The 2019 Consensus Conference regarding language disorders expresses itself as follows: “… to date the wealth of knowledge produced by the international scientific literature on DPL (Primary Language Disorders) still presents, on some specific junctions of the therapeutic diagnostic path, areas of uncertainty … (…) the results that were not always in agreement have limited, at an international level, the production of guidelines based on evidence-based medicine. The complexity of the phenomenon is also due to the variability of the clinical pictures and their course … “
The DSM-5 places the Language Disorder among the Neurodevelopmental Disorders in the category of Communication Disorders, defining it:
“… persistent difficulty in acquiring and using different language modalities (…) not attributable to sensory deficits, motor dysfunctions or other medical or neurological conditions …”
Only recently has there been talk of Language Disorder and not of SPECIFIC Language Disorder because it has been realized that in the complexity represented by defining language and in the problems that a child with these difficulties may encounter it is not entirely correct and appropriate to speak of specificity.
Like any stage that concerns the developmental age (where intelligence is normal and there are no sensory or neurological deficits), it is really difficult, if not impossible, to define and frame a child only because it has some characteristics and not others.
Language difficulties are defined with skills that are quantified on the basis of what a child is expected to be able to do at a certain period of his or her life (within 3 years).
A significant percentage of children who are diagnosed with a language disorder, if not resolved before preschool age, are thought to lead to a specific learning disorder.
If it is true that many children with language difficulties could present SLD, we can resume that thread already described in this blog in the article of 20 November 2020 (“Specific learning disorders”: What do children tell us?), Where we ask ourselves about the fact that even before reaching school age, something may have affected the child who is having difficulties.
We can affirm that it is essential to know how to help these children from every point of view but that first of all we must take care of their human reality, taking into consideration that there is a fundamental period where the greatest wealth is not expressed by words.
What is that first year of life made of (where the child still does not express himself in words and has nothing to do with school learning), in which everything, or a lot, can be decisive for the psychophysical development of the little ones?
But what is the language and what does it represent?
As soon as we are born we are able to emit sounds and we are predisposed to learn all those existing in the world and we can understand and subsequently produce all the languages to which we are exposed.
Each living form has its own way of communicating with its peers but there are substantial differences between the evolution of human language and other living beings and the motivation that drives man to express himself and communicate.
A first very obvious difference is certainly given by the fact that human language changes from birth and while the elephant’s trumpeting will forever remain a (more or less intense) trumpeting, the newborn’s cry will turn into verbal / articulated language.
Animals are capable of communicating hunger, danger, the needs necessary for their own survival and that of their species. They have their own intelligence and do amazing things. But never the useless and beautiful things that human beings can do!
The human being certainly cries if he is hungry or cold but his request to satisfy these needs also hides the certainty that the adult who satisfies these vital needs also responds to the need for a world made of affection and interest.
Instead, we should think that the child, who unlike animals possesses Thought and possesses it from birth, naturally has within himself the predisposition to seek and create an inter-human relationship, and that this relationship is fundamental even before he speaks.
We must not think that the child will develop articulated language only by imitation towards the world of the adults who care for him; from them he will surely learn the language that will be Chinese in China and Italian in Italy. Trivially, that you do not speak by imitation is also confirmed by some mistakes he makes and that it is unlikely that he has heard an adult pronounce. The child naturally possesses within himself the possibility of developing everything he needs if the external environment responds and is not disappointing.
It is therefore essential to deal with that period of life where verbal language is not present and the child expresses his inner world in other ways, creative and original; a world made of images that is knowable and must necessarily be listened to.
I think we should stop believing that the child is a wax tablet that can be modeled to one’s liking, that he learns only by imitation or that he only needs to be fed and warmed; instead we should think that the child has from birth the possibility of developing and growing without “defects” and / or deficiencies. And if this does not happen, have the courage to understand and research the reasons.
What should always be proposed (which is the common denominator of the articles I have written up to now) is a total taking charge of the child and a deep and broad look at his internal reality, on that world of affections, sensations and images linked to its most significant reports.
Certainly the job of the speech therapist is to intervene on the symptoms and solve some problems with the more or less effective use of “techniques” the various difficulties that a child has, but which difficulty is overcome if the causes are not also addressed?
With this last question, I once again reiterate the importance of a job that involves several professionals and a project that includes family and school, where possible and necessary.