corresponding to his mental development, while understanding speech usually does not suffer.
Classification
According to the speech therapy classification, the disorder of expressive speech corresponds to the general underdevelopment of speech at level 1-3.
With a general underdevelopment of first-level speech (alalia), the child is almost silent, while specific disorders of understanding speech and intelligence can not be detected (in most cases the intellect is below the average level).
Causes and pathogenesis
At the root of the disturbances is a delay in the maturation of neural connections, caused by the organic lesion of the cortical speech zones (in the postcentral and premotor zones of the left dominant hemisphere in right-handed people). There is evidence of the role of genetic factors. Of particular importance is the unfavorable social environment, in which the child is in contact with people who have a low level of speech development.
Symptoms
General underdevelopment of speech level 1-3 is manifested by the different severity of violations of expressive speech. They note the poverty of the vocabulary, the low level of verbal generalization, the difficulty of the expanded speech statement, grammatical errors (errors in the use of verbal endings, violations of word formation), difficulties in using prepositions, verbs, and unions. Characteristic is the adequate use of non-verbal cues, gestures, the desire for communication. Violation of spoken language becomes apparent from infancy without any long phase of normal speech use. And although normal speech development is largely individualized, the absence of individual words or close to them speech formations by two years or simple phrases of 2-3 words by three years should be regarded as a sign of delay. Underdevelopment of speech inhibits the development of cognitive activity of the child, which is often manifested by a delay in mental development in general.
Differential diagnostics
Differentiation from secondary disorders due to deafness is based on audiometric data and the presence of qualitative pathological signs of speech pathology.
Differentiation from acquired aphasia or dysphasia due to neurologic pathology is based on the observation of the period of normal speech development before trauma or other exogenous organic influences, manifestations of the endogenous organic process. In doubtful cases, instrumental methods (EEG, EchoEG, MRI of the brain, CT of the brain) are carried out to conduct differential diagnostics and establish an anatomical focus of the lesion.
Differentiation with common developmental disorders is based on such symptoms as the absence of imaginary play in children with a common disability of the development of the internal language, inadequate use of gestures, violations in the nonverbal sphere of intelligence,
Treatment
Courses logopedic classes, classes with a psychologist, consultative treatment with a psychiatrist according to the testimony.
Forecast
The maximum possible development of speech function and compensation of mental and psychoneurological disorders.
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