Language and speech disorders

Rationale

A language disorder is defined as an impairment in comprehension and/or use of the form, content, or function of language. A speech disorder is defined as impaired articulation, fluency, and/or voice production.

Causal Conditions

(list not exhaustive)

1. Language disorder
   1. Delayed and developmental language impairment (e.g., deafness, autism spectrum disorder, neglect, abuse)
   2. Degenerative, vascular, or other central nervous system disorders (e.g., stroke)
   3. Metabolic or nutritional causes (e.g., Wernicke encephalopathy)
   4. Head injury
2. Speech disorder
   1. Articulation disorder (e.g., dysarthria)
   2. Fluency (e.g., stuttering, Parkinson disease)
   3. Speech apparatus lesions (e.g., cleft palate, head and neck neoplasm)

Key Objectives

Given a patient with a language or speech disorder, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan. Particular attention should be paid to differentiating language from speech disorders.

Enabling Objectives

Given a patient with a language disorder or a speech disorder, the candidate will

1. list and interpret critical clinical findings, including those based on
   1. an assessment of hearing in a child,
   2. evidence of a structural abnormality of the central or cranial nervous system (e.g., malignancy), and
   3. results of an appropriate neurologic examination;
2. list and interpret critical investigations (e.g., hearing tests);
3. construct an effective initial management plan, including
   1. referring the patient for specialized care with appropriate health care professionals (e.g., speech therapist; ear, nose, and throat surgeon) if necessary, and
   2. counselling and educating the patient and/or family, particularly regarding the psychosocial impact on function.