Language Pathologies

CHAPTER I.- CONCEPTS AND DEFINITIONS

The first definition of the term pathology in our language is found in the
Dictionary of the Royal Academy in its latest edition, which mentions that
pathology is a part of medicine, which teaches us to know diseases, both
physical and mental, their nature, causes and symptoms. From this definition it
is worth highlighting the clarification of bodily and mental illnesses.

The definition and classification of these communication pathologies vary

depending on the different authors. In order to accurately define and have exact
knowledge of what this research really means, it is necessary to know some of
the basic concepts about this topic:

 LANGUAGE: the content, the way of organizing words and their use.

 SPEECH: refers to the mechanisms of vocal production, to the adequate

coordination of the phono-articulatory organs to carry out the verbal
emission. The articulatory mechanisms.

 DISORDER: some of the functions are altered.

 LANGUAGE DISORDER: the formulation and understanding of meaning

are affected. (Language delay, Dysphasia, Aphasia).

 SPEECH DISORDER: any problem that arises from damage to the

motor and perceptual functions of fluid language and articulation, which
would be the two major aspects related to speech. (Dyslalias,
Dyglossias, Dysarthria, Dysphemia).

It can be stated, in general, that language alterations , anomalies ,

disturbances or disorders make linguistic communication more or less
persistently difficult, affecting not only linguistic aspects (phonological,
syntactic or semantic, both at the level of comprehension and decoding as
expression or production-coding), but also intellectual and personality,
interfering in the relationships and school, social and family performance of
the affected individuals.
CHAPTER II.- CLASSIFICATION CRITERIA

Various criteria can be used to classify language disorders, such as:

 Etiology (depending on its origin). It refers to the difference between

organic alterations (genetic, neurological, and anatomical) and functional
alterations (difficulties traditionally considered psychological, which do
not affect social and emotional communication, but compromise linguistic
learning), defining the former. as those that have an organic origin and
the latter as those that do not depend on an organic base. We must not
forget, however, the frequency with which an organically based language
alteration can significantly compromise psychological processes at an
evolutionary level. Exceptionally, the etiology may occur after 6
months:

 Prenatal causes: of genetic origin, dietary, metabolic, toxic and

as a result of the consumption of a medication by the mother.

 Perinatal causes: prematurity, anoxia during

childbirth, prolonged births, baby suffocation, trauma from the use
of forceps, etc.

 Postnatal causes: such as infections, trauma, carbon dioxide

poisoning, dehydration, and Rh incompatibility.

 Chronology. Depending on this factor, a dichotomy can be established

between acquired alterations and alterations in language acquisition. The
acquired ones may have a known organic cause and occur when the
language is sufficiently acquired, as occurs, for example, with aphasic
disorders.
In the second case we find a problem that usually manifests itself from
the beginning of language development and that may or may not have a
known cause, such as the cases of delays from the moment language
begins.

 Associated disorders : In many cases the motor alteration by which this

disorder is characterized does not appear in isolation, but is aggravated
by the coexistence of other disorders:

 Presence of epileptic seizures. Epilepsy is a chronic disease of

the nervous system characterized by seizures in which there is a
sudden loss of consciousness, convulsions of the extremities, and
a large amount of saliva coming out of the mouth. This alteration
occurs between 30 and 40% of cases.
 Sensory alterations: auditory disorders, visual anomalies
(strabismus, acute visual insufficiency, visual incoordination, gaze
deviations), etc. are common.

 Perceptual alterations: the child encounters a series of

difficulties in exploring his environment due to the motor limitations
 he presents: non-integrated body scheme, alterations in spatial
structure, difficulty in figure-ground discrimination, alterations in
reading and writing, in the drawing.

 Emotional alterations: a series of personality alterations will

occur as a consequence of emotional disorders (anxiety, lack of
assertive thinking, maladjusted self-image)

 Relational alterations: such as the dependence of these people

on their families, educators, etc. It would be advisable to
compensate for the lack of motor self-sufficiency taking into
account the individual characteristics of each subject, avoiding
attitudes of overprotection...

 Intellectual alterations.

 Linguistic disorders: these children may present articulatory

difficulties (dysarthrias and anarthrias), tachylalia (alterations in
verbal fluency), bradylalia (excessively slow speech rate), palilalia
(involuntary repetition of syllables, words or phrases) and absence
of language productive. In reading, it is common to find dyslexias
and disortograms.

 Expression and understanding. Here, receptive alterations are

distinguished, taking into account that we must avoid concentrating on
just one of these aspects given the frequent interrelation that usually
exists between both, since there are numerous pathologies in which both
areas are affected. Language alterations that preferentially affect
expression.

Difference between sound and phoneme, from a linguistic point of view.

Sound refers to the emission made when speaking; It is a physical entity
that is produced by the vibration of the air as it passes through the vocal
cords and by the transformation that this column of air undergoes as it
passes through the mouth and nasal cavity. The phoneme is an abstract
entity and refers to the concept we have of sounds; Thanks to this mental
representation we are able to recognize the sounds made by very
diverse people and in different ways (young children, elderly people), and
thus understand what they say, because we can place their productions
in the phonological scheme that we all have. speakers of the same
language. By “phonetic” we will understand, therefore, what concerns
sound and when speaking of “phonological” we refer to phonemes.
In the literature, different terms are sometimes found to refer to some of
the most well-known alterations that affect the production of sounds,
which can lead to confusion. One of them is “dyslalia”.

 Language- speech. The impairment of comprehension and expression

would lead to a language alteration, and the impairment of production
would lead to a specific speech problem. Language difficulties are in
 principle more serious than speech difficulties since they affect the
structure of the language, while speech difficulties refer to the most
external aspects of communication, especially issues of voice, rhythm
and articulation. It is not difficult to find children with alterations between
both pathologies, and thus there may be students with very generalized
articulation difficulties that could lead to a language problem.

Likewise, language pathologies can be classified according to the different

meanings of the words Language and Speech:

 Language disorders
language delay
Dysphasia
Aphasia
 Speech Disorders (understood as articulated verbal language)
Dislalias
Dyglossias
Dysphemia
Dysarthria

Figure 1: Child articulating words.

(Zajecia_speech therapist)

Trying to unify criteria referring to the variety of existing taxonomies, other

authors mention classifying language disorders according to their origin, their
motor function or their brain dysfunction into:

A. Organic disorders :

Broca and Wernicke were pioneers in the study of language disorders

with the aim of locating brain areas specifically related to language. Early
research revealed that the areas of language functions are located in the
left hemisphere (SEE lateralization ), close to the union of the temporal,
frontal and parietal lobes. Lesions in Broca's area , located in the inferior
gyrus of the left frontal lobe, cause language, motor and expressive
disorders. Lesions in Wernicke's area , located in the superior gyrus of
the left temporal lobe , produce receptive or sensory disorders, that is,
they affect the expression of language.

Organic disorders may include:

1. Aphasia :
a) Wernicke's receptive/sensory aphasia (verbal deafness
or auditory agnosia, verbal blindness/alexia or visual
agnosia),
b) Broca's expressive or motor aphasia (apraxia or
dyspraxia),
c) mixed aphasia (agnosia and apraxia),
d) evolutionary or developmental aphasia (*expressive
developmental aphasia and developmental sensory
aphasia).
2. Alalia .
3. Dysarthria .

b. Delay in language acquisition.

c. Functional or articulatory disorders:
1. Dyslalia .
2. Dysphemia or stuttering .

d. Disorders, not attributable to dysfunctions, associated with

clinical conditions:
1. Autism .
2. Mental deficiency .
3. Selective mutism .
4. Cerebral palsy .
5. Dyslexia ; dysgraphia ; dysorthography .
CHAPTER III.- LANGUAGE PATHOLOGIES

Having a broad criterion and having already defined the types of classification, I
develop the different language pathologies in general to have a broad
knowledge of each pathology without having to have restrictions according to
previous classifications:

1) LANGUAGE DELAY:

DEFINITION: the non-appearance of language at a chronological age that

normally already occurs or its incorrect development. That child who does not
speak, speaks little or speaks badly for his or her chronological age.

• Verbal Production:

- Appearance of the first words at 2 years old.

- Union of two words at 3 years old.
- Use of very simple phrases: SV-OD, coordinated and juxtaposed.
- Verb tenses: gerunds and presents.
- Little use of plurals and verbal morphemes.
- Reduced vocabulary.
- Poor categorization.
- Difficulties in repeating words and phrases
- Incapable of repeating linguistic structures that are not integrated.
- Phonological simplification processes.
- Communicative intention and use of gestures that compensate for their
expressive deficit.
-
• Comprehension:

- Always better than expression.

- Better in family contexts.
- The understanding of spatial and temporal concepts, attributes of shape, color,
size are very difficult to understand and are not integrated into their normal
language.

TYPES OF LANGUAGE DELAY:

• Mild Language Delay:

o Phonology:
- Consonantal reduction.
- Absence of the multiple vibrating /r/, replaced by /l/ or /d/.
- Substitution of /s/ for /t/.
- Reduction of the adult consonant system to a simpler one.

o Semantics:
- Scarce.
- Normal understanding.
o Morphosyntax:
- Ordinary level.
- Intelligible emissions.

o Pragmatics:
- Useful language that resolves situations.
- Get the collaboration of others.
- Follow conversations, know how to listen.
In Mild Language Delay, the area that is most affected is PHONOLOGY.

• Moderate Language Delay:

o Phonology:
- Reduction of consonant patterns, you will be understood less.
- Absence of fricatives, being replaced by stops: /f/-/p/, /O/-/t/…
- Talk about baby.
- Omissions of initial consonants: head-athet.

o Semantics:
- Poverty of expressive vocabulary, they name familiar objects, but do not know
the names of many other objects.
- They understand the most everyday things for them and their environment.

o Morphosyntax:
- Deficits in gender and number and in the tense morphemes of verbs.
- Absence of subordinates and juxtaposition.
- Very simple sentence structure.

o Pragmatics:
- Uses language functions poorly.
- Abundant imperatives and verbal gestures calling for attention.
- Little initiative and few social ways to initiate conversations.

• Severe Language Delay:

o Phonology:
- Multiple dyslalias.
- Speech intelligibility.
- Very reduced phonological patterns
- Very large deficit in this area.

o Semantics:
- It takes you to the place where the object is so you can take it instead of
asking for it verbally.
- Difficult understanding: does not identify the objects that are part of his family
life.
- Very scarce vocabulary.
- Serious problems communicating your wishes.
o Syntax:
- Very primitive stages: holophrase, telegraphic speech.

o Pragmatics:
- He speaks very little and nothing is understood.
- Self-centered conversation.
- It does not have an adequate linguistic form.
- Little communicative interest.

CAUSAL FACTORS OF LANGUAGE DELAY

a) Neurobiological Approach:
- Genetic factor: there has been delay in siblings and parents.
- The environment: will mark the direction of the delay.
- Inattention-hyperkinesia syndrome.
- Hearing loss resulting from otitis in the middle ear, especially when they occur
in the period of 2 to 4 years, which is when hearing discrimination work is
important.

b) Cognitive origin approach:

- It could be said that it is a consequence but not a causal factor.

c) Motor Factors:
- Incorrect exercise due to a lack of coordination of the orofacial organs and
their agility.
- On the other hand, also proprioceptive sensations.

d) Psychosocioaffective factors:
- Affective relationships between parents and children, medium cultural level.
- A large majority of children with RL cause them to have problems in their
emotional development
- Low sociocultural levels can disturb the child's forms of poor and delayed
linguistic production.
- Unstimulating family environment.
- Overprotection.

2) DYSPHASIA:

DEFINITION: a set of extremely complex symptoms that affect all aspects of

language and appear associated with other developmental disorders and have
no known etiology. The appearance of the first words is at 3 years, the first word
combinations from 4 years and the persistence of schematic language after 6
years indicate the severity of the disorder. There are serious comprehension
problems and important associated disorders such as attention difficulties and
psychomotor delay. Slow or very slow evolution.

TYPES OF DYSPHASIA

1-EXPRESSIVE DYSPHASIA:
- Heterogeneous group.
- Failure in language learning without cognitive alterations, sensory deficits or
alterations in social interaction, intact articulatory organs and with sufficient
stimulation.
- It is mainly reflected in production, although comprehension difficulties also
appear in a specific exam.

2-COMPREHENSIVE DYSPHASIA:
- Severe language alteration.
- Severe language delay, especially receptive.
- No demonstrable acquired injury, no organ problems, no emotional problems,
no hearing difficulties except for auditory processing necessary for language.
- Differential diagnosis: DM, DEAFNESS and AUTISM.
- The cause is unknown: possible alteration or dysfunction between the brain
processes that give meaning to sound and the auditory pathways.
- Unfavorable prognosis.
“Child who the teacher tells us is deficient, who does not understand what is
said to him, with problems generalizing learning and recall problems.”

3) APHASIA:

DEFINITION: alteration of expressive and/or receptive language due to a brain

injury. It is a common disorder and constitutes a pathology unknown to Spanish
society.

CAUSES OF APHASIA

Aphasia is caused by brain trauma or infection, such as:

 Cerebrovascular accident or stroke: it is the most common cause of

aphasia, especially that caused by thrombotic or embolic ischemia .
 Craniocerebral trauma : usually caused by an accident.
 Localized or diffuse infections of the brain , such as brain abscess or
encephalitis .

TYPES OF APHASIA:

BROCA'S APHASIA: predominance of expression disorders over

comprehension.
WERNICKE'S APHASIA: there is a profound alteration of verbal understanding.
His expression is very fluid.
4). DYSLALIAS: DEFICITS FUNCTIONAL DISORDERS OF THE JOINT

- Omissions, substitutions or distortions in the pronunciation of phonemes.

- There are no organic, auditory or intellectual anomalies, nor neurological
alterations.
- The difficulties focus on phonemes that are acquired last.
- The errors that generally occur are: z/s, r/l.

CAUSES

Psychological and
Functional Causes
Environmental Causes
Poor motor skills Emotional problems.
Lack of auditory
Shyness, jealousy.
discrimination.
Respiratory dysfunction. Overprotective family attitudes.
Muscle tension. Parental anxiety.
Unstimulating environment.
Sociocultural level.
Bilingualism

TYPES OF DYSLALIA

TO. Evolutionary or physiological dyslalia : To correctly articulate the

phonemes of a language, a maturity of the brain and the speech apparatus is
required. There is a phase in language development in which the child does not
articulate or distorts some phonemes; These errors are called evolutionary
dyslalias. They normally disappear over time and should never be intervened
before the age of four, especially /r/ and symphonies.

They tend to cause some anxiety in some parents who believe they see in them
a symptom of delay and they should be advised to speak clearly to their child,
abandoning the persistent patterns of child language. The best intervention is to
convince the family to stop these bad habits.

b. Audiogenic dyslalia: Its cause is a hearing deficiency. The boy or

girl who does not hear well does not articulate correctly, will confuse
phonemes that offer some similarity by not having correct auditory
discrimination. These types of alterations are called audiogenic
dyslalias.

The hearing impaired will present other language alterations, mainly

voice, and the study of their audiometry will give us guidelines on the
possible adaptation of a prosthesis. The intervention will basically be
aimed at increasing your auditory discrimination, improving your voice
or correcting altered phonemes and implanting non-existent ones.
c. Organic dyslalia: Joint disorders whose cause is organic are called
organic dyslalia.

If the brain's neural centers (CNS) are affected, they are called dysarthrias and
are part of the language disorders of those with motor disabilities.

If we refer to anomalies or malformations of the speech organs: lips, tongue,

palate, etc. They are called dysglosias.

d. Functional dyslalia: It is the alteration of the joint produced by a malfunction

of the articulatory organs. The child with functional dyslalia does not use these
organs correctly when articulating a phoneme despite there being no organic
cause.

The following linguistic pathologies are the result of neurological

conditions in brain domains or channels with which motor activity
is controlled. These three pathologies do not directly affect the
encoding process but rather the phase in which once the message has
been formulated, the patient is prevented from carrying out the
motor activity that allows it to be externalized. Dyspraxias and
dysarthrias very often accompany aphasia.

5 ) DISGLOSIES:

DEFINITION: consists of a difficulty in oral production due to anatomical and/or

functional alterations of the articulatory organs and whose cause is of peripheral
origin.

CAUSES:

- Congenital craniofacial malformations.

- Growth disorders.
- Anomalies acquired as a result of injuries to the orofacial structure or surgical
removals.

EXAMPLES:

- Cleft lip
- Palatine cleft
- Malformation of the tongue.
• They may require surgical intervention and later speech therapy intervention.
6) DYSARTHRIA:

DEFINITION: disorder of verbal expression caused by an alteration in the

muscular control of speech mechanisms. It includes motor dysfunctions of
breathing, phonation, resonance, articulation and prosody.
Motor disturbance; The rhythm of speech, intensity, resonance of the voice and
the production of phonemes are altered.

CAUSES

It is caused by damage or aggression to brain structures that intervene in the

normal process of speech and voice. This damage can occur for different
reasons (insufficient cerebral oxygenation, trauma) before, during or after
childbirth, always in the first 3 years of existence, or due to progressive
neurological diseases at different stages of life (Parkinson's, for example). .

TYPES OF DYSATRIA

a) Bulbar dysarthria: Caused by an injury to the medulla oblongata (base of

the brain stem ), affecting the nuclei of the oro-linguo-palato-pharyngeal
apparatus.

b)Pseudobulbar dysarthria: The lesion is located in the corticobulbar

pathways , which link the cerebral cortex , which sends voluntary stimuli, with
the centers of the medulla oblongata . It may be due to lacunar infarcts or
diseases such as amyotrophic lateral sclerosis (ALS).

c)Cerebellar dysarthria: It is due to involvement of the cerebellum , an

important organ in the coordination of movement . In this case there is candid,
syllabic speech, with a certain tremor and hoarseness .

d) Parkinsonian dysarthria: Which occurs in the context of Parkinson's

Disease or other parkinsonian syndromes

7) DYSPHEMIA OR STUTTERING

DEFINITION: Stuttering or dysphemia is a speech disorder (not a language

disorder ) that is characterized by involuntary interruptions of speech that are
accompanied by muscle tension in the face and neck, fear and stress . They are
the visible expression of the interaction of certain organic, psychological and
social factors that determine and guide in the individual the formation of a being,
an action and a feeling with its own characteristics.
It typically begins between the second and fourth year of life, although it is often
confused with age-related difficulties when speaking. In the end, only one in 20
children ends up stuttering, and many of them outgrow the disorder in
adolescence .
The reaction of the affected person's environment is decisive for the
appearance of numerous physical symptoms associated with stuttering,
especially in the first years of manifestation: muscle tension in the face and
neck , fear and stress .

TYPES OF DYSPHEMIA

1.- ACCORDING TO ITS CAUSE

a) Neurogenic : It is caused by an injury or blow to the brain. It is also

known as acquired stuttering. Stuttering can occur in any part of the word
. They stutter even when singing or whispering. They do not show fear or
anxiety.

b) Psychogenic : It is the least common. It is caused by some severe

trauma . By the 19th century, it was thought to be the primary cause of
stuttering. With recent studies, it has been shown that it was not correct.
Stuttering is independent of the situation. They do not show anxiety .

c) Developmental : It is the most common type of stuttering. It occurs when

the child is learning language and speech , around 2 and 5 years old.
When the child is learning more complex grammatical structures, he or
she has differences inherent to this learning . Some will react
appropriately, recovering from this phase. Others, if the appropriate
intensity and relationship factors have been present to trigger stuttering,
will react to these differences by developing strategies to overcome them
(use of force and tension in speech) and hide them (avoid speaking).
These children are very likely to become stutterers.

2.- ACCORDING TO ITS EFFECT

 Tonic : characterized by multiple interruptions caused by spasms. During

interruptions the patient shows facial rigidity and tension. It is the one
with the worst diagnosis.
 Clonic : characterized by repetitions of syllables and entire words, more
frequent in consonants than in vowels, even more so in stops, and which
occur mostly at the beginning rather than in the middle of a word.
 Tonic-clonic or mixed : it is the most common type, because it is
difficult to find a pure tonic or clonic dysphemic, most combine the two
symptoms
CHAPTER IV: LANGUAGE PATHOLOGIES ASSOCIATED WITH CLINICAL
CONDITIONS

Among those disorders not associated with some dysfunctions but with those
that are the cause of some clinical condition, we have the following pathologies
due to:

1) AUTISM

Autism is a childhood psychosis (a serious mental illness) that manifests itself

through a series of personality disorders and a lack of interest in the
environment.
The word “autism” refers to the loss of contact with reality, generating total or
partial difficulty in communicating with others.

Kanner speaks of “early infantile autism” and describes it as “a withdrawal from

all contact with people, an obsessive desire to preserve identity, a very skillful
relationship with objects, the presentation of a very intelligent and thoughtful
physiognomy, in addition to mutism.” or a type of language that does not seem
intended for interpersonal communication.”

People with classic autism show different types of symptoms: limited social
interaction , problems with verbal and non-verbal communication . The
characteristics of autism usually appear during the first three years of childhood
(often not noticed before age 2 or 3) and continue throughout life.

We are facing a profound disorder in the development of a subject that involves

important alterations in their behavior and language (universal symptoms in any
conceptual approach to this term).
They are quite different from normal children and from those who have a
handicap of any kind, although some of their problems will be present in others.
Hence the importance of a differential diagnosis.
The etiology of autism is unknown; the agents responsible for the genesis of
autism must largely be found in the environment.

§ Psychosocial causes, according to which children are potentially normal at

the time of birth, but become “different” as a result of unfavorable influences
from their psychosocial environment.
In this sense, we find disturbances in the mother-child interaction,
inexperience and hyperanxiety of young mothers, very early birth of a sibling
compared to the previous one, changes of residence, psychological
characteristics of the parents, alterations in the early stages of the child's
psychological development, language differences, loss of a parent, parental
divorce, etc.

§ Organic causes: genetic factors (a genetic anomaly is transmitted

hereditarily), prenatal (rubella, lack of vitamins in the diet, drug use, trauma,
other causes...) and perinatal (use of forceps, anoxia during childbirth,
encephalitis, meningitis, etc.).
Language in the autistic child.

They manifest more or less serious alterations in their communicative-linguistic

development.
By the age of two, no autistic person presents language.
The alterations that we can find in an autistic person range from absolute
mutism to language characterized by:

· Lack of spontaneous sentence formation.

· Semantic ignorance of words.
· Immediate or delayed echolalia.
· Alteration of prosodic elements.
· Limited capacity for abstraction.
· Timeless sequencing of ideas.
· Pronominal change.
· Frequent use of “no”.

Alterations in gestural and facial language:

The autistic person has a very limited gestural language. Given the disinterest
or indifference they show towards their surroundings, they do not understand
the gestural language of others and do not know how to express themselves
mime; This is observable in the first years of life in which you can acquire some
gestural understanding if you develop the capacity for visual observation.
They often have to be taught social gestures as simple as smiling or hugging.

Productive language alterations:

Some autistic people do not acquire oral language, although others use very
characteristic language. One of these symptoms is echolalia , that is, the
repetition of words or phrases uttered by the subject themselves and by other
people. He mechanically repeats what he has heard without communicative
intention. Some do not pass this stage.
These repetitions can occur as soon as they hear them (immediate echolalia)
or be timeless repetitions (delayed, delayed, or delayed echolalia).
Echolalia can occur during some phase of language acquisition in some normal
subjects, although in these it does not usually last over time and is loaded with
greater communicative intentions than in autistic people.
Articulatory alterations and disorders in the prosodic elements of language are
common in autistic children. If they correctly repeat simple phrases or words
that they have heard at a given moment, it is normal that in their spontaneous
expression alterations in articulation, tone of voice, accents, pauses... even a
certain semantic richness is observed, but if well analyzed , shows a real
inability to communicate.
His speech is slow, irregular and halting, sometimes it is fast and sometimes it
is monotonous. Their voice is high-pitched, shouty or guttural and barely
audible. They have difficulties controlling the intensity of their voice. In some,
articulation problems are more pronounced than comprehension problems,
although there are also subjects who never had pronunciation difficulties.
Prohibitive phrases abound, with statements of a markedly negative nature.
There seems to be a correlation between pronominal inversion and echolalia,
which is why it is suggested that the former may be a consequence of the
latter.
The delay in syntactic development is another manifestation worth highlighting.
The lack of logical structuring of the sentence is similar to that of normal
children, although in autistic children there is greater temporal durability of
asyntactic constructions.
The elimination of links, determinants... makes its production acquire a
telegraphic form.
The use of the present, to the detriment of other verb tenses, is a symptom of
the language of autistic people, who have difficulties in the use and
understanding of verb tenses due to their disconcerting characteristic of
changing according to circumstances.

Comprehensive language disorders:

The majority of autistic children do not show interest in language, they show
contradictory responses to the sounds in their environment, being especially
receptive to certain sounds and indifferent towards others, which will condition
the development of their comprehensive language.
Linguistic polysemy has little value for the autistic person. These tend to learn a
single name for each thing, so they easily confuse words that have more than
one meaning. The semantic and pragmatic components of language present
patterns of severe deviation in their development.
The dimensions of the linguistic system will present with important alterations in
autistic subjects who have managed to develop normal language

2) MENTAL DEFICIENCY

Mental retardation refers to substantial limitations in current development. It is

characterized by significantly below average intellectual functioning, which
occurs along with associated limitations in two or more of the following adaptive
skill areas: communication, self-care, home life, social skills, community
utilization, self-governance , health and safety, functional academic skills,
leisure and work. Mental retardation usually manifests itself before the age of
eighteen.
Situations of apparently good language can be the product of positive
influences of exogenous etiology. We would be dealing with children with a
deceptive verbal fluency with important structural gaps that would not support a
complete analysis of the dimensions of language.
If language appears, it will remain in the most basic form related to requests,
rejections or emotions. The existence of deficient children with fluent language
performance is not very common. All children with disabilities present language
disorders to a greater or lesser extent, but not all children with significant
language disorders are deficient.
The acquisition and development of language in children with mental retardation
is slower than that of “normal” children.
In the development of the DM language it is worth specifying:
  Early, previously planned action is necessary.
 The linguistic prognosis varies considerably from one child to another.
 It usually presents associated non-linguistic disorders that have a
negative impact on language acquisition and development.
 There is a greater impact on the productive component of language .
Asyntactic constructions, verbal fluency problems and articulatory
alterations abound.
 Linguistic age does not usually correspond to chronological or mental
age.
 There is no causal correlation between IQ and linguistic competence.
 There are usually no big differences in terms of vocabulary, as long as
we compare them with subjects of the same mental age.
 Language development goes through the same stages as in the “normal”
child, although more slowly and for a longer duration.
 The components of language (phonology, syntax, semantics and
pragmatics) are affected to a greater or lesser degree.

Although the language is very poor, it allows them to communicate. They use
the symbolic word (they use the word phrase). Dyslexias, alexias, dyslalias and
hyperrinolalia (air escapes through the nose) usually appear.
Their auditory and visual attention is small (it is necessary to constantly change
their stimuli), they have poor memory and alterations in the rhythm of speech
(tachylalia and bradylalia).
Occasionally they may seem to speak melodically, but in reality they are
meaningless words (not a meaningful message).
The first words will appear very late. They are going to have practical difficulties,
difficulties organizing movements, etc.
If they acquire a more or less structured language, they will use word-phrases
and agglutinating phrases.
Regarding their semantics, their vocabulary is very small, it is difficult for them
to understand interrogative pronouns, prohibitions and denials.
It is very common for them to present dyslalia, slurring and stuttering. Their tone
is usually monotonous and sometimes makes what they say unintelligible.
Their tone of voice varies greatly depending on whether they are nervous (it
gets louder) or if they are tired (it gets worse).

3) MUTISM

Selective mutism is a condition of social anxiety , where a person who is able to

speak is unable to express themselves verbally given certain situations.
This disorder is not considered a communication disorder, in that most children
communicate through facial expressions, gestures, etc. In some cases,
selective mutism is a symptom of a developmental disorder or a psychotic
disorder .

When making the diagnosis it can be easily confused as a selective type of

Autism or Asperger's syndrome , especially if the child acts withdrawn with his
psychologist. This can lead to incorrect treatment.

Selective mutism is characterized by:

  Consistent failure to speak in specific social situations (for example, at
school, where there is an expectation of speaking) despite expressing
oneself verbally in other situations.
 Interferes with educational or employment achievements, or with social
communication .
 Failure to speak is not due to lack of knowledge of the spoken language
required in the social situation.
 It is not considered a communication disorder (e.g., stuttering ), and it
does not occur exclusively during schizophrenia or another psychotic
disorder.

4) CEREBRAL PALSY

Cerebral palsy describes a group of disorders of psychomotor development ,

which cause a limitation in the patient's activity, attributed to problems in the
brain development of the fetus or child. The psychomotor disorders of cerebral
palsy are often accompanied by sensory, cognitive, communication and
perception problems, and sometimes, behavioral disorders. CP brain lesions
occur from the fetal period to the age of 3 years. Brain damage after the age of
3 years into the adult period can manifest as CP, but by definition these lesions
are not CP.

Their characteristics are:

 Firstly, the disorders are due to a brain injury that interferes with the
child's normal development. It occurs in the first year of life, or even in
the gestation period, and can occur up to three years of age.
 It is distinguished by dominant damage to motor functions, which affects
tone, posture and movement.
 Finally, there is a generalized concept that the injury is not evolutionary
but its consequences may vary in the child. Motor disorders in most
cases affect the oral organs and hinder the development of eating and
speech.

5) DYSLEXIA

Dyslexia is called dyslexia (from dys- -difficulty, anomaly, and the Greek λέξις,
speech or diction ) to the reading disorder that makes it impossible to do it
correctly. Although conventionally the term is also applied to difficulty in correct
writing , in this case the appropriate medical term is dysgraphia . In more
technical terms, in psychology and psychiatry, dyslexia is defined as a
discrepancy between the learning potential and the level of performance of a
subject, without the existence of sensory, physical, motor problems or
educational deficiencies.

There are hereditary factors that predispose to suffering from it. However, other
factors that may be involved in the course of the disorder are still unclear, such
as genetic causes, difficulties in pregnancy or childbirth , brain injuries,
emotional problems, spatiotemporal deficits or problems with sequential
orientation. of visual perception or adaptive difficulties at school.
Likewise, from the field of psycholinguistics , it has been seen that one of the
central deficits in dyslexia, especially in younger children, is low phonological
awareness . Phonological awareness is the knowledge that people have to
divide speech and writing into increasingly smaller structures. This is compatible
with the neurological studies mentioned above, since deficits of this type have
been observed in subjects who have suffered a brain injury in the angular gyrus.
CONCLUSIONS

First.- Language and brain, as we have shown, have an unquestionable

functional relationship. Thought is expressed through language,
the ability to express ideas, emotions and feelings with words is
a reality that differentiates us from animals. But the human brain
still remains a mystery despite the advances made and human
speech is, ultimately, a reflection of ourselves and therefore, of
our brain.

Second.- Scientific research now proposes solutions even to previously

incurable pathologies. The study of genetics, DNA, stem cells
and other discoveries could offer solutions when correcting
injuries or solving congenital dysfunctions.

Third.- The very varied attempts to classify language disorders are proof of the
difficult combination between the particularities of each speaker
and the generality of language in the human species. We opt for
a broader classification that depends less on the linguistic
community analyzed and the techniques and methods of
analysis and more on the processes of language comprehension
and expression from a multichannel conception.

Quarter. - Some classifications have been based on clinical observations,

others on empirical data and are the result of the combination of
both methods, but in none of them have we found precise
references on visual languages.