Therapeutic considerations with the language impaired preschool child

This paper examines the relevance of language impairment to the development of psychiatric disorders of childhood. The literature showing a relationship between language impairment and psychiatric disorders is briefly reviewed. Although deficiencies of both expressive and receptive language have been associated with psychiatric disorder, this discussion focuses on disturbances of "receptive language". Some cases are described which illustrate the connections between deficient receptive language and disturbances of development. These disturbances of development range from excessive temper tantrums, with defiant and oppositional behavior, to mannerisms, the insistence on sameness and frank autistic symptoms. These disorders are understood in a developmental context in which deficiencies of receptive language are seen to interfere with the normal unfolding of the child's developing individuation, autonomy and independence. Depending on the severity of the language disorder and the responsivity of the environment, this results in a continuum of behavioral problems with oppositional and defiant behaviour at one end, and mannerisms and autistic symptoms on the other end. The implications for therapy and long term development are discussed.