Dislalia: types, symptoms, causes and treatment
The term dislalia refers to the difficulties in pronouncing certain sounds , which can occur in children of different ages. It is, according to the new international classifications of diagnosis of mental disorders, a disorder of speech sounds.
In this article we will see what dyslalia is, what are its types and causes, as well as some ways to perform evaluation and treatment.
- Related article: "The 8 types of speech disorders"
Language development
Oral language is the set of sounds that are articulated to express what we need, feel or think. It is about a behavior as well as a cognitive ability, and we develop it from the first years of life. Its manifestation is related to the maturation of the nervous system , specifically of sensory and motor area. To itself, it is related to the affective and social bonds that we establish, and to the development of other cognitive abilities.
Artigas and García-Nonell (2008) tell us that the development of language skills correspond to the child's chronological age. Thus, between 0 and 3 months of age, the emission of monotone sounds is expected. Between 9 and 12 months, negations are understood and caregivers are named (usually mom and dad). From the 3, simple questions are expected and their speech is understood by the family nucleus. By age 5, you can tell what happens to you and use articles; and towards 7 years a verbal fluency and the use of conjunctions are expected.
However, it may happen that in some cases the chronological age does not correspond to the development of the language , that is, that not all children acquire the same skills at the same time. For example, some children may begin to understand what people are saying, but with limitations to explain themselves. It can also happen that children express themselves verbally in a slow way, or with little fluency, or they may express themselves so fluently that their language is intelligible. Likewise, among the possibilities that are included in the development of language is what we have called "dislalia".
Maybe you're interested: "Bradilalia: what it is, causes, treatment and associated symptoms"
What is dislalia?
The word dislalia comes from the Greek "dys", which means "difficulty"; and "lalein" which means "to speak". Is about a difficulty in producing certain sounds or groups of sounds in the way that is considered appropriate. It can be detected, for example, when a child frequently resorts to the omission of a certain sound by means of silence or vocal lengthening. Or if the child always replaces the same sound with a similar one, what is a replacement case.
It can also be made visible by distortion, that is, when the child frequently resorts to the emission of an approximate sound, but that is not the one that fits with their conversation. Finally it may happen that the child inserts a sound as support .
Recent international definitions
The term "dislalia" has recently been displaced from the international classifications of mental disorders, however it continues to be used in everyday and specialized language to refer to the phonetic difficulties that some children have .
For its diagnosis, the DSM-V considers the latter no longer as "dislalia" but as a "Speech Sore Disorder" (TSH). It is a set of central alterations and own phonological component that occur at the level of the pronunciation of some phonemes.
6 types and causes
Although the classifications may vary, according to Aguilar-Valera (2017); Hernández and Rubalcaba (2017), there are the following types of dyslalia: physiological or evolutionary, organic, phonological, functional and mixed. Likewise, the dyslalia can be divided according to the difficulty in the specific pronunciation.
1. Physiological or evolutionary
It is considered an evolutionary dyslalia to the case in which the child he does not repeat by imitation those words he hears , even though its development and chronological age is considered adequate for this. Its development is therefore due to a determined maturation of the brain and the phonoarticulator device. It usually occurs around 4 years of age and becomes visible by a phonetically incorrect repetition.
2. Organic
It is a dyslalia of functional type when the joint is related to the peripheral organs that control speech. In this case the children they use substitution more frequently , the omission or distortion of the sound that is expected to be pronounced.
3. Audiógena
As the name implies, it is the dislalia that is a consequence of a hearing impairment .
4. Functional
It results from the operation of the gnostic recognition system and the practical production system, so its etiology is related to the development of cognitive processes .
5. Mixed
As its name says, a mixed dyslalia is one in which the manifestations of the previous types are presented simultaneously.
6. According to the pronunciation
According to the specific difficulties for pronunciation according to the alphabet, Peña-Casanova, 2014 (cit in Hernández and Rubalcaba, 2017), tells us that the dislalia can be divided as follows :
- Betacism: in the pronunciation of the B
- Deltacismo: pronunciation of the D
- Gammacismo: pronunciation of the G
- Kappacism: pronunciation of the K
- Mistacism: pronunciation of the M
- Rotacism: pronunciation of the R
- Sigmatism: pronunciation of the S
Possible causes, evaluation and treatment
The dislalia has a development and a multi-causal course. That is, it is caused by the presence of different elements, among which some determined organic function can be found, and also a parenting style that is not favoring fluency in language and communication.
It can be evaluated through the Glatzel Test , which takes into account nasal permeability and phonarticulation; or by the Rosenthal Test that considers the respiratory mode. It is also important to make qualitative assessments based on the observation of speech expression and reception, in order to determine the support needs in communication.
Treatments include speech therapy and muscle exercises necessary for the articulation: the lips, the tongue, the palate, the tonsils, the frenulum. The same exercises include activation of the nasal and oral apparatus, and it is important that they be planned with a certain frequency and rhythm, in correspondence with the needs and the zone of proximal development of the child. Otherwise, far from favoring its development, it can hinder and cause impatience or manifestations of anxiety.
To determine an adequate treatment, it is important to begin by knowing the cause of the dyslalia as well as the immediate needs of both the child and the family or their immediate environment.
Bibliographic references:
- Aguilar-Valera, J.A. (2017). Communication disorders from the DSM-V. The need for differential diagnoses. Neuropsychology Notebooks (11) 1: 144-156.
- Hernández, A. and Ruvalcaba, I. (2017). Language disorders Retrieved July 31, 2018. Available at // s3.amazonaws.com/academia.edu.documents/51549900/ORL-Tranches-of-the-language.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1533037090&Signature=grC1KSPM7lu6uMiWTjlnBZEU9VQ%3D&response-content-disposition=inline % 3B% 20filename% 3DTests_of_language_University_of_G.pdf.
