|What are Speech-Language Disorders?|
Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to injury to the brain-most commonly from a stroke, particularly in older individuals. But brain injuries resulting in aphasia may also arise from head trauma, from brain tumors, or from infections.
Aphasia can be so severe as to make communication with the patient almost impossible, or it can be very mild. It may affect mainly a single aspect of language use, such as the ability to retrieve the names of objects, or the ability to put words together into sentences, or the ability to read. More commonly, however, multiple aspects of communication are impaired, while some channels remain accessible for a limited exchange of information.
Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.
Apraxia of speech is a motor speech disorder. The messages from the brain to the mouth are disrupted, and the person cannot move his or her lips or tongue to the right place to say sounds correctly, even though the muscles are not weak. The severity of apraxia depends on the nature of the brain damage. Apraxia can occur in conjunction with dysarthria (muscle weakness affecting speech production) or aphasia (language difficulties related to neurological damage). Apraxia of speech is also known as acquired apraxia of speech, verbal apraxia, and dyspraxia.
An articulation impairment is a deficiency in an ability to produce sounds motoricaly or difficulty in having two articulators meet to produce the sound in isolation, syllable, sentence, paragraph or in conversational speech which is not consistent with chronological age. Articulation errors are considered motor-based errors. An articulation problem may be defined as difficulty in producing a single or a few sounds with no pattern or derivable rule. Articulation errors are described as a substitution, omission, addition, and distortion. Not all sound substitutions and omissions are speech errors. It's vital to take dialect and accent into consideration. Substitution is when a child replaces a sound with another sound (wamp/lamp). A distortion error is one that a child makes when he doesn’t correctly produce a sound (frontal lisp/s).
Augmentative and Alternative Communication (AAC)
Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write. People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth. AAC users should not stop using speech if they are able to do so. The AAC aids and devices are used to enhance their communication.
Cleft Lip and Palate
The term "cleft" means a split or a divide. Children can be born with a variety of cleft types and with variable severity. In a cleft lip there is a separation of the sides of the upper lip. This separation often includes the bones of the upper jaw and/or gum. A cleft palate is an opening in the roof of the mouth (called the "hard palate" and "soft palate") in which the two sides of the palate did not join while your baby was developing in utero. Cleft lip and cleft palate can occur on one side (unilateral) or on both sides (bilateral). Because the lip and the palate develop separately, it is possible to have a cleft lip, a cleft palate, or both.
Speech difficulty, or “aphasia,” is common in people with dementia, and may even be one of the first symptoms you notice. Problems may range from simply forgetting a word to have trouble following the conversation. Just because your loved one is not carrying on conversation as they once did, does not mean that they aren’t listening to you or don’t want to engage. Often times, they can not recall the word they want to use. The part of their brain responsible for memory and learning new things is compromised.
Dysarthria is a motor speech disorder. It results from impaired movement of the muscles used for speech production, including the lips, tongue, vocal folds, and/or diaphragm. The type and severity of dysarthria depend on which area of the nervous system is affected.
Dyslexia has been used to refer to the specific learning problem of reading. The term language-based learning disability, or just learning disabilities, is better because of the relationship between spoken and written language. Many children with reading problems have spoken language problems.
Dysphagia is the medical term for swallowing difficulty/disorder. That means there can be a difficulty with any part of the swallowing process from the preparation for feeding/swallowing, to the esophagus where digestion begins to take over. Difficulty in oral preparation or difficulty moving material from the mouth to the stomach. All behavioral, sensory, and preliminary motor acts in preparation for the swallow, including cognitive awareness of the upcoming eating situation, visual recognition of food, and all of the physiologic responses to the smell and presence of food such as increased salivation. Positioning food in the mouth and the oral manipulation preceding the swallow, including suckling, sucking, and masticating.
Dysphemia is the clinical term for stuttering, which affects the fluency of speech. It begins during childhood and, in some cases, lasts throughout life. The disorder is characterized by disruptions in the production of speech sounds, also called "disfluencies." Most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by "um" or "uh." Disfluencies are not necessarily a problem; however, they can impede communication when a person produces too many of them.
The effects of cancer on speech and swallowing depend on the location and size of the growth. For example, a sore or lump on the lips may limit movement. This could result in unclear production of speech sounds made with the lips such as /p/, /b/, and /m/. Limited movement of the lips might also reduce a person's ability to hold food in his or her mouth when eating. Cancer of the tongue can cause problems with some sounds, such as /l/ and /r/. It may also limit the ability to move food around the mouth or push food back toward the throat during swallowing. A growth on the roof of the mouth (soft palate) or in the throat may change the nasal quality of the voice.
Orofacial Myofunctional Disorders
Orofacial Myofunctional Disorders (OMD) are abnormal movements or positioning of the tongue, lips and jaw during speech or swallowing, or at rest. One type of OMD is tongue thrust, when the tongue rests too far forward in the mouth or moves too far forward during speech or swallowing.
A phonological process disorder is a simplification of the sound system that also affects intelligibility. Students with phonological process problems demonstrate difficulty in acquiring a phonological system; involving organizing the patterns of sounds in the brain and the output, not necessarily in the motor production of the sounds like articulation errors. A phonological process is a patterned modification of the adult speech system.
Selective mutism (formerly known as elective mutism) usually happens during childhood. A child with selective mutism does not speak in certain situations, like at school, but speaks at other times, like at home or with friends. Selective mutism often starts before a child is 5 years old. It is usually first noticed when the child starts school.
Specific Language Impairment (SLI)
Specific language impairment (SLI) is a language disorder that delays the mastery of language skills in children who have no hearing loss or other developmental delays. SLI is also called developmental language disorder, language delay, or developmental dysphasia. It is one of the most common childhood learning disabilities, affecting approximately 7 to 8 percent of children in kindergarten. The impact of SLI persists into adulthood.
Tracheostomy and Ventilators
People who have a tracheostomy cannot speak in the same way as those who do not. Air no longer passes through the vocal folds so the person cannot produce sounds easily. In some cases, the person may be able to say a few sounds but will quickly run out of air. For some people, a tracheostomy tube alone may not be enough. The tube may need to be connected to a breathing machine (ventilator) that provides a mixture of gases for life support. People on ventilators can speak as long as the tracheostomy tube allows air to flow through the vocal folds. However, the speech patterns of ventilator users may sound different.
Transgender Voice Therapy
If you are transgender, you may want change the way you speak. You may choose to have voice and communication therapy to help make these changes. An speech-language pathologist can work with you to change how you sound. The SLP will talk with you about your goals. The SLP will listen to your vocal pitch, or how high or deep your voice sounds. The SLP will also listen to the words you use and watch how you communicate nonverbally. If you try to change your voice on your own, you may do things that hurt it. You can end up sounding raspy or lose your voice. The SLP will help you stop behaviors that may hurt your voice and teach you safer ways to speak.
Traumatic Brain Injury (TBI)
Traumatic brain injury (TBI) is a form of brain injury caused by sudden damage to the brain. Depending on the source of the trauma, TBIs can be either open or closed head injuries. The consequences of TBI may include physical, sensory, cognitive-communication, swallowing and behavioral issues. These problems significantly impair the affected person's ability to live independently. The problems vary depending on how widespread the brain damage is and the location of the injury.
Although elective, the goal in accent modification training is to help the individual speak effectively so that speech is “listener friendly.” Accent elimination is not the intention of this training. The individual is actually learning an American accent. After a careful analysis of the individual’s speech patterns, a customized training program is designed.