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Diagnostik

Überlegungen zur psychologischen Frühdiagnostik von Sprachentwicklungsstörungen

Published Online:September 01, 2006https://doi.org/10.1026//0942-5403.8.2.92

Abstract

Zusammenfassung. Eine gestörte Sprachentwicklung stellt einen Risikofaktor für die weitere kognitive und psychosoziale Entwicklung eines Kindes dar, ebenso für den Erwerb der sekundären Sprachleistungen Lesen und Rechtschreibung und für die schulische Laufbahn. Besondere Bedeutung kommt daher der Erkennung von gestörter Sprachentwicklung im vorsprachlichen Abschnitt zu, also im ersten Lebensjahr eines Kindes. Frühdiagnostik ist aufgrund der Kontinuität von vorsprachlicher und sprachlicher Entwicklung möglich, auch wenn sie im klinischen Einsatz in Deutschland bislang noch keiner systematischen Ergebnisevaluation unterzogen wurde. Die Bemühungen um Public Health und Gesundheitsförderung legen einen Paradigmenwechsel nahe: Von der medizinlastigen Ursachenforschung der gestörten Sprachentwicklung zur primären und sekundären Prävention. Hierbei ist keine risikogruppen-, sondern populationsorientierte Prävention anzustreben. Prävention ist dann leistbar, wenn der Beginn einer verzögerten oder abweichenden Sprachentwicklung frühzeitig erkannt wird. Drei diagnostische Prädiktoren (zwei für das erste Lebensjahr und einer ab 1;6 Jahren) werden vorgestellt, wobei der Untersuchungsaufwand im ersten Lebensjahr naturgemäß sehr hoch ist, weil die Diagnostik unmittelbar am Kind und seiner primären Bezugsperson ansetzt: Die Qualität der frühen Mutter-Kind-Interaktion, die haptische Exploration und der expressive Wortschatz ab dem 18./20. Monat.


Considerations on the early psychodiagnostics of developmental language disorders

Abstract. Impaired language development counts as a risk factor in the further cognitive and psychosocial development of the child, for acquiring the secondary verbal performances in reading and writing during its career in school. Therefore, early identification of disordered language development, in other words, in the first year of life is of special importance. Early diagnosis can be carried out based on the continuity of prelinguistic and linguistic development, even though the results of such studies have not been subjected to any systematic evaluation in clinical practice in Germany. As part of the efforts of the public health system and health promotion, it's about time that a paradigm change take place in the medically burdened causal research in impaired language development by starting to apply primary and secondary prevention. Here, the aim should not be directed at risk groups, but rather at population-oriented protection. Prevention can only be implemented if delayed or deviant language development can be recognized in an early stage. Three diagnostic predictors (two for the 1st year of life and one starting at the 1;6 years of age) are presented: The quality of the mother-child interaction, the haptic exploration, and the productive vocabulary. The instrumental expenditure is very large in the first year because diagnosis focuses directly on the child and its primary reference person.

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