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language disorders in children Alternative Names
communication disorders in children
Definition
Some children develop problems with language. Language is defined as any method of expression or communication. It can be verbal or non-verbal.
What is going on in the body?
Language is not the same as speaking, though the two are often related. Speaking, or speech, is the use of the voice to express ideas. A child may be unable to speak or talk, but still able to communicate using sign language. However, children with language difficulties usually have trouble speaking due to the language problem. There are many different causes of language problems in children.
What are the signs and symptoms of the condition?
There are many different types of language problems seen in children, including: - language delay, which may represent delayed or total lack of language development
- developmental aphasia, a problem in developing language that can result in poor pronunciation, limited speech, and problems with grammar
- vocabulary difficulties
- receptive language disorder, or an inability to understand language
- language disorders related to decreased intelligence or IQ, which may affect multiple areas of language development
- expressive language disorder, or a limited ability to communicate even though language can be understood
- autistic expression, which describes the use of a bizarre, individual form of language
- elective mutism, or using language only in certain situations
- psychotic or disorganised language, the use of language that is disorganised and hard to understand
Other types of language problems are also possible.
What are the causes and risks of the condition?
There are many causes of language problems, including:
Hearing impairments, which interfere with the ability to learn vocal language. In the case of complete deafness, language can often be learned if taught without sound. This is the basis for sign language. Children need to hear sounds in order to learn and imitate them. Hearing loss can be due to different causes. chronic otitis media, or repeated middle ear infections in children, is a common cause of hearing loss. Meningitis, an infection of the lining that surrounds the brain, is another cause.
Nervous system conditions or damage, which may affect the ability to learn language. Nervous system disorders can result in a wide variety of language problems. This depends on the area of the brain that is affected. Examples include: Autism, a form of brain dysfunction that usually occurs for unknown reasons. Affected children fail to develop normal language. They may use language in a way that cannot be understood by other people.
elective mutism, a condition in which a child chooses not to use language in certain settings. This usually means the child has an emotional or psychiatric disturbance. This disturbance may occur due to child abuse, neglect, or other problems.
Lack of education. Children can only learn a language if they are taught it.
Other causes of language problems are also possible. Sometimes, no cause can be found.
What can be done to prevent the condition?
Prevention is often not possible. Providing a loving, supportive home can prevent cases due to child abuse or neglect. Mothers who avoid alcohol use during pregnancy can prevent cases from this cause.
Genetic counselling may be of benefit in reducing the incidence of Down Syndrome. Neonatal screening will detect PKU and treatment can be instituted immediately.
How is the condition diagnosed?
The parents or a teacher often notice the problem first. Diagnosis starts with a history and physical examination. In some cases, this may be all that is needed to figure out the cause. In other cases, further testing may be needed.
The tests used depend on the suspected cause. For instance, a formal hearing test may be done if hearing loss is suspected. One such test is called brain stem-evoked response audiometry, or a BAER test. A formal test of intelligence, also called an IQ test, may be done to test for mental retardation. Formal language tests can also help determine the nature of the language problem. Examples of language tests include the Early Language Milestone Scale and the Clinical Linguistic Assessment Measurement Test. An x-ray test called a cranial CT scan may be ordered if nervous system damage is suspected.
Psychological tests, such as a Rorschach inkblot test, may be ordered if an emotional problem is suspected.
What are the long-term effects of the condition?
Children with language problems may have trouble in school or with peers. As children get older, they will have social, work, and relationship problems if the language disorder remains. Other long-term effects are related to the cause. For instance, those with hearing impairment often quickly catch up to their peers once a hearing aid is used. In these cases, there may be no long-term effects. Some children with cerebral palsy have severe mental retardation and movement problems. These children may need around-the-clock care.
What are the risks to others?
Language disorders are not contagious. They pose no risk to others. Parents and family members of affected children may experience guilt or other negative feelings. If the cause of the language disorder is an infection, such as otitis media, the infection may be contagious.
What are the treatments for the condition?
Treatment is directed at the cause, when possible. For instance, children with trouble hearing often benefit from a hearing aid. Children who are completely deaf can often learn sign language. Children being abused can be taken out of the abusive environment. This is often enough to improve the child's language problem. Children with psychiatric problems may benefit from medications and counselling. Children with Chronic otitis media may benefit from antibiotics. Some of these children may also benefit from surgery for ear tube insertion.
Speech therapy can be beneficial for children with nervous system damage. Special classes or learning environments are often advised for children with more severe problems, such as cerebral palsy or Down syndrome. Parents may have to lower their expectations for language development in some cases.
What are the side effects of the treatments?
Surgery to place tubes into the eardrums may result in eardrum damage or new infections. Medications used for psychiatric problems may cause allergic reactions, sleepiness, or stomach upset.
What happens after treatment for the condition?
This is related to the cause and the success of treatment. Those with cerebral palsy or mental retardation may need lifelong therapy and treatment. Those with hearing impairment may have their language problem "cured" by a hearing aid. These children may need no further treatment once they catch up with their peers.
How is the condition monitored?
The parents can report any change in the child's language or response from treatment to the doctor. Other monitoring relates to the cause. For instance, children with emotional problems often need frequent counselling and monitoring. This can be done to help watch for difficulties in other areas.
Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
