A distinction can be made between different types of developmental disorders. These include in particular
- Developmental disorders of speech and language
- Developmental disorders of school skills, e.g. reading and spelling disorder (dyslexia), arithmetic disorder (dyscalculia)
- Developmental disorders of motor functions
- Profound developmental disorders, e.g. autism, Rett syndrome
Developmental disorders of speech and language refer to inadequate language development from the outset. It cannot be attributed to
- neurological disorders
- environmental factors (e.g. moving to another language area)
- sensory impairments (hearing impairment) or
- insufficient intelligence
can be attributed. It should be noted that children do not develop in the same way. Many children develop at a rather slow pace, at least in certain phases. This does not necessarily have to be a disorder. A disorder only exists if
- the development of the relevant function is extremely slow over a longer period of time, or
- related functions are impaired at the same time.
For example, a speech disorder is more likely to be present if there are pronounced reading or writing problems at the same time.
However, if all functions develop less well, this could indicate a general reduction in intelligence.
What speech and language disorders are there?
A specific disorder of speech development is the so-called articulation disorder. It manifests itself in the use of sounds or sound combinations that are
- are completely missing,
- are used incorrectly or distorted or
- are replaced by other sounds.
Articulation disorders are the most common speech development disorders. They occur in around 7 percent of 5-year-old boys and 2 percent of 5-year-old girls.
In the case of expressive language disorders, the child is unable to express themselves in an age-appropriate manner. For example, they cannot speak age-appropriate sentences. However, speech comprehension towards others is normal.
If speech comprehension is impaired, this is referred to as a receptive language disorder.
Stuttering is a disorder of the speech process. The flow of speech is inhibited or interrupted. Those affected often repeat or stretch sounds or syllables. Stuttering occurs in 5 percent of 5-year-old boys and 2 percent of 5-year-old girls.
Poluttering is also a speech fluency disorder. It is characterized by an extremely unrhythmic and irregular flow of speech, sometimes at a very fast rate.
These developmental disorders include
- reading and spelling disorder (dyslexia) and
- dyscalculia (dyscalculia).
Both disorders occur as partial performance disorders, i.e. the remaining skills are developed according to age.
Around 10 percent of all children are affected by partial performance disorders, boys significantly more than girls. Rates of reading and spelling disorders are between 4 and 7 percent. Up to 6 percent of children are affected by dyscalculia.
In the case of these developmental disorders, the school assessments of the respective impaired functions are in the lowest range. There are often additional problems such as inattention or hyperactivity.
The disorder does not easily disappear when the child is offered more support.
Affected children often experience failure, ridicule and poor performance. This leads to emotional problems such as
- anxiety,
- disorders in social behavior,
- psychosomatic symptoms (physical complaints due to psychological problems) or school refusal.
- refusal to go to school.
Reading and spelling disorder
Dyslexia manifests itself
- in the omission, reversal, substitution or addition of letters or words when writing and reading,
- a slow reading speed with pronounced starting difficulties and frequent hesitation and
- in the swapping of letters in words or words in sentences.
Reading comprehension is also impaired. Affected children cannot, for example, reproduce what they have read in their own words or draw their own conclusions from what they have read. Dyslexia is often preceded by a delay in language development.
In adulthood, difficulties with spelling in particular can persist. Reading skills usually normalize.
Dyslexia is a common reading and spelling disorder © photophonie | AdobeStock
Instead of a reading and spelling disorder, in some cases a pure spelling disorder can be observed. Reading ability and comprehension remain unimpaired.
Therapeutically, the focus is on providing parents and children with information and practicing the impaired functions. In addition, depending on the legal situation in the respective federal state, school law options may be used. These include dyslexia bonuses or additional remedial teaching.
Case study: Reading and spelling disorder (dyslexia)
9-year-old Joachim is referred to the child and adolescent psychiatric outpatient clinic by his pediatrician. Until he started school, he had been a cheerful and age-appropriate boy. From the beginning of first grade, despite support from his teacher and mother, he had great difficulties in acquiring reading and writing skills. It is noticeable that Joachim writes the same words on the same page very differently and even has difficulty copying one word from another. In all other subjects, however, he performs very well and actively participates.
The reading and writing problems have been going on for two and a half years. Joachim enjoys school less and less. He often sleeps badly and often complains of stomach ache in the morning, which means he is often unable to go to school.
Arithmetic disorder (dyscalculia)
In dyscalculia, affected children only master basic arithmetic skills well below the age standard. These include the four basic arithmetic operations.
Various errors can occur. Those affected
- do not understand the concepts of arithmetic operations, for example,
- do not understand or recognize mathematical expressions and symbols,
- do not remember the multiplication tables, or
- do not understand the number structure and the correct number sequence.
It is possible that the affected children have below-average spatial imagination.
Children with this disorder are clumsy in their motor skills (movements). For example, they have difficulties
- dress themselves,
- tie their shoes,
- work with scissors and glue,
- drawing or painting.
They learn more complicated movements such as riding a bike or swimming very slowly. Due to deficits in school, sport and leisure activities, the affected children easily find themselves in an outsider position.
When making a diagnosis, the doctor checks whether the developmental disorders may also be due to a visual impairment.
Approximately 1.4 percent of all pupils are affected, boys twice as often as girls. Therapeutically, exercise therapy and body awareness training are indicated.
Like Rett syndrome, autism is one of the so-called profound developmental disorders. They are characterized by
- severe impairment of social interactions and communication as well as
- stereotypical and little varying interests or movements
characterized.
Autism
In early childhood autism, which begins before the age of 3, social interactions are severely impaired. The children are poor at assessing social signals and show little reaction to the respective social context. There is a lack of social or emotional reciprocity, and there is hardly any social play.
Language development is often also impaired. The existing language is hardly used socially and is not used flexibly.
In addition, the children show rigid, severely restricted and frequently repetitive patterns of behavior (stereotypies). For example
- they often touch or smell things or
- ritualistically deal with timetables or dates.
In addition to these characteristics, autistic children often have various behavioral problems such as
- Fears,
- self-harm (e.g. banging their head against the wall or biting their hand),
- sleep and eating disorders.
Asperger's syndrome is a milder form. Here, too, the children show
- impaired communication,
- stereotypical behavior and
- an idiosyncratic use of language
In contrast, intellectual performance and the development of language skills are not impaired.
Up to 0.1 percent of all children are autistic, with boys being affected two to three times as often as girls.
Rett syndrome
Rett syndrome only affects girls and begins between the 7th and 24th month of life. This is when there is a partial or complete loss of previously acquired motor and language skills. Stereotypical writhing hand movements are typical.
In the course of the disease, physical abnormalities also occur. Symptoms such as slower head growth and epileptic seizures can also occur. Overall, the course of the disease is poor and cannot be decisively influenced in a positive way.
