Dyslalia: types, symptoms, causes and treatment.

We explain what is this phenomenon linked to language development and speech difficulties.

The term dyslalia refers to difficulties in pronouncing certain sounds, which can occur in children of different ages.The term dyslalia refers to difficulties in pronouncing certain sounds, which can occur in children of different ages. It is, according to the new international diagnostic classifications of mental disorders, a disorder of speech sounds.

In this article we will see what is the dyslalia, which are its types and causes, as well as some forms of evaluation and treatment.

Language development

Oral language is the set of sounds that are articulated to express what we need, feel or think. It is both a behavior and a cognitive skill, and we develop it from the first years of life. Its manifestation is related to the maturation of the nervous system, specifically in the sensory and motor areas.specifically in the sensory and motor areas. It is also related to the affective and social bonds we establish, and to 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 the child. Thus, between 0 and 3 months of age, the emission of monochord sounds is expected. Between 9 and 12 months, negations are understood and caregivers (usually mom and dad) are named. From 3 years of age, simple questions are expected and their speech is understood by the nuclear family. By 5 years of age, they can tell what is happening to them and use articles; and by 7 years of age, verbal fluency and the use of conjunctions are expected.

However, In some cases, chronological age may not correspond to language development, i.e., not all children acquire the same skills at the same time.that is, not all children acquire the same skills at the same time. For example, some children may begin to understand what people say to them, but have limitations in explaining themselves. It may also be the case that children express themselves verbally in a slow, or not very fluent manner, or it may be the case that they express themselves so fluently that their language is intelligible. Likewise, among the possibilities that are included within the development of language is what we have called "dyslalia".

What is dyslalia?

The word dyslalia comes from the Greek "dys", which means "difficulty"; and "lalein" which means "to speak". It is a a difficulty in producing certain sounds or groups of sounds. in a way that is considered appropriate. It can be detected, for example, when a child frequently resorts to the omission of a particular sound by means of a silence or vocal elongation. Or if the child always replaces the same sound with a similar one, which is a case of substitution.

It can also be visible by distortion, i.e. when the child frequently resorts to the emission of an approximate sound, but which is not the one that fits his conversation. Finally it may happen that the child inserts a sound as a support..

Recent international definitions

The term "dyslalia" has recently been removed from the international classifications of mental disorders, but it continues to be used in everyday and specialized language to refer to phonetic difficulties presented by some children with dyslalia..

For its diagnosis, the DSM-V considers the latter no longer as "dyslalia" but as a "Speech Sounds Disorder" (SSD). It is a set of central and specific alterations of the phonological component that occur at the level of pronunciation of some phonemes.

6 types and causes

Although classifications may vary, according to Aguilar-Valera (2017); Hernandez and Rubalcaba (2017), there are the following types of dyslalia: physiological or developmental, organic, phonological, functional and mixed. Likewise, dyslalia can be divided according to the difficulty in specific pronunciation.

1. Physiological or developmental

A developmental dyslalia is considered a case in which the child does not repeat by imitation does not repeat by imitation the words he/she hears, even if his/her development and chronological ageeven when their development and chronological age are considered adequate for this. Its development is therefore due to a certain maturation of the brain and the phonoarticulatory apparatus. It usually occurs around 4 years of age and is made visible by a phonemically incorrect repetition.

2. Organic

It is a dyslalia of functional type when the articulation is related to the peripheral organs that control speech. In this case children most frequently use substitution, omission or distortion.In this case, children most often use substitution, omission or distortion of the expected sound to be pronounced.

3. Audiogenic

As its name indicates, it is the dyslalia that is a consequence of a hearing is a consequence of a hearing impairment..

4. Functional

It results from the functioning of the gnostic recognition system and the system of practical production, so its etiology is related to the development of cognitive processes.

5. Mixed

As its name implies, a mixed dyslalia is one in which the manifestations of the previous types are present simultaneously.

6. According to pronunciation

According to the specific pronunciation difficulties 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
• Gammacism: pronunciation of G
• Kappacism: pronunciation of K
• Mystacism: pronunciation of M
• Rotacism: pronunciation of R
• Sigmatism: pronunciation of S

Possible causes, evaluation and treatment

Dyslalia has a multicausal course and development. That is to say, it is caused by the presence of different elements, among which may be a certain organic function, and also a style of upbringing that is not favoring fluency in language and communication.

It can be evaluated through the Glatzel Testwhich 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 speech reception in order to determine communication support needs.

Treatments include speech therapy and exercises of the muscles required for articulation necessary for articulation: lips, tongue, palate, tonsils, frenulum. The same exercises include activation of the nasal and oral apparatus, and it is important that they are planned with a determined frequency and rhythm, in correspondence with the needs and the zone of proximal development of the child. Otherwise, far from favoring its development, it may hinder and cause impatience or anxiety manifestations.

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

Bibliographical references:

• Aguilar-Valera, J.A.. (2017). Communication disorders from the DSM-V. The need for differential diagnoses. Cuadernos de Neuropsicología (11) 1: 144-156.
• Hernández, A. and Ruvalcaba, I. (2017). Language disorders. Retrieved July 31, 2018. Available at https://s3.amazonaws.com/academia.edu.documents/51549900/ORL-Transtornos-del-lenguaje.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1533037090&Signature=grC1KSPM7lu6uMiWTjlnBZEU9VQ%3D&response-content-disposition=inline%3B%20filename%3DTrastornos_del_lenguaje_Universidad_de_G.pdf.