Subtipos de trastorno específico del desarrollo del lenguaje: perfiles clínicos en una muestra hispanohablante

Abstract

Introduction. Specific language impairment (SLI) can be viewed as a continuum with different subtypes depending on the combination of deficits and strengths in each of the components of linguistic behavior. Aim. To analyze the phenomenological profiles in a correlative series of Spanish children in order to facilitate their endophenotypic differentiation and the choice of strategies of intervention. Patients and methods. 86 referred children, aged 4 to 9 years, with a mean non-verbal inteligence quotient of 93 (range 72-114) and accomplishing clinical criteria of SLI. Apart from clinical interview and neurological examination, a protocol of questionnaires and tests was used in all subjects in order to measure their formal (phonological, syntactic, lexical) and functional (semantic and pragmatic) linguistic abilities. A cluster analysis of variables was used in order to investigate SLI subtypes. Results. In the total sample, a 24% of whole series have a pure phonological expressive disorder. 55% of subjects have mixed receptive/expressive disorders; from these, the most pervasive subtype is due to verbal agnosia (11%), but more frequently observed subtypes affect syntax reception and expression combined to difficulties in phonological programming (36%) or in lexical retrieval (8%). Furthermore, 21% of the total sample present with difficulties in pragmatic use of language even if their formal linguistic abilities and non-verbal behavior are normal. Conclusions. Our empyrical approach confirms that the admitted SLI subtypes in international literature applies to Spanish-speaking children for endophenotyping and intervention-planning purposes.

Behavior Problems in Children With Specific Language Impairment

“…A similar proportion (20%) was also found in a sample of ages 3.5-9.5 years (n ¼ 86). 49 A larger proportion (30%) was described in a school sample (n ¼ 41, ages 6-13 years). 41 Probably, much larger samples would be required to evaluate the prevalence in the general population.…”

Como crianças e adolescentes com Distúrbio Específico de Linguagem compreendem a linguagem oral?

“…Comprehension deficits may be explained, in part, by the lack of linguistic knowledge, especially morphology and syntax (4)(5) , which are seriously impaired in children with SLI (1,3) . However, considering the complexity of language comprehension (14,17,(20)(21) , difficulties in higher-order linguistic processing must be considered as well (32) .…”

“…Specific Language Impairment (SLI) is a primary language disorder, diagnosed clinically according to inclusion and exclusion criteria adopted internationally (1,2) . Complex and heterogeneous, the disorder is characterized by several linguistic and non-linguistic impairments (1,3) , among which verbal comprehension difficulties can be emphasized. These deficits may be explained by either lack of linguistic knowledge (4,5) or limited linguistic processing (6)(7)(8)(9)(10)(11)(12) .…”

Compreensão literal e inferencial em crianças com distúrbio específico de linguagem

“…O Distúrbio Específico de Linguagem (DEL) refere-se à dificuldade em adquirir e desenvolver linguagem na ausência de privação ambiental e de quaisquer comprometimentos clínicoscomo deficit sensorial ou motor, deficiência mental, distúrbio emocional e lesão neurológica (Plante, 1998;Leonard 2000;Bishop, 2006;Crespo-Eguílaz, Narbona, 2006). O diagnóstico é estabelecido por critérios de inclusão e exclusão adotados internacionalmente (Castro-Rebolledo et al, 2004;Bishop, 2006 Botting, 1999;Crespo-Eguílaz, Narbona, 2006).…”

“…Os sujeitos mais velhos com DEL apresentaram pior desempenho, o que contraria os resultados de Bishop e Adams (1992). Uma explicação cabível seria a heterogeneidade em termos de gravidade (Castro-Rebolledo et al, 2004;Bishop, 2006;Crespo-Eguílaz, Narbona, 2006). Os sujeitos mais velhos em atendimento no LIF apresentam alterações linguísticas graves.…”