Language Delay in Children

Year 2024, , 260 - 265, 22.07.2024

Funda Akpınar , Pelin Çelik

https://doi.org/10.12956/tchd.1475173

Abstract

Concerns about language development are among the most common complaints that parents seek medical advice regarding their children’s development. Developmental language disorder refers to a delay in children’s receptive or expressive language development without an underlying medical condition. Risk factors such as prematurity, low socioeconomic status, screen exposure, maternal depression and family history can affect language development in children. In a child presenting with a complaint of delay in language development, a detailed anamnesis should be taken, including developmental history, home environment, family history and psychosocial risk factors.
The evaluation of a child should include not only language development but also all areas of development (language, cognitive, motor, relationship, social-emotional) using a standatdized developmental assessment tool. A detailed physical examination should be performed to check for accompanying genetic, neurological and other medical conditions (e.g. cleft palate). Regardless of the result of newborn hearing screening, all children should undergo hearing tests, and if necessary, hemogram and iron parameters should be evaluated. If there is a history of regression, delay in the relationship area, or signs of accompanying neurudevelopmental problems, further evaluation should be performed. It should not be fogotten that a delay in language development may be the initial sign of problems such as cognitive delay, autism spectrum disoeder, hearing loss, and speech pronounciation disorder.
Early intervention shoul be planned for children with delayed language development and should not be waited for. Monitoring and supporting each child’s development with family-centered methods is the most effective method for the prevention, early diagnosis, and early intervention of all developmental difficulties, including delay in language development.

Keywords

Language delay, Speech, Early childhood development

Çocuklarda Gecikmiş Konuşma

Abstract

Dil gelişimi ile ilgili kaygılar ailelerin çocuklarının gelişimleri ile ilgili hekim başvurusunda bulundukları en sık yakınmalardandır. Gelişimsel dil bozukluğu altta yatan tıbbi bir neden olmadan alıcı ya da ifade edici dil gelişimindeki gecikmeyi ifade eder. Prematürite, düşük sosyoekonomik düzey, ekran maruziyeti, anne depresyonu, aile öyküsü gibi risk etmenleri çocuklarda dil gelişimini etkileyebilmektedir. Dil gelişiminde gecikme yakınması ile başvuran bir çocukta, gelişimsel öykü, ev ortamı, aile öyküsü ve psikososyal risk etmenlerini içeren ayrıntılı bir anamnez alınmalıdır. Çocuğun sadece dil gelişimi değil, tüm gelişim alanları (dil, bilişsel, hareket, ilişki, sosyal duygusal) standart bir gelişimi değerlendirme aracı ile değerlendirilmelidir. Eşlik edebilecek genetik, nörolojik ve diğer tıbbi durumlar (örneğin yarık damak) açısından ayrıntılı fizik muayene yapılmalıdır. Yenidoğan işitme taraması sonucundan bağımsız olarak tüm çocuklarda işitme testi yapılmalı, gerekli durumlarda hemogram, demir parametreleri değerlendirilmelidir. Regresyon öyküsü, ilişki alanında gecikme ya da eşlik edebilecek nörogelişimsel sorun bulgularının olması durumunda ileri değerlendirme yapılmalıdır. Dil gelişimindeki gecikmenin bilişsel gecikme, otizm spektrum bozukluğu, işitme kaybı, konuşma sesletim bozukluğu gibi sorunların ilk bulgusu olabileceği unutulmamalıdır. Dil gelişiminde gecikmesi olan çocuklara erken girişim planlanmalı, beklenmemelidir. Her çocuğun sağlık izlemi içerisinde gelişiminin aile merkezli yöntemler ile izlenmesi ve desteklenmesi dil gelişiminde gecikme de dahil olmak üzere, tüm gelişimsel zorlukların önlenmesi, erken tanınması ve erken müdahalesi için en etkili yöntemdir.

Keywords

Dil gelişiminde gecikme, Konuşma, Erken çocukluk dönemi gelişimi

References

• Feltner C, Wallace IF, Nowell S, Orr CJ, Raffa B, Cook Middleton J, et al. Screening for Speech and Language Delay and Disorders in Children Age 5 Years or Younger: An Evidence Review for the U.S. Rockville Preventive Services Task Force. JAMA 2024;331:335-51.
• Feldman HM, Messick C. Language and speech disorders. In: Elias ER, Blum ER, Jimenez NJ, Stancin M Feldman HM. Developmental and Behavioral Pediatrics. 5th. Philadelphia: PA. Elsevier, 2022:72-90.
• Wallace IF, Berkman ND, Watson LR, Coyne-Beasley T, Wood CT, Cullen K, et al. Screening for Speech and Language Delay in Children 5 Years Old and Younger: A Systematic Review. Pediatrics 2015;136: e448-62.
• Siu AL, US Preventive Services Task Force. Screening for speech and language delay and disorders in children aged 5 years or younger: US preventive services task force recommendation statement. Pediatrics 2015;136:e474–81.
• Zablotsky B, Black LI, Maenner MJ, Schieve LA, Danielson ML, Bitsko RH, et al. Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017. Pediatrics 2019;144: e20190811.
• Bölte S, Neufeld J, Marschik PB, Williams ZJ, Gallagher L, Lai MC. Sex and gender in neurodevelopmental conditions. Nat Rev Neurol 2023; 19: 136-59.
• Roberts MY, Curtis PR, Sone BJ, Hampton LH. Association of Parent Training With Child Language Development: A Systematic Review and Meta-analysis. JAMA Pediatr 2019; 173:671-80.
• Bishop DV. What Causes Specific Language Impairment in Children? Curr Dir Psychol Sci 2006; 15: 217-21.
• Bishop DV, Price TS, Dale PS, Plomin R. Outcomes of early language delay: II. Etiology of transient and persistent language difficulties. J Speech Lang Hear Res 2003;46: 561-75.
• Synnes A, Luu TM, Moddemann D, Church P, Lee D, Vincer M, et al. Determinants of Developmental Outcomes in a Very Preterm Canadian Cohort. Arch Dis Child Fetal Neonatal Ed 2017;102: 234–5.
• van Noort-van der Spek IL, Franken MC, Weisglas-Kuperus N. Language functions in preterm-born children: a systematic review and meta-analysis . Pediatrics 2012;129: 745-54.
• Noble KG, Engelhardt LE, Brito NH, Mack LJ, Nail EJ, Angal J, et al. Socioeconomic disparities in neurocognitive development in the first two years of life. Dev Psychobiol 2015:57; 535-51.
• Justice LM, Jiang H, Purtell KM, Schmeer K, Boone K, Bates R, et al. Conditions of Poverty, Parent-Child Interactions, and Toddlers’ Early Language Skills in Low-Income Families. Matern Child Health J 2019; 23: 971-8.
• Sania A, Sudfeld CR, Danaei G, Fink G, McCoy DC, Zhu Z, et al. Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries. BMJ Open 2019; 9: e026449.
• Hageman JR. Screen Time and 30 Million Words. Pediatr Ann 2019; 48:e337.
• Council on Communications and Media. Media and Young Minds. Pediatrics 2016;138: e20162591.
• Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA. Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis. JAMA Pediatr 2020; 174: 665-75.
• Takahashi I, Obara T, Ishikuro M, Murakami K, Ueno F, Noda A, et al. Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years. JAMA Pediatr 2023;177: 1039-46.
• Brushe ME, Haag DG, Melhuish EC, Reilly S, Gregory T. Screen Time and Parent-Child Talk When Children Are Aged 12 to 36 Months. JAMA Pediatr 2024; 178: 369-75.
• McArthur BA, Browne D, McDonald S, Tough S, Madigan S. Longitudinal Associations Between Screen Use and Reading in Preschool-Aged Children. Pediatrics 2021;147;. e2020011429.
• Çelik P, Ayrancı Sucaklı İ, Yakut Hİ. Initial symptom of different developmental problems: Language delay. Turkish J Pediatr Dis 2019; 13: 468-74.
• O’Leary N, Jairaj C, Molloy EJ, McAuliffe FM, Nixon E, O’Keane V. Antenatal depression and the impact on infant cognitive, language and motor development at six and twelve months postpartum. Early Hum Dev 2019;134: 41-6.
• Skurtveit S, Selmer R, Roth C, Hernandez-Diaz S, Handal M. Prenatal exposure to antidepressants and language competence at age three: results from a large population-based pregnancy cohort in Norway. BJOG 2014; 121:1621-31.
• O’Leary N, Jairaj C, Nixon E, Quigley J, O’Keane V. Antenatal depression and maternal infant directed speech during the first postnatal year. Infant Behav Dev 2021;64:101605.
• Whitehurst GJ, Arnold DS, Smith M, Fischel JE, Lonigan CJ, Valdez-Menchaca MC. Family history in developmental expressive language delay. J Speech Hear Res 1991;34:1150-7.
• Barry JG, Yasin I, Bishop DV. Heritable risk factors associated with language impairments. Genes Brain Behav 2007;6: 66-76.
• Kumar A, Zubair M, Gulraiz A, Kalla S, Khan S, Patel S, et al. An Assessment of Risk Factors of Delayed Speech and Language in Children: A Cross-Sectional Study. Cureus 2022;14: e29623.
• van Wijngaarden V, de Wilde H, Mink van der Molen D, Petter J, Stegeman I, Gerrits E, et al. Genetic outcomes in children with developmental language disorder: a systematic review. Front Pediat 2024;12: 1315229.
• Choudhury N, Benasich AAJ. A family aggregation study: the influence of family history and other risk factors on language development. Speech Lang Hear Res 2003; 46: 261-72.
• Bishop DVM, North T, Donlan C. Genetic basis of specific language impairment: Evidence from a twin study. Dev Med Child Neurol 1995; 37: 56-71.
• Hayiou-Thomas ME, Kovas Y, Harlaar N, Plomin R, Bishop DV, Dale PS. Common aetiology for diverse language skills in 4 1/2-year-old twins. J Child Lang 2006; 33: 339-68.
• Rice ML, Taylor CL, Zubrick SR, Hoffman L, Earnest KK. Heritability of Specific Language Impairment and Nonspecific Language Impairment at Ages 4 and 6 Years Across Phenotypes of Speech, Language, and Nonverbal Cognition. J Speech Lang Hear Res 2020; 63:793-813.
• Hoff E, Tulloch MK, Core C. Profiles of Minority-Majority Language Proficiency in 5-Year-Olds. Child Dev 2021;92: 1801-16.
• American Speech-Language-Hearing Association-Learning More Than One Language. Available from:https://www.asha.org/public/speech/development/Learning-Two-Languages/ .Accessed at 9.04.2024.
• Cheung RW, Willan K, Dickerson J, Bowyer-Crane C. Risk factors for early language delay in children within a minority ethnic, bilingual, deprived environment (Born in Bradford’s Better Start): a UK community birth cohort study. BMJ Paediatr Open 2023;7: e001764.
• Ozturk Ertem I, Krishnamurthy V, Mulaudzi MC, Sguassero Y, Bilik B, Srinivasan R, et al. Validation of the International Guide for Monitoring Child Development demonstrates good sensitivity and specificity in four diverse countries. Acta Paediatr 2019;108: 1074-86.
• Bayley N. Bayley Scales of Infant and Toddler Development. 3rd ed. San Antonio, TX: Harcourt Assessment Inc;2006.
• Ertem IO, Krishnamurthy V, Mulaudzi MC, Sguassero Y, Balta H, Gulumser O, et al. Similarities and differences in child development from birth to age 3 years by sex and across four countries: a cross-sectional, observational study. Lancet Glob Health 2018;6:279-91.
• Aral N, Baran G, Gürsoy F, Köksal Akyol A, Ayhan AB, Erdoğan S et al. Brigance Erken Gelişim Envanteri’nin altı yaş Türk çocukları için uyarlama çalışması. Cagdas Egitim Dergisi 2008;33: 353.
• Savaşır I, Sezgin N, Erol N. Ankara Gelişim Tarama Envanteri El Kitabı. Ankara: Ankara Üniversitesi Tıp Fakültesi 1995.
• Temel F, Ersoy Ö, Avcı N, Turla A. Gazi erken çocukluk değerlendirme aracı. Ankara: Rekmay Ltd. Şti 2004.
• Allen D Buz Harlor Jr, Charles Bower; Committee on Practice and Ambulatory Medicine; Section on Otolaryngology-Head and Neck Surgery. Hearing assessment in infants and children: recommendations beyond neonatal screening. Pediatrics 2009; 124:1252-63.
• Language Delay. Available from: https://www.uptodate.com/login. Accessed at: 09.04.2024.
• Reilly S, McKean C, Morgan A, Wake M. Identifying and managing common childhood language and speech impairments. BMJ 2015;350: h2318.
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed (DSM-V). Washington DC: APA, 2013.
• World Health Organization, United Nations Children’s Fund, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.
• Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ 2023; 72: 1-14.
• Speech Sound Disorders-Articulation and Phonology. Available from:https://www.asha.org/practice-portal/clinical-topics/articulation-and-phonology/#collapse_8. Accessed at: 08 04 2024.
• Black LI, Vahratian A, Hoffman HJ. Communication Disorders and Use of Intervention Services Among Children Aged 3-17 Years: United States, 2012. NCHS Data Brief 2015; 205: 1-8.
• HM Feldman. Evaluation and management of language and speech disorders in preschool children. Pediatr Rev 2005; 26: 131-42.
• Buschmann A, Jooss B, Rupp A, Dockter S, Blaschtikowitz H, Heggen I, et al. Children with developmental language delay at 24 months of age: results of a diagnostic work-up. Dev Med Child Neurol 2008;50: 223-9.
• Szumlas GA, Petronio P, Mitchell MJ, Johnson AJ, Henry TR, DeWitt TG. A Combined Reach Out and Read and Imagination Library Program on Kindergarten Readiness. Pediatrics 2021;147: e2020027581.
• Reynolds AJ, Temple JA, Ou SR, Arteaga IA, White BA. School-based early childhood education and age-28 well-being: effects by timing, dosage, and subgroups. Science 2011;333: 360-4.
• Yoshikawa H, Leyva D, Snow CE, Treviño E, Barata MC, Weiland C, et al. Experimental impacts of a teacher professional development program in Chile on preschool classroom quality and child outcomes. Dev Psychol 2015; 51: 309-22.
• Law J, Garrett Z, Nye C. Speech and language therapy interventions for children with primary speech and language delay or disorder. Cochrane Database Syst Rev 2003; 2003: CD00411