Dysphasia is a language disorder that affects children and can persist into adulthood. It causes difficulties in understanding and using words correctly, making everyday communication difficult. In this article, we look at its symptoms, causes and treatment.
Key points
- Dysphasia is a lifelong developmental disorder of oral language that requires speech and language therapy to improve expression and comprehension.
- There are different forms of dysphasia (expressive, receptive, mixed) with specific characteristics, requiring adapted rehabilitation methods.
- Early diagnosis, generally after the age of five, and multidisciplinary treatment are essential to improve language skills and reduce the impact on daily life and school.
Definition of dysphasia
Dysphasia is a primary disorder of oral language development that persists throughout life. Unlike other disorders, it is characterised by significant difficulties in:
- oral language expression and comprehension
- pronunciation
- comprehension
- sentence construction
- use of vocabulary.
This disorder is often confused with other deficiencies, but it is clearly distinguishable from sensory and intellectual disorders and malformations of the phonatory organs. Contrary to what one might think, dysphasia is not linked to a sensory, psychiatric, neurological or intellectual deficit.
Dysphasic children present a language delay without any associated hearing or intellectual deficiency. Speech therapy is essential to help them overcome speech barriers and improve their communication.
Understanding and defining dysphasia is the first step towards effective treatment.
The different forms of dysphasia
Dysphasia comes in different forms, each with its own characteristics and challenges. The main forms include:
- Phonological-syntactic dysphasia
- Lexical-semantic dysphasia
- Semantic-pragmatic dysphasia
- Phonological dysphasia
- Receptive dysphasia
Understanding these different forms of dysphasia enables us to better adapt rehabilitation and support methods.
Expressive dysphasia
Expressive dysphasia is characterised by difficulties in making oneself understood. Children with this type of dysphasia have impaired language and difficulty expressing themselves. Their speech may be choppy and telegraphic, making communication difficult.
Children with developmental language disorder may also have difficulties with syntactic awareness. Their speech may seem disjointed, with short sentences that are difficult to understand. These specific manifestations require speech therapy to help children improve their elocution and expression.
Receptive dysphasia
Receptive dysphasia involves difficulties in understanding a transmitted message. Children with this type of dysphasia may behave in a similar way to deaf children, using gestures and facial expressions to communicate because of their difficulty in understanding spoken language.
These children may also have difficulty accessing abstraction and understanding complex verbal messages. Speech therapy and appropriate communication strategies are essential to improve their understanding and social integration.
Mixed dysphasia
Mixed dysphasia combines difficulties in both expressing and understanding language. Children with mixed dysphasia may struggle to formulate correct sentences while at the same time having difficulty understanding what is said to them.
These simultaneous difficulties greatly complicate their daily lives, both academically and socially. Speech therapy must therefore be adapted to meet the specific needs of these children, by working on both aspects of language.
Possible causes of dysphasia
The causes of dysphasia are many and often complex. The disorder is neurological in origin and may be present from early childhood. Cerebral anomalies, genetic factors and epileptic disorders are among the main causes identified.
Genetic factors
Dysphasia can be influenced by genetic mutations. A significant example is the FOXP2 gene mutation, which was identified in a family of patients with apraxia of speech.
Furthermore, a familial susceptibility is often observed, suggesting a potential genetic origin for dysphasia. This genetic component requires particular attention during diagnosis and management.
Brain abnormalities
Structural abnormalities of the brain, particularly in the language regions, are linked to dysphasia. These abnormalities may include neuronal migration disorders and atypical perisylvian asymmetries.
Abnormal activation of the left hemisphere has also been observed in some people with dysphasia. These brain abnormalities underline the importance of a thorough neurological assessment in the diagnosis of dysphasia.
Epilepsy and other medical conditions
Studies have established a link between language development disorder (LDD) and epilepsy. Epileptiform activity has been observed in some dysphasic children during light sleep.
Dysphasia can also coexist with other 'dys' disorders such as dyslexia and dyscalculia. This coexistence of disorders requires a multidisciplinary approach for effective treatment.
Symptoms and warning signs
Parents often start to worry about language delays in a child around the age of 2, and even more so at the age of 3. The first symptoms of dysphasia can appear as early as the first few years of life, with difficulties in processing and emitting sounds.
Language delay
Dysphasic children may have delays in producing their first words, sometimes up to the age of 3. They may not start talking until they are 2 or 3 years old, which often worries parents.
In addition, these children may have a limited vocabulary for their age and use reduced, telegraphic speech, making their message difficult to understand. Speech therapy is crucial to help overcome these language delays and improve their language skills.
Difficulties with comprehension
Receptive dysphasia is an inability to recognise speech sounds despite normal hearing. These children may behave in a similar way to a deaf child, communicating through facial expressions and gestures.
Children with receptive dysphasia may also experience frustration and anger as a result of difficulties in making themselves understood. These difficulties can lead to withdrawal and aggressive outbursts.
Pronunciation problems
Children with dysphasia may have choppy, unintelligible speech with poorly constructed sentences. Children with phonological dysphasia have difficulty producing certain sounds and may distort words.
These pronunciation problems often result in short sentences that are difficult to understand. These difficulties also have an impact on reading and writing, requiring appropriate speech therapy.
Diagnosis of dysphasia
The diagnosis of dysphasia is based on a multidisciplinary assessment including child psychiatric interviews, a speech therapy assessment and a psychological assessment. Symptoms must persist for at least five years to be diagnosed, and exclusion criteria may include psychotic disorders or other pathologies.
Multidisciplinary assessment
A multidisciplinary assessment includes psychological, psychomotor and neuropsychological evaluations for a complete diagnosis. A multidisciplinary team, including a psychomotor therapist and a neuropsychologist, is often involved in the assessment and management of dysphasic children.
Neuropsychological assessment is essential to differentiate dysphasia from other disorders such as autism or intellectual disability. The clinical psychologist also assesses the presence of behavioural problems and psychological difficulties in the child.
Age of diagnosis
Dysphasia is generally diagnosed from the age of 5, although signs may be visible earlier. The DSM-V emphasises that language skills become more stable and predictive from the age of four.
Some studies indicate that markers of language deviance generally appear in children after the age of five or six. Early diagnosis enables more effective treatment, improving the child's prospects for development.
Care and treatment
Treatment for dysphasia includes speech therapy and complementary therapies. Early treatment is crucial, as it significantly improves the child's chances of progressing.
Speech and language therapy
After the age of three, individual or group therapy may be considered for dysphasic children. Individual re-education is recommended for children diagnosed with dysphasia.
Visual aids are often used to support communication during speech therapy. Speech therapy helps dysphasic children to partially overcome their disability by improving their expression.
Complementary therapies
It is advisable to incorporate psychomotor and occupational therapy interventions to complement the treatment of dysphasia. These complementary therapies play a crucial role in the child's overall development.
Psychomotor therapy helps to improve coordination and fine motor skills, while occupational therapy focuses on independence in daily activities. These therapies complement speech and language therapy, offering a holistic approach to care.
Support at school
Dysphasic children often need visual aids such as pictograms to help with understanding. Planning elements of the school routine in detail and illustrating them with images or pictograms facilitates their learning.
Including dysphasic children in nursery school, with the support of school psychologists and speech therapists, improves their self-esteem and encourages their development. Writing and reading aids can also make learning easier for dysphasic children.
Impact of dysphasia on daily life
Dysphasia has an impact on the professional and social skills of adults, sometimes requiring specific adjustments at work to adapt to their communication needs.
Children with expressive language problems may also have difficulty making themselves understood, which can cause frustration and problems with self-esteem.
Difficulties at school
Children with dysphasia can have significant difficulties at school, requiring educational adaptations. They often have reading and writing difficulties, with a gap between what they can read and what they understand.
These children may suffer from a working memory deficit, making it difficult to memorise oral instructions. Their limited vocabulary and difficulty in finding appropriate words can hamper their success at school.
Social interaction
Dysphasic children may have difficulty understanding simple instructions, which has an impact on their social interaction. They often use gestures and facial expressions to compensate for difficulties with verbal communication.
These children may isolate themselves or express themselves in ways other than speech, such as temper tantrums or insistent gestures. They often feel misunderstood by their peers, which can affect their self-esteem and lead to isolation and frustration.
Working life
People working with dysphasics need to be informed and made aware of the issues in order to prevent misunderstandings and provide effective support. Adults with dysphasia can benefit from ritualised schedules to help them organise their work better.
However, speech therapy is more difficult to implement for adults because of their family and professional commitments. They may also have difficulty obtaining professional qualifications and establishing social relationships in the workplace.
Prevention and awareness
Dysphasia cannot be prevented or predicted, but early diagnosis and speech and language therapy can help improve language development and reduce the risk of educational failure and isolation.
Local initiatives aim to improve the reception and early diagnosis of children suffering from dysphasia.
The role of parents and teachers
Parents play a crucial role by reporting language delays from the age of 2 and by working with educators and health professionals. Testimonies from parents show the importance of early detection and treatment from nursery school onwards.
Teachers need to be made aware of and trained to spot the signs of dysphasia and to work with specialists to help children. It is essential that nursery teachers are informed about dysphasia and methods of supporting dysphasic children in the classroom.
Awareness campaigns
Awareness campaigns aim to inform the public about the importance of early diagnosis and appropriate intervention for children with dysphasia. These campaigns play a key role in reducing stigma and improving care.
In a nutshell
The importance of early detection and management of dysphasia cannot be underestimated. With appropriate speech therapy and complementary therapies, dysphasic children can improve their communication and quality of life.
In conclusion, whether you are a parent, teacher or healthcare professional, your role is crucial in supporting children with dysphasia. Together, we can ensure that these children have the best chance of flourishing and succeeding.
Frequently asked questions
What is dysphasia?
Dysphasia is a primary disorder of oral language development, characterised by significant difficulties in expressing and understanding oral language. It is a disorder that affects childhood in particular and may require specialised support.
What are the symptoms of dysphasia?
Dysphasia is characterised by symptoms such as language delay, comprehension difficulties and pronunciation problems. It is important to consult a specialist for a precise diagnosis.
How is dysphasia diagnosed?
Dysphasia is diagnosed through a multidisciplinary assessment including child psychiatric interviews, a speech therapy assessment and a psychological assessment, generally from the age of 5.
What treatments are available for dysphasia?
The treatments available for dysphasia mainly include speech therapy, psychomotor therapy and occupational therapy. It is essential to consult a specialist to determine the best treatment plan.
What role do parents and teachers play in the treatment of dysphasia?
Parents and teachers play a crucial role in working with health professionals to support children with dysphasia. It is important to report language delays and to use appropriate methods.
Contenuto originale del team di scrittura di Upbility. La riproduzione di questo articolo, in tutto o in parte, senza accredito all'editore è vietata.
