Speech Disorders and Language Disorders: Causes

Speech disorders

Pathogenesis (disease development) of speech disorders.

Speech disorders refer to impaired articulation of speech. Speech fluency disorders can be distinguished from speech motor disorders. Speech fluency disorders include:

  • Logophobia – refers to the speech anxiety of the speech impaired.
  • Mutism (F94.0) – muteness with the speech organ intact; especially in depression, dementia, stupor (drive disorder; condition with complete loss of activity in an otherwise awake state of consciousness)
  • Polter (F98.6) – overhasty and slurred speech.
  • Stuttering (F98.5)

Speech motor disorders include:

  • Dysarthria (R47.1) – acquired speech disorder caused by a speech motor dysfunction; speech becomes slurred and “washed out”; dysarthrias are among the most common neurogenic communication disorders
  • Dysglossia – disorder of speech caused by abnormalities of the tongue, palate, etc.
  • Dyslalia (stammering)

Etiology (causes) of speech disorders

Disease-related causes of dysarthria.

Psyche – Nervous System (F00-F99; G00-G99).

  • Degenerative basal ganglia diseases (Huntington’s disease, Parkinson’s syndromes).
  • Motoneuron diseases – group of diseases affecting the motoneurons. Motoneurons are nerve cells of the central nervous system that exert direct or indirect control over a muscle with their axon
  • Multiple Sclerosis (MS)
  • Myasthenia gravis (MG; synonyms: myasthenia gravis pseudoparalytica; MG); rare neurological autoimmune disease in which specific antibodies against the acetylcholine receptors are present, with characteristic symptoms such as an abnormal load-dependent and painless muscle weakness, an asymmetry, in addition to the local also a temporal variability (fluctuation) in the course of hours, days or Weeks, an improvement after recovery or rest periods; clinically can be differentiated a purely ocular (“concerning the eye”), a faciopharyngeal (face (Facies) and pharynx (pharynx) concerning) emphasized and a generalized myasthenia; about 10% of cases already show a manifestation in childhood.
  • Primary dystonias – disorders whose only symptom is dystonia (disorders of postural and motor control) (no underlying disease).
  • Progressive supranuclear gaze palsy (PSP; synonym: Steele-Richardson-Olszewski syndrome (SRO)) – neurodegenerative disease of unknown etiology associated with progressive cell destruction in the basal ganglia; leading symptom: progressive paresis (paralysis) of the eye muscles associated with a Parkinson’s-like symptom picture.
  • Spinocerebellar ataxias (SCA) – group of clinically similar neurodegenerative diseases; symptomatology: dependent on the focus of degeneration.
  • Cerebrovascular diseases (ischemic infarcts and hemorrhages of cerebral vessels).

Injuries, poisonings, and certain other sequelae of external causes (S00-T98).

Speech disorders

Pathogenesis (disease development) of speech disorders.

The clear majority of aphasias (approximately 80%) are caused by cerebrovascular diseases such as apoplexy (stroke). Vascularly caused (vascular) aphasias are divided into four standard syndromes:

  • Global aphasia: most severe disorder of aphasia; all language modalities such as speech production, comprehension, reading, and writing are affected Leading symptoms: speech automatisms, stereotypies; spontaneous speech, repetition, language comprehension, and word finding are impaired
  • Broca’s aphasia: patients usually speak haltingly in incomplete sentences and occurrence of errors in the formation of sounds (eg, phonematic paraphasias) Guiding symptoms: existing agrammatism, often also a speech apraxia (disturbance of the initiation and execution of the movement sequences necessary for speech); spontaneous speech and after-speech are disturbed
  • Wernicke’s aphasia (former name: sensory aphasia): leading symptoms: paragrammatism as well as paraphasias; speech is often fluent, however, overshooting and content-poor, while a disturbance of speech comprehension can often be determined; after-speech is disturbed/paraphrastic (word confusion disorder)
  • Anamnestic or anatomic aphasia: is often caused by temporoparietal lesionsLeading symptoms: Word-finding problems and content-poor speech phrases; repetition and speech comprehension are mildly impaired; word finding is impaired

Etiology (causes) of speech disorders

Disease-related causes

Cardiovascular (I00-I99).

  • Apoplexy (stroke) and other cerebrovascular diseases.

Neoplasms – tumor diseases (C00-D48).

  • Brain tumors, unspecified

Ears – mastoid process (H60-H95)

  • Hearing disorder, unspecified

Psyche – nervous system (F00-F99; G00-G99)

  • Anxiety disorders
  • Auditory processing and perceptual disorders (AVWS).
  • Attachment disorders
  • Dementia, unspecified
  • Encephalitis (inflammation of the brain)
  • Inflammatory brain disease, unspecified.
  • Epilepsy (seizure disorder)
  • Frontal brain syndrome – personality changes occurring after lesion of the frontal brain base, such as aloofness, disinhibition, etc.
  • Hyperkinetic disorders – period occurring in children with increased restlessness associated with attention deficit disorder.
  • Childhood aphasia (Engl. acquired childhood aphasia) – caused by an acute brain damage, which is accompanied by a partial or even complete loss of previously acquired language skills.
  • Communication disorders in confusion
  • Landau-Kleffner syndrome – aphasia and epilepsy in childhood.
  • Alzheimer’s disease
  • Multi-infarct dementia – dementia due to brain damage after multiple strokes.
  • Multiple sclerosis (MS)
  • Intelligence impairment, unspecified
  • Mental illness, unspecified
  • Psychoses, unspecified
  • Schizophrenia
  • Selective mutism (synonym: elective mutism; Latin : mutus “mute”) – emotionally conditioned mental disorder in which linguistic communication is severely impaired; the clinical picture is characterized by selective speech with certain people or in defined situations articulation, comprehension and expression of the affected, however, are usually within the normal range, at most they are slightly developmentally delayed
  • Profound developmental disorders such as early childhood autism – congenital, incurable perceptual and information processing disorder of the brain.
  • Circumscribed developmental disorders of motor functions such as developmental disorders of oral motor skills, phonetic disorders.

Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99).

  • Acquired aphasia, unspecified.

Injuries, poisonings, and other sequelae of external causes (S00-T98).

  • Hypoxic injury (damage caused by insufficient oxygen supply to the tissues) of the brain
  • Traumatic brain injury (TBI)

Other causes

  • Neglect – children showing signs of neglect may be more likely to have speech problems

Language development disorders

The at least 6-month language delay before 36 months of age marks the language development delay.From the age of > 36 months is called a language development disorder. Examples of circumscribed developmental disorder of speech and language (UESS):

  • Biographical causes
    • Incidence of language development disorders and dyslexia in the family.
  • Failure to reach typical milestones and landmarks (see history below).
  • Lack of skills in individual language areas (phonation, vocabulary, grammar and pragmatics).
  • Lack of interest in communication of the child
  • Behavioral problems