Clinical and Genetic Aspects of Speech Development Disorders Associated with Epileptic Encephalopathies and Autism Spectrum Disorders in Children

Abstract

Introduction. The article deals with the problems of speech development disorders in children, including young children with autism spectrum disorders that are based on epileptic encephalopathy. The current state of the scientific problem of the etiology and pathogenesis, as well as the classification of speech development disorders in children, was analyzed. For the first time, the role of neuroadaptogenic drugs in the correction of speech disorders in children was showed. Purpose. Evaluation of the effectiveness of neuroadaptogenic drugs сogivis and silenta in the complex therapy of speech disorders in children. Materials and methods. We examined 68 children aged from 2 to 7 years. Among them, 28 ones had the ASD criteria. A specific speech disorder was diagnosed in 40 children. The examination and treatment was carried out on the base of the Department of Psychoneurology for children with perinatal pathology and orphan diseases of the State Institution “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. Lukyanova of the National Academy of Medical Sciences of Ukraine”. All children underwent a comprehensive examination, which included taking anamnesis with clarification of the features of the course of the prenatal and perinatal period, clinical and neurological examination, assessment on the Autism Treatment Evaluation Checklist (ATEC) scale, as well as the Global Impression Clinical Scale, and instrumental methods: video-EEG monitoring during night sleep, magnetic resonance imaging (MRI) of the brain using the Philips Achieva 3.0 Tesla magnetic resonance imager. The bioelectrical activity of the brain was recorded in the standard way on the 16-channel diagnostic complex Spectrum+ as a part of the Neuron-Spectrum+ EEG signal unit. In addition to clinical and neurological examination, the state of their speech functions was also assessed. Before starting the course of treatment, all patients were consulted by a speech therapist using the methods of standard speech therapy examination and establishing the degree of speech disorder. During the initial speech therapy examination, the degree of speech disorder was established: in 14 children (21%), it corresponded to the 1st level, in 35 children (52%) – to the 2nd level, 19 children (27%) – to the 3rd level. Among children with ASD, the degree of speech disorder was more pronounced: in 18 children (65%) – level 1, in 20 children (35%) – level 2. All 68 children received basic treatment for 4 weeks, which included speech therapy correction 3 times a week for 60 minutes, massage courses, and physiotherapy exercises. All children were randomized into two equal groups of 34 children each. Children from the first group, in addition to basic treatment, received drug therapy, which consisted of taking the drug cogivis 5 ml 2 times a day in the morning and afternoon, as well as taking 5 ml of the drug silenta in the evening. The duration of treatment was 4 weeks. Results. Complex therapy with cogivis and silenta in 38 children with specific speech disorders showed a positive result in improving speech activity, understanding the addressed speech, decrease of the number of grammatical errors, asthenic manifestations, and increased attention and perseverance in 27 (71%) children with expressive and receptive speech disorders. Among children with speech disorders of the 1st level, positive dynamics in the form of the increase of the development of speech by the level 1 was observed in 57.7% of children, in children with speech disorders of the 2nd level – in 65.7%, of the 3rd level – 88.3%. In the subgroup with impaired development of predominantly expressive speech, positive dynamics was noted in 67.8% of cases. In the subgroup with a specific articulation disorder, an improvement of speech activity was observed in 71.5% of children. Conclusion. In children with speech disorders, it is necessary to include the drugs with neuroadaptogenic action cogivis and silenta in the complex therapy. Joint prescription of drugs with neuroadaptogenic action silenta and cogivis in children with speech disorders leads to improvement of their quality of life due to persistent improvement of speech development, improvement of vocabulary and speech quality, normalization of the emotional and behavioral sphere.