Manifestations of language disorders in children Language disorders in childhood are mainly manifested in two aspects, on the one hand, slow development, manifested as non-speaking, late speech and short utterances, low vocabulary; on the other hand, they can speak but cannot speak clearly, although they have language expression, but often have poor pronunciation, which affects communication with others and also affects learning. 1, delayed language development: refers to the state that children’s language development lags behind the actual age level. Characteristics are expressed in three aspects, language expression disorder: has passed the age of speech can not speak or to 2 years old will only speak a single word, 4-5 years old still can not express in sentences; oral language comprehension disorder: 1 year 6 months – 2 years old still have difficulty understanding spoken language, can not follow instructions; 2, communication disorder: can not communicate with others effectively, including receiving information from others and express their own ideas. Causes of delayed language development include hearing impairment, intellectual disability, autism spectrum disorder, disengagement from the language environment and specific idiosyncratic disorders. 3. Dysarthria: It is a disorder of articulation, resonance, rhythm and other speech motor control due to organic lesions of the articulatory organ neuromuscles that cause muscle weakness, abnormal muscle tone and motor incoordination of the articulatory organ. Characteristics: The affected children usually have normal auditory comprehension and can correctly select vocabulary and grammatical arrangement, but cannot control stress, volume and pitch well, and in severe cases, they cannot speak at all or lose the ability to articulate. Causes of dysarthria include cerebral palsy, encephalitis, and traumatic brain injury. There is a special type of dysarthria in which the articulation error is fixed, but the hearing, intelligence and articulatory organs are normal, and the reason is unclear. Tests that need to be perfected 1. Complete set of tests for diction: including subjective assessment of the movement of the child’s articulatory organs such as lips, tongue and jaw, as well as detailed quantitative objective assessment of the child’s breathing, vocalization, resonance and diction using computerized acoustic analysis technology to understand the source of the child’s pronunciation errors. 2.Language delay assessment: The child’s language development level will be assessed in terms of the child’s communication ability, hands-on ability, language comprehension and language expression. 3.Auditory brainstem response test: Normal hearing input is the basis of language expression, so it is necessary to routinely do hearing tests for children with language disorders. 4, intelligence testing: good language expression requires the correct construction of ideas, so intellectual development has a large impact on language, and the child’s level of intellectual development needs to be assessed. Language rehabilitation training treatment (a) Delayed language development in children 1. Treatment principles: Based on the current stage of children’s language development, horizontal development and vertical improvement. 2. Treatment techniques: ① Language training place: Children’s training room requires a spacious room with sound insulation and sound absorption, and avoid excessive visual stimulation in the training room. ② Training time: Language training is best arranged in the morning, especially the examination, because the patient’s spirit is more full, the mind is more awake, the afternoon tolerance is poorer than the morning. Each training time of 30 minutes is appropriate, if available, it is best to perform language training once a day within a year after the onset of the disease. Training to three months as a course of treatment, can adhere to more than one course of treatment, some clinical continued for many years. ③ Training forms Individual training: Individual training procedures can be developed according to the specific situation of the child, such as the degree of severity, the focus of the disorder, residual language function, etc., and then develop the training content. Group training: Speech therapy in small groups can improve the child’s social adaptation, reduce psychological anxiety, increase the desire to communicate, and play a positive role in improving secondary impairments due to language disorders, such as psychological aspects, emotional aspects, and interpersonal relationships. ④Language training implementation principles: In principle, language training must be done with the consent and joint assistance of the family and the child himself. Training should be conducted according to the type and severity of the language disorder. Improve the initiative and motivation of the child to train. Appropriate amount of training. Repeat appropriate training in order to achieve results, but do not force and do not overexert. Appropriate enhancement and feedback to reinforce positive responses and eliminate undesirable responses. ⑤ Family guidance: According to the training procedure and daily training content, leave homework for the child to improve confidence and see hope. ⑥Implementation methods of language training: Play therapy: It is good for building human relationships, promoting visual communication and consolidating training effects. Operant topics: including concepts such as matching, selection, and numbers. Training of gesture symbols: Gesture symbols are the basis for mastering language symbols and word symbols. Types: condition-dependent gesture symbols, want, hug, give me; gesture symbols indicating things: cap cap; gesture symbols indicating actions: eat, sleep, wash, cut; gesture symbols indicating relative relationships: up, down, big, small. Speech training:Listening comprehension: from easy to difficult, such as from 1/3 choice → 1/4 choice → 1/5 choice → 1/6 choice → 1/8 choice → 1/12 choice; noun → verb → adjective → size → color → phrase. Repetition: The therapist should observe the child’s oral changes. Naming: sound and vocal expression, pay attention to the coordination of sound quality, tone and volume. Training of words: word shape discrimination; combination of word symbols and meaning learning Word card emission attention: syllables should be somewhat different; category combination; quantity from 1/2 match → 1/3 match → 1/4 match, not more than 4 sheets at a time, especially brand new ones. 2. Treatment goals ① Establish basic communication between people such as sight communication ②Promote basic means of communication such as gestural communication and writing board communication. (3) Establish verbal-textual communication in children who are fully able to normalize. (2) Dysarthria treatment 1.Treatment principle: induce the child to pronounce correctly and achieve normal speech communication. 2.Treatment techniques ①Required conditions: room of at least 12 square meters, a bed as needed; a large mirror in the standing position; oral apparatus ②Time: 30 minutes. ③ training plan: the child’s condition is evaluated and a plan is made from three aspects: restoration of the function of the organ of articulation, motor training of articulation, and sound production. ④Constructive organ motor function training: correct articulatory posture, relaxation training, breathing training, jaw movement, double lip closure and tongue movement, nasopharyngeal atresia training. ⑤ Issuance of the same sound at the same construal point: issuance of vowels, issuance of labial sounds, issuance of lingual apical sounds, issuance of lingual root sounds, issuance of lingual edge sounds, issuance of light high sounds, issuance of lingual apical and supra-dental dorsal sounds. (6) Issuance of sounds with different constituent points (7) Issuance of non-meaningful syllables (8) Issuance of meaningful syllables (9) Smooth speech 3. Treatment goals: Training goals are determined according to the severity of the condition. Notes to parents (1) The child should be accompanied by parents, and attention should be paid to auditory stimulation and oral tactile stimulation. (2) Observe and understand the type and degree of speech disorder of the child. (3) Observe the child’s ability to adapt to the environment and observation of the surroundings, and pay attention to the coordination of the lips and teeth when speaking. (4) Design a variety of play scenarios according to the child’s language level to promote language development. (5) Conduct language training with the help of appropriate toys and small training devices. (6) Insist on reinforcement of the training effect in daily life. Health education (1) Inform parents of the condition, build their patience and confidence in time treatment, insist on home training, and apply existing achievements in daily life activities. (2) Inform parents of the key points of safety care, and give the child a tag with home address and telephone number to avoid getting lost. (3) Encourage the child to communicate more with children of the same age and send him/her to school to receive education according to his/her intelligence and language ability.