Intellectual Disability and Language Disorder

Abstract

Intellectual disability (ID) and language disorders are neurodevelopmental conditions arising in early childhood. Child psychiatrists are likely to encounter children with ID and language disorders because both are strongly associated with challenging behaviors and mental disorder. Because early intervention is associated with optimal outcomes, child psychiatrists must be aware of their signs and symptoms, particularly as related to delays in cognitive and adaptive function. Optimal management of both ID and language disorders requires a multidisciplinary, team-based, and family centered approach. Child psychiatrists play an important role on this team, given their expertise with contextualizing and treating challenging behaviors.

Keywords: Early intervention; Global developmental delay; Intellectual disability; Language disorder; Multidisciplinary care.

Figure 1

Causes of ID and their respective percentages are shown, together with a list of currently recommended genetic testing. Several non-genetic factors also lead to ID, including congenital infections, exposures to teratogens or toxins, prematurity, hypoxia, trauma, intracranial hemorrhage, central nervous system infection or malignancy, psychosocial deprivation, malnutrition, or acquired hypothyroidism. Data from Moeschler JB, Shevell M. Comprehensive Evaluation of the Child With Intellectual Disability or Global Developmental Delays. Pediatrics 2014;134(3):e903-e918; and Pivalizza P, Lalani SR. Intellectual disability in children: Evaluation for a cause. UpToDate. Waltham, MA; 2016.

Figure 2

Language disorders affect one or more fundamental aspects of language: form, content, and function. Deficits may involve morphology (understanding and use of the building blocks of words), syntax (grammar), and semantics (vocabulary). Phonology, the ability to distinguish and use speech sounds appropriately, is affected in Speech Sound Disorder. Disorders of pragmatics, the use of language, are encompassed within Social Communication (Pragmatic) Disorder.