Expressive and mixed receptive-expressive language disorders   …

Expressive and mixed receptive-expressive language disorders     

The Assignment

• Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources.

Areas of importance you should address, but are not limited to, are:

• Signs and symptoms according to the DSM-5
• Differential diagnoses
• Incidence
• Development and course
• Prognosis
• Considerations related to culture, gender, age
• Pharmacological treatments, including any side effects
• Nonpharmacological treatments
• Diagnostics and labs
• Comorbidities
• Legal and ethical considerations
• Pertinent patient education considerations

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Expressive and Mixed Receptive-Expressive Language Disorders

• Definition of expressive language disorder. 
• Definition of receptive-expressive language disorder

Signs and symptoms according to the DSM-5 

Difficulties are acquiring and using language due to deficits in the comprehension or production of vocabulary, sentence structure, and discourse (APA, 2013). 

• Difficulty in putting words together into sentences
• Limited use of complex sentences
• Difficulty producing speech sounds
• Sound and syllable repetitions
• Hard in acquiring and using spoken and written language (APA, 2013).
• A person with a speech unspecified communication disorder diagnosis experiences symptoms of a speech disorder but does not meet enough of the diagnostic criteria (Diamond, 2016).

Differential Diagnosis

• Normal development Variation
• Sensory Impairment
• Intellectual disability
• Neurological Disorder 
• Language Regression (Nitido & Plante, 2020). 

Incidence

• Children younger than 6 years have a language disorder that lasted for a week or longer during the past 12 months and is at greater risk (Lindsay & Strand, 2016).
• Anyone can have aphasia (unable to use or understand language), but most people with aphasia are in their middle to late years. Men and women are equally affected. Nearly 180,000 Americans acquire the disorder each year. About 1 million people in the U.S currently have aphasia (Davis et al., 2021).

Development and course

• A child has four; the deficits become more noticeable and easily measured. If language disorder is indeed diagnosed at a younger age, it is like to continue into adulthood, and one’s language strengths and deficits will change with age and development.
• Communication disorders often run in families or carry over from one family member to another. 
• Changes appear across the dimensions of language like sounds, words, grammar, narratives/expository texts, and conversational skills in age-graded increments and synchronization (APA, 2013).

Prognosis

• Language disorders can be triggered by damage to the central nervous system, Seizures, stroke, or traumatic head injuries. Follow-up treatment is necessary sometimes when relapses occur.
• Language disorders can happen during a premature birth, and genetic disorders can cause language disabilities in children with developmental problems like autism spectrum disorder, hearing loss, and learning disabilities.
• The rapidity and degree of recovery depend on the severity of the disorder, the child’s willingness to do therapies, and the timely institution of speech and other therapeutic interventions. As many as 50% of children with mild cases recover spontaneously, while severe cases continue to display some features of language impairment. Prognosis in receptive type is not as good as inexpressive types.

Considerations related to culture, gender, age

• Culture affects the communication disorder to phenomena found in the immediate environment.
• Religion or beliefs play a key role in some communities that may determine those with language and speech disorders.
• The statistic indicates that females are focused more on getting accepted by the community and adhering to the community’s norms than males.
• Boys have a higher risk for late language emergencies and a Greater prevalence of speech disorders.
• For kids between the ages of 3-and 17, nearly 1 in 12 has had a voice, speech-language, or swallowing disorder.
• Almost 11% of children among children ages 3-6 have a communication disorder.

Pharmacological treatments, including any side effects

Some clinicians may also recommend stimulant medications to treat any impulsive or hyperactivity symptoms. It is a variation on a common intervention typically used for treating ADHD

1. Methylphenidate is the most used medicine for ADHD. It is a group of treatments called stimulants. Methylphenidate may be treated in adults, teenagers, and children over the age of 5 with ADHD (Stahl, 2021).

Common side effects of methylphenidate include:

• A slight elevated in blood pressure and increased heart rate
• Decrease of appetite, which can lead to weight loss or poor weight gain
• Trouble sleeping

 

1. Lisdexamfetamine is a medicine that stimulates parts of the brain. An adult may be offered the first-choice medicine instead of methylphenidate. Lisdexamfetamine. It comes in a capsule, taken daily (Stahl, 2021).

Well known side effects of Lisdexamfetamine is

• Decreased appetite, which possible to weight loss or poor weight gain
• Aggression
• Drowsiness

1. Dexamphetamine is like Lisdexamfetamine and works in the same way. It may be treated in adults, teenagers, and children over the age of 5 with ADHD (Stahl, 2021).

Common side effects of dexamphetamine include:

• Decreased appetite
• Mood swings
• Agitation and aggression

1. Atomoxetine may be used for adults, teenagers, and children over the age of 5 if it cannot use methylphenidate or Lisdexamfetamine. It is also licensed for use in adults if symptoms of ADHD are confirmed (Stahl, 2021).

Common side effects of atomoxetine include:

• A slight increase in blood pressure and heart rate
• Nausea and vomiting
• Stomach aches
• Atomoxetine has also been linked to more severe side effects that are important to look out for, including suicidal thoughts and liver damage.

1. Guanfacine acts on the part of the brain to improve attention, and it also reduces blood pressure (Stahl, 2021).

Common side effects include:

• Tiredness or fatigue
• Headache
• Abdominal pain

Nonpharmacological treatments 

• Behavior intervention/techniques
• Behavior approach or teach social communication behavior in one-on-one
• Peer-medicated or peer-implanted intervention

Diagnostics and labs

• Early intervention is the key to managing communication disorders successfully.
• The clinical Linguistic Auditory Milestone Scale (CLAMS) was developed to screen for language delays in young children between birth and 3 years of age.

Comorbidities

• Language disorders are associated with neurodevelopmental disorders such as learning disorders in literacy and numeracy, attention-deficit hyperactivity disorder, autism spectrum disorder, conduct disorder, and developmental coordination disorder (APA, 2013). 
• Language disorders are also associated with social/ pragmatic communication disorders in which a positive family history of speech or language disorders is frequently present.

 

Legal and ethical considerations

The difficulty in providing informed assessments of bilingual children is magnified since many school-based speeches, and language pathologists are neither proficient in a second language nor adequately trained to offer nonbiased bilingual reviews (Gillon & Macfarlane, 2017). -Families for whom English is not the first language may lack the facility or cultural confidence to question what they are told or even know what questions to ask. 

Pertinent patient education considerations

• Technology has made patient education material more accessible
• Determine the patient’s learning style
• Stimulate patient’s interest
• Consider the patient’s limitations and strengths
• Include family members in health care management

 References

APA. (2013). DSM-5 guidebook (5th ed.). American Psychological Association.

Davis, E. S., Loeb, D., & Lee, T. (2021) Implementing play and language therapy to work with preschool children with language and behavioral issues. International Journal of Play Therapy, 30(2), 157-166. https://doi.org/10.1037/pla0000148)

Diamond, E. L. (2016). Communication Disorders. Communique, 45(4), 1-26.

Gillon, G., & Macfarlane, A. H. (2017). A culturally responsive framework for enhancing phonological awareness development in children with speech and language impairment. Speech, Language and Hearing, 20(3), 163- 173. https://doi.org/10.1080/2050571x.2016.1265738

Lindsay, G., & Strand, S. (2016). Children with Language Impairment: Prevalence, Associated

Difficulties, and Ethnic Disproportionality in an English Population. Frontiers In

Education, 1. https://doi.org/10.3389/feduc.2016.00002

Nitido, H., & Plante, E. (2020). Diagnosis of Developmental Language Disorder in Research Studies. Journal of Speech, Language & Hearing Research, 63(8), 2777-2788. https://doi.org/10.1044/2020_JSLHR-20-00091

Stahl, S. M. (2021). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press

 

Please revise the underlined sections and proofread them for me. Thank you.

 

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