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Behind the Scenes of Developmental Language Disorder: Time to Call Neuropsychology Back on Stage

机译:发展性语言障碍的幕后花絮:将神经心理学召回舞台的时间

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摘要

Although the Developmental Language Disorder (DLD), also known as Specific Language Impairment in children has been the focus of unceasing scientific attention for decades, the nature and mechanisms of this disorder remain unclear. Most importantly, we still cannot reliably identify children requiring urgent intervention among other ‘late talkers’ at an early age and understand the high prevalence of comorbidity with psychiatric phenomena such as Autism Spectrum Disorder. One of the main reasons for this is the traditional ‘diagnosis-by-exclusion,’ resulting in heterogeneity of the DLD population. This paper proposes an alternative approach to the diagnosis, treatment and research of DLD, claiming that it is these children’s multiple deficits in neuropsychological development, which impede the spontaneous acquisition of their first language. Specifically, this review of the state-of-the-art in DLD research demonstrates deep and systematic interconnections between the speech and other higher cognitive functions developing in early childhood, including perception, attention and executive functions. In the proposed framework, speech is, therefore, considered as one of neuropsychological abilities, and the delay in its development is explained by other neuropsychological deficits, resulting in highly individual clinical profiles. By considering DLD as a complex neuropsychological syndrome, whose successful treatment depends on a holistic approach to diagnosis and intervention, we may significantly increase the efficacy of speech therapy, and also better understand the flexibility of the developing brain, its compensatory mechanisms and hence the comorbidity of DLD with psychiatric symptoms. Implications for using this paradigm in future scientific research are discussed.
机译:尽管发展性语言障碍(DLD)(也称为儿童的特定语言障碍)一直是数十年来不断引起科学关注的焦点,但这种障碍的性质和机制仍不清楚。最重要的是,我们仍然无法可靠地识别出需要在其他“晚说话者”中进行紧急干预的儿童,并无法理解自闭症谱系障碍等精神病合并症的高患病率。造成这种情况的主要原因之一是传统的“排除诊断”,导致DLD人群的异质性。本文提出了另一种诊断,治疗和研究DLD的方法,声称正是这些儿童神经心理发育的多重缺陷,阻碍了他们母语的自然习得。具体而言,对DLD研究的最新进展的回顾表明,语音与儿童早期发展的其他更高认知功能(包括感知,注意力和执行功能)之间存在着深层次的系统联系。因此,在提出的框架中,语音被认为是神经心理学的能力之一,其发展的延迟可以用其他神经心理学的缺陷来解释,从而导致高度个人化的临床特征。通过将DLD视为复杂的神经心理学综合征,其成功的治疗取决于整体的诊断和干预方法,我们可以显着提高言语治疗的功效,也可以更好地理解发育中的大脑的灵活性,其代偿机制以及因此而引起的合并症DLD伴有精神病症状。讨论了在将来的科学研究中使用这种范例的含义。

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