Syntactic phonological disorder: what is it, symptoms, causes and treatment

Within the group of communication disorders we can find a fairly heterogeneous group of alterations, having certain common characteristics: appearance in preschool steppe, close relationship with learning disorders, must There must be generalized deficiencies and they must not be the result of any motor or sensory alteration, environmental factors or other mental condition.

Syntactic phonological disorder is a type of sound and speech disorder, characterized by the inability to correctly form the sounds of the words of the mother tongue, appropriate to the age and expected evolutionarily.

In this article we will explain in more detail what syntactic phonological disorder consists of. through its characteristics, diagnostic criteria and also its symptoms, and why it is important to seek the help of a specialist.

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What is syntactic phonological disorder?

Syntactic phonological disorder can be found in the main manuals on mental disorders of the American Psychiatric Association (DSM-IV-TR and DSM-5)

within the category of "Communication disorders", and is called "phonological disorder".

On the other hand, in the manuals of the World Health Organization this disorder has the following names: "Specific pronunciation disorder", within the category “Specific speech and language development disorders” (ICD-10) and “Speech sound development disorder” (ICD-11), in the category “Speech or language development disorders”. language".

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) we can find four criteria that should be met in order to make a diagnosis of phonological disorder; these criteria being the ones we are going to comment on below.

First, there should be a persistent disturbance in the phonological articulation of language (inability to articulate speech sounds that would be expected for the person's age and according to the mother tongue), which would generate a great difficulty so that the speech of that person can be understood, and may prevent verbal communication with other people (Criterion A). In addition, there is a notable deficiency when it comes to producing spoken sounds, so it will interfere with the social participation of that person, as well as in their communication, and in the labor or academic development (Criterion B).

These alterations that hinder the phonological articulation of language, should begin and be detected in the early stages of the evolutionary development of that person (Criterion C).

Finally, articulatory difficulties, in order to make a diagnosis of a phonological disorder, should not have developed from an acquired or congenital condition (p. g., cleft palate, cerebral palsy, hearing deficits, etc.), nor because of any other neurological or medical disease (Criterion D).

It should be noted that it hardly undergoes changes in terms of criteria with respect to the previous version, the DSM-IV-TR. On the other hand, the ICD-10 proposes diagnostic criteria that are very similar to those that appear in the DSM. In order to make the diagnosis of phonological disorder, which in this manual would be called speech sound development disorder, the ICD-11 mentions that the difficulties and errors of the person should be outside the limits of a normal variation expected according to the level of intellectual functioning and with the age.

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Characteristics of this speech alteration

Syntactic phonological disorder, in addition to appearing in the DSM-5 with the name of "phonological disorder", also appears in other diagnostic classifications such as the one made by Rapin and Allen about "Specific Developmental Language Disorders" (SDD), where this disorder is classified within the subcategory of "Mixed expression-comprehension disorders".

The main characteristics of syntactic phonological disorder are these:

• Notable difficulties in terms of verbal fluency.

• The articulation of language is altered.

• Very limited language expression in relation to conventional and narrative discourse.

• Mixed receptive-expressive deficit, so he has difficulty both understanding and expressing himself.

• There is a deficient syntax: omission of links, short phrases and also morphological markers.

• His understanding of the language is better than his expression.

• Variables of the difficulty to understand: semantic ambiguity, speed of emission, length of the sentence.

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Main symptoms of syntactic phonological disorder

Syntactic phonological disorder if it affects language closely, the person could have notable difficulties when expressing a great variety of phonemes, so that his language could become intelligible to people who are listening to what he intends express. Next we will see what are the most common errors that can be found because of this communication disorder.

1. Processes related to syllabic structure

One of the main symptoms that we can see to detect a possible case of syntactic phonological disorder occurs when we see some condition in the processes related to the syllabic structure, such as the following: omit startup constants (p. say ‘ufanda’ instead of saying ‘scarf’), omit the constants at the end (p. eg, instead of saying 'pencil', say 'lapi'), among other types of omissions (eg. g., omitting initial unstressed syllables, reducing diphthongs to a single letter, simplifying consonant word clusters, etc.).

2. assimilatory processes

Another of the most common symptoms that we can find to detect a possible case of syntactic phonological disorder would be the following: nasal assimilations (p. say 'tambon' instead of 'tambor'), alveolar assimilations (p. g., 'book' instead of saying 'book') and many others (p. g., labial assimilations, velar assimilations, interdental assimilations, dental assimilations, etc.).

3. Investment

Among the most frequent symptoms within a possible syntactic phonological disorder we can find "inversion", which consists of changing the sounds of the order words (p. g., saying ‘cocholate’ instead of saying ‘chocolate’).

4. Addition

The "addition" would be another of the symptoms that could be indicative of a syntactic phonological disorder, being characterized by the action by that person of insert a sound (or a letter) that does not correspond to the word next to a sound that is not able to articulate correctly (For example, when he wants to say the word 'three', he inserts a letter and says 'teres', or when he wants to say 'white', he says 'balanco'.

5. Omission

The "omission" would also be one of the symptoms that could serve as a signal to evaluate a possible case of syntactic phonological disorder, being characterized by the difficulty that a child experiences in pronouncing a phoneme and, therefore, omits it directly (p. instead of saying the word 'zapato', say 'apato'), being able to omit the entire syllable (for example, saying 'lida' instead of pronouncing the word 'salida').

6. Substitution

The "substitution" could be another of the possible symptoms of a syntactic phonological disorder that consists of the production of errors when articulating a word. sound, so he ends up replacing it with another that he can articulate (for example, a child who has difficulty pronouncing the letter “r”, says ‘can’ instead of 'rat'.

On the other hand, a “substitution” could also occur by having difficulties in discrimination or auditory perception, so that in this type of case the child does not correctly perceive a phoneme and, therefore, emits it later just as she had understood it (p. g., saying ‘jueba’ instead of ‘play’).

7. Distortion

Finally, it is worth mentioning "distortion", since it could be another of the possible symptoms of syntactic phonological disorder, being characterized by being a sound expressed in a distorted way when it is given in a deformed or incorrect way, which means that when that person does not use the substitution, he does not correctly emit the sound.

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Treatment for language and communication disorders

Now that we have seen what syntactic phonological disorder consists of, it is convenient to give a brief information about the general characteristics about intervention for language disorders usually. And it is that in these types of cases you should always seek the help of a specialist.

Today there are still many questions about what would be the best intervention for language disorders and of communication, varying quite a bit depending on the specific disorder, its severity and the characteristics of each person. Still, it should be noted that There are some general principles that are usually taken into account in any treatment for this type of disorder., these being the following:

• It is very important to help the child become actively involved in treatment.
• There must be continuous feedback to guide the child when their verbalizations do not conform to expectations.
• You should try to keep the child motivated in the process.
• The learning content must be meaningful and motivating for the child.
• It is very important that there is repetitive practice (several trials must be done to consolidate learning).
• Specific objectives should be set for each session.
• Learning should be scaffolded as much as possible to reduce errors and thus progress.