The pattern and prognosis of speech disorders among children in Enugu, Nigeria

Of 965 children with neurological disorders seen in the Child Neurology Clinic of the University of Nigeria Teaching Hospital, Enugu over a 3-year period (1985-87), 80 (8.3%; 41 boys and 39 girls) had speech problems. The most common speech disorder was dyslalia. Twenty-six (32.5%) of the 80 children were mentally retarded. Besides speech problems, some of the children had other neurological disorders such as hyperactivity, recurrent seizures, microcephaly and deafness. Varying degrees of improvement in speech were observed in only eight girls and four boys, amounting to 24% of the 50 who were followed up for a period ranging from 3 months to 3 years (mean follow-up period 12.26 months). Eight of those who improved (66.6%) did so within the first 18 months of follow-up. There was a disturbingly high rate of default from follow-up, 30 of the patients (37.5%) failing to keep appointments at the clinic after the first assessment. Also, there was a long delay between onset of symptoms and presentation to hospital (mean delay 45.3 months). With the recent acquisition of the services of a speech therapist by the hospital, it is hoped that the prognosis for children with speech problems will be considerably improved.