1. Disorder of speech and language Presenter Dr Ramkumar G S Chair person Dr Sanjeev Jain Psychiatry,NIMHANS. 26.06.2009

2. Thinking Vs Speaking Functions of thinking and speaking overlap and cannot be readily separated from each other; at the same time they are clearly different.

3. Thinking <‑‑----> speech Maher(1972) ' The language is a mirror of thought' Sapir-Whorf hypothesis- Language influence cognition Pinker(1994) Thinking occur in the language of thought

4. Elements of language Phonemes /k/ sound in the words k it and s k ill . Morphemes may be a word such as 'do' or 'un' Syntax(grammar)‏ Semantics Prosody Pragmatics

5. Language Vs Speech Speech is the aspect of language that corresponds to the mechanical and articulatory function that allow language to be vocalised. Chomsky's theory of language (1986) is the most influential- Language is like an instinct , children must have inate capability to grasp language “ universal grammar ”

6. Everyday use of language Use of words in spoken speech( articulation, fluency, naming, repitition)‏ Comprehend spoken speech Read to one self(not aloud)‏ Ability to write Comprehend other symbols(musical, mathematical)‏

7. Speech Disturbances Aphonia Organic cause, dissociation Dysphonia 9 th cranial nerve ,vocal cord palsy Dysarthria brainstem lesions, structural and muscular lesions , idiosyncratic

8. Speech Disturbances Stuttering and Stammering Logoclonia Parkinsonism Echolalia exicted schizophrenia, mental retardation, organic states- dementia. Changes in volume and intonation of speech

9. Speech Disturbances Unintelligible speech Dysphasia Paragrammatism and incoherence of syntax (word salad)‏ Altered speed of association (mania, depression)‏ Private symbolism Neologisms, stock words or phrases, cryptolalia or cryptographia

10. Organic Disorders of Language Aphasia Loss of language altogether Dysphasia Impairment of or difficulty with language Sensory(receptive,fluent),motor(expressive,nonfluent) ,nominal , global Broca's aphasia, wernicke's aphasia

13. Psychogenic abnormalities Mania flight of ideas, pressure of talk Hysterical mutism Approximate answers Hehephrenic Schizophrenia, dissociative disorder, ganser syndrome, organic causes. Paraphasia Pseudologia fantastica Histronic, Dissocial PD

14. Mutism Psychiatric learning disability, organic brain disease(drug related), functional psychosis and neurosis , personality disorders, depression, catatonia, dissociative disorder Stupor Functional, metabolic causes, akinetic mutism.

15. Andreasen(1979)‏ Description of cognitive and linquistic behaviour based on phenomena demonstrated without making inferences for concepts of 'global' thought disorder. Derailment, loss of goal, poverty of content of speech, tangentiality and illogicality were particularly charecteristic of schizophrenia.

16. Summary Speech and language disorders overlap with thought disorder. Need to distinguish organic causes from psychiatric/psychological causes. Thank You