COMMUNICATION

DISORDERS
Exceptional Psychology
 How can
communicating
become a
disorder?
 I love u
(Message)
Communica Sender

tion
• It is the interactive exchange of
information, ideas, feelings,
needs, and desires.
Receiver
• Each communication interaction
includes three elements: a) a
message, b) a sender who
expresses the message, and c) a
receiver who responds to the
message
 What’s the
importance of
communication
among children?
Uses of
Communicati
on
• Narrating
• Explaining and Informing
• Requesting
• Expressing
1. Narrating
• Children need to be able to tell (and follow the
telling of) a story—a sequence of related events
connected in an orderly, clear, and interesting
manner
• Five-year-old Cindy tells her teacher, “I had a
birthday party. I wore a funny hat. Daddy made a
cake, and Mommy took pictures.”
2. Explaining
• Teachers expect children to interpret the
explanations of others in speech and writing and to
put what they understand into words so their
listeners or readers will be able to understand it
• In a typical classroom, children must frequently
respond to teachers’ questions: “Which number is
larger?” or “How do you suppose the story will
end?”
3. Requesting
• Children are expected to communicate their
wishes and desires to others in socially
appropriate ways
• A child who has learned to state requests clearly
and politely is more likely to get what she wants
and less likely to engage in inappropriate behavior
to communicate her needs
4. Expressing
• It is important for children to express
their personal feelings and opinions
and to respond to the feelings of
others
• Speech and language can convey joy,
fear, frustration, humor, sympathy, and
anger
• A child writes, “I have just moved. And
it is hard to find a friend because I am
shy.”
Communicatio
n
• Although speech and language form the
message system most often used in
human communication, spoken or written
words are not necessary for
communication to occur.
• Both paralinguistic behaviors and
nonlinguistic cues play major roles in
human communication
I. Paralinguistic
Behaviors

• Include speech modifications (e.g.,

variations in stress, pitch, intonation, rate of
delivery, pauses and nonlanguage sounds
(e.g., “oohh,” laughter) that change the
form and meaning of the message
Say this sentence in different tones Ogie Diaz Acting
“I HATE YOU” Workshop
1. Betrayed/Broken

2. Pissed off

3. Pabebe
II. Nonlinguistic
Cues

• include body posture, facial expressions,

gestures, eye contact, head and body
movement, and physical proximity
• Some researchers estimate that two-thirds
or more of the information in some face-to-
face interactions may be communicated by
nonspeech means
Five Dimensions of
Language
• There are five dimensions of language that define its form
(phonology, morphology, syntax), content (semantics), and
use (pragmatics)
1.Phonology
• Refers to the linguistic rules governing a language’s sound
system. Phonological rules apply to the sequence and
combination of sounds of a given language.
• A phoneme is a speech sound that differentiates word
meanings. For example, only the initial phoneme prevents
the words pear and bear from being identical, yet in one
case, we think of a fruit and in the other a large animal
2. Morphology
• Refers to a language’s basic units of meaning and how
those units are combined into words
• Morphemes, the smallest elements of language that carry
meaning, can be sounds, syllables, or whole words
Morphemes
Free Morphemes
• Can stand alone (e.g., fit, slow)
Morphemes
Bound Morphemes
• Do not carry meaning by themselves; they are grammatical
markers that change the meaning of words when attached
to free morphemes (e.g., unfit, slowly)
 Mali. Dapat,
ikaw AY
MAbaho
3. Syntax
Baho
ikaw.
is the system of rules governing the meaningful
arrangement of words. If morpheme could be
strung together in any order, language would be an
unintelligible tangle of words
Syntactical rules are language specific (e.g.,
Japanese and English have different rules), and they
specify the acceptable (i.e., grammatical)
relationships among subject, verb, object, and
other sentence elements
Ang
bigat 4. Semantics
• Concerns the meaning of words and
combinations of words. The semantic knowledge
of competent language users includes vocabulary
and concept development, connotative meanings
Ang
by context
bigat • Hot refers to temperature when discussing the
weather but something else when talking about
an athlete’s recent performance
5.Pragmatics
There are three kinds of pragmatic skills
• (a) using language for different purposes (e.g., greeting,
informing, demanding, promising, requesting)
• (b) changing language according to the needs of a listener
or situation (e.g., talking differently to a baby than to an
adult, giving background information to an unfamiliar
listener, speaking differently in a classroom than on a
playground)
• (c) following rules for conversations and storytelling (e.g.,
taking turns, staying on topic, rephrasing when
misunderstood, standing at an appropriate distance during
conversations, using facial expressions and eye contact
Overview of Typical
Language
Development
Birth to 6 months
• Infant first communicates by crying, which produces a reliable
consequence in the form of parental attention
• Different types of crying develop—a parent can often tell from
the baby’s cry whether she is wet, tired, or hungry
• Comfort sounds—coos, gurgles, and sighs—contain some vowels
and consonants
• Comfort sounds develop into babbling, sounds that in the
beginning are apparently made for the enjoyment of feeling and
hearing them.
• Vowel sounds, such as /i/ (pronounced “ee”) and /e/ (pronounced
“uh”), are produced earlier than consonants, such as /m/, /b/, and
/p/
• Infant does not attach meaning to words she hears from others
but may react differently to loud and soft voices
• Infant turns eyes and head in the direction of a sound
7 to 12 months
• Babbling becomes differentiated before the end of the first
year and contains some of the same phonetic elements as
the meaningful speech of 2-year-old infants
• Baby develops inflection—her voice rises and falls
• She may respond appropriately to “no,” “bye-bye,” or her
own name and may perform an action, such as clapping her
hands, when told to
• She will repeat simple sounds and words, such as “mama.”
12 to 18 months
• By 18 months, most children have learned to say several
words with appropriate meaning
• Pronunciation is far from perfect; baby may say “tup” when
you point to a cup or “goggie” when she sees a dog
• She communicates by pointing and perhaps saying a word
or two
• She responds to simple commands such as “Give me the
cup” and “Open your mouth.”
18 to 24 months
• Most children go through a stage of echolalia, in which
they repeat, or echo, the speech they hear. Echolalia is a
normal phase of language development, and most children
outgrow it by about the age of 21⁄2 years
• There is a great spurt in acquisition and use of speech; baby
begins to combine words into short sentences, such as
“Daddy bye-bye” and “Want cookie.”
• Receptive vocabulary grows even more rapidly; at 2 years
of age, she may understand more than 1,000 words
• Understands such concepts as “soon” and “later” and
makes more subtle distinctions between objects such as
cats and dogs and knives, forks, and spoons
2 to 3 years
• The 2-year-old child talks, saying sentences such as “I won’t
tell you” and asking questions such as, “Where my daddy
go?”
• She participates in conversations.
• She identifies colors, uses plurals, and tells simple stories
about her experiences.
• She can follow compound commands such as “Pick up the
doll and bring it to me.”
• She uses most vowel sounds and some consonant sounds
correctly.
3 to 4 years
• The normal 3-year-old child has lots to say, speaks rapidly, and asks
many questions
• She may have an expressive vocabulary of 900–1,000 different words,
using sentences of three to four words
• Sentences are longer and more varied: “Cindy’s playing in water;
“Mommy went to work”; “The cat is hungry.”
• She used speech to request, protest, agree, and make jokes
• She understands children’s stories; grasps such concepts as funny,
bigger, and secret; and can complete simple analogies such as “In the
daytime it is light; at night it is…”
• She substitutes certain sounds or words (“b-b-ball”, “li-li-little”). These
repetitions and hesitations are normal and do not indicate that the
child will develop a habit of stuttering
4 to 5 years
• The child has a vocabulary of more than 1,500-2,000 words and uses
sentences averaging five words in length
• She begins to modify her speech for the listener; for example, she
uses longer and more complex sentences when talking to her mother
than when addressing a baby or a doll
• She can define words such as “hat”, “stove”, and “policeman” and can
ask questions such as “How did you do that? or “Who made this?”
• She uses conjunction such as “if”, “when”, and “because”
• She recites poems and sings songs from memory
• She may still have difficulty with consonant sounds such as /r/, /s/,
/z/, and /j/ and with blends such as “tr”, “gl”, “sk”, and “str”
Communicat
ion Disorder
• “An impairment in the ability to
receive, send, process, and
comprehend concepts or verbal,
non-verbal and graphic symbol
systems”
Communicat
ion Disorder
• To be eligible for special education
services, a child’s communication
disorder must have an adverse
effect on learning. The Individuals
with Disabilities Education
• Act (IDEA) defines speech or
language impairment as “a
communication disorder, such as
stuttering, impaired articulation, a
language impairment, or a voice
impairment that adversely affects
a child’s educational performance”
Communicat
ion Disorder
• Specialists in the field of
communication disorders make
a distinction between speech
impairments and language
impairments. A child may have a
speech impairment, a language
impairment, or both
What do you think
are the differences of
speech impairments
and language
impairments?
Speech
Impairments
• A widely used definition
considers speech to be impaired
“when it deviates so far from the
speech of other people that it
a. calls attention
b. interferes with
communication,
c. provokes distress in the
speaker or the listener”
Speech
Impairments
Three basic types of speech
impairments are:
• Articulation disorders (errors in the
production of speech sounds)
• Fluency disorders (difficulties with
the flow or rhythm of speech)
• Voice disorders (problems with the
quality or use of one’s voice)
 • Many children have mild to moderate speech
impairments. Their speech can usually be
understood, but they may mispronounce certain
Speech sounds or use immature speech, similar to that of
younger children. These problems often disappear
Impairmen as a child matures

ts • If a mild or moderate articulation problem does

not improve over an extended period or if it has an
adverse effect on the child’s interaction with
others, referral to an SLP is indicated
 • Impaired comprehension and/or use of spoken,
written, and/or other symbol systems
• Language disorders involves the following:
Language a. The form of language(phonology, morphology,
Disorders b.
and syntax)
The content of language (semantics)
c. The function of language in communication
(pragmatics) in any combination
Language • Some children have serious difficulties in
understanding language or expressing themselves
Disorders through language
Receptive Language Disorders
• A child with a receptive language disorder may struggle learning the days of the
week in proper order or following a sequence of commands such as “Pick up the
paint brushes, wash them in the sink, and then put them on a paper towel to
dry.”
Expressive Language Disorders
• A child with an expressive language disorder may have a limited vocabulary for
her age, say sounds or words in the wrong order (e.g., “hostipal,” “aminal,”
“wipe shield winders”), and use tenses and plurals incorrectly (e.g., “Them
throwed a balls”)
• Children with an expressive language disorder may or may not also have
difficulty in receptive language
• For instance, a child may be able to count out six pennies when asked and
shown the symbol 6, but she may not be able to say “six” when shown the
symbol. In that case, the child has an expressive difficulty, but her receptive
language seems adequate
Difference Between Receptive &
Expressive Language Disorders
• https://youtu.be/oKOkSxcOz_U
 Four basic kinds of speech-sound errors occur:

Speech- • Distortions
• Substitutions
Sound • Omissions
Errors • Additions
Distortions
• A speech sound is distorted when it sounds more like the
intended phoneme than another speech sound but is
conspicuously wrong.
• The /s/ sound, for example, is relatively difficult to produce;
children may produce the word “sleep” as “schleep,”
“zleep,” or “thleep.”

Some speakers have a lisp; others a whistling /s/. Distortions

can cause misunderstanding, although parents and teachers
often become accustomed to them
Substitution
s
• Children sometimes substitute
one sound for another, as in
saying “train” for “crane” or
“doze” for “those.”
• Children who substitute sounds
are often certain they have said
the correct word and may resist
correction
• Sound substitutions can cause
considerable confusion for the
listener
Omissions

• Children may omit certain

sounds, as in saying “cool” for
“school.”
• They may drop consonants from
the ends of words, as in “pos”
for “post.” Most of us leave out
sounds at times, but an
extensive omission problem can
make speech unintelligible.
Additions
• The addition of extra sounds makes comprehension
difficult. For example, a child might say “buhrown” for
“brown” or “hamber” for “hammer.”
Articulation
Disorders
• A child with an articulation disorder is not able to
produce a given sound physically because that
sound is not in his repertoire
• A severe articulation disorder is present when a child
pronounces so many sounds poorly that his speech is
unintelligible most of the time; even the child’s
parents, teachers, and peers cannot easily understand
him
Articulation
Disorders
• The child with a severe articulation disorder may say,
“Yeh me yuh a da wido,” instead of “Let me look out
the window,” or perhaps “Do foop is dood” for “That
soup is good.”
• The fact that articulation disorders are prevalent does
not mean that teachers, parents, and specialists
should regard them as simple or unimportant
Example of Articulation Disorder
among adults
• https://youtu.be/gONcRDjuUSU
Phonologica
l Disorders
• A child with a phonological
disorder has the ability to
produce a given sound but does
so inconsistently; she produces
the same sound correctly in
some instances and incorrectly
in others
• Children with phonological
disorders are apt to experience
problems in academic areas, and
they are especially at risk for
difficulties in reading and writing
 • A fluency disorder is an “interruption in the flow of
speaking characterized by atypical rate, rhythm,
Fluency and repetitions in sounds, syllables, words, and
phrases
Disorders • This may be accompanied by excessive tension,
struggle behavior, and secondary mannerisms”
 • The best-known (and in some ways least
understood) fluency disorder is stuttering, a
condition marked by rapid-fire repetitions of
consonant or vowel sounds, especially at the
Stuttering beginnings of words, prolongations, hesitations,
interjections, and complete verbal blocks
• Developmental stuttering is considered a disorder
of childhood. Its onset is usually between the ages
of 2 and 4 years and rarely after age 12 years
 • Stuttering is situational; that is, it appears to be
related to the setting or circumstances of speech
• A child may be more likely to stutter when talking
Stuttering with people whose opinions matter most to him,
such as parents and teachers, and in situations
such as being called on to speak in front of the
class
 • Most people who stutter are fluent about 90% of
Stuttering the time; a child with a fluency disorder may not
stutter at all when singing, talking to a pet, or
reciting a poem in unison with others
 • A type of fluency disorder known as cluttering is
characterized by excessive speech rate, repetitions,
extra sounds, mispronounced sounds, and poor or
Cluttering absent use of pauses. The clutterer’s speech is
garbled to the point of unintelligibility
• “Let’s go!” may be uttered as “Sko!” and “Did you
eat?” collapsed to “Jeet?”
 Voice • A voice disorder is characterized by “the abnormal
production and/or absences of vocal quality, pitch,
Disorders loudness, resonance, and/or duration, which is
inappropriate for an individual’s age and/or sex”
 Two Basic
The two basic
types of voice
disorders involve
Types of
phonation and
resonance Voice
Disorders
Phonation Disorder
• Causes the voice to sound breathy, hoarse, husky, or
strained most of the time. In severe cases, there is no voice
at all
• Phonation disorders can have organic causes, such as
growths or irritations on the vocal cords, but hoarseness
most frequently comes from chronic vocal abuse, such as
yelling, imitating noises, or habitually talking while anxious
or tense
• Misuse of the voice causes swelling of the vocal folds,
which in turn can lead to growths known as vocal nodules,
nodes, or polyps
Resonance Disorder
• It is characterized by either too many sounds coming out
through the air passages of the nose (hypernasality) or,
conversely, not enough resonance of the nasal passages
(hyponasality)
• A hypernasal speaker may be perceived as talking through
her nose or having an unpleasant twang
• A child with hyponasality (sometimes called denasality)
may sound like he has a chronic cold or a stuffed nose even
when he does not
Prevalence of
Communication
Disorders
• Estimates of the prevalence of communication
disorders in children vary widely. Reliable figures
are hard to come by because investigators often
use different definitions of speech and language
disorders and sample different populations
• In the 2012 to 2013 school year, about 1,356,000
children ages 6 to 21 years received special
education and related services under the IDEA’s
disability category “speech or language
impairment”
Prevalence of
Communication
Disorders
• Speech or language impairment is the second
largest disability category after learning
disabilities
• Approximately 50% of children who receive
special education services because of another
primary disability (e.g., intellectual disabilities,
learning disabilities, hearing impairments) also
have communication disorders
Causes of Speech
Impairments
• Examples of physical factors that frequently
result in speech impairments are cleft palate,
paralysis of the speech muscles, absence of
teeth, craniofacial abnormalities, enlarged
adenoids, and traumatic brain injury
• Dysarthria is the collective name for a group
of speech disorders caused by neuromuscular
impairments that affect the movements
necessary for proper respiration, phonation,
resonation, articulation, or prosodic aspects
of speech
Causes of Speech
Impairments
• Lack of precise motor control needed to
produce and sequence sounds causes
distorted and repeated sounds
• An organic speech impairment may be a
child’s primary disability, or it may be
secondary to other disabilities, such as
cerebral palsy or intellectual disabilities
Causes of Language
Disorders
• Factors that can contribute to language
disorders in children include
developmental and intellectual
disabilities, autism, traumatic brain injury,
child abuse and neglect, hearing loss, and
structural abnormalities of the speech
mechanism
Causes of Language
Disorders
• Research indicates that genetics may
contribute to communication disorders
• Environmental influences also play an
important part in delayed, disordered, or
absent language. The communication
efforts of some children are reinforced;
other children, unfortunately, are
punished for talking, gesturing, or
otherwise attempting to communicate
• A child who has little stimulation at home
and few chances to speak, listen, explore,
and interact with others will probably
have little motivation for communicating
and may well experience delays in
language development
Identification and
Assessment
Screening and Teacher Observation
• In some school districts, SLPs screen the spoken language abilities of
all kindergarten children
• These screenings might involve norm-referenced tests, informal
assessments developed by the SLP, and questionnaires or checklists
for parents and teachers
Evaluation Components
• Case History and Physical Examination
• Articulation
• Hearing
• Phonological Awareness and Processing
• Overall language development and vocabulary
• Language samples
• Observation in natural settings
 • Most professional speech and language
assessments begin by documenting the child’s
Case case history
• This typically involves completing a biographical
History and form that includes information such as the
child’s birth and developmental history, health
Physical record, scores on achievement and intelligence
Examinatio tests, and adjustment to school
• The specialist carefully examines the child’s
n mouth, noting any irregularities in the tongue,
lips, teeth, palate, or other structures that may
affect speech production
 • The specialist assesses speech errors and
Articulation records sounds pronounced incorrectly, types of
mispronunciations, and number of errors
 • The child’s hearing is assessed to determine
Hearing whether a hearing problem is causing the
suspected communication disorder
Phonologic
al • Children without such phonological awareness
and processing skills not only have problems
Awareness with receptive and expressive spoken language
but also have great difficulties in learning to
and read

Processing
Overall
language
development
and vocabulary
• The amount of
vocabulary a child has
acquired is generally a
good indicator of
language competence
Language
Samples
• An important part of any evaluation for
communication disorders is obtaining
accurate samples of the child’s expressive
speech and language
• The examiner considers factors such as
intelligibility and fluency of speech, voice
quality, and use of vocabulary and
grammar
Observation in
Natural Settings
• Observation and measurement of
children’s language use in social contexts
and everyday activities are important
elements of assessment for
communication disorders
• It is imperative that the observer sample
the child’s communication behavior across
various settings rather than limit it to a
clinic or an examining room
Observation in
Natural Settings
• Observation and measurement of
children’s language use in social contexts
and everyday activities are important
elements of assessment for
communication disorders
• It is imperative that the observer sample
the child’s communication behavior across
various settings rather than limit it to a
clinic or an examining room
Educational
Approaches
Speech-Language Pathologist
• Speech-language pathologist is the preferred term for a school-based
professional with primary responsibility for identifying, evaluating,
and providing therapeutic services to children with communication
disorders
• As a key member of a child’s IEP team, the SLP’s goal is to correct the
child’s speech and language problems or to help the child achieve the
maximum communicative potential, which may involve compensatory
techniques and augmentative and alternative means of
communication
Treating Speech-Sound Errors
Articulation Errors
• The goals of therapy for articulation problems are acquisition of
correct speech sound(s), generalization of the correct sound(s) to all
settings and contexts (especially the classroom), and maintenance of
the correct sound(s) after therapy has ended
• Articulation therapy involves discrimination and production activities
Discriminatio
n Activities
• Discrimination activities teach
the child to detect the
differences between similar
sounds (e.g., the /t/ in tape,
the /k/in cape) and to
differentiate between correct
and distorted speech sounds
• The SLP provides auditory,
visual, and tactile feedback to
help the child learn to match his
speech to that of a standard
model
Production
Activities
• Production is the ability to
produce a given speech sound
alone and in various contexts
• Therapy emphasizes the
repetitive production of sounds
in various contexts, with special
attention to the motor skills
involved in articulation. The SLP
may have the child carefully
watch how sounds are produced
and then use a mirror to monitor
his own speech production.
Treating
Speech-
Sound Errors
Phonological Errors
• When a child’s spoken language includes
phonological errors, therapy helps the child
identify the error pattern(s) and produce
more linguistically appropriate sound
patterns
• For example, a child who frequently omits
final consonants might be taught to
recognize the difference between
minimally contrastive words—perhaps
using a set of cards with the words sea,
seed, seal, seam, and seat
Treating Fluency Disorders
• For example, a child who frequently omits final consonants might be
taught to recognize the difference between minimally contrastive
words—perhaps using a set of cards with the words sea, seed, seal,
seam, and seat.
• One example of a behaviorally based stuttering
treatment approach is the Lidcombe Program, which
trains parents to ignore their child’s stuttering initially
and reinforce fluent utterances with frequent praise
(e.g., “That was smooth talking!”)
Treating Fluency Disorders
• Children may learn to manage their stuttering by deliberately
prolonging certain sounds or by speaking slowly to get through a
“block.” They may increase their confidence and fluency by speaking
in groups, where pressure is minimized and successful speech is
positively reinforced
Treating Voice Disorders
• A thorough medical examination should always be sought for a child
with a voice disorder. Surgery or other medical interventions can
often treat organic causes
• In addition, SLPs often recommend environmental modifications; a
person who is consistently required to speak in a noisy setting, for
example, may use a small microphone to reduce vocal straining and
shouting
Treating
Language
Disorders
• Since children learn through
imitation, it is important for the
teacher or specialist to speak
clearly, use correct inflections,
and provide a rich variety of
words and sentences
Treating
Language
Disorders
• Children with very limited spoken
language might be taught how to
orally “read” pictures as a
language enhancement activity
• Teachers can use storyboards and
song boards with pictures
illustrating language: The teacher
places and removes pictures from
the board as she tells the story or
points to the appropriate picture
while singing a line