TREATMENT
SPEECH SOUND DISORDERS
Difficulty producing the sounds in a language accurately, making it challenging for others to understand. Speech disorders can be DEVELOPMENTAL, NEUROLOGICAL, or from STRUCTURAL changes of the mouth, whether congenital (born with it) or acquired (happened after birth).
DEVELOPMENTAL
An ARTICULATION disorder is considered DEVELOPMENTAL because most speech sound errors are a typical part of a child’s speech development. If a child has not outgrown their speech errors by about 4 years old, then they might benefit from speech therapy.
NEUROLOGICAL
CHILDHOOD APRAXIA OF SPEECH is a disruption in the signals sent from the brain to the oral-facial muscles that interferes with how they coordinate movement to produce speech. It is known as a motor (movement) planning disorder. There is nothing wrong with the integrity of the muscles. Research indicates that children with apraxia respond best to frequent, intensive speech practice.
DYSARTHRIA is speech that is affected by speech muscles weakened by damage to the nerves that control these muscles. This weakness may cause speech to sound slowed, strained, breathy, too nasal, weak, or monotone, among many other characteristics.
STRUCTURAL
ENLARGED ADENOIDS OR TONSILS can take up too much space at the opening of the throat. This may cause some sounds to be distorted, or may block the voice from RESONATING into the nasal cavity for the sounds M, N, NG. An otolaryngologist (ENT) will determine if it is medically necessary to remove the tonsils or adenoids. Speech therapy will be helpful after surgery to relearn the correct way to produce sounds.
A child born with a CLEFT PALATE will need speech therapy after surgery to learn how to produce certain sounds correctly, especially sounds that are made with a small burst of air like P, B, T, D, K, G.
LANGUAGE DISORDERS
RECEPTIVE-EXPRESSIVE
A RECEPTIVE language disorder is the difficulty UNDERSTANDING what others mean when they communicate a message.
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LISTENING
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READING
An EXPRESSIVE language disorder is difficulty USING language to communicate a message to others.
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SPEAKING
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WRITING
A child can have an impairment in either receptive or expressive language, or both, and the impairment can be in spoken or written form, or both.
RECEPTIVE and EXPRESSIVE language have the same rules and features...content (meaning), form (structure), and use (intention).
To understand and use language successfully we need to know
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the meaning of words,
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how smaller parts of a word can change its meaning, (like adding -ed or -ing to indicate verb tense),
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in what order do words go so that a sentence makes sense (The leaf fell from the tree. vs The tree fell from the leaf.),
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the social rules of language - the things we say without saying a word... a look, a gesture, the tone of voice.
SOCIAL LANGUAGE
A SOCIAL communication disorder is the difficulty reading or using verbal and nonverbal language that is appropriate to the situation. Successful social communication comes from knowing:
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what are acceptable things to say to a person if they are sad vs when they are excited,
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how to read and use nonverbal cues like someone rolling their eyes, shrugging their shoulders, or responding with only a facial expression,
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what tone of voice to use,
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higher-level language that has indirect meaning like inferences, similes, or sarcasm.
VOICE AND RESONANCE DISORDERS
VELOPHARYNGEAL DYSFUNCTION
During normal speech, the soft tissue of the palate at the far back of the mouth, along with the side and back walls of the throat, contract like a purse string to keep the air stream/voice in the mouth. When these muscles don't work properly (velopharyngeal incompetency (VPI)), when there is a structural issue, like a cleft palate (velopharyngeal insufficiency (VPI)), or when specific sounds were learned incorrectly as in an articulation disorder (velopharyngeal mislearning (VPM)), air escapes into the nasal cavity and through the nose, causing the voice to sound "hypernasal" or too nasal. Speech therapy helps a child relearn how to effectively redirect the airflow into the oral cavity without escaping into the nasal cavity during speech.
LARYNGEAL or PHARYNGEAL RECONSTRUCTION
Sometimes surgery is necessary to repair structural issues, like VPI, or damage to the neck area, as in long-term or repeated intubation, and this can affect the voice and speech.
VOCAL DYSFUNCTION
The vocal cords are like two tiny rubber bands that vibrate against each other when air from the belly (pushed from the diaphragm) passes through, creating voice. When the vocal cords or the muscles surrounding them aren't working properly, voicing might sound raspy, strained, or breathy, just to name a few. Because your voice is a big part of who you are, it's important to get help when it's not working properly. A speech pathologist teaches "vocal hygiene", that is ways to take care of the voice, as well as strategies to compensate for parts of the voice that aren't working. Some reasons a person might have trouble with their voice:
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Vocal cord PARALYSIS occurs when the nerve that controls the vocal cord is damaged.
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SPASMS of the vocal cords can make them get "stuck" in an open position making the voice sound breathy all the time, or in a closed position, making the voice sound strained or strangled.
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HABITUAL ABUSE or overuse such as continually talking too loudly, yelling, clearing the throat, and putting unnecessary strain or tension on the neck can cause the tissue of the vocal cords to become irritated and blister, forming vocal NODULES or POLYPS. Learning to change speaking habits can reverse the damage.
It's important to always see a doctor (ENT) for problems with the voice, especially in adults, because it may be indicative of a more serious medical issue.
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FLUENCY DISORDERS
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Dysfluency is difficulty producing a smooth, continuous flow of speech at a consistent and reasonable rate. Many children have dysfluent speech around the age of 3 or 4 years and then grow out of it. Those who require speech therapy learn strategies to ease through their dyfluencies and often with family support, learn to understand and manage the emotions involved in stuttering.
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STUTTERING is an interruption in the flow of speech. A person might have difficulty getting a word started, known as BLOCKING, or they may repeat a sound, syllable, or word several times, known as REPETITIONS, or stay on the same sound for a period of time, known as PROLONGATIONS.
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CLUTTERING is another form of dysfluent speech that involves increased and/or irregular speech rate, atypical pauses, dropping syllables in words and phrases, and forming disorganized sentences by starting, stopping, restarting, and moving around topics.
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TREATMENT IS AVAILABLE FOR
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COMMUNICATION DISORDERS RELATED TO:
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DOWN SYNDROME and other chromosomal or genetic disorders
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CEREBRAL PALSY
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PREMATURE BIRTH
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INTELLECTUAL IMPAIRMENTS
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FREQUENT EAR INFECTIONS and other HEARING-related concerns
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ATTENTION DEFICIT - HYPERACTIVITY DISORDER
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EXECUTIVE FUNCTIONING DISORDER
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COGNITIVE-LINGUISTIC IMPAIRMENTS - Congenital or Acquired
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AUTISM SPECTRUM DISORDER