When to go to the speech therapist

The language disorders They encompass a multitude of aspects that go through issues such as understanding, production, gestures, socialization or children's speech. To identify possible anomalies and know when it will be necessary go to a speech therapist, it is necessary to know the process of normal language acquisition and its various stages.

We must distinguish clearly between the different components affected in language disorders, such as speech, grammar or vocabulary and processes such as comprehension or expression. Hence the importance of the differential diagnosis that an accredited professional must perform.

Problems in language may be secondary symptoms of some general developmental disorder such as autism or Down syndrome, but there is a group of children in whom, during their normal growth, specific problems of acquisition of language. In the latter case, the most common, the spectrum of problems is wide, they are usually identified late and generate controversy over when to intervene with a treatment.

Within this group the diagnosis is complex, since in most cases, the child with language problems usually has mixed deficits that combine expression and comprehension. In this last area, although there are tests to detect delays in comprehension, the problem only comes to light when the child faces the problem. learning to read.

The specialists point out that between birth and 6 years, there is a period of extraordinary cerebral plasticity. Language disorders are dynamic and can improve or result in false positives, but "waiting is a bad policy", because recovery is often illusory. Therefore, early intervention is important, regardless of the age of the child, provided there are delays, for example in the speaks, because waiting at the time of reading complicates the prognosis and always has global consequences in the learning process of the child.

Stages of language development in children

Knowing the stages of language development in children will help parents identify possible anomalies or delays. These are the main aspects that parents should observe in the communicative development of their children:

- First year and a half of life: During this period babies use increasingly sophisticated strategies to communicate with parents. From the most initial cries to smiles as a complaint, the gurgles, gestural anticipation before the first games (cuckoo) and the game with sounds through sound sequences. These first include the vowels and then progress to the use of consonants and later combine both elements. It is time for the first games, communicative exchanges and the socialization of babies. If a year and a half the child only uses vowels, is the first symptom that something is not right.

-  Between 18 and 24 months: it is a very important stage because children are already beginning to use words. At this age they use several words and begin the first combinations of two words that constitute the early beginnings of the syntax. The lack of word combination is a clear clinical marker that the child is a candidate for a language disorder.

-  From 2 to 4 years old: it is the stage of the linguistic explosion, in which more and more vocabulary is used and which allows that from one month to the next the children can learn to perform simple sentences (subject, verb and object).

- From the age of 4: the construction of oral language is more elaborate and at 5 years there is already a complexity that allows them to tell experiences and tell small stories.

From the age of 3 there are already instruments of language evaluation powerful that allow to detect problems of production and comprehension. At this stage it is key that the child has interest in communicating and that the milestones of language development follow one another normally: construction of vocabulary, combination of words, linguistic explosion and increasingly elaborate sentences.

Expression, understanding and articulation in children

In language disorders, expression and comprehension can intervene and combine with speech problems. With regard to expressive language, aspects such as difficulties in the elaboration of simple sentences, telling a story, conjugating verbs or using derivations of words (bread, baker, bakery) are examined.

Regarding the field of comprehension, it is possible that the problems go unnoticed in the child until the stage of reading is presented and clearly manifested in the field of oral and written language. They are the most difficult to diagnose and, to do so, the narratives and visual images that appear in children's stories are used as a tool.

In most cases, parents come to the speech therapist's office because of articulatory speech problems. These may have a neurological or organic basis, such as brain dysfunction or abnormality in regions associated with speech development or physical defects in peripheral organs such as the tongue, jaw or teeth.

When the component is not organic, but functional, it would be dislalias. These functional disorders are derived from aspects such as poor coordination of organs involved in language, bad breath, tensions or nerves or a socioeconomic context in which there are inaccuracies in language. All these aspects have a better prognosis and recover well.

Treatment of language disorders

All these language disorders can be improved if there is an adequate environment in the child's classroom, if their teacher acts and undertakes activities that help correct these problems and if afterwards at home the child continues to be supported through an appropriate correction. But all this supposes a wide margin of variability in which the different results advise the intervention of a specialist.

The language treatments are long and the progress made should be verified in the child. In many cases, when the parents see a rapid positive progression they leave the treatment, which causes the problems to reoccur.

Although it is difficult to establish a generic pattern of action, since it depends on the problem and the child, there are cases in which functional speech disorders (dyslalias) can be corrected in two or three weekly sessions for two or three months.

Victor Acosta. President of the Spanish Association of Speech Therapy, Phoniatrics and Audiology.

Video: Speech Therapy: What to Expect | Cincinnati Children's

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