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Language is the medium through which we share our ideas, emotions, and beliefs. Language and speech skills are the basis for human social interactions and learning. Delays in the early development of these skills may thus affect several domains of functioning in a child’s life. Children with delayed language are at increased risk for learning disabilities, such as difficulties of reading and writing, which may negatively impact a child’s academic achievement. As adults, individuals with language and speech difficulties may hold lower-skilled jobs and experience more behavior problems and impaired psychosocial adjustment as compared to individuals with normal skills. For these reasons, pediatric clinicians should be skilled at evaluating language development and managing delays and disorders.


Language is the distinctly human ability to use a system of arbitrary symbols to convey meaning among individuals. Language is symbolic, structured, and generative. Receptive language refers to what a child understands, and expressive language refers to what a child produces. While language refers to this system of symbols, speech refers to the usual output of this system in which the medium of exchange is a set of decodable vocal sounds. Speech requires the coordination of the respiratory, laryngeal, velopharyngeal, and oral motor mechanisms. Other language outputs exist, such as sign language and written language. This distinction between the concept of language and speech carries significant clinical relevance. Difficulties can affect purely language, or speech, or a combination of the 2; management must be adjusted accordingly. eTable 86.1 enumerates and defines several elements of language and speech that may be disordered in developmental difficulties.

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eTable 86.1. Elements of Speech and Language Which May Be Disrupted

Atypical development of language and speech is classified as delayed or disordered. Delayed language develops in the typical sequence but at a slower rate. Disordered ...

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