These problems are noted, for example, when speaking, regulating the speed of speech, etc.
Virtually all the acts we carry out are communicative. Gestures, faces, sounds, smells and even distances are and have always been used to obtain information about the actions, motivations and thoughts of others.
Even the absence of action is indicative of something. However, in addition to the above, the human being has one more element to communicate, a symbolic one. This symbolic element is language, which is expressed orally through speech.
Oral speech or language is one of the most fundamental means of communication and bonding for the human being. This ability develops throughout the life cycle, going from emitting simple holophrases or single words with intent to being able to construct elaborations as complex as a Shakespearean play.
However, in many people the development of this ability or its normal functioning can be delayed or altered due to multiple causes. These alterations in oral communication have been studied by sciences such as psychology and medicine, and different types of speech disorders have been conceptualized on the basis of them. And no, dyslexia is not one of them, as it only sticks to reading problems.
When language fails: speech disorders
Communicating is fundamental for the development of the human being. And a large part of our communication skills depends, as we have said, on speech.
However, speech is not something that appears suddenly (although some authors such as Noam Chomsky became famous for arguing that we have innate structures that allow the development of this ability), but 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 ability, fluency and understanding of speech, vocabulary and the ability to find words, grammar and syntax, and even when and how we should 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 development of the understanding and expression of language that limit the correct functioning and / or socio-emotional evolution of the individual.
Let’s see some of the most common below.
1. Language disorder or dysphasia
This disorder supposes the presence of a disability in the understanding and expression of language in children with a level of intelligence typical of their level of development, not only at the oral level, 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 any of the cases, the child may have problems in expressive or receptive language, that is, the problem can occur at the level of defects in the emission of language or in its understanding. Children with this disorder tend to 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 aphasia in adult subjects, although with the particularity that greater brain 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 substitution of sounds, distortions of the correct ones or the lack (omission) or addition (insertion) of these. For example, a problem with the shape of the tongue can cause dyslalia.
Although these types of problems are common in childhood, in order to be considered dyslalia, the errors made must be inappropriate for the infant’s level of development, interfering with social and academic performance.
3. Childhood-onset dysphemia, stuttering or fluency disorder
Dysphemia is a disorder widely known by society as a whole, although we often refer to it as stuttering. It is a disorder focused on the execution of speech, specifically its fluency and rhythm. During the emission of speech, 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 performance) and makes communication and social adaptation difficult. This problem only appears when talking to someone, being able to speak normally in complete solitude, and is not due to brain or perceptual injuries.
Dysphemic disorder usually begins between the ages of three and eight. This is due to the fact that the normal speech pattern begins to be acquired at this age. Depending on its duration, several subtypes of dysphemia can be found: evolutionary type (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 speech to not 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 when it comes to articulating or understanding the literal content of the message that is transmitted. However, those who suffer from it suffer 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 adapting communication to the context in which they find themselves, as well as understanding the metaphorical or implicit meaning of what is said to them and even changing the way of explaining something, regulating the conversation with other elements such as the gestures or respect the turns of speech.
Like dysarthria, dysglossia is a disorder that causes severe difficulty in articulating the sounds that make up speech. In this case, however, the problem lies in the presence of alterations in the orophonatory organs themselves, such as congenital malformations. Thus, here there are already easily identifiable flaws in the morphology of well-defined parts of the body.
7. Tachyphemia or sputtering
It is a speech disorder characterized by excessively fast 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 use of exciting 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 aphasia. We understand aphasia as that loss or alteration of language in adult subjects (in children we would be faced with the aforementioned dysphasias) due to the presence of a brain alteration or injury. Depending on the location or damaged brain structure, the effects on language will be different, allowing its study to find different typologies.
Types of aphasias
Although we can find various classifications such as Luria or Jakobson, the best known and most used classification takes into account the presence of verbal fluency, verbal comprehension and repetition capacity in different types of injuries.
- Broca’s aphasia : Characterized by causing high difficulty in producing language and expressing oneself, 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 Broca’s area.
- Transcortical motor aphasia : As in Broca’s aphasia, there is a difficulty to emit a fluid and coherent language while the understanding of the language 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 to him. It is produced by a lesion in the pars triangularis, a region close to and connected to Broca’s area.
- Wernicke’s aphasia : In this aphasia the patient shows a high level of fluency in language, although what he says may not make great sense. The main characteristic of this aphasia is that it causes severe difficulties in understanding auditory information, which in turn causes it to be unable to repeat information from outside. The brain injury would be in Wernicke’s 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 Wernicke’s except for the detail that the repetition is preserved.
- Conduction aphasia : Broca’s and Wernicke’s areas are connected to each other by a bundle of nerve fibers called an arcuate fasciculus. In this case, both verbal expression and comprehension are relatively correct, but repetition would be greatly impaired. It must be borne in mind that to repeat something we first have to understand what comes to us and then re-express it, with what if the connection between both areas repetition is impaired is impaired.
- Global aphasia : This type of aphasia is due to massive damage to the hemisphere specialized in language. All aspects of the language would be severely damaged.
- 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.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
- Belloch, Sandín and Ramos (2008). Manual of Psychopathology. Madrid. McGraw-Hill. (vol. 1 and 2) Revised edition.
- Santos, JL (2012). Psychopathology. CEDE Preparation Manual PIR, 01. CEDE: Madrid.