Phoniatrics I pp 725-748 | Cite as

Rehabilitation and Prognosis of Developmental Disorders of Speech and Language

  • Karina DanczaEmail author
  • Dirk Deuster
  • Mona Hegazi
  • Christiane Kiese-Himmel
  • Claudia Koch-Günnewig
  • Katrin Neumann
  • Karen Reichmuth
  • Amélie Elisabeth Tillmanns
  • Sharon Tuppeny
Part of the European Manual of Medicine book series (EUROMANUAL)


Several behavioural speech-language therapies have been proven in meta-analyses and systematic reviews to be effective in the treatment of developmental disorders of speech and language (DDSL), at least in the short term. Computerised intervention programmes have not shown convincing evidence for their superiority over conventional treatment. Additional interventions may help to improve a child’s language outcome, such as occupational therapy that addresses the challenges in children’s daily occupations (e.g. self-care, being productive, leisure) or physiotherapy for neuromotor disorders and sensorimotor difficulties. Augmentative and alternative communication (AAC) interventions are usually applied for children with profound impairment of their communication. Duties of phoniatricians in the management of DDSL comprise an early detection; diagnostics by using valid assessment tools, including the identification of co-morbidities; making the diagnosis; parent counselling; setting-up of an intervention plan; and supervision and regular outcome assessment of treatment and rehabilitation.

The prognosis of DDSL depends on factors such as type of the language disorder, symptom severity for the specific linguistic domains, co-morbidities, multi-level risk factors such as concomitant problems in the family environment (e.g. poverty, socio-economic disadvantage, unstimulating environment) and other individual conditions (e.g. preterm birth, poor health, recurrent otitis media). In general, a trend for improvement can be observed over time. Residual symptoms, however, persist, carrying into mid-childhood, adolescence and adulthood, and individuals may suffer from lifelong consequences such as communication disorders, psychosocial disturbances, academic deficits and behavioural problems. Substantial interindividual outcome differences can be found. Children who receive early and appropriate therapy are more likely to have a better outcome.


Developmental language disorder Intervention Therapy Rehabilitation Prognosis 


  1. American Speech-Language-Hearing Association (2005) Roles and responsibilities of speech-language pathologists with respect to augmentative and alternative communication: position statement. Available via Accessed 3 May 2018
  2. Baker B, Hill K, Devylder R (2000) Core vocabulary is the same across environments. Paper presented at a meeting of the technology and persons with disabilities conference at California State University, Northridge, Los Angeles, CAGoogle Scholar
  3. Balandin S, Iacono T (1999) Crews, Wusses, and Whoppas: core and fringe vocabularies of Australian meal-break conversations in the workplace. Augment Altern Commun 15(2):95–109CrossRefGoogle Scholar
  4. Banajee M, Dicarlo C, Buras Stricklin S (2003) Core vocabulary determination for toddlers. Augment Altern Commun 19(2):67–73CrossRefGoogle Scholar
  5. Beukelman D, Mirenda P (2005) Symbols and rate enhancement. Augmentative alternative communication: supporting children and adults with complex communication need. Paul H. Brookes Pub. Co., Baltimore, pp 65–67Google Scholar
  6. Beukelman D, McGinnis J, Morrow D (1991) Vocabulary selection in augmentative and alternative communication. Augment Altern Commun 7(3):171–185CrossRefGoogle Scholar
  7. Bobath K (1984) Uma base neurofisiológica para o tratamento da paralisia cerebral, 2nd edn. Manole, São PauloGoogle Scholar
  8. Boenisch J (2014) Kern-Vokabular im Kindes- und Jugendalter: Vergleichsstudie zum Sprachgebrauch von Schülerinnen und Schülern mit und ohne geistige Behinderung und Konsequenzen für die UK. UK & Forschung 3:4–23. Sonderbeilage Unterstützte Kommunikation 1/2014Google Scholar
  9. Boenisch J, Sachse S (2007) Diagnostik und Beratung in der Unterstützten Kommunikation. Theorie, Forschung, Praxis. Von Loeper Literaturverlag, KarlsruheGoogle Scholar
  10. Boenisch J, Soto G (2015) The oral core vocabulary of typically developing English-speaking school-aged children. Augment Altern Commun 31(1):77–84PubMedCrossRefPubMedCentralGoogle Scholar
  11. Boons T, Brokx JP, Dhooge I et al (2012) Predictors of spoken language development following pediatric cochlear implantation. Ear Hear 33(5):617–639PubMedCrossRefPubMedCentralGoogle Scholar
  12. Branson D, Demchak M (2009) The use of augmentative and alternative communication methods with infants and toddlers with disabilities: a research review. Augment Altern Commun 25(4):274–286PubMedCrossRefPubMedCentralGoogle Scholar
  13. Cirrin FM, Gillam RB (2008) Language intervention practices for school-age children with spoken language disorders: a systematic review. Lang Speech Hear Serv Sch 39:110–137CrossRefGoogle Scholar
  14. Costantino MA, Bonati M (2014) A scoping review of interventions to supplement spoken communication for children with limited speech or language skills. PLoS One 9(3):e90744. Scholar
  15. Cress CJ, Marvin CA (2003) Common questions about AAC services in early intervention. Augment Altern Commun 19(4):264–272CrossRefGoogle Scholar
  16. Dale PS, Price TS, Bishop DV et al (2003) Outcomes of early language delay: I. Predicting persistent and transient language difficulties at 3 and 4 years. J Speech Lang Hear Res 46(3):544–560PubMedCrossRefPubMedCentralGoogle Scholar
  17. Dirks T, Hadders-Algra M (2011) The role of the family in intervention of infants at high risk of cerebral palsy: a systematic analysis. Dev Med Child Neurol 53(Suppl 4):62–67PubMedCrossRefPubMedCentralGoogle Scholar
  18. Duran MH, Guimaraes CA, Medeiros LL, Guerreiro MM (2009) Landau-Kleffner syndrome: long-term follow-up. Brain Dev 31(1):58–63PubMedCrossRefPubMedCentralGoogle Scholar
  19. Engelhardt HT (1996) The foundations of bioethics. Oxford University Press, New YorkGoogle Scholar
  20. Fisher AG (2009) Occupational therapy intervention process model: a model for planning and implementing top-down, client centred, and occupation-based interventions. Three Star Press, Fort CollinsGoogle Scholar
  21. Fisher AG, Bryze K, Hume V et al (2007) School assessment of motor and process skills, 2nd edn. Three Star Press, Fort CollinsGoogle Scholar
  22. Franki I, Desloovere K, De Cat J et al (2012) The evidence-base for conceptual approaches and additional therapies targeting lower limb function in children with cerebral palsy: a systematic review using the ICF as a framework. J Rehabil Med 44(5):396–405PubMedCrossRefPubMedCentralGoogle Scholar
  23. Graham F, Rodger S, Ziviani J (2013) Effectiveness of occupational performance coaching in improving children’s and mothers’ performance and mothers’ self-competence. Am J Occup Ther 67(1):10–18PubMedCrossRefPubMedCentralGoogle Scholar
  24. Granlund M, Björck-Akesson E, Wilder J et al (2008) Interventions for children in a family environment: implementing evidence in practice. Augment Altern Commun 24(3):207–219PubMedCrossRefPubMedCentralGoogle Scholar
  25. Gutzmann H (1912) Sprachheilkunde. Vorlesungen über die Störungen der Sprache mit besonderer Berücksichtigung der Therapie. Fischer’s medicinische Buchhandlung, H. Kornfeld, BerlinGoogle Scholar
  26. Hetzroni OE (2004) AAC and literacy. Review. Disabil Rehabil 26(21–22):1305–1312PubMedCrossRefPubMedCentralGoogle Scholar
  27. Hirata GC, Santos RS (2012) Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: a systematic review of the speech therapy approach. Int Arch Otorhinolaryngol 16(3):396–399PubMedPubMedCentralGoogle Scholar
  28. Johnson CJ, Beitchman JH, Brownlie EB (2010) Twenty-year follow-up of children with and without speech-language impairments: family, educational, occupational, and quality of life outcomes. Am J Speech Lang Pathol 19(1):51–65PubMedCrossRefPubMedCentralGoogle Scholar
  29. Kim LS, Jeong SW, Lee YM et al (2010) Cochlear implantation in children. Auris Nasus Larynx 37(1):6–17PubMedCrossRefPubMedCentralGoogle Scholar
  30. Koppenhaver D, Williams A (2010) A conceptual review of writing research in augmentative and alternative communication. Augment Altern Commun 26(3):158–176. Scholar
  31. Korbmacher HM, Limbrock JG, Kahl-Nieke B (2006) Long-term evaluation of orofacial function in children with Down syndrome after treatment with a stimulating plate according to Castillo Morales. J Clin Pediatr Dent 30(4):325–328PubMedCrossRefPubMedCentralGoogle Scholar
  32. Kronenberger WG, Henning SC, Colson BG et al (2011) Working memory training for children with cochlear implants: a pilot study. J Speech Lang Hear Res 54(4):1182–1196PubMedCrossRefPubMedCentralGoogle Scholar
  33. Law M, Darrah J (2014) Emerging therapy approaches: an emphasis on function. J Child Neurol 29(8):1101–1107PubMedCrossRefPubMedCentralGoogle Scholar
  34. Light J, Drager K (2007) AAC technologies for young children with complex communication needs: state of the science and future research directions. Augment Altern Commun 23(3):204–216PubMedCrossRefPubMedCentralGoogle Scholar
  35. Locke EA, Latham GP (2002) Building a practically useful theory of goal setting and task motivation: a 35-year odyssey. Am Psychol 57(9):705–717PubMedCrossRefPubMedCentralGoogle Scholar
  36. Loo JH, Bamiou DE, Campbell N et al (2010) Computer-based auditory training (CBAT): benefits for children with language- and reading-related learning difficulties. Review. Dev Med Child Neurol 52(8):708–717PubMedCrossRefPubMedCentralGoogle Scholar
  37. Meinzen-Derr J, Wiley S, Grether S et al (2011) Children with Cochlea implants and developmental disabilities: a language skills study with developmentally matched hearing peers. Res Dev Disabil 32(2):757–767PubMedCrossRefPubMedCentralGoogle Scholar
  38. Meinzen-Derr J, Wiley S, Grether S et al (2013) Functional performance among children with cochlear implants and additional disabilities. Cochlear Implants Int 14(4):181–189. Epub 2013 Feb 9CrossRefPubMedPubMedCentralGoogle Scholar
  39. Merzenich MM, Jenkins WM, Johnston P et al (1996) Temporal processing deficits of language-learning impaired children ameliorated by training. Science 271(5245):77–81PubMedCrossRefPubMedCentralGoogle Scholar
  40. Millar DC, Light JC, Schlosser RW (2006) The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. J Speech Lang Hear Res 49(2):248–264PubMedCrossRefPubMedCentralGoogle Scholar
  41. Morales RC (1999) Terapia de regulação orofacial: Conceito RCM. Memnon, São PauloGoogle Scholar
  42. Neumann K, Euler HA, Bosshardt HG et al (2016) Pathogenese, Diagnostik und Behandlung von Redeflussstörungen. Evidenz- und konsensbasierte S3-Leitlinie, AWMF-Registernummer 049-013, Version 1. 2016. Im Auftrag der Leitliniengruppe [Pathogenesis, diagnostics, and treatment of fluency disorders. Evidence and consensus-based S3-guideline, AWMF-registry number 049-013, version 1. 2016. On behalf of the consensus group]. Available via Accessed 5 Oct 2016
  43. Patel DR (2005) Therapeutic interventions in cerebral palsy. Indian J Pediatr 72(11):979–983PubMedCrossRefPubMedCentralGoogle Scholar
  44. Rescorla LA (2011) Late talkers: do good predictors of outcome exist? Dev Disabil Res Rev 17(2):141–150PubMedCrossRefPubMedCentralGoogle Scholar
  45. Rescorla LA, Dale PS (2013) Late talkers: language development, interventions, and outcomes. Paul H Brookes Publishing, BaltimoreGoogle Scholar
  46. Sachse S, von Suchodoletz W (2013) Sprachentwicklung von der U7 bis zur U7a bei Kindern mit und ohne Sprachentwicklungsverzögerungen. Klin Pediatr 225(4):194–200CrossRefGoogle Scholar
  47. Sachse S, Willke M (2011) Fokuswörter in der Unterstützten Kommunikation. Ein Konzept zum sukzessiven Wortschatzaufbau. In: Bollmeyer H et al (eds) UK inklusive—Teilhabe durch Unterstützte Kommunikation. Von Loeper Literaturverlag, KarlsruheGoogle Scholar
  48. Sandler W, Lillo-Martin D (2006) Sign language and linguistic universals. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  49. Sevcik RA, Barton-Hulsey A, Romski M (2008) Early intervention, AAC, and transition to school for young children with significant spoken communication disorders and their families. Semin Speech Lang 29(2):92–100PubMedCrossRefPubMedCentralGoogle Scholar
  50. Shinaver CS, Entwistle PC, Söderqvist S (2014) Cogmed WM training: reviewing the reviews. Appl Neuropsychol Child 3(3):163–172PubMedCrossRefPubMedCentralGoogle Scholar
  51. Sisson CB (2009) A meta-analytic investigation into the efficacy of Fast ForWord intervention on improving academic performance. Doctoral dissertation, Regent University. Diss Abstr Int, Section A: Humanities and Social Sciences 69(12-A):4633Google Scholar
  52. Strong GK, Torgerson CJ, Torgerson D et al (2011) A systematic meta-analytic review of evidence for the effectiveness of the ‘Fast ForWord’ language intervention program. J Child Psychol Psychiatry 52(3):224–235PubMedPubMedCentralCrossRefGoogle Scholar
  53. Tallal P (1980) Auditory temporal perception, phonics, and reading disabilities in children. Brain Lang 9(2):182–198PubMedCrossRefPubMedCentralGoogle Scholar
  54. Tallal P (2013) Fast ForWord®: the birth of the neurocognitive training revolution. Prog Brain Res 207:175–207PubMedCrossRefPubMedCentralGoogle Scholar
  55. Townsend E, Polatajko HJ (2007) Enabling occupation II: advancing an occupational therapy vision for health, well-being and justice through occupation. Canadian Association of Occupational Therapists, OttawaGoogle Scholar
  56. von Loeper Literaturverlag, isaac—Gesellschaft für Unterstützte Kommunikation e. V. (eds) (2012) Handbuch der Unterstützten Kommunikation, vol 1–2. Von Loeper Literaturverlag, KarlsruheGoogle Scholar
  57. von Tetzchner S, Martinsen H (1992) Introduction to symbolic and augmentative communication. Whurr/Wiley, LondonGoogle Scholar
  58. Walker M, Armfield A (1981) What is the Makaton vocabulary? Spec Educ Forward Trends 8(3):19–20PubMedPubMedCentralGoogle Scholar
  59. Walker VL, Snell ME (2013) Effects of augmentative and alternative communication on challenging behavior: a meta-analysis. Review. Augment Altern Commun 29(2):117–131PubMedCrossRefPubMedCentralGoogle Scholar
  60. Waltersbacher A, Wissenschaftliches Institut der AOK (WIdO) (2015) Heilmittelbericht 2015. [Scientific Institute of the AOK (WIdO). Remedy report 2015]. Available via Accessed 11 Sept 2016
  61. Washington KN, Warr-Leeper GA (2006) A collaborative approach to computer-assisted treatment of preschool children with specific language impairment. OSLA Connect J 2(2):10–11Google Scholar
  62. Washington KN, Warr-Leeper G, Thomas-Stonell N (2011) Exploring the outcomes of a novel computer-assisted treatment program targeting expressive-grammar deficits in preschoolers with SLI. J Commun Dis 44(3):315–330CrossRefGoogle Scholar
  63. Wilkinson KM, Hennig S (2007) The state of research and practice in augmentative and alternative communication for children with developmental/intellectual disabilities. Ment Retard Dev Disabil Res Rev 13(1):58–69PubMedCrossRefPubMedCentralGoogle Scholar
  64. World Health Organization (2001) International classification of functioning, disability and health: ICF. World Health Organization, GenevaGoogle Scholar
  65. World Health Organization (2007) International classification of functioning, disability, and health: children and youth version: ICF-CY. WHO Press, Geneva. Available via Accessed 31 Aug 2014Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  • Karina Dancza
    • 1
    Email author
  • Dirk Deuster
    • 3
  • Mona Hegazi
    • 4
  • Christiane Kiese-Himmel
    • 5
  • Claudia Koch-Günnewig
    • 6
  • Katrin Neumann
    • 7
  • Karen Reichmuth
    • 3
  • Amélie Elisabeth Tillmanns
    • 3
  • Sharon Tuppeny
    • 2
  1. 1.Singapore Institute of TechnologyHealth and Social Sciences ClusterSingaporeSingapore
  2. 2.Royal College of Occupational TherapistsLondonUK
  3. 3.Clinic of Phoniatrics and PedaudiologyUniversity Hospital MünsterMünsterGermany
  4. 4.ENT DepartmentAin Shams UniversityCairoEgypt
  5. 5.Phoniatrics/Pediatric Audiological PsychologyUniversity Medical Center GöttingenGöttingenGermany
  6. 6.Physiotherapy Practice for ChildrenMünsterGermany
  7. 7.Department of Phoniatrics and Pediatric Audiology, ENT ClinicSt. Elisabeth Hospital, University of BochumBochumGermany

Personalised recommendations