28. Disorders of Speech and Language + Autism Spectrum Disorder

Question 1

Normal speech development (2 aspects):

Answer 1

• Intact pathway: includes hearing sensitivity, perception, intelligence, motor skill, emotional stability
• Favourable environment: adequate learning exposure and stimulation, reinforces the attempts and expectations

Question 2

Developmental language disorder:

Answer 2

Umbrella term for childhood language disorder, most common disability of childhood, children with DLD may have problems reading and writing

Question 3

Classification of developmental language disorder:

Answer 3

Speech disorder, language disorder

Question 4

Speech disorders:

Answer 4

• Articulation (focus on errors (e.g., distortions and substitutions) in production of individual speech sounds)
• Fluency (rate/rhythm and repetition of speech sounds)
• Voice (pitch and volume inappropriate for age/sex

Question 5

Language disorders

Answer 5

• Impaired comprehension
• Grammar, syntax and morphology
• Pragmatic use of language

Question 6

Autism spectrum disorders:

Answer 6

Pathological neurodevelopmental process leads to characteristic triad of symptoms: impaired social interaction, impaired verbal/non-verbal communication, repetitive and restrictive behaviour

Question 7

Epidemiology of autism spectrum disorders:

Answer 7

• Males>Females 3:1
• Usually diagnosed >2yo
• Siblings at higher risk of ASD too

Question 8

Pathogenesis of ASD:

Answer 8

1) Genetic – factors which alter brain development and synaptic connectivity; certain genes are silenced prenatally.
2) Neurobiological – differences in cortical volume, anatomy and neurotransmitter concentrations
3) Environmental trigger – toxic exposures, teratogens, perinatal insults/infections with underlying genetics

Question 9

DSM:

Answer 9

Diagnostic and Statistical Manual

Question 10

Social interaction in ASD:

Answer 10

• Lack of response to name
• Limited eye contact
• Establishing joint attention – will not bring/point to object of interest
• Understanding/expression of facial expressions and gestures - pointing, waving, nodding/shaking head
• Little interest in developing relationships with caregivers/other, prefer to play by themselves.

Question 11

Verbal communication in ASD:

Answer 11

• Language not used as a tool for communication – would repeat words inappropriately or imitate speech
• Turn taking in speech
• Relevant response to conversation and maintaining the topic of conversation
• Literal understanding of speech, metaphors, and expressions hard to grasp

Question 12

Repetitive and Restrictive Behaviour in ASD:

Answer 12

• Stereotyped motor mannerisms – rocking back and forth, flapping hands, spinning in circles
• Hypo/hyper reactivity to sensations – ie would avoid soft textures and seek shiny surfaces
• Strong preference for sameness of environment and routine
• Non imaginative play