Dyslalia: types, symptoms, causes and treatment

The term dyslalia refers to the difficulty of 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 assessment and treatment.

    Language development

    Oral language is the set of sounds that are articulated to manifest what we need, feel or think. It is both a behavior and a cognitive skill, and we develop it in the early years of life. Its manifestation is related to the maturation of the nervous system, Specifically sensory and motor zone. By itself, it is related to the emotional and social bonds we make and the development of other cognitive skills.

    Artigas and García-Nonell (2008) tell us that the development of language skills corresponds to the chronological age of a child. Thus, between 0 and 3 months, the emission of monotonous sounds is expected. Between 9 and 12 months, refusals are included and caregivers (usually mother and father) are appointed. From 3, simple questions are expected and their speech is understood by the family. Around the age of 5, he can explain what is happening to him and use articles; and by the age of 7, 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 languageIn other words, not all children learn the same skills at the same time. For example, some children may begin to understand what people tell them, but with limitations in explaining themselves. Children may also express themselves verbally slowly, or not fluently, or they may be speaking so fluently that their language is intelligible. In addition, among the possibilities that are included in the development of language, there is what we have called “dyslalia”.

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    What is dyslalia?

    The word dyslalia comes from the Greek “dys”, which means “difficulty”; and “lalein” which means “to speak”. This is difficulty producing certain sounds or groups of sounds in the manner deemed appropriate. It can be detected, for example, when a child often 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, which is a case of substitution.

    It can also be made visible by distortion, that is, when the child frequently resorts to the emission of an approximate sound, but this is not what corresponds to his conversation. finally it may happen that the child inserts a sound as a support.

    Recent international definitions

    The term “dyslalia” has recently been moved from international classifications of mental disorders, but it continues to be used in common and specialized language to refer to the phonetic difficulties that some children present.

    For its diagnosis, the DSM-V considers the latter no longer as a “dyslalia” but as a “sound-to-speech disorder” (TSH). It is a set of central alterations specific to the phonological component that occur in the pronunciation of certain phonemes.

    6 types and causes

    Although classifications 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, dyslalia can be divided according to the specific pronunciation difficulty.

    1. Physiological or evolutionary

    It is considered a progressive dyslalia in the event that the child he does not repeat by imitation those words he hears, Although its development and chronological age are considered appropriate for this. Its development is therefore due to a certain maturation of the brain and the phonoarticulatory apparatus. It usually presents around the age of 4 and is made visible by phonetically incorrect repetition.

    2. Organic

    It is a functional type dyslalia when the joint is linked to the peripheral organs that control speech. In this case, the children they use substitution more often, The omission or distortion of the expected sound.

    3. Audiogenic

    As the name suggests, it is dyslalia that it is a consequence of a hearing loss.

    4. Functional

    It results from the functioning of a system of Gnostic recognition and of the system of practical production, its etiology is therefore linked to the development of cognitive processes.

    5. Mixed

    As the name suggests, mixed dyslalia is one in which the manifestations of the above types occur simultaneously.

    6. According to pronunciation

    According to the specific difficulties of pronunciation according to the alphabet, Peña-Casanova, 2014 (cited in Hernández and Rubalcaba, 2017), tells us that dyslalia can be divided as follows:

    • Betacism: in the pronunciation of B
    • Deltacism: pronunciation of D
    • Gammacismo: pronunciation of G
    • Kappacismo: pronunciation of K
    • Mistacism: pronunciation of M
    • Rotacism: pronunciation of R
    • Sigmatism: pronunciation of the S

    Possible causes, assessment and treatment

    Dyslalia has a multicausal development and course. In other words, it is caused by the presence of different elements, among which there is a certain organic function, as well as by a parenting style that does not promote mastery of language and communication.

    It can be assessed through the Glatzel test, Which takes into account nasal patency and phonoarticulation; or by the Rosenthal test which considers the respiratory mode. It is also important to perform qualitative assessments based on observation of speech expression and reception, in order to determine communication support needs.

    Treatments include speech therapy and muscle exercises necessary for the joint: lips, tongue, palate, tonsils, hoop. The same exercises include the activation of the nasal and oral apparatus, and it is important that they are planned with a certain frequency and a certain rhythm, in correspondence with the needs and the zone of development close to the child. Otherwise, far from promoting their development, it can embarrass and cause impatience or manifestations of anxiety.

    To determine the appropriate treatment, it is important to begin by knowing the causes of the dyslalia as well as the immediate needs of the child and the family or their immediate environment.

    Bibliographical references:

    • Aguilar-Valera, JA (2017). DSM-V communication disorders. The need for differential diagnoses. Notebooks of neuropsychology (11) 1: 144-156.
    • Hernández, A. and Ruvalcaba, I. (2017). Language disorders. Accessed July 31, 2018.Available from https://s3.amazonaws.com/academia.edu.documents/51549900/ORL-Transtornos-del-lenguaje.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=153303grVZ3Dlnidad_nom_pdf.

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