What are speech disorders? What are its causes, signs, types, diagnosis and treatment? What could cause this symptom? Definition: Speech disorders or speech disorders are problems and deviations in speech and impairments in verbal communication and other related areas, in particular speech motor skills. The symptoms of these disorders range from inability to perceive speech to logorrhea or speech incontinence. In addition, these symptoms can appear in both children and adults. In this article we will talk about the signs, types and classification of speech disorders, how to diagnose and treat these disorders.

Causes of speech disorders

The causes of speech disorders are many and varied, and vary depending on the trigger of the disease. Among organic reasons, which include all those associated with damage to the speech organs, can be distinguished:

• Hereditary causes: when speech disorders are inherited from parents.
• Congenital causes: when speech disorders are caused by taking medications or complications during pregnancy.
• Perinatal reasons: Speech disorders are caused by complications during childbirth.
• Postnatal causes: Speech disorders appear after birth, for example as a result of premature birth.

In addition to organic, there are also functional reasons, i.e. pathologies of the organs involved in speech. Endocrine causes are mainly related to the psychomotor development of the child. Reasons related to environment, can also occur and influence speech - a person’s linguistic characteristics are influenced by his environment. And finally psychosomatic reasons also play an important role in the development of speech disorders, since our thoughts have power over us and can provoke abnormal oral speech. Conversely, difficulties and speech disorders can negatively affect thinking. All this makes it difficult to speak correctly and understand speech.

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Symptoms of speech disorders

Depending on the type of speech disorder and the area affected, there are various symptoms that indicate a possible speech disorder. Speaking about the classification of general symptoms of speech disorders, the following types of symptoms can be distinguished:

• Symptoms of expressive language disorder: In this disorder, the vocabulary is very limited, and the person has difficulty remembering and pronouncing long phrases.
• Symptoms of expressive-receptive speech disorder: In addition to the symptoms observed in the previous case, there are also problems associated with perception, understanding of speech, words or phrases.
• Symptoms of a phonological disorder: characterized by the inability to use individual sounds when speaking; there are errors in pronunciation, reproduction and/or use of sounds.

In addition, perhaps one of the most noticeable disorders is stuttering - a violation of the fluency, rhythm and organization of speech.

Even though speech is a complex process, and there are many different speech pathologies, certain signs can be identified that generally indicate the possible development of a speech disorder. Talking about speech disorders in children, the following signs can be noted:

• Expressive language disorder: This problem may be evidenced by the child’s meager vocabulary compared to children of his age and underdeveloped speech. It is difficult for a child to remember new words, he confuses the tense forms of verbs, uses general words in conversation (things, this, etc.) instead of specific names, speaks little, pronounces meaningless phrases, although he is able to pronounce words correctly, uses certain sentence structures or constantly repeats the same phrases when speaking.
• Receptive language disorder: with this speech disorder, the child often does not feel interested in talking in his presence, it is difficult for him to follow directions or understand what is said to him, asked, and also understand what is written.

Below you can watch a video about the development of human speech. Don't forget to turn on subtitles in Russian.

Speech disorders: classification and types

Speaking about the general classification of existing types of speech disorders, we can highlight the following:

1- Dysarthria:

These are pronunciation disorders caused by damage to the muscles of the speech apparatus.

2- Dyslalia:

Dyslalia is a sound pronunciation disorder characterized by the absence, substitution, confusion or distortion of phonemes and sounds in spoken speech. There are several types of dyslalia:

• Physiological dyslalia: Children often pronounce sounds incorrectly - this is due to the insufficient development of speech organs in childhood. This is absolutely normal and should not alarm parents - unless the problem does not go away on its own over time.
• Audiogenic dyslalia: As the name suggests, this disorder is associated with a child's hearing impairment, which prevents him from correctly recognizing, imitating and reproducing sounds. It is logical that if a person has difficulty hearing, he will also have difficulty speaking.
• Functional dyslalia: Long-term physiological dyslalia, which has already been preserved when the speech apparatus has been formed, can develop into functional dyslalia. With this type of dyslalia, the structure of the organs is not disturbed, but the child mixes, distorts or replaces sounds.
• Organic or mechanical dyslalia: this type of dyslalia is also called dysglosia. They are associated with structural defects of the speech organs. Let's take a closer look.

3- Dysglossia

Dysglosia (not to be confused with diglossia or a variant of bilingualism) is a speech disorder, as we mentioned above, associated with defects (clefts) of the organs involved in speech. The following subspecies are distinguished:

• Lip dysglossia: associated with changes in the shape of the lips, cleft lips. The most well-known pathologies of this type are cleft lip and cleft palate.
• Dysglosia of the jaw: caused by irregularities in the shape, clefts of the upper, lower or both jaws.
• Dental dysglossia: speech disorder due to gaps between teeth or improper positioning of teeth.
• Language dysglosia: caused by clefts and other tongue defects. Pathologies that may be the causes of these disorders are ankyloglossia (short frenulum of the tongue), macroglossia (abnormally large tongue), and unilateral or bilateral paralysis.
• Nasal dysglosia: associated with pathologies that do not allow air to enter the lungs correctly.
• Palatal dysglosia: caused by cleft palates.

4- Dysphemia

Dysphemias are speech disorders characterized by impaired articulation with repeated interruptions and repetitions caused by poor ideomotor brain coordination. An example of dysphemia is stuttering.

5- Aphasia

This type of speech disorder can manifest itself at any age, since it is associated with local damage to the parts of the brain involved in speech and represents the absence or impairment of already formed speech.

• : Broca's aphasia or efferent motor aphasia is caused by damage to the motor speech center or Broca's center and adjacent areas. Characterized by great difficulties with articulation and telegraphic speech (very short phrases). Speech expression suffers the most (hence why it is also called expressive aphasia), while speech understanding is preserved or suffers less.

• Wernicke's aphasia or sensory aphasia: speech impairment caused by damage to the left temporal lobe, adjacent to the auditory cortex. It is characterized by fluent but uninformative (paragrammatic) speech, impaired phonemic hearing, and problems distinguishing the sound composition of words. Sufferers of this disorder also have difficulty understanding speech.

• Conductive or wire aphasia: This type of motor aphasia is caused by damage to the arcuate fasciculus and/or other connections of the temporal and frontal lobes. The disorder is characterized by an impairment in the ability to repeat words and sentences, while maintaining understanding and fairly fluent spontaneous speech. With conductive aphasia, there are often problems with reading, writing, and remembering names.

• Transcortical sensory aphasia: this type of speech disorder is caused by damage to the connections between the parietal and temporal lobes and is associated with impaired comprehension of single words, although the ability to repeat is relatively intact.
• Transcortical motor aphasia: This speech disorder is caused by subcortical lesions in areas below the motor cortex and is associated with disturbances in spontaneous speech, while memory for names is not affected.
• Anomic aphasia: associated with lesions in various areas of the temporal and parietal lobes and is characterized by disturbances in the pronunciation of individual words.
• Global or total aphasia: complete loss of the ability to speak and understand speech. All language functions are impaired.

6- Dyslexia

Neuropsychological

7- Specific speech disorder

Specific language or language development disorder is a delay in the learning and use of language or the inability to use it in the absence of brain damage, normal mental development, adequate sensory development and the absence of psychopathology. Often children with a specific language disorder also show signs of dyslalia and the other disorders mentioned above.

8- ADHD or Attention Deficit Hyperactivity Disorder

ADHD is associated with language impairment and also causes learning and communication problems. According to research, children with ADHD experience difficulties with syntax and phonological organization of speech. They also have problems with semantic organization and auditory memory. Currently, tools have been developed for neuropsychological testing of ADHD, neuroeducational programs to address learning difficulties in school, and games for cognitive stimulation of children with ADHD.

Neuropsychological

9- Dyscalculia

Despite the fact that this disorder does not affect speech (as much as others), in this case the understanding of another language - mathematical - suffers. Dyscalculia affects the ability to work with numbers and understand mathematical terms. People suffering from dyscalculia do not understand the logic of the mathematical process. Currently, there are professional instruments for neuropsychological testing of dyscalculia and games for cognitive stimulation of children with dyscalculia.

Diagnosis of speech disorders

To diagnose a speech disorder, you need to follow certain recommendations and conduct special tests. It is important to focus on studying cases of speech disorders in children to try to identify problems that may lead to the development of pathology and follow a series of strategies.

Before making a diagnosis, it is necessary to request information first of all from the parents and the school where the child is studying. These are the most important sources of information about the child’s behavior and the development of his problems. Then you need to talk to the child himself, use recordings, and conduct audiometry. In addition, to complete the diagnosis, it is necessary to conduct neuropsychological and specific tests, as well as a survey of parents, caregivers and teachers.

Speech disorders: how to help your child at home

As we have already learned, there are no definite and clear symptoms of speech disorders, since they are very diverse, of varying degrees of severity and bring various problems to the people who suffer from them. Below we will give some general tips that you can use at home if your child has a speech disorder.

Since we are primarily talking about communication problems, try to communicate with your child as much as possible. Listen to music together, sing, listen to him and definitely don't interrupt him, give him time to say what he wants, be patient.

Reading is also very useful, and it is better to read in an interactive form. Discussing what you read, drawings, coming up with different endings to a book - all this is very useful for the development of speech.

And finally, the most important step is to identify what exactly is the child's problem? and then contact the appropriate specialist.

For more specific diseases such as dyslexia, dyscalculia, ADHD, specific speech disorder, a different, more in-depth intervention is required. Which one exactly - you can find the answer by following the links provided above.

Speech disorders: how to help your child at school

In educational institutions, it is important to use special programs to detect speech difficulties, which makes it possible to apply early intervention if necessary. There are neuro-educational platforms that can be very helpful.

Teachers play a vital role in the normal development of a child as they mediate the learning process and facilitate the child's adaptation to school.

With the help of a suitable educational program, you can achieve successful learning

"Guide to teaching children with oral and written language disorders" makes the following recommendations:

The educational institution must guarantee an environment conducive to the development of speech and social interaction of students.
Help should come primarily from teachers.
School counselors should support this function, not replace it.
It is necessary to include in the curriculum subjects that promote the development of oral speech.
The management of the educational institution must ensure the coordinated work of all teaching staff, both teachers working with speech and writing disorders, and support staff, to maintain a unified approach and work together.

Translation by Anna Inozemtseva Spanish

This is a specific developmental disorder in which a child's understanding of language is at a lower level than would be expected for his or her age. In this case, all aspects of language use are affected and there are articulation disorders.

However, impaired ability to understand language is not associated with mental retardation, since psychological examination of such children using written IQ tests does not reveal any intellectual impairment. But examination of the ability to understand oral speech reveals significant deviations from the norm, which do not correspond to good data from intelligence research.

This disorder occurs in 3-10% of school-age children, and is 2-3 times more common in boys than girls.

Moderate receptive language disorder is usually detected by age 4 years. Mild forms of the disorder may not be detected until 7-9 years of age, when the child’s language should become more complex, and in severe forms the disorder is detected by the age of 2 years.

Children with receptive speech disorder understand other people's speech with difficulty and with a long delay, but their other intellectual activities not related to speech are within age norms.

In cases where difficulty in understanding someone else's speech is combined with an inability or difficulty in one's own speech expression, they speak of a receptive-expressive speech disorder.

In external manifestations, receptive speech disorder in children under 2 years of age resembles expressive speech disorder - the child cannot independently pronounce words or repeat words spoken by other people.

But unlike language expression disorder, where a child can point to an object without naming it, a child with receptive language disorder does not understand commands and is unable to point to common household objects when asked to do so.

Such a child does not speak words, but he does not have hearing impairment, and he reacts to other sounds (bell, beep, rattle), but not to speech. In general, these children respond better to environmental sounds than to speech sounds.

Such children begin to speak late. In their speech, they make many mistakes, miss, and distort many sounds. In general, their language acquisition is slower than that of normal children.

In severe cases, children are unable to understand simple words and sentences. In mild cases, children have difficulty understanding only complex words, terms or complex sentences.

Children with receptive language disorder also have other problems. They cannot process visual symbols into verbal ones. For example, when asked to describe what is drawn in the picture, such a child has difficulty. He cannot recognize the basic properties of objects. For example, he cannot distinguish a passenger car from a truck, domestic animals from wild ones, and so on.

Most of these children show changes in the electroencephalogram. There is a partial defect in hearing correct tones and an inability to identify the source of sound, although their hearing is generally normal.

Receptive language disorder is usually accompanied by articulation disorders.

The consequence of all these disorders is poor performance at school, as well as difficulties in communication and everyday life, which requires understanding someone else's speech.

The prognosis for receptive language disorder is generally worse than for speech expression disorder, especially in severe cases. But with proper treatment started in a timely manner, the effect is good. In mild cases, the prognosis is favorable.

A specific developmental disorder in which the child's understanding of speech is below the level appropriate for his mental age. In all cases, expansive speech is also noticeably impaired and a defect in verbal-sound pronunciation is not uncommon.

Diagnostic instructions:

Inability to respond to familiar names (in the absence of nonverbal cues) from the first birthday; failure to identify at least a few common objects by 18 months, or failure to follow simple instructions by age 2 years, should be accepted as significant signs of language delay. Late impairments include: inability to understand grammatical structures (negations, questions, comparisons, etc.), failure to understand more subtle aspects of speech (tone of voice, gestures, etc.).

A diagnosis can only be made when the severity of the delay in receptive language development is beyond normal variations for the child's mental age and when criteria for pervasive developmental disorder are not met. In almost all cases, the development of expressive speech is also seriously delayed, and violations of verbal-sound pronunciation are common. Of all the variants of specific speech development disorders, this variant has the highest level of concomitant socio-emotional-behavioral disorders. These disorders do not have any specific manifestations, but hyperactivity and inattention, social inappropriateness and isolation from peers, anxiety, sensitivity or excessive shyness are quite common. Children with more severe forms of receptive language impairment may experience quite significant delays in social development; Imitative speech is possible with a lack of understanding of its meaning and a limitation of interests may appear. However, they differ from autistic children, usually showing normal social interaction, normal role-playing, normal looking to parents for comfort, nearly normal use of gestures, and only mild impairment in nonverbal communication. It is not uncommon to have some degree of high-pitched hearing loss, but the degree of deafness is not sufficient to cause speech impairment.

It should be noted:

Similar speech disorders of the receptive (sensory) type are observed in adults, which are always accompanied by a mental disorder and are organically caused. In this regard, in such patients, the subheading “Other non-psychotic disorders due to brain damage and dysfunction or somatic illness” (F06.82x) should be used as the first code. The sixth character is placed depending on the etiology of the disease. The structure of speech disorders is indicated by the second code R47.0.

Included:

Developmental receptive dysphasia;

Developmental receptive aphasia;

Lack of perception of words;

Verbal deafness;

Sensory agnosia;

Sensory alalia;

Congenital auditory immunity;

Wernicke's developmental aphasia.

Excluded:

Acquired aphasia with epilepsy (Landau-Klefner syndrome) (F80.3x);

Autism (F84.0х, F84.1х);

Selective mutism (F94.0);

Mental retardation (F70 - F79);

Speech delay due to deafness (H90 - H91);

Dysphasia and aphasia of the expressive type (F80.1);

Organically caused speech disorders of the expressive type in adults (F06.82x with the second code R47.0);

Organically caused speech disorders of the receptive type in adults (F06.82x with the second code R47.0);

Dysphasia and aphasia NOS (R47.0).

Speech comprehension disorders are a fairly heterogeneous group of disorders. A child may not understand speech for various reasons. For example, with hearing loss, he is not able to clearly distinguish the sounds of his native speech; with mental retardation, it is difficult for him to understand the meaning of what he heard. Autism also has a specific language comprehension problem associated with the literal perception of words and expressions, as well as the inability to use speech to communicate information. In addition, an autistic child, immersed in his own sensory experience of learning about the world around him (visual or tactile), quite often does not perceive speech as a source of information about what is happening around him.

In recent years, I have increasingly become acquainted with autistic children who have been diagnosed by speech therapists with “sensory” or “sensory-motor alalia.” Parents of such children are focused on the fact that all developmental and behavioral problems are associated with such a speech disorder.On the other hand, we have often observed preschool children who were diagnosed with autistic disorder only on the basis that they did not respond to their name, did not repeat words meaningfully, and could not answer simple questions. At the same time, they showed enviable intelligence in cases where understanding of the situation did not depend on the verbal instructions of an adult. Such children easily predicted the meaning of what was happening by the parent’s facial expression, intonation, surrounding environment, etc. That is, they clearly demonstrated the ability for social intuition (the ability to predict the intentions of other people), which is known to be impaired in.

In the international classification of diseases, receptive language disorder is allocated to a separate category (F80.2) and is opposed to autism (F84). That is, it is assumed that although in autism there are problems with receptive speech (that is, a violation of the understanding of directed speech), they should be distinguished from an isolated disorder of language development called “receptive speech disorder” (apparently, the term “sensory alalia” was used by speech therapists of the post-Soviet spaces designate this particular speech disorder). The term “receptive speech”, in fact, has a broader meaning and includes any processes of perception and understanding of speech, as opposed to the concept of “expressive speech,” that is, speaking.As often happens in medical terminology, some confusion occurs when the name of the disorder - “receptive language disorder” - is identified with any comprehension problems that occur in various types of developmental disorders, including autism.

What significance can all of the above have for the rehabilitation of children?

1. Children suffering from autism and children with receptive language disorder have a number of similar behavioral symptoms, however, the rehabilitation of children with receptive language disorder and children with autism has its own characteristics. Therefore, a correct and timely diagnosis is a necessary condition for effective corrective work.

2. A speech therapist who suspects a child has problems understanding speech may not take into account the peculiarities of his behavior, as well as other symptoms characteristic of autistic disorders, since he is not an expert in the field of child psychiatry. Parents can spend a long time focusing their efforts exclusively on speech therapy correction, without paying attention to the formation of social skills and adaptive behavior, which are impaired in autism. In addition, the speech therapy diagnosis “sensory alalia” or “sensory-motor alalia” is psychologically easier to accept by parents and can “lull” their vigilance regarding possible autism for a long time.

3. Overdiagnosis causes no less harm, when one or two similar symptoms occurring in various developmental problems are an argument for making a diagnosis of autism.

The purpose of this article is to familiarize parents with the signs of receptive speech disorder so that they can more competently identify problems with their child’s speech development. In addition, below are general recommendations for preschool children who have already been diagnosed with receptive language disorder.

SIGNS OF RECEPtive SPEECH DISORDER.

1. Impaired understanding of spoken speech. The child does not give an adequate reaction to speech addressed to him:

- there may be no reaction to speech at all, and the child gives the impression of being deaf;

- it seems that the child either hears or does not hear;

May respond to whispered speech and not respond to loud speech;

Does not respond to his name;

Often correctly follows instructions with the same wording and, on the contrary, finds it difficult to comprehend a rephrased question or request;

understands mother's speech better;

Inadequately answers simple questions (for example, to the question “how old are you?” - says your name);

Repeats the question asked;

- often gives “guessing” answers (for example, he answers “yes” to any question);

Visual reinforcement of addressed speech with gestures, intonation or facial expressions significantly improves understanding;

The child, as a rule, watches the facial expressions and gestures of the adults around him, trying to guess the adult’s expectations;

Characteristic is the correct reaction to simple requests from loved ones in a familiar home environment and confusion and misunderstanding in an unusual environment.

3. Relative preservation of initiative speech. If receptive disorders are not accompanied by serious disturbances in sound pronunciation, then, as a rule, the child develops the ability to proactively address others, adequately using simple speech utterances, that is, the communicative side of speech does not suffer (unlike autism, in which it is the communicative side of speech that is ineffective) .

4. Impaired communication behavior. Avoidance of verbal communication with others occurs as a result of the fact that the child already has a negative experience when his inability to understand the speaker led to “unpleasant” consequences (the mother’s anger, punishment for “disobedience” or unforeseen events). Given an emotionally comfortable environment, a child with understanding problems demonstrates communicative and active behavior and interacts with adults and children at an accessible level. In a circle of children, such a child strives to “unite” with a “safe ally”, with low communicative activity, when interacting with whom it is easy to initiate and control what is happening and avoids active, sociable children who ask a lot of questions and dominate the group.

5. Sufficient development of visual intelligence. Most children with receptive disorders are quite productive when performing visual tasks presented in an adequate form, when the essence of the task is explained in a non-verbal way. In addition, such children are quite adapted to everyday life and easily generalize their accumulated everyday experience by observing those around them.

6. Striving for environmental sustainability. In contrast to the rigidity of behavior in autism, a child with receptive speech disorders strives to maintain a constant environment due to a lack of understanding of what an adult is trying to explain to him through speech, or when a similar situation is associated with negative life experiences. This symptom is almost always considered by parents as a manifestation of stubbornness and capriciousness and is suppressed quite harshly, which leads to even greater behavioral maladjustment.

7. Anxiety. This symptom often accompanies speech understanding disorders and indicates a serious disorder in the child’s adaptation. The degree of anxiety, as a rule, is not directly related to the depth of the receptive disorder, but depends on the intrafamily psychological situation and the immediate social environment in which the child is located.

8. Obsessive actions. The appearance of obsessive actions always indicates severe maladaptation associated both with the depth of the speech disorder and with an inadequate social environment (behavior of family members, inadequacy of correctional work). Most often, obsessive actions are represented by biting or licking lips, shaking hands, but more complex ones are also found. As with autism, these movements are self-stimulating in nature and are a way of “relieving internal tension,” but unlike autistic children with receptive disorders, obsessive actions do not look pretentious and are less persistent in nature.

9. Violations of voluntary regulation of one's own behavior. Children with speech comprehension disorders tend to be hyperactive and impulsive. This is due to the fact that in preschool age the function of voluntary regulation of behavior is performed by the speech of surrounding adults. If the understanding of addressed speech is impaired, the child is therefore unable to independently control his own impulsiveness. In addition, hyperactive behavior, exhaustion and impulsivity can act as accompanying symptoms that complicate correctional work.

FOR RECEPtive SPEECH DISORDERS

Receptive speech disorder does not mean the child is mentally incompetent. This is one of the complex developmental disorders that has a number of similar symptoms to autism spectrum disorders, and about which many specialists working with children, unfortunately, know very little.

A child with such problems needs not only the help of specialists. It is necessary that the child’s entire life and the behavior of surrounding adults be built taking into account the problem. This means that improving the understanding of spoken speech is possible only if the child’s environment is “adjusted” to the child (including all family members, relatives, kindergarten teachers)

Impaired speech understanding can be quite difficult to recognize in a child’s usual family environment. If a child uses words and answers simple questions, this does not always mean that he understands the meaning of these words. A small child is guided not so much by the meaning of words, but by the intonation, facial expression, gaze, and gestures of the speaker. In addition, many verbal statements addressed to the child are repeated within the family every day (“sit down,” “come here,” etc.), and the child recognizes them, figuratively speaking, “in person,” without fully understanding them content. That is why he, as a rule, understands his mother better, with whom he spends most of his time.

In addition, a child with problems understanding speech is often not deprived of the ability to repeat the speech of those around him, easily remembers poems and everyday sayings of his parents, and can be verbose, which often creates the illusion of proper speech development.

It should be noted that a child with receptive speech disorder is very vulnerable, his behavior is maladaptive, he can be anxious, fearful, or capricious, pugnacious, uncontrollable, “doing everything his own way.” His behavior is unstable: in a familiar, familiar situation (usually at home), he can be stubborn, demanding, capricious, and in an unfamiliar environment he becomes expressly anxious, silent, and refuses contact.

As mentioned above, such children often experience obsessive movements. The appearance of such movements, as a rule, indicates the severity of the problem of understanding speech or that the adult environment of the child is behaving inappropriately. It is very important that the child feels protected and is confident that an adult will always support him and help him cope with a difficult situation. It is necessary to be attentive to the emotional state of your child. “Bad” behavior and disobedience are most often a kind of call for help.

It should be said that the rules that must be followed to help a child understand speech better are not complicated, but a necessary condition for their effectiveness is continuity, duration and compliance by all adults surrounding the child.

RULES

INTERACTIONS WITH A PRESCHOOL CHILD WITH RECEPTIONAL SPEECH DISORDER

1. Carefully observe how the child reacts to addressed speech (ignores, gets lost, does not do what is asked; watches gestures and facial expressions; does not always respond to his name, “he sometimes hears, sometimes he doesn’t hear”; better understands his mother).

2. Reduce the intensity of verbal appeals to the child and observe the following rules:

In the same situations, use the same wording of verbal statements (for example, “Let’s go for a walk!”, but not “We’ll go for a walk later today!”, or “Let’s go for a walk with the kids!”);

Words must be pronounced clearly, loudly enough, emphasized, but using natural intonation;

If necessary, reinforce by pointing to an object when naming it or demonstrating an action;

It is necessary to expand the vocabulary only with those words that denote objects and actions from the child’s real life;

To view and comment, use children’s books or pictures with bright, realistic drawings, preferably reflecting the child’s visual experience;

Do not use contextual information (fairy tales, abstract texts and expressions), because Such information is almost impossible to support with additional techniques that improve understanding. For example, how can you “demonstrate” “Kolobok” to a child, explain the expression “I scraped the bottom of the barrel” or “Once upon a time”?

3. Help for a child with receptive speech impairment should be woven into the daily life of the family.

4. The daily routine should be organized in accordance with age standards (sleep time, meals, etc.) and be stable from day to day. This regime is the basis for the child’s feeling of safety and predictability of events, which is extremely important for adaptation in case of speech understanding disorders.

5. Each event or action of the daily routine must be accompanied by the same speech commentary (its volume and content depend on the degree of violation of understanding - the more pronounced the problem, the more concise).

6. Of particular importance is the formation of an understanding of simple requests and appeals: “give me...”; help your child express his desire (“Mom, give me some water”, “I’m thirsty”). When speaking for him, demonstrate how this should be done using other family members (“Dad, give me bread!”, “Here, Mom, bread!”);

7. It is necessary to constantly support the child, help, show patience, and in no case should you scold the child for the wrong reaction to verbal requests.

In conclusion, it should be said that when a diagnosis of receptive speech disorder is made at an early age and adequate correctional support is provided, in most cases the problem can be compensated for until complete recovery.

Epidemiology. The prevalence of receptive language disorder is 3 - 10% of school-age children, but severe cases are represented in the proportion of 1:2000: Unlike expressive language disorder, there is no disproportion by gender of patients. No genetic burden was detected.

Reasons. The cause of receptive language disorder is unknown. Correlations with organic cerebral factors that could play an etiological role have not been convincingly confirmed, although patients usually exhibit multiple signs of cortical failure. Relatives of patients have a higher prevalence of convulsive syndrome and specific reading disorder than in the population. A selective impairment in the discrimination of sound signals is possible, since most patients exhibit higher sensitivity to the perception of non-speech sounds.

Clinic. The core manifestation is a selective delay in the formation of the ability to understand the meaning of verbal information with the relative preservation of non-verbal intelligence. In mild cases, a delayed understanding of complex sentences or unusual, abstract linguistic forms, idiomatic phrases, or humor is detected. In severe cases, these difficulties extend to simple words and phrases. Severe forms of the disorder attract attention by the age of 2, while milder forms can be detected only with the beginning of schooling. In most cases, the formation of speech expression skills is also delayed, which makes the clinical picture of both disorders almost identical with the significant difference that in expressive speech disorder the development of receptive skills is not delayed.

Unlike expressive disorder, children with receptive language disorder by the age of one and a half years cannot point to familiar household objects when they are named and by the age of two years can not understand simple instructions. They exhibit a certain ability for social interaction, can engage in role-playing games, and use sign language to a limited extent. Outwardly, they can be mistaken for deaf, but they respond adequately to auditory stimuli other than speech. If they begin to speak later, they demonstrate delayed acquisition of speech skills and severe articulation disorders. Mutism, echolalia, and neologisms may be observed. Most patients have an increased threshold of auditory sensitivity, lack of hearing for music and an inability to localize the source of sound.

Bilateral EEG abnormalities are possible. Comorbidity with other disorders of psychological development and emotional-behavioral disorders is high, but combinations with coordination disorder, impaired attention, and functional enuresis are less likely. The disorder significantly impedes the child's learning and acquisition of adaptive daily living skills based on understanding verbal and sign communication. The prognosis is favorable only in mild cases of the disorder.

Diagnosis. To be diagnosed with receptive language disorder, the condition must meet the following criteria:

1. receptive language skills determined by the test method are at least two standard deviations below the level corresponding to the child’s age;
2. receptive language test data correlate with nonverbal IQ within one standard deviation;
3. there are no pervasive developmental disorders, neurological, sensory or somatic disorders that could directly affect receptive language;
4. IQ above 70.

In most cases, the combination with an expressive language disorder necessitates two diagnoses.

Differential diagnosis determined by the tasks formulated in criterion 3 for diagnosing receptive speech disorder. In contrast to cases of autistic disorder, more developed social skills, higher levels of nonverbal intelligence, and a more sensitive response to external stimuli are found.

Treatment. The main method of therapy is behavioral training of receptive and expressive speech skills. There is debate about whether treatment is more effective in an individual or group setting. The use of games based on symbolic thinking and imagination in therapy and communication with parents is encouraged, since there is no evidence that the use of nonverbal communication inhibits the development of speech skills. The child needs observation by a defectologist until the delay in speech development is eliminated. Psychotherapy and family counseling are often necessary to correct low levels of self-affirmation and train social skills.