Disorders of Language Development: Diagnosis and Intervention

Children with delayed language (no words by 18 months of age or phrases by 24 months of age), and those whose speech is distorted, require evaluation. The pediatrician can assess language and cognitive function in the office through brief observation of the child's play and use of language, paying particular attention to articulation, sentence structure, appropriateness of content, and ability to engage in dialogue. Comprehension is assessed by the child's responses to questions and commands. On this basis it is possible to classify dysphasic children into several distinct categories of syndromes that warrant specific interventions. Appropriate intervention for dysphasic preschool-aged children entails referral to specialized educational programs rather than providing weekly speech and language sessions. Children with severe deficits in comprehension and those unable to express themselves orally may required an alternative channel of communication such as sign language, communication boards, or the written or printed word. Prognosis varies among syndromes; many are the harbingers of later learning disabilities.