Speech Disorders and Language Disorders: Medical History

Medical history (history of illness) represents an important component in the diagnosis of speech and language disorders. Family history

  • What is the general health of your family members?
  • Are there any diseases in your family that are common?
  • Are there any hereditary diseases in your family?

Social history

  • What is your profession?
  • Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

  • What changes have you noticed?
  • How long have these changes existed?
  • Did the change occur all of a sudden? *
  • Is the change continuously there or does it only occur under certain circumstances (when?)?
  • Have there been any other symptoms besides the speech/language disturbance? Headaches, nausea, paralysis, etc.?

Vegetative anamnesis incl. nutritional anamnesis.

  • Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
  • Do you drink alcohol more often? If yes, what drink(s) and how many glasses of it per day?
  • Do you use drugs? If yes, which drugs and how often per day or per week?

Self history incl. medication history.

  • Pre-existing conditions (neurological diseases; hearing disorders).
  • Operations (operations on the central nervous system)
  • Trauma (injuries: e.g., traumatic brain injury, TBI).
  • Radiotherapy
  • Allergies
  • Medication history

* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)

Diagnostic criteria of medical early detection of circumscribed developmental disorders of speech and language (UESS) [modified after 1, 2]

Time Language development
U1 Immediately after birth Infant crying
U2 3rd-10th day of life Hearing screening/newborn hearing test (measurement of otoacoustic emissions (OAE).
U3 4-5 weeks of life Recognition of rhythmic and prosodic features of native language.
U4 3rd-4th month of life Responds (e.g., with smile or spontaneous physical contact) to address or nonverbal communication from primary caregivers
Sends clear signals to primary caregiver himself/herself through gaze, facial expressions, gestures, or sounds
Reassures primary caregiver through body or eye contact
Cooing
U5 6-7 months of life Rhythmic syllable chains (e.g., “mem-mem”).
U6 10-12 months of life Spontaneous utterance of longer strings of syllables.
Uses different consonants (e.g., “maba”)
Produces syllable doublings (e.g., “ba-ba”).
Produces first words (e.g., “mom” or “no”)
Can understand short prompts
Shows reaction to his own name
U7 21-24 months of life Passive vocabulary includes approximately 200 words
One-word speech: speaks about 50-200 words at 18 months (cutoff at 24 months of life: at least 20 correct words, except for daddy and mommy. Uses simple two-word utterances, e.g., “Daddy come!”).
Points or looks at 3 named body parts.
Expresses through gestures or speech (shaking head or saying no) that it rejects something
U7a 34th-36th month of life Understands simple prepositions and two-part orders (e.g., “Put the pencil on the table!”)
Productive vocabulary includes over 450 words
Speaks at least three-word sentences
Produces first consonant compounds (e.g., “bl”)
Uses simple preposition (e.g.{ “below”)
Speaks of himself in the first person
Knows and says his call name
Pronounces all sounds correctly (except sibilants)
Can match basic colors
U8 46-48 months of age Understands more complex prepositions (e.g., “next to”)
Speaks six-word sentences in child language
Correctly uses verb division and verb inflection
Stories are told approximately in time and logical progression
Uses different tenses in narratives
U9 60th-64th month of life Counts to 10
Uses generic/subordinate terms (e.g., clothing)
Error-free phonation (except for “s”)
Uncertainty with more complex grammatical structures (negations, questions, etc.) can still occur

Interpretation

  • The presence of at least a 6-month language delay before 36 months of age identifies a language development delay.

If applicable, insert standardized parent questionnaire.