CLINICAL AND NEUROLOGICAL ANALYSIS OF SPEECH DISORDERS IN CHILDREN WITH VARIOUS FORMS OF ORGANIC CENTRAL NERVOUS SYSTEM PATHOLOGY

Özet

Speech disorders in children with organic central nervous system pathology remain a significant issue in pediatric neurology due to their high prevalence and impact on cognitive development. A comprehensive clinical and neurological assessment, including evaluation of higher cortical functions and neurophysiological data, is a key approach for the accurate diagnosis and differentiation of these disorders.

Objective. To perform a comparative clinical and neurological analysis of the structure, frequency, and pathogenetic mechanisms of speech disorders in children with cerebral palsy, epilepsy, and autism spectrum disorders, and to identify key neurological factors influencing speech development and their clinical significance.

Materials and Methods. The study included 150 children aged 3–10 years: 40 patients with cerebral palsy, 38 with epilepsy, 42 with autism spectrum disorders and 30 children with developmental language disorder. All participants underwent a comprehensive neurological examination, including assessment of motor status, higher cortical functions, electroencephalographic data, and neuroimaging findings.

Results. Speech disorders were identified in 95% of children with cerebral palsy, 65.8% with epilepsy, and 92.9% with autism spectrum disorders. In cerebral palsy, dysarthric disorders predominated and were associated with lesions of the corticobulbar pathways and subcortical structures. In epilepsy, speech disturbances were mainly cognitive-dysphasic and often transient, demonstrating correlation with seizure frequency and disease duration. In autism spectrum disorders, impairments were primarily neurocognitive and related to social communication, occurring in the absence of significant motor deficits.

Conclusions. Speech disorders in children with organic central nervous system pathology differ significantly in their clinical presentation and pathogenetic mechanisms depending on the underlying nosological form. These findings emphasize the importance of a differentiated neurological approach to diagnosis, prognosis, and the selection of comprehensive therapeutic and rehabilitation strategies. The absence of unified clinical and neurological assessment algorithms complicates timely diagnosis and management, highlighting the need for their development and implementation.