Speech and Language Disorders

Definition
A speech disorder is a condition in which a person has problems creating or forming the speech
sounds needed to communicate with others. This can make the child's /individuals speech
difficult to understand.
Common speech disorders are:
 Articulation disorders
 Phonological disorders
 Fluency
 Voice disorders or resonance disorders
Speech disorders are different from language disorders in children. Language disorders refer to
someone having difficulty with:
 Getting their meaning or message across to others (expressive language)
 Understanding the message coming from others (receptive language)
Alternative Names
Articulation deficiency; Articulation disorder; Phonological disorder; Voice disorders; Vocal
disorders; Dysfluency; Communication disorder - speech disorder; Speech disorder - stuttering;
Cluttering; Stammering; Childhood onset fluency disorder
Causes
Speech is one of the main ways in which we communicate with those around us. It develops
naturally, along with other signs of normal growth and development. Disorders of speech and
language are common in preschool age children.
Dysfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be
the most serious dysfluency. It may be caused by:
 Genetic abnormalities
 Emotional stress
 Any trauma to brain or infection
Articulation and phonological disorders may occur in other family members. Other causes
include:
 Problems or changes in the structure or shape of the muscles and bones used to make
speech sounds. These changes may include cleft palate and tooth problems.
  Damage to parts of the brain or the nerves (such as from cerebral palsy) that control how
the muscles work together to create speech.
 Hearing loss.
Voice disorders are caused by problems when air passes from the lungs, through the vocal cords,
and then through the throat, nose, mouth, and lips. A voice disorder may be due to:
 Acid from the stomach moving upward (GERD)
 Cancer of the throat
 Cleft palate or other problems with the palate
 Conditions that damage the nerves that supply the muscles of the vocal cords
 Laryngeal webs or clefts (a birth defect in which a thin layer of tissue is between the
vocal cords)
 Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or ulcers) on the
vocal cords
 Overuse of the vocal cords from screaming, constantly clearing the throat, or singing
 Hearing loss
Symptoms
DYSFLUENCY
Stuttering is the most common type of dysfluency.
Symptoms of dysfluency can include:
 Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my
doll. I...I see you.)
 Putting in (interjecting) extra sounds or words (We went to the...uh...store.)
 Making words longer (I am Boooobbby Jones.)
 Pausing during a sentence or words, often with the lips together
 Tension in the voice or sounds
 Frustration with attempts to communicate
 Head jerking while talking
 Eye blinking while talking
 Embarrassment with speech
ARTICULATION DISORDER
The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."
 Certain sounds (like "r", "l", or "s") may be consistently distorted or changed (such as
making the 's' sound with a whistle).
 Errors may make it hard for people to understand the person (only family members may
be able to understand a child).
PHONOLOGICAL DISORDER
The child does not use some or all of the speech sounds to form words as expected for their age.
 The last or first sound of words (most often consonants) may be left out or changed.
 The child may have no problem pronouncing the same sound in other words (a child may
say "boo" for "book" and "pi" for "pig", but may have no problem saying "key" or "go").
VOICE DISORDERS
Other speech problems include:
 Hoarseness to the voice
 Voice may break in or out
 Pitch of the voice may change suddenly
 Voice may be too loud or too soft
 Person may run out of air during a sentence
 Speech may sound odd because too much air is escaping through the hose (hypernasality)
or too little air is coming out through the nose (hyponasality)
Exams and Tests
Your health care provider will ask about your child's developmental and family history. The
provider will do some neurological screening and check for:
 Fluency of speech
 Any emotional stress
 Any underlying condition
 Effect of speech disorder on daily life
Some other evaluation tools used to identify and diagnose speech disorders are:
 Denver Articulation Screening Examination.
 Leiter International Performance scale-3.
 Goldman-Fristoe Test of Articulation 3 (GFTA-3).
  Arizona Articulation and Phonology Scale 4th Revision (Arizona-4).
 Prosody-voice screening profile.
A hearing test may also be done to rule out hearing loss as a cause of the speech disorder.
Treatment
Children may outgrow milder forms of speech disorders. The type of treatment will depend on
the severity of the speech disorder and its cause.
Speech therapy may help with more severe symptoms or any speech problems that do not
improve.
In therapy, the therapist may teach your child how to use their tongue to create certain sounds.
If a child has a speech disorder, parents are encouraged to:
 Avoid expressing too much concern about the problem, which can actually make matters
worse by making the child more self-conscious.
 Avoid stressful social situations whenever possible.
 Listen patiently to the child, make eye contact, don't interrupt, and show love and
acceptance. Avoid finishing sentences for them.
 Set aside time for talking.
Support Groups
The following organizations are good resources for information on speech disorder and its
treatment:
 American Institute for Stuttering -- stutteringtreatment.org
 American Speech-Language-Hearing Association (ASHA) -- www.asha.org/
 The Stuttering Foundation -- www.stutteringhelp.org
 National Stuttering Association (NSA) -- westutter.org
Outlook (Prognosis)
Outlook depends on the cause of the disorder. Speech can often be improved with speech
therapy. Early treatment is likely to have better results.
Possible Complications
Speech disorders may lead to challenges with social interactions due to difficulty
communicating.
When to Contact a Medical Professional
Call your provider if:
  Your child's speech is not developing according to normal milestones.
 You think your child is in a high-risk group.
 Your child is showing signs of a speech disorder.
Prevention
Hearing loss is a risk factor for speech disorders. At-risk infants should be referred to an
audiologist for a hearing test. Hearing and speech therapy can then be started, if necessary.
As young children begin to speak, some disfluency is common, and most of the time, it goes
away without treatment. If you place too much attention on the disfluency, a stuttering pattern
may develop.