The dyslalia It is one of the most common language disorders among children during the preschool and primary school years. It is a disorder of the articulation of different phonemes or groups of phonemes.
In dyslalia, the organs that intervene in speech, also called phonoarticulatory organs (lips, jaw, soft palate, tongue, etc.), are placed in an incorrect way, giving rise to an inappropriate pronunciation of certain sounds or phonemes.
Dyslalia is characterized by the presence of errors in the articulation of speech sounds in people who do not show a pathology related to the central nervous system.
On some occasions, this pronunciation defect derived from poor articulation can become automated and normalized, this is evidenced in written language.
Dyslalia can affect any consonant or vowel. However, the alteration of pronunciation occurs more frequently in some sounds such as / r /, since their articulation requires greater agility and precision in their movements..
It also tends to occur in / k /, because the articulation point is not visible and therefore imitation is more difficult, as well as in / s /, where there is a deformation in the articulatory position of the tongue.
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Following Pascual (1988), dyslalia can be classified according to its etiology. Thus, we distinguish between:
This type of dyslalia occurs in some phases of child speech development where children still do not articulate different sounds well or distort some phonemes.
The causes of this phenomenon can be immaturity, absence of auditory discrimination, lack of control in the murmur, respiratory disturbances or inadequate movements in the articulatory organs.
Within the evolution of the maturity of the child these difficulties are overcome, only if they persist between four or five years is when we would consider it as pathological.
The etiology of audiogenic dyslalia lies in the presence of an auditory deficit which is accompanied by other language alterations, such as voice and rhythm.
Correct hearing is essential in order to properly articulate sounds..
Organic dyslalia originates due to an injury to the central nervous system (dysarthria) or due to an organic alteration of the peripheral organs of speech without damage to the central nervous system (dysglossia).
Functional dyslalia is caused by an inadequate functioning of the articulatory organs, without evidence of organic damage or injury. Among functional dyslalias we distinguish phonetic disorders and phonological disorders.
Phonetic disorders are alterations in the production of phonemes. The alteration is focused on the motor aspect of the joint.
Errors are stable, and it is observable that errors in sound appear equally in the repetition of spontaneous language. There is no alteration in the auditory discrimination processes.
Phonological disorders are alterations at the perceptual and organizational level, that is, in the processes of auditory discrimination, affecting the mechanisms of conceptualization of sounds and the relationship between meaning and signifier..
In these cases, the oral expression of the language is poor and depending on the severity it can become unintelligible.
Errors are often fluctuating. In isolation the sounds could be articulated well, but the pronunciation of the word is affected.
Among the most common causes of functional dyslalia we find:
There is a difficulty in articulating language and fine motor skills. There seems to be a direct relationship between motor delay and the degree of language delay in pronunciation alterations.
This is the most common cause in cases of dyslalia. Children with dyslalia present clumsiness in the movements of the articulatory organs and a deficit in general motor coordination, which is only observable in terms of fine motor skills.
In these cases, in the person with dyslalia there are difficulties in the perception and organization of space and time.
If the child has difficulties to perceive it and has not internalized the spatio-temporal notions, the language is difficult.
The development of this perception is important for language to evolve.
The individual cannot imitate sounds because he does not perceive them correctly, that is, he is not able to discriminate.
Sometimes the child hears well, but analyzes or makes an inadequate integration of the phonemes that he hears.
There is a wide variety of psychological factors that can affect language development, such as any affective disorder, family maladjustment, lack of affection, jealousy between siblings, trauma or overprotective environments..
Among the environmental factors, situations of bilingualism, maternal overprotection, institutionalization of the child or learning by imitation have been highlighted, as well as at a low cultural level.
In these cases, functional dyslalia would be secondary to intellectual deficit.
The symptoms of dyslalia vary depending on the degree of involvement. The difficulty of articulation can range from a specific phoneme to many phonemes, thus making the language unintelligible..
The symptomatology consists of the commission of errors. The most common mistakes made in dyslalia are:
Substitution error consists of replacing one sound with another.
For example, the individual is unable to pronounce the sound / r / so he replaces it with another phoneme that is easier for him, such as the sound / l /, that is to say "brass" instead of "mouse".
Sometimes, the child makes this substitution error due to hearing discrimination deficit, that is, the child improperly perceives a word and makes this sound as it is perceived.
For example, the child perceives "van" instead of "van." Substitution can occur at the beginning, in the middle or at the end of the word.
The distortion error consists of when we give it an incorrect or deformed shape trying to approximate it more or less to the appropriate joint.
They are mainly due to improper positioning of the articulation organs. For example, the child says "perdo" instead of "dog.".
The individual omits the phoneme that they cannot pronounce, but does not replace it.
Sometimes this omission is of a single phoneme such as "osquilleta" instead of "rosquilleta" and other times the omission is of a complete syllable "lota" instead of "ball".
If two consonant groups have to be pronounced "bla", "cri", etc., the liquid consonant is omitted.
The addition error consists of adding a phoneme to the word to facilitate pronunciation.
For example "tigeres" instead of "tigers", "four" instead of "four" or say "aratón" instead of "mouse".
The problem with this type of error is that it can become automated and turns it into one more word.
The inversion error consists of modifying the order of the sounds. For example, it says "cacheta" instead of "jacket".
For the evaluation of functional dyslalia in children, we must take into account the following aspects:
The interview with the parents is of great relevance to obtain an anamnesis of the problem, both personal and family.
This interview is the necessary first step in any diagnosis. Not only strictly linguistic data will be explored, but also those that refer to general maturation.
In this interview, information related to personal data such as personal history, motor development, personality, schooling, as well as family data will be collected..
To carry out the evaluation in dyslalias, it is necessary to examine the joint to know exactly what are the defects that the subject presents. This evaluation of pronunciation must be exhaustive and systematic so that it does not lead to a misdiagnosis.
Therefore, it is necessary to detail the situation of the phoneme-problem, if it is initial, intermediate or final and to what type of expression it refers, if repeated, directed or spontaneous language, depending on the frequency, will vary its articulation difficulties from one to the other. other.
It is necessary to consider that those difficulties that arise in repeated language will also appear in directed and spontaneous language, since we assume that if the child cannot imitate, he will not be able to do it spontaneously either..
For the evaluation of repeated language, a list of words is used in which the examined sound is contained in all the mentioned situations. To evaluate directed language we present some objects or pictures known to the child, whose names contain the phoneme to be examined.
To assess spontaneous language, informal conversation, questions, etc. are used. Thus, a psychological evaluation could be considered if there is a disparity between repeated and spontaneous language, the former being correctly elaborated, while spontaneous speech becomes unintelligible.
This could lead us to consider an affective-emotional problem, in which case, a psychological examination of the child would be necessary..
In many cases, a motor delay can be a causative factor that favors the appearance of a functional dyslalia.
Sometimes the motor delay is generalized and in other cases the difficulty is specifically in the movement of the articulatory organs.
It is important to assess the ability of auditory perception in reference to the discrimination of environmental sounds, joints and words.
To carry out this evaluation, you will be proposed pairs from each of the three areas to examine:
Familiar sounds are used to assess the discrimination of environmental sounds, for example newspaper sheets.
Stimulus A will be “tearing a sheet of newspaper” and stimulus B will be “crumpling a sheet of newspaper”, the subject with his back to the professional must say which sound belongs to which action.
To evaluate the discrimination of joints we will choose three similar syllables such as "ba", "da", "ga".
These stimuli are presented in pairs and the individual has to be able to discriminate what each sound is..
To evaluate the discrimination of words, words are chosen to be able to evaluate the ability to discriminate the sounds of the articulation inserted within words.
For this, they are asked to repeat the words that you are presenting in pairs, if they are different or if it is the same words, such as "little", "mouth" / "cat", "duck /.
Breathing is necessary for the emission of the voice and the articulation of language.
It is important to know the respiratory capacity of the individual, if there are defects in the respiratory process and the control and directionality of the expired air.
Muscle tension plays a role in the articulation of language. Especially in the mouth area, since it sometimes blocks the agility to articulate words.
To develop an articulation program we must establish:
Shaping is an operant technique used to increase behaviors. This technique is indicated when the behavior we want to achieve does not exist. To do this, we will reinforce the approaches (the parts in which we have divided the behavior) until we reach the final goal..
The reinforcer must be contingent and must be delivered immediately after the conduct is issued. To apply the molding it is necessary:
The phases that we are going to follow will be:
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