The diagnostic assessment of speech and language function in the first 6 years of life is an important clinical procedure. Although scales measuring verbal and communication skills, and articulatory competence, exist, their value as predictive instruments has not been generally accepted by clinicians. We assume that this is due to the wide individual differences in rate of acquisition of language, and the vulnerability to stress of any function in the process of development. These factors, the child’s rate of acquisition and response to stress and stimulation, are part of the diagnostic assessment. We view stress and stimulation as having a nonspecific cause and effect relationship. For example, one child may respond to separation from the maternal figure by deviation in pronunciation, another by mutism, and still another by behavioral symptoms, while there are other children who would show no observable consequence to such trauma. Likewise, the stimulation of an intervention program may be responded to in different ways. These assumptions have been used as guidelines in the Pre-School Program for Visually Handicapped Children at the New York Association for the Blind, where longitudinal as well as cross-sectional studies are used for the full evaluation of language function. The visually impaired child relies to an even greater extent than the sighted child on verbal language. For him in particular, the ability to develop language will determine the extent of his successful adaptation to life. Attention to early development of language and the design of early intervention procedures are of central importance to our work with preschool children. There are three groups of children in which language and speech may not develop adequately or at all. The first are those who have impaired auditory functions. The second are those who have central nervous system dysfunctions, and the third are those who have experienced serious emotional deprivation or trauma. When language development is deficient, the child’s intellectual and emotional growth may be seriously affected.
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