Early Recognition of Language Disorders in Children: Insights from Professor Gao Liqun of Beijing Language and Culture University

Nov 04, 2016 08:05 CST Updated 08:05

Gao Liqun, Secretary-General of the Speech and Hearing Rehabilitation Professional Committee of the China Association for Promotion of Rehabilitation Technology Transformation and Development

Dean, School of Rehabilitation Sciences, Beijing Language and Culture University

This year, Beijing Language and Culture University established the School of Rehabilitation Science and the School of Speech-Language Rehabilitation in May and September, respectively, introducing the new concept of “Rehabilitation Science.” What kind of discipline is Rehabilitation Science? How can speech-language rehabilitation be effectively delivered to children with language disorders? VCBeat (WeChat ID: vcbeat) visited the School of Rehabilitation Science at Beijing Language and Culture University, where Dean Gao Liqun provided insights into the current state of rehabilitation for children with language disorders in China.

Rehabilitation Science Aligns with the Healthy China Strategy

Previously, the disciplines commonly associated with rehabilitation were Rehabilitation Medicine or Rehabilitation Therapy. However, the concept of Rehabilitation Science has been proposed abroad for at least 70 years. It encompasses nearly all aspects related to human health, such as audiology, speech-language pathology, dental care, sports health, nutrition, and preventive medicine. Rehabilitation Science transcends the traditional boundaries of medicine, expanding into the broader realm of health. With the introduction of the "Healthy China" national strategy, the conventional concept of clinical medicine can no longer adequately address current needs. Therefore, the introduction of the concept of Rehabilitation Science is conducive to the development of China’s health sector. Based on this understanding, Beijing Language and Culture University has adjusted and developed its academic disciplines by establishing the School of Rehabilitation Sciences. Rehabilitation Science is inherently a multidisciplinary field that integrates various domains, including not only language but also cognition, motor function, oral health, and nutrition. The research previously conducted at Beijing Language and Culture University on language health, treatment of language disorders, and promotion of children’s language development all fall within the scope of Rehabilitation Science.

The Incidence of Language Disorders Is Not Low

In China, the prevalence of language disorders in children is approximately 2%–3%; this statistic accounts only for relatively severe cases. If children with stuttering, dyslexia, dysgraphia, and learning disabilities are included, the proportion may reach as high as 11%. A significant reason for this substantial discrepancy is the lack of standardized methods for identifying and diagnosing conditions such as dyslexia and specific language impairment. These disorders are often not detected until children enter school age and encounter difficulties during reading and writing instruction. Language impairments affect various aspects of children’s learning, leading to dyslexia, dysgraphia, and learning disabilities. Currently, within the education sector, these issues are frequently categorized under the label of “students with learning difficulties,” a term that merely describes the phenomenon of academic struggle without addressing or enabling the identification and diagnosis of its underlying causes. Many research institutions in China, including scholars from Beijing Normal University, the Institute of Psychology at the Chinese Academy of Sciences, and South China Normal University, have conducted studies on dyslexia among Chinese-speaking children. In fact, the prevalence of dyslexia in China is not low, estimated at around 5%–7%, which is broadly comparable to the 5%–9% reported in Western countries.

Addressing children’s language disorders solely through speech therapy may not yield optimal outcomes; instead, a multidisciplinary approach is required, which underscores the very purpose of rehabilitation science. Language rehabilitation also encompasses hearing rehabilitation, motor rehabilitation, cognitive rehabilitation, and social communication rehabilitation, all of which can help children gradually overcome their language barriers.

Insufficient Awareness of Language Barriers

In fact, our country performs better than Western nations in language education. Both domestic and international academic circles generally agree that Chinese language education in primary and secondary schools on the Chinese mainland is more effective than that in the Hong Kong and Taiwan regions. However, this emphasis on language education has not translated into a corresponding focus on addressing language-related issues. It is only when children enter the formal learning stage and encounter language barriers that concerns begin to arise.This is related to the traditional Chinese belief that "noble children speak late," and that they will outgrow it as they age.It is also closely related to our insufficient understanding of childhood language disorders themselves.。

There is a golden period for children’s language acquisition, which spans from birth to age six.Therefore, we should shift our focus on children's language issues from the school-age period to the ages of 3 to 6, or even earlier.If left untreated for a prolonged period, childhood language disorders can be as detrimental as any other chronic medical condition. Therefore, through the initiatives of the China Association for the Promotion of Rehabilitation Technology Translation and Development, we aim to enhance public awareness of this issue. In first-tier cities and certain provincial capitals, an increasing number of parents are recognizing the importance of addressing language disorders and seeking assistance from speech-language pathologists. However, across the country, the overall level of attention paid to language disorders still requires significant improvement through extensive public education campaigns.

Lack of Professional Speech-Language Pathologists

There are many types of language disorders, with more than twenty subtypes, including hearing impairments, articulatory organ abnormalities, and cleft lip and palate. These conditions can be addressed through advanced technologies. For instance, the use of cochlear implants and hearing aids can improve hearing in 30% to 70% of children, thereby enabling them to develop speech capabilities. The incidence of cleft lip and palate is approximately 1 per 1,000 births. Screening can be performed during pregnancy using genetic testing and ultrasound. After birth, early oral reconstructive surgery can be carried out, allowing for effective treatment and rehabilitation.

There are other more severe or complex language disorders caused by multifactorial etiologies, for which the efficacy of medical technology is limited. Examples include autism spectrum disorder (ASD), developmental delays, and delayed brain development. The pathogenesis of ASD remains unclear, and there are currently no effective technological interventions to address it. Although modern speech-related technologies—such as text-to-speech devices, augmentative and alternative communication (AAC) systems, picture exchange communication systems (PECS), and robotics—can serve as adjunctive tools for training children with these conditions to some extent, the most critical factor remains the cultivation of professional speech-language pathologists rather than reliance on technology. Some children with ASD can communicate effectively with machines but struggle with human interaction, which is precisely a core symptom of the disorder. Continued reliance on machine-mediated communication may, in fact, exacerbate their symptoms. Therefore, a cautious approach should be adopted regarding the use of technological products in the rehabilitation of children with language disorders. The current primary shortage is not of technology, but of qualified therapeutic professionals.

Emphasize Rehabilitation Skills Training for Parents

Since 2012, the new administration in China has attached great importance to childhood disability issues. From late 2013 to 2014, the State Council, the China Disabled Persons’ Federation (CDPF), and 14 other national ministries and commissions jointly released a plan for urgent rehabilitative interventions for children with disabilities aged 0–6 years. This initiative has been effectively implemented across the CDPF systems in all provinces, municipalities, and autonomous regions nationwide. However, the plan focuses solely on addressing the needs of children and does not include provisions for professional training for parents.In pediatric rehabilitation, parents should also be included, with efforts made to provide them with education on rehabilitation knowledge, training in rehabilitation skills, and psychological counseling. However, due to a shortage of professional technical personnel and constraints on resource investment, the vast majority of rehabilitation medical institutions in China currently focus solely on children, failing to adopt a family-centered approach.

To further explore the development trends of technological innovation and translation in the healthcare industry, the China Association for Promotion of Rehabilitation Technology Translation and Development held the “2016 China Rehabilitation Technology Innovation and Industry Development Forum and the Third Member Representative Congress of the China Association for Promotion of Rehabilitation Technology Translation and Development” at the Beijing National Convention Center on November 5–6, 2016.

Centered on the theme “Focusing on Healthy China, Promoting Innovative Industries,” this forum will uphold the conference mission of “Learning, Communication, Discussion, and Exchange.” It will delve into key issues such as driving innovative development in medical and health industry technologies and fostering deeper integration among industry, academia, research, and technology transfer. The forum will also interpret and discuss hot topics, policies and regulations, guiding principles, and development models related to the implementation of the national strategy of “Healthy China.”