Language Delay and Disorders 7APDs include attention deficit disorder (ADD), and the two diagnostic labels are used by some
professionals interchangeably. ADD and attention deficit hyperactivity disorder (ADHD) are over-
used terms and frequently misdiagnosed attention interaction disorders (see Barkley, 1997). The
medical management of these conditions and the use of psychotropic medi cation are also excessive
and often inappropriate. Not all unruly children have ADHD. The disorder primarily affects boys,
who have difficulty regulating their actions and appreciating the consequences of their be hav ior.
They tend to be impulsive and incapable of inhibiting their statements and actions. These children
have deficiencies in mental executive functioning similar to those of some traumatically brain-
injured persons, although to a lesser extent. Children with ADD or ADHD display prob lems in
planning, regulating, and monitoring be hav ior. Thus, pragmatic language development is a pri-
mary therapy goal.
Autism
According to Hirsch (1998), pervasive developmental disorders occur in about 15 per
10,000 live births and are four times more common in boys than in girls. They include a broad
spectrum of developmental disorders that can affect cognitive, emotional, and social development.
Language development is compromised in many children with pervasive developmental disorders.
According to Fombonne (2009), pervasive developmental disorders are included among the child-
hood neurodevelopmental disorders.
Autism, a pervasive developmental disorder, comes from the Greek word autos, meaning self,
and is the tendency toward morbid self- absorption at the expense of regulation by outward real-
ity (Dirckx, 2001). “The social disfunction [sic] observed in autistic children is never observed in
normal children of any age and cannot be accounted for on the basis of mental retardation alone”
(Westby, 1998, p. 188). The etiology of autism is unknown, but is prob ably neurological and not
related to negative parent– child interaction. In the past, some authorities on autism believed it was
caused by early poor mother– child bonding, but this theory has since been rejected. Vitamin and
mineral deficiencies, infections, diseases, and other prenatal irregularities may cause areas of the
fetus’s brain to develop abnormally.
Although autism may cause deficits in all aspects of language development, the social-
communicative functions are particularly impaired, especially those pertaining to emotional
expression and reception. Persons with autism typically do not use speech to interact with others;
communication is often limited to a call system and random noncommunicative utterances.
Besides exhibiting deficits in pragmatic use of language, these persons typically engage in perse-
veration, the tendency to engage in an act longer than is warranted by the intensity of the stimuli
causing it. Related to the perseveration seen in autism is echolalia, the repetition of recently spoken
words. Self- stimulation is also common in autism. It can take the form of oral clicking, hand tap-
ping, eye strobing (moving the fin gers rapidly in front of the eyes to create a strobe effect), and self-
abusive be hav iors such as pinching and clawing the body. Sometimes persons with autism repeti-
tively strike themselves. The typical individual with autism is intellectually disabled, emotionally
detached from loved ones, socially isolated by choice, perseverative, echolalic, self- stimulative, and
profoundly delayed in speech and language development. Some persons with autism are savants.
Although intellectually disabled, autistic savants are highly developed and proficient in a par tic u-
lar musical, mathematical, or psycholinguistic function. Asperger syndrome is an autism- like per-
vasive developmental disorder marked primarily by social interaction deficits (Ozonoff, Dawson,
& McPartland, 2002).