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In children, language development takes place gradually and each child develops at his/her own pace. Throughout this period of learning, it is not uncommon that disorders emerge, with varying levels of severity. 
The issue of language development is of particular interest for multilingual families or expatriate families, who often question the impact of multilingualism on language acquisition.
Language disorders are most commonly identified by parents or at school. For a diagnosis and treatment of such disorders, families are referred to a speech and language therapist who specializes in communication and language.
What are the main categories of language disorders?
Written language
  • Dyslexia
This disorder affects reading and writing. There are several types of dyslexia. The most common form is a visual confusion of the letters “b” and “d”. Overall, there is a difficulty experienced when reading words, particularly those with an abstract meaning.
  • Dysorthographia
This disorder affects the learning of spellings. This results in difficulties in respecting the spelling of words, the breakdown of a group of words (“anospital” instead of “a hospital”), the transformation of sounds (“apicot” instead of “apricot”) or the inversion of syllables in a word.
  • Dysgraphia
This disorder makes it difficult for the child to organize their writing and may result in irregular letter shapes, extremely slow writing or on the contrary very impulsive writing.
  • Logico-mathematical disorders
These highlight difficulties in processing mathematical reasoning and operations. They are generally identified in elementary school and are increasingly taken into account and treated distinctly.

Oral language
  • Speech impairments
These involve not pronouncing certain sounds or changing them, such as lisping or sigmatism.
  • Speech and/or language delay
This is an incorrect use of sounds or phonemes (elements of spoken language, considered as separate units) in the word or sentence. This could also be the continued use of “baby talk” (with comprehension and/or expression problems) beyond a certain age, generally four years. For example, the child only uses a few words of vocabulary, does not use linking words and leaves verbs in the infinitive form.
  • Stuttering
In this disorder, the flow of speech is disrupted by repetitions of syllables or silent pauses or blocks.
How can we tell the difference between language disorders and language learning?
Language disorders must not be confused with certain ways of acquiring language in a multilingual environment, such as: 
  • A more restricted vocabulary compared to a monolingual child. A multilingual child learns a word in each language spoken. 
  • Alternating languages or using 2 or 3 languages when making a sentence.
  • Mutism is not uncommon in some multilingual children who will not speak for a given time, generally when a second language is introduced later and not concurrently with the first language. Be careful, this mutism does not mean that your child does not communicate with others.
Which warning signs could you pick up on?
According to the child’s age, it is preferable to consult your doctor, pediatrician or speech therapist if:
  • at any time, you notice a regression or if talking seems to be difficult for your child.
  • from birth, if your baby does not interact with you (looks, gestures, cries, etc.).
  • at 18 months, if your child does not use a word to express something or does not understand simple instructions.
  • at the age of 2, if your child cannot put together two words and does not point to any part of his/her body.
  • at the age of 3, if your child is not understood by those around him/her.
These are only guidelines and are under no circumstances to be understood as set development milestones. A child’s language skills depend on the family, social and cultural environment, and above all on his/her own pace of development. It may be that your child has focused more on motor development first.
How can MSH International can assist you?
MSH International can help you to find facilities offering pediatric and/or speech therapy consultations in your place of expatriation.
Please contact our medical team for advice.
A request for prior approval is generally necessary for speech and language therapy. Please refer to your summary of benefits, available on your MSH International member’s area to find out your level of coverage.
To support you at all times, MSH International also provides a video platform for speech therapy consultations, available in 5 languages. Offered by our provider Eutelmed, this service can be accessed at any time from your member’s area. The speech therapist will first propose a language assessment which will be used to make a diagnosis, set objectives and, where necessary, draft a rehabilitation plan.
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