Description
Speech delay, also known as alalia, refers to a delay in the development or use of the mechanisms that produce speech. Speech, as distinct from language, refers to the actual process of making sounds, using such organs and structures as the lungs, vocal cords, mouth, tongue, teeth, etc.
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Case Study on Evaluation and Management of Child whit Delayed Speech
Good communtcofionski//shove emergedos o key socio/skiil in moderndoy sociery.Childrenore noi exempifrom thispressure to communicateeffectively.porodoxicollyor perhops becouse of this pressure/here is on increosingoworenessof de/oysin /onguoge deve/opmentin children.Whetherbecouseof ihis increosingoworenessor becouseof otherbiological,sociolond environmenlolcousesthe incidenceof communicotion disorders in childrenhosrisen sharplyin the lostcoup/eof decodes.Given lhe increosing emphosison good communicotion ski//sin modern doy schoo/sond sociefzthis hos necessifofedthat childrenwitlt lhese disorders be identified eorly and provided with earlv interventionin order to prevent ihe coscoding negotive consequences o given child.The paperdescribesthe malar lo subrypesof communicoiion disorders found in children,th,eir couset why they need ro be-identified early onclhow rhisco, be done. The poper conc/u.des with o nole on interventiott possibi/ifiesond the need for increosingqworeness omong physicians,pediatricionsin porticulor.
lntroduciian Communicoiion, porriculoriy verbollonguogeis hoiledos the essenceof being humon ond the singleiroii thot seporotes us humonsfromoiher onimols.Communicoiion skillsore ploying on ever - increosingrole in todoy'ssociety. our undersiondin; of the processond sequenceof the ocquisitionof speech-
Keywords
speech-longuoge ocquisiiion,deloy,identificotion monogernenl &
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l o n g u c r g ek i i i sb y c h i l r j r e nh s v s o l s c s i n c r e c s e do n s i d e r o b lsyi n c et h e 1 9 7 0 s 'c From bir^th odulthooclchildreniecrrn to the dif{erent ospeciso{ verbol lcrngt.roge i n o g r c r d u oflo s h i o n- i n i t i c l l yl e o r n i n g t o u n d e r s i o r r dh e s i m p l e c o m m o n d st supportedby contextuolcues, moving on to o mostenT lhe speech sounds o{ crnri w,rrds, {ront then on to ihe q r o r n n r o i i c csrkl i l l so f c o r n b i r r i n g o r d sw nc.-rrcttives iinolly inlo sertiet-rces ond orrd !o 1hr:rlrc;-esubtlecrsps6ltof lonqucge s u c n o s e x c n o n g eo f o b s t r o c ti n { o r m o l i o n o n d o n o p p r e c i o t i o no f i o k e s o n d h u m o r e m e r g i n gg r o d u o l l yb Y odulthood.
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p o p u i c r t i c nP o n d e y n d A . i v c n i ,1 9 9 5 i i o io over9% ol ihe 0-l 6 yecr populoiicn (Suresh ond Sebostion, 2003). A. mcre reolistic esiimoteof octuol incidenceof thesedisordersis yetto be estoblished. Ccusotive Foctors The ori'oyo{ foctorsthoi couse o dei'.:y i n s p e e c h - l o n g u o goec q u i s i t i o n o n i ; e c b r o o d l yd i v i d e d i n t o t h e o r g o n i c r r
b i o l o g i c o o n d t h e p s y c h os o c i o l o r l e n v i r o n m e n t o lO f t h e m o r e e o s i l y . i d e n t i { i o b l eo m o n g t h e s e o r e t h e biologicolly couseddeloysond disorders s u c h o s h e o r i n g i m p o i r m e n t ,m e n i o l retordotion,congenitoldefectssuch cs The exp.losion { knowledgein these o cleftlip ond poloteor cerebrolpolsyonci 0 r e o sw o s c o n s e q u e n t o i h e c o m i n g n r - o r r i r eld s i o n s u c ho st r - o u m o t ibcr c i n e s togetherof different/diverse disciplines i n j u r y o r c e r e b r o l i n f e c t i c n sl i k e c o n c e r n e d i t hi o n q u o g e ,i so c q u i s i t i o n m e n i n g i t i so n d e n c e p h c l l t l sO f t n e s e w i b i o i o g i c c i l ; ; o u s e dd e l c y s . i r - is p e e c i - r o n d u s eb y c h i l d r e n . c t l o n g u o g ec c q u i s i t i o ni t e n t o r es e v i : r e i ' 1 ChiefonrongthenrwerePsycliology ond L i n g u i s t i c s i t h i h e i r v e r y d i v e r s e o { f e c l e d c h i i d i s r e i c t i v e l ve c s ! l v w i d e n i i { i , : b l e .lh e s o m e i s n c t i i u e . ' rnell-rods, iecrding the emergenceof o howeverof the niorenrildiyouectedsuch 1o o s u n i l o t e r o lo r m o d e r o t e i ys e v e r e n e w f i e l c io f i n v e s t i g o t i o nt,h o t o f ' P s y c h o l i n g u i s t i cls-'h. e r o b u s i n e w clisr..ipline psycholinguistics l only o{ no heoringlossor o mildmentolretordotion' d o cu m e n t e do r r d d e s c r i b e df h e s u b i l e or o subdurolcleft,wherethe inconsictent c h c r n g ei s o c h i i ds m o s t e r y { l o n g u o g e n o responses the child o{ten leocls1: o of f o i l u r e t o i d e n t i f yt h e p r o b l e m o r o f r o r n i n f o n c yt o o d u l t h o o d 'b u i o l s o neglectof the condition. provided on orroy of tools io identi{y d e l o y so n d d i s o r d e r sn t h e s o m e .T h e i Cquses of Speeeh Deloy
iclentificcriionspeech-lcrnguoge of deloys irrcl-rildren shlftedfrombeingo subiective o Mentol retordotion - i n l u i l i v e r o c e d u r eto o d e m o n s t r o b l e - o H e o r i n gl o s s p m e c s r : r o b l ee f i c i to r d e l o y . c M o t u r o t i o nd e l o y ( d e v e l o p m e n t c r i d l o n g u o g ed e l o y ) lnrcidence E s l i m c r t e s s p e e c h - l o n g u o gd e l o yi n of e c h i l d r e nin l n d i o o r e w i d e l yv o r i e d, r n d c Expressivelongu<lge disorcjer (developmeniol expressive ophcsio)
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{ o BilinEuci;si:, o Psi'c:csccicicjecrivcijon r Auriism r r Electivemutism Recepfive ophosio I n c r e o s ei n n u m b e r s ( W e t h e r b yo n d Prizont, 2000).Fudherspeech_ nguoge lo deloys/regressions ore,een ;n thule thot c h i l d r e no r e n o w b e i n gs e e no s o c o r e l e m e n to f t h e d i s o r d e rr o t h e r f h o p o c o n s e q u e n c e f t h e i r o u t i s mo r s o c i c r l o o loofness. F i n c l i y ,s p e c i f i cc h i l d h o o d s y n d r o m e s such os Aitention De{icitlHyperoctiviiy D i s o r d e r( A D H D ) ,F r o g i l eX s y n d r o m e omong ond Londou-Kleffnersyndrome, others, ore olso being increoiihgl! i d e n t i f i e d n dd e l o yi n s p e e c h _ l o n g r J o u o ocquisilionis often o mojorsyn-rptor_n of t h e s e c h i l d h o o ds y n d r o m e s( L o y s o n , Crois ond V/crtson, 20OO) Aport from these bioiogicol/orgcrnic foctors, environmentolfoctors,rl|'.r o, b ; - m u l t i l i n g u o l i s mo,c k o f o d e q u o t e l s t i m u l o i i o no r e o i s o k n o w nt o c o u s e d e i o y si n s p e e c h- l o n g u o g eo c q u i s i i i o n . l n d i o i s o c o u n i r yo f m o n y l o n e u o g e s o n d w h i l e o c h i l d i s o f i e n . o S r o b l *o f leorning more thon one iorrquocte: s i r n u l i o n e o u s l yp,r e s e r nd o y u r b o n l s i i u o i i o n sw h e r e i n m o r e l h o n o n e longuogeis spokenot home (porenfs f r o m d i f f e r e n tc o m m u n i i i e s ) ,w i t h o n
H Cerebrol polsy During the lost decode or two on i n c r e o s i n gn u m b e r o f c h i l d r e nw i t h developmenioionguogedisorders I such c s S p e c i f i cL o n g u o g el m p o i r m e n t( S L i ) , L e o r n i n gD i s c b i l i t y( L D )o n d D " u " l o p _ mentolVerbol Dysproxio (DVD)ore being identi{ied(Leonord,2000, Koronthonj R o z o r i o ,2 0 0 3 ) . E s s e n t i o l ltyh e s e o r e c h i l d r e nw i t h n o r m o l m e d i c o l o n d d e v e l o p m e n t oh i s t o r i e sw h o h o v e o l s p e c i { i cd e l o y i n t h e o c q u i s i t i o no f s p e e c h - l o n g u o g e n d s k i l l ss u c h o s o reod.ingond writing, with o degree of overlop befueen ihe wo. I n o d d i t i o n t h e i n c i d e n c eo f o i h e r d e v e l o p m e n t o ld i s o r d e r ss u c h o s Pervos.ive developmeniodisorders(pDD) I o n d t h e A u t i s m S p e c t r u mD i s o r d e r s (ASD),whichwere eorlierthoughtto be rore disorders ore showingon olorming
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need for os well os ovoilobility f o i n t e r v e n t i o n ,r e r e l o t i v e l yl g ho n d w e l l o h e s t o b l i s h e dn l n d i o . T h e m o r e s u b t i e i d i s o r d e r ss u c h o s S L l , P D D / A S Do n d DVD howeverore not known in equcl m e o s u r en o i o n l y t o t h e l o y p e r s o n u t b o l s o m o r e i m p o r t o n t l yt o g e n e r o l proctitioners crndpediotricions who ore omong ihe firstthotthe concerned fomily c o n s u l t s .T h e m o s t c o m m o n r e f r o i n r s 'notto .worry', uncie or grond fother An w h o s p o k el o l eb u t c o u g h tu p ! o t e rc r n d
i n w h i c h b c t h p o r e n t so r e e m p l o y e d , o f t e n w i t l r l o n g w o r k i n g h o u r s .A n i m m e d i o t eo l l o u io f t h e s ec h o n g i n gl i f e f s l y l e si s t h e l o c k o f m u c h n e e d e d s t i m u l o t i o no r i h e g r o w i n gi n f o n tw h o { r e c e i v e sp o s s i v ec o r e { r o m e l d e r l y grondporents ond/or nroid servonis- o s i t u o l i o nn o l l o o c o n d u c i v ef o r n o r m c l speech-longuoge velopmenl. de A m o n g l h e s c v e r o lc o u s e so f d e l o y e d spcech-lonqucqe quisifionescribed cc d r o b o v eo w o r e n e s s f c o n d i t i o n s u c ho s o o h e o r i n g i m p o i r r n e n to n d m e n t o l
turned out to be fine is o{tencited. Porodoxicolly,is indeedwherethere is ii o l r e o d yp o s i t i v e{ o m i l y h i s t o r yth o t t h e m o r e i n t r o c i o b l ed e l o y s i n s p e e c h l o n g u o g ed e v e l o p m e no c c u r " t Developrnentcl Mileslones for Speech-longuoge Acquisition: A brief descriplionof the milestones of s p e e c h - l c n g u o g ed e v e l o p m e n ti n n o r m o lc h i i d r e n. v i lnl o i b e o u t o { p l o c e h e r e .T h e b i r t hc r y i s c o n s i d e r e d s t h e f i r s te v e n ti n i h e d e v e l o o m e not f s c e e c h
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d o c u m e n t o i i o n f l o n g u o g es k i l l si n r h e o c h i l d e n h o n c i n go u r u n d e r s t o n d i nogf t h i sc o m p l e xo n d l o n gd r o w np r o c e s sl.r n o w b e c o m e c l e c r i h o i l e o r n i n gt o producewords wos bui one ospeciof i h e s e v e r o if o c e l s o i c o m m u n i c o t i o n t h r o u g h s p e e c h o n d l o n g u o g e .I n oddition to mosteryof words (lexicon) t h ec h i l dl e o r n sto d e c i p h eo , - , dp r o d r c e r
ulteronces suchos distinci typesof crying signi{yinghunger,discomfortond .gu os wellos comfod soundswhich.opp"trduring or iust ofter relieffrom'distress : y . h o s f e b d i n go r d i o p e r c h o n g i n g . UoUbti,.,-g T.henemerges the stoge . c h o r o c t e r i z ebdy i h e c h o i n"f go r I i n k i n i in o f s p e e c hs y l l o b l e sB y 6 - 7 m o n t h sr h J . chiid usesvocolizotionto get ottention o r r d e x p r e s sh i s d e m o n d s .T h i s i s f o i i o w e db y v o c c l p l o y i n w h i c h t o n o l chorocteristics f odull speech ore o replicoted.Then comesthe use of true w o r d sb e i w e e ni 2 - l 5 m o n i h s .
t h e s . p e e cs o u n d so f h i sl o r r q r j c r eoen d h t h e r u l e so c c o r d i r r gf o w h r c h l h e s e speech sounds ore corlbint_.rJ ( p h o n o l o g y )t,h e r u i e sg o v e r n r n qt h e c o m b i n o l i o no { w o r d s i n l o s e n l e n c e s (syntox), significonceof words crnd ihe t h e i rr e l o t e d n e sosm o n gt h e m s e l v eosn cj
W i t h t h e o d v e n t o f t h e d i s c i p l i n eo f psycholinguistics stud;, ihe process the of o f s p e e c h - l o n g u o goec q u i s i t i o ni n childrenreceived oddedimpetus.For on t h e f i r s tt i m e l i n g u i s i i cm e t h o d so n d p r e m i s e sw e r e o p p l i e d t o t h e o c t u o l
t h ee x t e r n o l w o r i ds e m o n i i c st)h,es o c i r : l ( r u l e st h o l g o v e r n t h e u s e o f l o n g u o g e ( p t o g m o l i c s )o n d t h e s t r u c l r , - " o l d i s c o u r s e s u c h o s s t o r yt e l l i n g o n d s n o r r o l i o n s .I n o d d i t i o nt h e r e i s t h e
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cvl e r o l o n g e r s p o n o f t i m e b e q i n n i n gi n e o r l y c h i l d h o o d b u t e x t e n d i n gi g h tu p t o o d u l t h o o d .W i i h i t r c o m eo n i n c r e o s i n g p p r e c i o t i o n f t h e o o s n o w b o l l i n ge f { e c to f l o g s t h o t o r e unottendedto. Assessmeniprocedures t h o i w e r e d e v e l o p e d{ r o m i h e . l 9 7 0 s o n w o r d s e r ef i n et u n e dt o p i c ku p e v e n w m o r g i n od e l o y s( o n et o t w o y e o r s )n t h e l i e j e u e l o p r r ri eIns c h e crJe sc f t h edi l f e r e n t o il o s p e c l s f l o n g u o g e .h e i m p o r l o n c e f o i o eorly iclenlificotion nd occurote o o s s e s s m e n tos1 e v e n r e l o t i v e l y n i n o r r d e l o y sh o v e b e e nh i g h l i g h t e C i v e nt h e g scholostic pressure thot is exededupon
Regretfcbly physicions/pediotricions the w h o h c v e o v i t o ir o l e i n e o r l yi d e n l i f i c c t i o no { c c r n n . : u n i c o i i o ns o r d e r s r e di o noi os yei sufficienily owore of the neecj for eorlyidentrficotion communicaticn of disorders. Thisis porticulorly true of ihe
d e v e l o p m e n t od i s o b i l i t i e s u c h o s S . i l ond PDD thot we ore now increosing,,r identifiring., comporedio otherbette,- os knownond moreobviousdisorders sucn o s h e o r i n g i m p o i r m e n to n d m e n t o l r e t o r d o t i o n .T h i s i s o l l t h e m o r e regrettoble since developmenicl d i s o b i l i t i essu c ho s P D D r e s p o n dw e l lt o eorlyinterveniion, whichis in focttheonly inlervention hosproducedconsisteni thot results.Even more imporlontlythe lock o { e c r l y i n i e r v e n t i o no f t e n l e o d s t o r e g r e s s i oo f o l r e o d yo c q u i r e ds k i l l s n c i n o e v e n t u o l l yt o i n t r o c t o b l eb e h o v i o r c l issues.
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Eorlyidentificoiionis tc be followed by oppropriotecounselingond refer-rols for o u rc h i l d r e nb o t hi n s c h o o l so n d i n i h e i r f u r t h e r m o n o g e m e n to n d p h y s i c i o n s h i g h l yc o m p e t i t i v e o c i o l e n v i r o n m e n t . hoveon importontroleio ploy,heretoo. s Giventhot verbolond or writien,literory The physicionis noi only the fir-st person l o n g u c g ei s t h e p r i m o r ym e d i u mo n to be contoctedby the fomily but is olso. r v h i c hc c o d e n r i cs k i ! l sc r e b o s e Ci t i s ihe mosttrusted. Appropriotecounseling fecu('inizrld thci ihe;e ci';rlr-iys ivlrirh c b y i i r ' . : 1 . ; h y s i c i c nr d r e f e r r o i+ o t h e i g e n e r o l i o rorr f w o w o u l d h o v ep r o b o b l concernedproiessionol goeso longwo,r, y hoclno overridingef{ecton the childs i n s e t t i n gt h e m o n o g e m e n tt r o i e c t o r y . overollcjevelopnrent now terrdio hove S p e e c hL on gu o g e P o i h o l o g i s t s / t h e r o cl ccrscociing{fect on the child's e pistsore now to be {ound in the mcioiperformoncein schoolcnd consequenily c i t i e so f I n d i o w i t h s e v e r o lt r o i n i n g o n h i s o r h e r o v e r o l lw e l i b e i n g . i n collegespi-oliferoting.is olsoirnportoni It m o d e r r rs o c i e l yc o n t i n u n i c o i i o nh o t . i s { o r t h e p h y s i c i o no c o u n s e lt h e { o m i l y t t regording the noture of intervenlion q u i c ko n d p r e c i s eh o s o h i g h p r e m i u m
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F i n o l l yo s r e s p o n s i b l ei i i z e n s f t n i s , c o counirywe olso hove o role to ploy in i n c r e o s i n on t r b l i r w o r e n e s sc i n d p r o v i d i n gf o r o d e q u o t e { o c i l i t i e sa n d socieiolsupport.Intenventions such cs s p e e c h - l o n g u o gte e r o p yg i v e n t h e i r h Iong-termnoturecon be expensive for fomilies. thedeveloped In couniries these orocticeshnve hepn in effectfor o few d e c o d e so n d e v e r y c h ' i l d i s p r o v i d e d iheseinterventions ond whenneeded os os o motter of right. We ore yet to recognize these developmentol d i s o b i l i t i eu n d e ri h e o n l y L o wt h o t w e s hove for the wel{ore o{ those with d i s q b i l i t i e s- P e r s o n sw i t h D i s o b i l i t i e s (EquolOpportunitiesProtection Rights oi ond Full Porficipoiion) .Act, 1995. lt is time thot we recognizethot oporl from o u r s o c i o lo n d m o r o l r e s p o n s i b i l i f i e s o
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2 ) L o y s o nT . J . , r o i s ,E . ,& W o t s o n L . R , C , 2 0 0 0 . H o n d b o o k o f E o r l yL c r r g u o g e : l m p o i r m e nitn C h i l d r e n :N o i u r e .D e l m o r T h o m s o nL e o r n i n gN Y . : 3 ) L e o n o r d ,L . B . 2 0 0 0 . C h i l d r e nw i l h S p e c i f i cL o n g u o g el r n p o i r m e r r t " .l i - l l\ Press:Cornbricige, Moss. 4 ) P o n d e yR . S .& A d v o n i ,[ . . ] ? 9 5 . ' P e r s p e c i i v e si n D i s o b i l i i y o n d R e h o b i l i t o t i o n ' .k o s :N e w D e l h i . Vi 5 ) S u r e s h ,P A . & S e b o s t i c n ,S . 2 0 0 3 .
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Speech delay, also known as alalia, refers to a delay in the development or use of the mechanisms that produce speech. Speech, as distinct from language, refers to the actual process of making sounds, using such organs and structures as the lungs, vocal cords, mouth, tongue, teeth, etc.
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Case Study on Evaluation and Management of Child whit Delayed Speech
Good communtcofionski//shove emergedos o key socio/skiil in moderndoy sociery.Childrenore noi exempifrom thispressure to communicateeffectively.porodoxicollyor perhops becouse of this pressure/here is on increosingoworenessof de/oysin /onguoge deve/opmentin children.Whetherbecouseof ihis increosingoworenessor becouseof otherbiological,sociolond environmenlolcousesthe incidenceof communicotion disorders in childrenhosrisen sharplyin the lostcoup/eof decodes.Given lhe increosing emphosison good communicotion ski//sin modern doy schoo/sond sociefzthis hos necessifofedthat childrenwitlt lhese disorders be identified eorly and provided with earlv interventionin order to prevent ihe coscoding negotive consequences o given child.The paperdescribesthe malar lo subrypesof communicoiion disorders found in children,th,eir couset why they need ro be-identified early onclhow rhisco, be done. The poper conc/u.des with o nole on interventiott possibi/ifiesond the need for increosingqworeness omong physicians,pediatricionsin porticulor.
lntroduciian Communicoiion, porriculoriy verbollonguogeis hoiledos the essenceof being humon ond the singleiroii thot seporotes us humonsfromoiher onimols.Communicoiion skillsore ploying on ever - increosingrole in todoy'ssociety. our undersiondin; of the processond sequenceof the ocquisitionof speech-
Keywords
speech-longuoge ocquisiiion,deloy,identificotion monogernenl &
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l o n g u c r g ek i i i sb y c h i l r j r e nh s v s o l s c s i n c r e c s e do n s i d e r o b lsyi n c et h e 1 9 7 0 s 'c From bir^th odulthooclchildreniecrrn to the dif{erent ospeciso{ verbol lcrngt.roge i n o g r c r d u oflo s h i o n- i n i t i c l l yl e o r n i n g t o u n d e r s i o r r dh e s i m p l e c o m m o n d st supportedby contextuolcues, moving on to o mostenT lhe speech sounds o{ crnri w,rrds, {ront then on to ihe q r o r n n r o i i c csrkl i l l so f c o r n b i r r i n g o r d sw nc.-rrcttives iinolly inlo sertiet-rces ond orrd !o 1hr:rlrc;-esubtlecrsps6ltof lonqucge s u c n o s e x c n o n g eo f o b s t r o c ti n { o r m o l i o n o n d o n o p p r e c i o t i o no f i o k e s o n d h u m o r e m e r g i n gg r o d u o l l yb Y odulthood.
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p o p u i c r t i c nP o n d e y n d A . i v c n i ,1 9 9 5 i i o io over9% ol ihe 0-l 6 yecr populoiicn (Suresh ond Sebostion, 2003). A. mcre reolistic esiimoteof octuol incidenceof thesedisordersis yetto be estoblished. Ccusotive Foctors The ori'oyo{ foctorsthoi couse o dei'.:y i n s p e e c h - l o n g u o goec q u i s i t i o n o n i ; e c b r o o d l yd i v i d e d i n t o t h e o r g o n i c r r
b i o l o g i c o o n d t h e p s y c h os o c i o l o r l e n v i r o n m e n t o lO f t h e m o r e e o s i l y . i d e n t i { i o b l eo m o n g t h e s e o r e t h e biologicolly couseddeloysond disorders s u c h o s h e o r i n g i m p o i r m e n t ,m e n i o l retordotion,congenitoldefectssuch cs The exp.losion { knowledgein these o cleftlip ond poloteor cerebrolpolsyonci 0 r e o sw o s c o n s e q u e n t o i h e c o m i n g n r - o r r i r eld s i o n s u c ho st r - o u m o t ibcr c i n e s togetherof different/diverse disciplines i n j u r y o r c e r e b r o l i n f e c t i c n sl i k e c o n c e r n e d i t hi o n q u o g e ,i so c q u i s i t i o n m e n i n g i t i so n d e n c e p h c l l t l sO f t n e s e w i b i o i o g i c c i l ; ; o u s e dd e l c y s . i r - is p e e c i - r o n d u s eb y c h i l d r e n . c t l o n g u o g ec c q u i s i t i o ni t e n t o r es e v i : r e i ' 1 ChiefonrongthenrwerePsycliology ond L i n g u i s t i c s i t h i h e i r v e r y d i v e r s e o { f e c l e d c h i i d i s r e i c t i v e l ve c s ! l v w i d e n i i { i , : b l e .lh e s o m e i s n c t i i u e . ' rnell-rods, iecrding the emergenceof o howeverof the niorenrildiyouectedsuch 1o o s u n i l o t e r o lo r m o d e r o t e i ys e v e r e n e w f i e l c io f i n v e s t i g o t i o nt,h o t o f ' P s y c h o l i n g u i s t i cls-'h. e r o b u s i n e w clisr..ipline psycholinguistics l only o{ no heoringlossor o mildmentolretordotion' d o cu m e n t e do r r d d e s c r i b e df h e s u b i l e or o subdurolcleft,wherethe inconsictent c h c r n g ei s o c h i i ds m o s t e r y { l o n g u o g e n o responses the child o{ten leocls1: o of f o i l u r e t o i d e n t i f yt h e p r o b l e m o r o f r o r n i n f o n c yt o o d u l t h o o d 'b u i o l s o neglectof the condition. provided on orroy of tools io identi{y d e l o y so n d d i s o r d e r sn t h e s o m e .T h e i Cquses of Speeeh Deloy
iclentificcriionspeech-lcrnguoge of deloys irrcl-rildren shlftedfrombeingo subiective o Mentol retordotion - i n l u i l i v e r o c e d u r eto o d e m o n s t r o b l e - o H e o r i n gl o s s p m e c s r : r o b l ee f i c i to r d e l o y . c M o t u r o t i o nd e l o y ( d e v e l o p m e n t c r i d l o n g u o g ed e l o y ) lnrcidence E s l i m c r t e s s p e e c h - l o n g u o gd e l o yi n of e c h i l d r e nin l n d i o o r e w i d e l yv o r i e d, r n d c Expressivelongu<lge disorcjer (developmeniol expressive ophcsio)
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{ o BilinEuci;si:, o Psi'c:csccicicjecrivcijon r Auriism r r Electivemutism Recepfive ophosio I n c r e o s ei n n u m b e r s ( W e t h e r b yo n d Prizont, 2000).Fudherspeech_ nguoge lo deloys/regressions ore,een ;n thule thot c h i l d r e no r e n o w b e i n gs e e no s o c o r e l e m e n to f t h e d i s o r d e rr o t h e r f h o p o c o n s e q u e n c e f t h e i r o u t i s mo r s o c i c r l o o loofness. F i n c l i y ,s p e c i f i cc h i l d h o o d s y n d r o m e s such os Aitention De{icitlHyperoctiviiy D i s o r d e r( A D H D ) ,F r o g i l eX s y n d r o m e omong ond Londou-Kleffnersyndrome, others, ore olso being increoiihgl! i d e n t i f i e d n dd e l o yi n s p e e c h _ l o n g r J o u o ocquisilionis often o mojorsyn-rptor_n of t h e s e c h i l d h o o ds y n d r o m e s( L o y s o n , Crois ond V/crtson, 20OO) Aport from these bioiogicol/orgcrnic foctors, environmentolfoctors,rl|'.r o, b ; - m u l t i l i n g u o l i s mo,c k o f o d e q u o t e l s t i m u l o i i o no r e o i s o k n o w nt o c o u s e d e i o y si n s p e e c h- l o n g u o g eo c q u i s i i i o n . l n d i o i s o c o u n i r yo f m o n y l o n e u o g e s o n d w h i l e o c h i l d i s o f i e n . o S r o b l *o f leorning more thon one iorrquocte: s i r n u l i o n e o u s l yp,r e s e r nd o y u r b o n l s i i u o i i o n sw h e r e i n m o r e l h o n o n e longuogeis spokenot home (porenfs f r o m d i f f e r e n tc o m m u n i i i e s ) ,w i t h o n
H Cerebrol polsy During the lost decode or two on i n c r e o s i n gn u m b e r o f c h i l d r e nw i t h developmenioionguogedisorders I such c s S p e c i f i cL o n g u o g el m p o i r m e n t( S L i ) , L e o r n i n gD i s c b i l i t y( L D )o n d D " u " l o p _ mentolVerbol Dysproxio (DVD)ore being identi{ied(Leonord,2000, Koronthonj R o z o r i o ,2 0 0 3 ) . E s s e n t i o l ltyh e s e o r e c h i l d r e nw i t h n o r m o l m e d i c o l o n d d e v e l o p m e n t oh i s t o r i e sw h o h o v e o l s p e c i { i cd e l o y i n t h e o c q u i s i t i o no f s p e e c h - l o n g u o g e n d s k i l l ss u c h o s o reod.ingond writing, with o degree of overlop befueen ihe wo. I n o d d i t i o n t h e i n c i d e n c eo f o i h e r d e v e l o p m e n t o ld i s o r d e r ss u c h o s Pervos.ive developmeniodisorders(pDD) I o n d t h e A u t i s m S p e c t r u mD i s o r d e r s (ASD),whichwere eorlierthoughtto be rore disorders ore showingon olorming
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need for os well os ovoilobility f o i n t e r v e n t i o n ,r e r e l o t i v e l yl g ho n d w e l l o h e s t o b l i s h e dn l n d i o . T h e m o r e s u b t i e i d i s o r d e r ss u c h o s S L l , P D D / A S Do n d DVD howeverore not known in equcl m e o s u r en o i o n l y t o t h e l o y p e r s o n u t b o l s o m o r e i m p o r t o n t l yt o g e n e r o l proctitioners crndpediotricions who ore omong ihe firstthotthe concerned fomily c o n s u l t s .T h e m o s t c o m m o n r e f r o i n r s 'notto .worry', uncie or grond fother An w h o s p o k el o l eb u t c o u g h tu p ! o t e rc r n d
i n w h i c h b c t h p o r e n t so r e e m p l o y e d , o f t e n w i t l r l o n g w o r k i n g h o u r s .A n i m m e d i o t eo l l o u io f t h e s ec h o n g i n gl i f e f s l y l e si s t h e l o c k o f m u c h n e e d e d s t i m u l o t i o no r i h e g r o w i n gi n f o n tw h o { r e c e i v e sp o s s i v ec o r e { r o m e l d e r l y grondporents ond/or nroid servonis- o s i t u o l i o nn o l l o o c o n d u c i v ef o r n o r m c l speech-longuoge velopmenl. de A m o n g l h e s c v e r o lc o u s e so f d e l o y e d spcech-lonqucqe quisifionescribed cc d r o b o v eo w o r e n e s s f c o n d i t i o n s u c ho s o o h e o r i n g i m p o i r r n e n to n d m e n t o l
turned out to be fine is o{tencited. Porodoxicolly,is indeedwherethere is ii o l r e o d yp o s i t i v e{ o m i l y h i s t o r yth o t t h e m o r e i n t r o c i o b l ed e l o y s i n s p e e c h l o n g u o g ed e v e l o p m e no c c u r " t Developrnentcl Mileslones for Speech-longuoge Acquisition: A brief descriplionof the milestones of s p e e c h - l c n g u o g ed e v e l o p m e n ti n n o r m o lc h i i d r e n. v i lnl o i b e o u t o { p l o c e h e r e .T h e b i r t hc r y i s c o n s i d e r e d s t h e f i r s te v e n ti n i h e d e v e l o o m e not f s c e e c h
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d o c u m e n t o i i o n f l o n g u o g es k i l l si n r h e o c h i l d e n h o n c i n go u r u n d e r s t o n d i nogf t h i sc o m p l e xo n d l o n gd r o w np r o c e s sl.r n o w b e c o m e c l e c r i h o i l e o r n i n gt o producewords wos bui one ospeciof i h e s e v e r o if o c e l s o i c o m m u n i c o t i o n t h r o u g h s p e e c h o n d l o n g u o g e .I n oddition to mosteryof words (lexicon) t h ec h i l dl e o r n sto d e c i p h eo , - , dp r o d r c e r
ulteronces suchos distinci typesof crying signi{yinghunger,discomfortond .gu os wellos comfod soundswhich.opp"trduring or iust ofter relieffrom'distress : y . h o s f e b d i n go r d i o p e r c h o n g i n g . UoUbti,.,-g T.henemerges the stoge . c h o r o c t e r i z ebdy i h e c h o i n"f go r I i n k i n i in o f s p e e c hs y l l o b l e sB y 6 - 7 m o n t h sr h J . chiid usesvocolizotionto get ottention o r r d e x p r e s sh i s d e m o n d s .T h i s i s f o i i o w e db y v o c c l p l o y i n w h i c h t o n o l chorocteristics f odull speech ore o replicoted.Then comesthe use of true w o r d sb e i w e e ni 2 - l 5 m o n i h s .
t h e s . p e e cs o u n d so f h i sl o r r q r j c r eoen d h t h e r u l e so c c o r d i r r gf o w h r c h l h e s e speech sounds ore corlbint_.rJ ( p h o n o l o g y )t,h e r u i e sg o v e r n r n qt h e c o m b i n o l i o no { w o r d s i n l o s e n l e n c e s (syntox), significonceof words crnd ihe t h e i rr e l o t e d n e sosm o n gt h e m s e l v eosn cj
W i t h t h e o d v e n t o f t h e d i s c i p l i n eo f psycholinguistics stud;, ihe process the of o f s p e e c h - l o n g u o goec q u i s i t i o ni n childrenreceived oddedimpetus.For on t h e f i r s tt i m e l i n g u i s i i cm e t h o d so n d p r e m i s e sw e r e o p p l i e d t o t h e o c t u o l
t h ee x t e r n o l w o r i ds e m o n i i c st)h,es o c i r : l ( r u l e st h o l g o v e r n t h e u s e o f l o n g u o g e ( p t o g m o l i c s )o n d t h e s t r u c l r , - " o l d i s c o u r s e s u c h o s s t o r yt e l l i n g o n d s n o r r o l i o n s .I n o d d i t i o nt h e r e i s t h e
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cvl e r o l o n g e r s p o n o f t i m e b e q i n n i n gi n e o r l y c h i l d h o o d b u t e x t e n d i n gi g h tu p t o o d u l t h o o d .W i i h i t r c o m eo n i n c r e o s i n g p p r e c i o t i o n f t h e o o s n o w b o l l i n ge f { e c to f l o g s t h o t o r e unottendedto. Assessmeniprocedures t h o i w e r e d e v e l o p e d{ r o m i h e . l 9 7 0 s o n w o r d s e r ef i n et u n e dt o p i c ku p e v e n w m o r g i n od e l o y s( o n et o t w o y e o r s )n t h e l i e j e u e l o p r r ri eIns c h e crJe sc f t h edi l f e r e n t o il o s p e c l s f l o n g u o g e .h e i m p o r l o n c e f o i o eorly iclenlificotion nd occurote o o s s e s s m e n tos1 e v e n r e l o t i v e l y n i n o r r d e l o y sh o v e b e e nh i g h l i g h t e C i v e nt h e g scholostic pressure thot is exededuponRegretfcbly physicions/pediotricions the w h o h c v e o v i t o ir o l e i n e o r l yi d e n l i f i c c t i o no { c c r n n . : u n i c o i i o ns o r d e r s r e di o noi os yei sufficienily owore of the neecj for eorlyidentrficotion communicaticn of disorders. Thisis porticulorly true of ihe
d e v e l o p m e n t od i s o b i l i t i e s u c h o s S . i l ond PDD thot we ore now increosing,,r identifiring., comporedio otherbette,- os knownond moreobviousdisorders sucn o s h e o r i n g i m p o i r m e n to n d m e n t o l r e t o r d o t i o n .T h i s i s o l l t h e m o r e regrettoble since developmenicl d i s o b i l i t i essu c ho s P D D r e s p o n dw e l lt o eorlyinterveniion, whichis in focttheonly inlervention hosproducedconsisteni thot results.Even more imporlontlythe lock o { e c r l y i n i e r v e n t i o no f t e n l e o d s t o r e g r e s s i oo f o l r e o d yo c q u i r e ds k i l l s n c i n o e v e n t u o l l yt o i n t r o c t o b l eb e h o v i o r c l issues.
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