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DYSPHASIA

You get the impression your child understands your gestures better than your words… and yet he is not deaf.

u He is intelligent… and very manipulative.

u He is observant… but has difficulty adapting to changes.

u He is sensitive to the atmosphere… but may react badly.

u He pays attention to intonation… but his attention and his concentration are short-lived.

And nevertheless he wants to communicate.

He manages to make himself understood by his family using :

u Expression… « his eyes speak ».

u Gestures… « he mimes to speak ».

u Actions… « he acts and shows with his body to speak ».

Language disorders include a specific language deficiency known as dysphasia, which is always accompanied by learning disabilities. 

Dysphasia is a developmental language disorder. According to Dr. Isabelle Rapin, dysphasic syndromes are characterized by significantly acquisition of language, despite :

¨ Normal hearing.

¨ Normal non-verbal intelligence.

¨ The absence of severe brain damage.

¨ A stimulating language environment.

Dysphasia can be summarized as follows :

¨ It is a type of learning disability that affects primarily language.

¨ Children with the problem have normal IQ.

¨ Dysphasia is a permanent disorder that has repercussions on the child’s emotional, social, family and academic life; these repercussions are all the more serious since the problem is little known.

¨ The problem can be manifested in different ways as the child grows.

¨ There are no medications or surgical procedures that can be used to treat dysphasia. The evaluation is performed by a multidisciplinary team (psychologist, speech therapist, audiologist and paediatrics neurologist). The diagnosis must be made by a speech therapist since the problem is a language disorder.

¨ The extent of the problem is variable (mild, moderate, severe).

¨ The only possible treatment is special education and assistance in developing visual means of compensation. Special education training is required in school; often the aid of psychomotor expert, occupational therapist and psychologist is also required.

CAUSE OF DYSPHASIA

Researchers agree that dysphasia is neurologically based. Some researchers believe that people suffering from dysphasia are “brain different”.  Other researchers maintain that dysphasia reflects a variety of dysfunctions in the brain pathways required for language comprehension, development and programming. The nature of these dysfunctions is unknown; the cause, in most cases, is a genetic problem or a lesion appearing in the developing brain (during pregnancy, anoxia during childbirth, and so on).

The problem exists at birth; it does not occur after birth as a result of emotional or other trauma. Standard neurological tests do not necessarily provide information on the condition. Long-term observation and the pooling of data by all those involved are, still today, the only real ways of determining the presence and impact of the disorder.

Oral language deficiency of a dysphasic nature affects written language, i.e. reading and writing, to varying degrees. When dysphasia is mild, it cannot be detected at a early age because the signs are too inconspicuous; they usually do not become apparent until the child begins school.

Children affected by mild or moderate dysphasia can function in a regular classroom, with speech therapy and special education support. Children with moderate to severe disabilities of this nature may be placed in special language classes.

INTERVENTION

A number of approaches are used to promote communication with young children suffering from dysphasia. They include :

¨ Getting the child’s attention by calling his or her name or touching him or her gently.

¨ Choosing a topic that arouses the child’s interest.

¨ Adapting your way of speaking to the child’s level of language.

¨ Speaking slowly, using only a few words at a time, and articulating clearly.

¨ Not hesitating to repeat yourself several times.

¨ Using intonation, gestures and context.

¨ Encouraging the child to use only one language.

¨ Establishing a good relationship and having fun with the child, using all forms of communication (gestures, looks, etc.). Without communication, the child cannot learn.

¨ Encouraging the child to develop compensation strategies, by building on the child’s strengths.

¨ Using visual media to promote communication.

¨ Putting the child in daycare at an early age to encourage him or her to develop compensatory strategies.

Other approaches can be used to promote verbal comprehension in school, such as:

¨ Ensuring the student thoroughly understands the vocabulary used in class (and giving the parents a vocabulary list).

¨ Preparing definitions of/or illustrations for unfamiliar words or specific expressions.

¨ Reinforcing verbal messages through visual means: signs, gestures, facial expressions, illustrations, written words.

¨ Using visual material to illustrate ideas, directions, procedures and activities, and thus emphasize the topic being discussed in class.

¨ Illustrating the class routine with pictograms.

¨ Making audio recordings of the teacher’s presentations (to replace course notes).

¨ Giving clear, concise and orderly explanations in class.

¨ Providing a course outline.

¨ Addressing the child directly by calling him or her by name, making eye contact or touching the child when explaining something or giving instructions to the group.

¨ Checking whether the student has understood by asking him or her to restate what has been said.

¨ Adapting what you say (content) and how you say it (form) to the student’s level of comprehension.

¨ Associating verbal information with specific objects, actions and events to encourage greater comprehension; using concrete material and illustrating explanations with demonstrations.

¨ Avoiding excessive auditory, visual and verbal stimulation, e.g. continuous background noise.

¨ Planning a moment’s silence in class after an activity requiring comprehension, or alternating activities requiring comprehension with others that do not.

¨ Speaking more slowly.

¨ Repeating or reformulating what you have said.

¨ Articulating clearly.

¨ Keeping sentences short.

¨ Reinforcing comprehension, by alluding to the child’s experience, situations in his or her everyday life, personal objects or photos, then moving gradually away form them. Providing examples after presenting a new idea.

Extract from : « A Practical Guide to Learning Disabilities » Authors : Denise Destrempes-Marquez - Louise Lafleur - Éditions Hôpital Ste-Justine, 1999.