Disorder of speech and language

Presenter Dr Ramkumar G S

Chair person Dr Sanjeev Jain Psychiatry,NIMHANS.

26.06.2009

Thinking Vs Speaking

Functions of thinking and speaking overlap and

cannot be readily separated from each other;

at the same time they are clearly different.

Thinking <‑‑----> speech

Maher(1972) ' The language is a mirror of thought'

Sapir-Whorf hypothesis- Language influence cognition

Pinker(1994) Thinking occur in the language of thought

Elements of languagePhonemes /k/ sound in the words kit and skill.

Morphemes may be a word such as 'do' or 'un'

Syntax(grammar)

Semantics

Prosody

Pragmatics

Language Vs Speech

Speech is the aspect of language that corresponds to the mechanical and articulatory function that allow language to be vocalised.

Chomsky's theory of language (1986) is the most influential- Language is like an instinct , children must have inate capability to grasp language “universal grammar”

Everyday use of language

Use of words in spoken speech( articulation, fluency, naming, repitition)

Comprehend spoken speech

Read to one self(not aloud)

Ability to write

Comprehend other symbols(musical, mathematical)

Speech Disturbances

Aphonia Organic cause, dissociation

Dysphonia 9th cranial nerve ,vocal cord palsy

Dysarthria brainstem lesions, structural and muscular lesions , idiosyncratic

Speech Disturbances

Stuttering and Stammering

Logoclonia Parkinsonism

Echolalia exicted schizophrenia, mental retardation, organic states- dementia.

Changes in volume and intonation of speech

Speech DisturbancesUnintelligible speech

Dysphasia

Paragrammatism and incoherence of syntax(word salad)

Altered speed of association (mania, depression)

Private symbolism Neologisms, stock words or phrases, cryptolalia or cryptographia

Organic Disorders of Language

Aphasia Loss of language altogether

Dysphasia Impairment of or difficulty with languageSensory(receptive,fluent),motor(expressive,nonfluent) ,

nominal , global

Broca's aphasia, wernicke's aphasia

Psychogenic abnormalities

Mania flight of ideas, pressure of talk

Hysterical mutism

Approximate answers Hehephrenic Schizophrenia, dissociative disorder, ganser syndrome, organic causes.

Paraphasia

Pseudologia fantastica Histronic, Dissocial PD

Mutism

Psychiatric learning disability, organic brain disease(drug related), functional psychosis and neurosis , personality disorders, depression, catatonia, dissociative disorder

Stupor Functional, metabolic causes, akinetic mutism.

Andreasen(1979)

Description of cognitive and linquistic behaviour based on phenomena demonstrated without making inferences for concepts of 'global' thought disorder.

Derailment, loss of goal, poverty of content of speech, tangentiality and illogicality were particularly charecteristic of schizophrenia.

Summary

Speech and language disorders overlap with thought disorder.

Need to distinguish organic causes from psychiatric/psychological causes.

Thank You