When language fails: speech disorders
Communication is essential for the development of the human being. And a large part of our communicative capacity depends, as we have said, on speech.
However, speech is not something that appears suddenly (although some authors like Noam Chomsky became famous for defending that we have innate structures that allow the development of this ability), but that it has to be learned and developed. Language in general is a complex element that we will ideally acquire and consolidate throughout our physical and cognitive maturation.
Some of the elements that we have to acquire and improve are articulatory capacity, fluency and understanding of speech, vocabulary and the ability to find words, grammar and syntax , and even when and how we must communicate certain things in a certain way.
Although these milestones are generally acquired at certain evolutionary moments, in some subjects there are problems, deteriorations or poor developments in the understanding and expression of language that limit the correct functioning and / or socio-emotional evolution of the individual.
Let’s see below some of the most common.
1. Language disorder or dysphasia
This disorder involves the presence of a disability in the understanding and expression of language in children with a level of intelligence of their level of development, not only orally, but also in other facets such as written language or reading .
The language disorder or dysphasia can be evolutionary, in which case it could not be a consequence of other disorders, or acquired in the latter case being the product of some type of brain accident, seizure disorders or head trauma.
In either case, the child or child may have problems in expressive or receptive language, that is, the problem can occur at the level of defects in the language or understanding. Children with this disorder usually have a reduced vocabulary and a limited grammatical structure that causes speech to be inferior and more limited than expected.
In the case of acquired dysphasia, the effects would be equivalent to those of an aphasia in adult subjects, although with the particularity that greater cerebral plasticity during the development stage usually allows the appearance of language even when there is neuronal damage.
2. Phonological disorder or dyslalia
Another major oral language disorder is dyslalia. It is understood as such those disorders in which different errors occur in the articulation of words, the most frequent being the replacement of sounds, distortions of the correct ones or the lack (omission) or addition (insertion) of these . For example, a problem in the shape of the tongue can cause dyslalia.
Although there are frequent problems of this kind in childhood, in order to be considered dislalia, the mistakes made must be inappropriate for the level of development of the infant, interfering with social and academic performance.
3. Dysphemia, stuttering or early fluidity disorder in childhood
Dysphemia is a disorder widely known to society as a whole, although we usually refer to it as stuttering. It is a disorder focused on the execution of speech, specifically in its fluency and rhythm . During the speech broadcast, the person suffering from it suffers one or more spasms or blockages that interrupt the normal rhythm of communication.
Dysphemia is often experienced with shame and anxiety (which in turn worsens execution) and makes communication and social adaptation difficult. This problem only appears when talking with someone, being able to speak normally in complete solitude , and is not due to brain or perceptual injuries.
The dysphemic disorder usually begins between three and eight years of age. This is because at this age the normal pattern of speech begins to be acquired. Depending on its duration, several subtypes of dysphemia can be found: evolutionary (lasts a few months), benign (lasts a few years) or persistent (the latter being the chronic that can be observed in adults).
The speech disorder known as dysarthria refers to the difficulty in articulating words due to a neurological problem that causes the mouth and the muscles that emit the speech not to have the proper muscle tone and therefore do not respond correctly. Thus, the problem is not so much in the muscle tissues (although these also suffer in the long run due to their misuse) but in the way in which the nerves connect with them. It is one of the best known types of speech disorders.
5. Social communication disorder (pragmatic)
In this disorder we do not find problems at the time of articulation, nor understand the literal content of the message that is transmitted. However, those who suffer from it suffer a great difficulty, and this disorder is based on the presence of severe difficulties in the practical use of language.
Those who suffer from this disorder have problems to adapt the communication to the context in which they are, as well as to understand the metaphorical or implicit meaning of what they are told and even to change the way of explaining something, regulate the conversation with other elements such as the gestures or respect the word shifts.
Like dysarthria, dysglossia is a disorder that causes severe difficulty in articulating the sounds that make up speech . In this case, however, the problem is in the presence of alterations in the bucofonatorias organs themselves such as congenital malformations. Thus, here there are already easily identifiable failures in the morphology of well-defined parts of the body.
7. Tachyphemia or sputtering
It is a speech disorder characterized by exaggeratedly rapid speech, missing words along the way and making mistakes. Its presence is common in people with a very excited mood, including cases in which the subject is in a manic episode or as a result of consumption of excitatory substances. However, it can also occur during childhood without the need for an external alteration.
One of the most well-known and studied groups of disorders related to language is that of aphasias. We understand by aphasia that loss or alteration of language in adult subjects (in children we would be faced with the aforementioned dysphasia) due to the presence of an alteration or brain injury. Depending on the location or damaged brain structure the effects on language will be different, allowing its study to find different types.
Types of aphasias
Although we can find various classifications such as Luria or Jakobson, the best known and used classification takes into account the presence of verbal fluency, verbal comprehension and ability to repeat in different types of injuries
- Broca‘s Aphasia : Characterized by causing a high difficulty to produce language and express itself, but maintaining a good level of understanding. However, people with this type of aphasia are usually not able to repeat what they are told. It is mainly due to an injury or isolation of the Broca area.
- Transcortical motor aphasia : As in Broca‘s aphasia, there is a difficulty in issuing fluid and coherent language while language comprehension is maintained. The big difference is that in this case the subject is able to repeat (and with a good level of fluency) what is said. It is caused by an injury to pars triangularis, a region close to the Broca area and connected to it.
- Wernicke‘s aphasia : In this aphasia the patient shows a high level of language fluency, although what he says may not make much sense. The main characteristic of this aphasia is that it causes severe difficulties in understanding the auditory information, which in turn causes it to be unable to repeat the information coming from abroad. The brain injury would be found in the Wernicke area. In patients with schizophrenia who have language impairment, it is common to find alterations similar to those of this aphasia.
- Transcortical sensory aphasia : Caused by lesions in the area that joins the temporal, parietal and occipital lobes, this aphasia is similar to that of Wernicke except for the detail that the repetition is preserved.
- Driving aphasia : The areas of Broca and Wernicke are connected to each other by a bundle of nerve fibers called an arcuate fascicle. In this case, both verbal expression and comprehension are relatively correct, but the repetition would be very damaged. It must be borne in mind that to repeat something we must first understand what comes to us and then re-express it, so if the connection between both areas Repetition is impaired is impaired.
- Global aphasia : This type of aphasia is due to massive damage of the hemisphere specialized in language. All aspects of language would be severely impaired.
- Mixed transcortical aphasia : Damage to the temporal and parietal lobes can cause a severe deficit in almost all aspects of language. Basically there is an isolation of language, affecting expression and understanding, although repetition is maintained and it is even possible that the person is able to finish sentences