The term dyslalia refers to the difficulties in pronouncing certain sounds , which can occur in children of different ages. According to the new international diagnostic classifications of mental disorders, it is a speech sound disorder.

In this article we will see what dyslalia is, what its types and causes are, as well as some ways to perform evaluation and treatment.

Language development

Oral language is the set of sounds that are articulated to manifest what we need, feel or think. It is both a behaviour and a cognitive skill, and we develop it from the first years of life. Its manifestation is related to the maturation of the nervous system , specifically the sensory and motor areas. In itself, it is related to the affective and social bonds that we establish, and to the development of other cognitive skills.

Artigas and García-Nonell (2008) tell us that the development of language skills corresponds to the chronological age of the child. Thus, between 0 and 3 months of age the emission of monochord sounds is expected. Between 9 and 12 months, denials are understood and caregivers (usually mom and dad) are named. From the age of 3 simple questions are expected and their speech is understood by the family unit. By the age of 5 she can tell what is happening to her and use articles; and by the age of 7 verbal fluency and the use of conjunctions are expected.

However, it may be that in some cases the chronological age does not correspond to language development , i.e. not all children acquire the same skills at the same time. For example, some children may begin to understand what people say to them, but have limitations in explaining themselves. Children may also express themselves verbally in a slow manner, or with little fluency, or they may express themselves so fluently that their language is intelligible. Likewise, among the possibilities that fall within the development of language is what we have called “dyslalia”.

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What is dyslalia?

The word dyslalia comes from the Greek word “dys”, which means “difficulty”; and “lalein” which means “to speak”. It is a difficulty in producing certain sounds or groups of sounds in the way that is considered appropriate. It can be detected, for example, when a child frequently resorts to omitting a certain sound by means of silence or vocal elongation. Or if the child always replaces the same sound with a similar one, which is a case of substitution.

It can also be made visible by distortion, i.e. when the child frequently resorts to emitting a sound that is approximate but not the one that fits in with his or her conversation. Finally it can happen that the child inserts a sound as a support .

Recent international definitions

The term “dyslalia” has recently been removed from international classifications of mental disorders, but it continues to be used in everyday and specialized language to refer to the phonetic difficulties that some children present .

For its diagnosis, the DSM-V considers the latter no longer as “dyslalia” but as a “Speech Sound Disorder” (STD) . This is a set of central and phonological component alterations that occur at the level of pronunciation of some phonemes.

6 types and causes

Although classifications may vary, according to Aguilar-Valera (2017); Hernández and Rubalcaba (2017), there are the following types of dyslalia: physiological or evolutionary, organic, phonological, functional and mixed. Likewise, dyslalia can be divided according to specific pronunciation difficulty.

1. Physiological or evolutionary

It is considered a developmental dyslalia the case in which the child does not repeat by imitation those words he hears , even though his development and chronological age is considered adequate for this. Its development is therefore due to a certain maturation of the brain and the phonemic apparatus. It usually occurs around 4 years of age and is made visible by phonetically incorrect repetition.

2. Organic

This is functional dyslalia when the joint is related to the peripheral organs that control speech. In this case, children most often use substitution , omission or distortion of the expected sound.

3. Audiogenic

As the name suggests, it is dyslalia which is the result of a hearing impairment .

4. Functional

It results from the functioning of the gnostic recognition system and the practical production system, so that its etiology is related to the development of the cognitive processes .

5. Mixed

As its name implies, a mixed dyslalia is one in which the manifestations of the previous types are presented simultaneously.

6. According to pronunciation

According to the specific difficulties of pronunciation according to the alphabet, Peña-Casanova, 2014 (cit in Hernández and Rubalcaba, 2017), tells us that dyslalia can be divided as follows :

  • Betacism: in the pronunciation of B
  • Deltacism: pronunciation of the D
  • Gammacism: pronunciation of the G
  • Kappacism: pronunciation of the K
  • Mystacism: pronunciation of the M
  • Rotacism: pronunciation of the R
  • Sigmatism: pronunciation of the S

Possible causes, evaluation and treatment

Dyslalia has a multi-causal development and course. That is to say, it is caused by the presence of different elements, among which some organic function can be found, and also a style of upbringing that is not favoring fluency in language and communication.

It can be evaluated through the Glatzel Test , which takes into account nasal permeability and phonoarticulation; or by the Rosenthal Test which considers the respiratory mode. It is also important to make qualitative assessments based on observation of expression and reception of speech, so that communication support needs are determined.

Treatments include speech therapy and exercises of the muscles necessary for the joint: the lips, the tongue, the palate, the tonsils, the frenulum. The same exercises include activation of the nasal and oral apparatus, and it is important that they are planned with a determined frequency and rhythm, in correspondence with the needs and the area of proximal development of the child. Otherwise, far from favoring their development, it may hinder and cause impatience or manifestations of anxiety.

To determine appropriate treatment, it is important to begin by understanding the cause of the dyslalia as well as the immediate needs of the child and the family or immediate environment.

Bibliographic references:

  • Aguilar-Valera, J.A. (2017). Communication disorders from the DSM-V. The need for differential diagnosis. Cuadernos de Neuropsicología (11) 1: 144-156.
  • Hernández, A. and Ruvalcaba, I. (2017). Language disorders. Recovered July 31, 2018. Available at