» Speech & Language
Speech problems in focus
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Dr Marjorie Goodban. |
Speaking at the Chester conference, Dr Goodban said that only four of every hundred people with the syndrome have language skills within the normal or low-normal limits. Based on studies the Illinois-based doctor has carried out, 53% of the children older than four are able to combine two or more words into sentences. One third has fewer than two words or no speech.
Dr Goodban said there are several factors that lead to speech and language problems. “The majority of individuals with CdLS have oral motor apraxia - that is a difficulty imitating or producing voluntary movements of the mouth where there are no signs of paralysis of weakness,” Dr Goodban said.
There are also problems with retro-micrognathia (the lower jaw is retruded and small). “The retrusion of the lower jaw makes the tongue movements necessary for
pronunciation even more difficult to make. This can also lead to misalignment of the teeth that can also affect pronunciation. There are also problems from hearing loss as well as from the overall developmental delay,” she said.
Dr Goodban says that there is encouraging news that well over half of children with CdLS are developing speech and language by the age of four.
“What is interesting is that there is an uneven development of skills. For example, we now know that the individual’s receptive language skills (what the child understands) is typically much higher than the expressive skills (what the child says). We also know that the non-verbal cognitive skills (what the child is able to understand by watching) appears to be much higher than expressive language abilities.”
Dr Goodban has been comparing the CdLS communication development levels with that of Downs Syndrome and fragile X syndrome and found similar results.
Dr Goodban was asked about a CdLS child who had uttered particular words and then never used them again.
“I have heard this before from a number of places,” Dr Goodban said, “the utterance is usually many levels above the current level of performance, for example a child struggling with simple single syllable words suddenly, unexpectedly utters a multi-syllable word with perfect articulation. We don’t know why this happens but we do know that this behaviour has been observed in adults with apraxia and in children with autism.”
Reaching Out newsletter
October 2000