Alalia forms
Isolation of form determines the entire tactics of training. With motor alalia, the programming and reproduction of speech suffers: the child wants to speak, strives to communicate, uses gestures and facial expressions, but the word breaks up or is replaced by onomatopoeia. With sensory alalia, understanding is impaired: the child actively and a lot pronounces sets of sounds, but does not fulfill simple requests and often gives the impression of being deaf or inattentive. There is also a mixed version, when both links are affected.
- Motor: understanding is intact, speech is almost absent
- Sensory: speech is heard, but understanding is impaired
- Sensorimotor (mixed) form
- Often accompanied by attention and behavior disorders
- Hearing is normal in all forms
Reasons
The basis is damage or immaturity of the speech areas of the brain. Most often these are consequences of oxygen starvation during pregnancy and childbirth, extreme prematurity, severe jaundice of newborns, neuroinfection or traumatic brain injury at an early age. Hereditary predisposition to speech disorders is also important. An unfavorable speech environment in itself does not cause alalia, but it noticeably worsens the result if the child is not spoken to much and remains in front of the screen for a long time.
- Fetal hypoxia and asphyxia during childbirth
- Extreme prematurity and low weight
- Severe jaundice of newborns
- Neuroinfections: meningitis, encephalitis
- Traumatic brain injury in the first years of life
- Hereditary predisposition
When is it time to contact
Expecting a child to “talk by age five” is dangerous: lost time cannot be returned, and speech is closely related to thinking and learning. Focus on age milestones: by one year the child babbles and understands simple requests, by one and a half years he speaks about a dozen words, by two years he constructs a simple two-word phrase, by three years he speaks in sentences that are understandable to outsiders. Lagging behind any of the milestones is a reason for consultation, not for waiting.
- No babbling by 10–12 months
- No pointing gesture by 15–18 months
- Less than 10 words by 1.5 years
- No two-word phrase by age 2
- Speech is incomprehensible to others at 3 years old
- The child does not comply with simple requests without a gesture
Survey
The first mandatory step is an objective hearing test, because the behavior of a hearing-impaired child is very similar in appearance to sensory alalia. Next, the speech therapist evaluates speech understanding, vocabulary, syllable structure, sound pronunciation and the ability to communicate with gestures. A pediatric neurologist examines the child and, if necessary, prescribes an EEG to exclude epileptic activity affecting speech, and an MRI of the brain if structural changes are suspected. A psychologist helps distinguish alalia from autism spectrum disorders.
- Objective hearing test by an audiologist
- Speech therapy diagnostics of understanding and speech
- Neurological examination
- EEG, if indicated - during sleep
- MRI of the brain as prescribed by a neurologist
- Assessment of behavior and communication by a psychologist
Correction and the role of the family
Speech therapy work for alalia is long-term and gradual: first, the need for communication and understanding is formed, then the word, syllable structure, phrase and coherent speech. Classes once a week are not enough - you need short daily work at home on assignments from a speech therapist. Medicines are prescribed by a neurologist for specific indications; they create conditions for studying, but do not stimulate speech themselves. Screen time is sharply limited: passive viewing does not develop speech and displaces live communication.
- Regular classes with a speech therapist according to a staged program
- Daily short exercises at home
- A lot of live speech from an adult, commenting on actions
- Using gestures and cards as temporary support
- Strict restriction of cartoons and tablet
- Observation by a neurologist and treatment of associated disorders
- Classes to develop attention, memory and motor skills