Identifying and managing common childhood language and speech impairments

Abstract

The bottom line • Language, speech, and stuttering impairments are common in childhood and often have debilitating long term social, educational, and health consequences• These impairments may occur in isolation; however, they are often the first presenting symptom of developmental conditions and as such practitioners should actively seek causes (for example, hearing impairment) and associated problems (for example, learning disability, autism)• In the first 3-4 years of life, speech and language development varies greatly between normal children• There is evidence that treatment is effective for speech disorders after 3 years of age• Treatment is effective for major distressing stuttering that has lasted for more than 12 months• Treatment can improve difficulties with expressive language that are present beyond 3 years of age, but has little impact on receptive difficulties Sources and selection criteriaWe carried out a search of Medline using the terms "children", "language", "speech", "stuttering" or "stammering" AND "delay", "disorder", "impairment", "treatment", and "intervention."We also searched the Cochrane database of systematic reviews using the terms "children", "language", "speech", and "stuttering/stammering". Incidence and prevalence data were derived from prospective longitudinal cohorts and cross-sectional population studies with direct assessment of children.For intervention studies we considered randomised controlled trials to be the gold standard.example, autism) and co-occur in conditions such as attention-deficit/hyperactivity disorder at a higher level than could be expected by chance.22 In contrast, the onset of stuttering is associated with higher, rather than lower, maternal education.6 Even in population studies with both sufficient sample size and breadth to build comprehensive risk models, much of the preschool variance in all three disorders remains unexplained. [1][2]][3] Rapid advances in discovery are anticipated over the coming decade, unraveling the complex genetic, environmental, and neural origins.[23][24][25][26][27][28][29]

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