Speech- and language-impaired children have a higher risk for developing a psychiatric disturbance compared with normal language controls, with girls being at greater risk than boys. 1 There is as well an association between early childhood speech and language disorders and young adult psychiatric disorders. This association underscores the importance of effective and early interventions. 2 Indeed, recent research in child psychiatry has demonstrated a high prevalence of speech, language, and communication disorders in children referred to psychiatric and mental health settings for emotional and behavioral problems. Conversely, children referred to speech and language clinics for communication disorders have been found to have a high rate of diagnosable psychiatric disorders. 3 Because of the link between communication impairments and psychiatric disorders, it is important for nurses and other healthcare professionals to engage in communication, speech, and language evaluation for children during infancy through early childhood. It is collaboration between mental health and communication professionals that allows for early identification and intervention. Early identification of children with developmental delay or developmental disabilities may lead to intervention at a young age when chances for improvement may be best. 4 Psychiatric disorder at age 12.5 years was more likely to co-occur with language disorder than with speech disorder.5 These issues can propagate in domestic settings. There is a significantly higher prevalence rate of language-related problems in families of speech and language impaired children than in normal language controls, particularly in the case of girls, notably in families with histories of stuttering and reading disabilities.6
Elective mutism, an ICD-9 disturbance of emotions specific to childhood and adolescence that excludes pervasive developmental disorder and specific developmental disorders of speech and language is a syndrome in which speech-language pathologists can help with differential diagnoses.7 Speech language pathologists can assist as well in distinguishing between attention deficit disorder (ADD) with hyperactivity (ADDH) and without hyperactivity (ADDWO). The literature has revealed areas of possible differences not only in the core symptoms, but also associated conduct and emotional symptoms, social relations functioning, learning, medical disorders, family history, and course and outcome of the disorder.8
Partnership with the speech-language community is fundamental in more profound disorders, too. In Primary progressive aphasia, characterized by insidious onset and gradual progression of speech and language impairment, misdiagnosis is a risk. To mitigate this, if a patient presents with new psychiatric symptoms accompanied by new onset speech or language impairment, referral to a speech-language pathologist is recommended.9 As well, individuals with schizophrenia display speech and language impairments that greatly impact their integration to the society. Speech and language therapy is integral to their rehabilitation. The therapy settings vary widely.10
1 Beitchman JH, Hood J, Inglis A. Psychiatric risk in children with speech and language disorders. J Abnorm Child Psychol. 1990 Jun;18(3):283-96. doi: 10.1007/BF00916566.
2 Beitchman JH, Wilson B, Johnson CJ, Atkinson L, Young A, Adlaf E, Escobar M, Douglas L. Fourteen-year follow-up of speech/language-impaired and control children: psychiatric outcome. J Am Acad Child Adolesc Psychiatry. 2001 Jan;40(1):75-82. doi: 10.1097/00004583-200101000-00019.
3 Prizant BM, Audet LR, Burke GM, Hummel LJ, Maher SR, Theadore G. Communication disorders and emotional/behavioral disorders in children and adolescents. J Speech Hear Disord. 1990 May;55(2):179-92. doi: 10.1044/jshd.5502.179.
4 Wankoff LS. Warning signs in the development of speech, language, and communication: when to refer to a speech-language pathologist. J Child Adolesc Psychiatr Nurs. 2011 Aug;24(3):175-84. doi: 10.1111/j.1744-6171.2011.00292.x.
5 Beitchman JH, Brownlie EB, Inglis A, Wild J, Ferguson B, Schachter D, Lancee W, Wilson B, Mathews R. Seven-year follow-up of speech/language impaired and control children: psychiatric outcome. J Child Psychol Psychiatry. 1996 Nov;37(8):961-70. doi: 10.1111/j.1469-7610.1996.tb01493.x.
6 Beitchman JH, Hood J, Inglis A. Familial transmission of speech and language impairment: a preliminary investigation. Can J Psychiatry. 1992 Apr;37(3):151-6. doi: 10.1177/070674379203700301.
7 Kristensen H. Elective mutism–associated with developmental disorder/delay. Two case studies. Eur Child Adolesc Psychiatry. 1997 Dec;6(4):234-9. doi: 10.1007/BF00539931.
8 Cantwell DP, Baker L. Attention deficit disorder with and without hyperactivity: a review and comparison of matched groups. J Am Acad Child Adolesc Psychiatry. 1992 May;31(3):432-8. doi: 10.1097/00004583-199205000-00008.
9 Mulder-Heijstra MMP, Jokel RR, Chertkow HH, Conn DDK, Mah LL. Primary Progressive Aphasia Presenting With Neuropsychiatric Symptoms. J Geriatr Psychiatry Neurol. 2022 Jul;35(4):574-579. doi: 10.1177/08919887211036189.
10 Joyal M, Bonneau A, Fecteau S. Speech and language therapies to improve pragmatics and discourse skills in patients with schizophrenia. Psychiatry Res. 2016 Jun 30;240:88-95. doi:
10.1016/j.psychres.2016.04.010.
MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.
