Speech and language development and disorders in children (original) (raw)

1990, Current Opinion in Pediatrics

Communication is the exchange of information using a socially accepted system of symbols and behaviors. Although humans communicate with gestures, posture, and facial expression, most human communication relies heavily on converting ideas into language that is written or spoken. Spoken communication is received by the listener through hearing. Language is a socially agreed on, rule-governed system of symbols that is used to represent ideas about the world. Language includes shared understanding of what words mean (semantics); the capacity to change words in systematic ways, such as adding ''s'' to the end of a noun to make it plural (morphology); and rules that govern word order in a sentence (syntax). 1 The use of language as a social tool (pragmatics) involves a complex set of rules about using eye contact, interpreting nonverbal messages together with words that may have a different literal meaning, structuring requests that are polite, and sustaining conversation topics. Language disorders are identified when a person has difficulty with expressive language (sharing his or her thoughts and ideas), receptive language (understanding what others say), or pragmatic language (the social use of language). 1 Speech is the oral means of communicating language. Speech is produced through the complex coordination of respiration and laryngeal, velopharyngeal, and articulatory movements. Respiration provides the air pressure to initiate sound production through vocal fold vibration at the larynx. Sound from the larynx together with airflow are then directed nasally or orally by the velopharynx and shaped by the other articulators (eg, tongue, lips, teeth, and jaw) to create speech sounds. When these sounds are sequenced together, listeners are able to recognize words and sentences. Speech production can be categorized into three main areas: voice, fluency, and speech intelligibility, which includes articulation and speech resonance. 1 Voice quality reflects the sound produced by the vocal folds, a function that is influenced by respiratory support. Fluency refers to the rhythm and rate of speech, whereas articulation refers