In the Children's Health Care Center of the Capital Institute of Pediatrics (hereinafter referred to as the "Capital Children's Institute"), there is such a special outpatient clinic - the language and speech clinic, which is the first professional clinic in China to open and diagnose and treat problems related to children's language and language development.
What are the manifestations of speech and language disorders in children, and how can they be intervened? How is stuttering and training in children? What are the time points that should be paid attention to in children's language intervention? Wang Jianhong, deputy chief physician of the Health Department of the First Children's Institute, introduced the situation of the language and speech clinic to Zhongxin Health, and answered questions about the symptoms and diagnosis and treatment of children's language and speech disorders.
What are the manifestations of speech and language disorders in children?
According to the first child, language and speech disorders are common developmental disorders in childhood, which can affect children's future reading, writing, learning and social skills.
Language development delay and disorder are mainly manifested in children's abnormal language development, language comprehension or language expression lags behind the language level of children of the same age; Speech disorder is an abnormality of clarity, fluency and intelligibility in the process of language expression, mainly including speech disorder, voice impairment and fluency impairment.
In clinical work, children often come to the doctor for 'not speaking well', but this 'bad' needs to be analyzed in a specific situation. The content of the child's speech is not good, and the expression is relatively simple, which is a language problem; Unclear and fluency in pronunciation is a speech problem that needs to be evaluated for different issues. Wang Jianhong introduced to Zhongxin Health.
Wang Jianhong said that children speak late, backward in language comprehension, reading and oral expression, unclear pronunciation, fluency and other problems are all within the scope of language and speech outpatient treatment.
How to intervene in children with speech and language disorders?
Wang Jianhong suggested that for developing children, if parents are not sure about their language and speech development, they should go to the clinical clinic for assessment and screening, and intervene as soon as possible in case of abnormal development.
She said that for children with normal language development, parents can improve their language skills by imitating picture books with their children in daily life, reading aloud, and narrating stories or plots after reading. Of course, some children participate in age-appropriate facilitator classes and reading classes, which can also improve their language expression or comprehension skills to a certain extent.
She introduced that children who visit the clinic for "unclear pronunciation" first need to rule out hearing impairment and oral deformities, assess the child's language development process, and test their pronunciation problems, test which pronunciation the child says wrong, what is the wrong form, and guide parents and children how to train the wrong speech. Training for erroneous speech usually starts with a single tone, moves on to a syllable, and then to words, words, and sentences.
She also pointed out that specific language and speech disorders are a separate neurodevelopmental disorder, but for children with autism spectrum disorder or other neurodevelopmental disorders, language and speech disorders are one of the manifestations, which not only requires a comprehensive assessment of children, but also needs systematic training in their language, cognition, behavior, etc.
Wang Jianhong said that in the diagnosis and treatment of language and language clinics, it is very important not only to intervene in children's symptoms, but also to carry out **, and it is necessary to conduct comprehensive assessment and clinical guidance for children.
According to the first children's institute, children's language-speech development will be affected by various factors, and it is intricate, involving multiple professional disciplines such as child health care, otolaryngology, neurology, and other professional disciplines.
How is stuttering and training in children?
Wang Jianhong said that for children's stuttering, it is important for parents and children to monitor stuttering behavior in their lives. Through monitoring, we can understand whether there are stuttering, procrastination, repetition and frequency in the child's language expression, and whether it is accompanied by physical changes, such as whether the expression is not fluent, whether it is accompanied by squeezing eyes, shrugging shoulders, and distorting the mouth and face, so as to judge the degree of stuttering of the child. At the same time, it is necessary to understand the duration of stuttering, usually the above symptoms persist for more than half a year, and the presence of stuttering is considered.
She introduced that the mechanism of stuttering is very complex, and the specific intervention methods should also be combined with the characteristics of children themselves. If it is a "true" stutter, that is, there is a pause between words, or a stutter after a specific pronunciation, which lasts for a long time and has poor self-control adjustment, speech training is required; If it is a developmental stutter, which occurs intermittently, lasts for a short time, and can self-regulate, parents need to communicate and interact with their children more, create a state of natural communication, improve their pragmatic ability, let children understand what language to use in what situations, and enhance their ability to extract words.
Wang Jianhong emphasized that when children have problems with non-fluent expression, some parents will criticize their children, or let their children repeat words that are not fluent, which may have a psychological impact on children, resulting in their disapproval of themselves or social withdrawal. "Parents should set a good example, give their children reasonable guidance, and don't criticize their children for not speaking fluently. ”
She also pointed out that if there is only one child in the family, and the others are adults or older children, the language ability and speed of the family are much higher than that of small children, which may create a "high demand" language environment. For example, if the family speaks at a relatively fast pace, but the child's speech speed is not so fast, it will be affected by the surrounding language environment and automatically speed up the speech speed, while the child's ability to process and extract language or speech is relatively insufficient, which will cause stuttering. "Therefore, it is very important to assess the language environment of families with children who stutter. ”
What are the time points that should be paid attention to in children's language intervention?
Wang Jianhong pointed out that some parents believe that their children can speak when they grow up, or think that "noble people speak late", and do not assess and intervene early in language problems, and if their children's language problems persist, it will have an impact on their future social and academic life.
She emphasized that the best period of children's language development is 0-6 years old, and the best period for oral expression initiation is 0-3 years old.
She said that in the language development period before the age of 0-1, if the child has a backward non-verbal expression ability such as eye contact, physical communication or specific vocalization, it is necessary to intervene to strengthen the child's eye, body expression and oral stimulation; In the period of language development after the age of 1, if the child is not able to consciously call Mom and Dad by the age of 1 and a half, and by the age of 2 he is still unable to speak phrases, and his vocabulary is very small, he needs to intervene and correct.
Clinically, language development problems are usually diagnosed as language delay before the age of 4 years, and after the age of 4 years, if the child still has language development problems, the diagnosis of language disorder is made. However, it is recommended that the screening and intervention for language development delay should be moved forward, detected as soon as possible, and intervened as soon as possible, rather than waiting until more than 3 years old or 4 years old to see if it is a language development problem. Wang Jianhong said.
Author: Zhang Yuhui Shao Meng.
*: China News Network.