Delay in the development of spoken language and comprehension

Specialty: Pediatrics.

• Child language delay
• suspected specific language disorder
• speech delay

Why it occurs

• Conductive or sensorineural hearing loss (hearing loss due to chronic recurrent bilateral serous otitis media or congenital anomalies of the cochlea/auditory nerve, primary physical cause of language delay)
• Autism Spectrum Disorder or ASD (alteration of neurobiological development that jointly affects verbal/non-verbal communication, social interaction and associates restrictive or repetitive behaviors)
• Specific Language Impairment or SLI/Developmental Language Disorder (persistent primary difficulty in the acquisition and use of oral language without obvious neurological, sensory or intellectual cause)
• Intellectual disability or global developmental delay (cognitive delay that proportionally limits language acquisition and general understanding)
• Selective mutism or severe psychosocial factors (severe social anxiety, extreme linguistic deprivation in the family environment or emotional neglect).

Initial workup

Complete hearing evaluation (priority first-line diagnostic test): Otoacoustic emissions (OAS) and Brainstem Auditory Evoked Potentials (BEATC) or age-adapted behavioral audiometry by pediatric otorhinolaryngology to rule out hearing loss. Detailed speech therapy and neuropsychological evaluation using standardized language scales (such as the PLS-5 scale or the Boston test). Application of autism screening questionnaires (such as the M-CHAT-R/F) if you associate social communication difficulties. Assessment of general cognitive development using the Bayley scale or WPPSI according to the child's age.

Standard management

• There is no specific pharmacological treatment for delayed language development. The fundamental treatment is early speech therapy intervention and personalized speech and language therapy. If ADHD or extreme impulsivity coexists that prevents learning and attention in therapies: Methylphenidate — psychostimulant, indicated only in people over 6 years of age under strict indication of pediatric neurology; doses of 0.5 to 1.2 mg/kg/day orally
• If chronic serous otitis media is associated with proven hearing loss, surgical treatment of transtympanic drainage is indicated, frequently accompanied by adenoidectomy.