Speech disorder

Definition

According to the American Speech-Language-Hearing Association (ASHA), a language disorder is an impairment in comprehension use of the spoken, written, or other symbol system.

Description

Speech disorders affect the language and mechanics, the content of speech, or the function of language in communication. Because speech disorders affect a person's ability to communicate effectively, every aspect of the person's life can be affected, for example, the person's ability to make friends, and to communicate at school or at work.

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a neurological disease that attacks the nerve cells in the brain that control voluntary muscles. ALS causes motor neurons to die so that the brain and spinal cord are unable to send messages to the muscles telling them to move. Because the muscles are not functioning, they begin to atrophy. Muscles in the face and jaw can be affected, and thereby affecting a person's speech.

Aphasia results from damage to the language centers of the brain, which affects a person's ability to communicate through speaking, listening, and writing.

Persons with aphasia have trouble with expressive language, what is said, or receptive language, what is understood. Not only are speech and understanding speech affected, but also reading and writing is affected. The severity of aphasia varies from person to person, but in the most severe cases, a person may not be able to understand speech at all. Persons with mild aphasia may only become confused when speech becomes lengthy and complicated.

Developmental apraxia is a disorder that affects the nervous system and affects a person's ability to sequence and say sounds, syllables, and words. The brain does not send the correct messages to the mouth and jaw so that the person can say what he or she wants to say.

Children who are suffering from this disorder don't babble as an infant and first words are delayed. Older children may have more difficulty with longer phrases, and may appear to be searching for words to express a thought. Listeners will likely have a difficult time understanding the child.

Laryngeal cancer is characterized by a malignant growth in the larynx, or the voice box, which sometimes requires removal of the larynx or part of it.

Cancer anywhere in the throat affects speech, swallowing, and chewing. Depending on the size of the growth, a person may have trouble moving the mouth and lips. Therefore, speech sounds and eating will be affected and a person will have trouble communicating.

Orofacial myofunctional disorder (OMD) causes the tongue to move forward in an exaggerated manner while a person is speaking or swallowing. The tongue also may protrude when resting in the mouth.

Because heredity contributes to the size and shape of a person's mouth, there may be genetic reasons for the disorder. Allergies also affect the mouth and face muscles, which make it difficult to breathe because of nasal congestion. Because a person may sleep with the tongue protruding, lip muscles weaken. Enlarged tonsils also can block airways, creating the same breathing problems. Additionally, thumb-sucking, nail-biting, and teeth-clenching and grinding also can contribute to the disorder.

Stuttering is a disorder of speech fluency that frequently interrupts the flow of speech.

Because children typically stumble and confuse their words as speech develops, stuttering is not immediately evident. It is usually when children become older and continue to stumble that stuttering becomes evident.

— Meghan Gourley

Speech disorders may be classified according to their causes or symptoms. The major causes are organic, imitative environmental, and psychogenic. Organic disorders may result from disease, impairment, or absence of the organs of speech. Imitative disorders occur when the child imitates defective speech. A speech disorder has a psychogenic origin when there is a psychological basis for its presence. A classification includes disorders of articulation, rhythm, voice, and symbolization.

Disorders of articulation may be so severe that the resultant speech is unintelligible. Specific sounds or groups of sounds may be omitted, added, substituted, or distorted. The following are some examples of this type of disorder: Lalling, involving misarticulated r, l, t, and d sounds, may be caused by poor control of the tongue tip. In lisping, misarticulated sibilant sounds, particularly s and z, are often substituted by the th sound. Delayed speech, involving the absence of many consonants and poor intelligibility, is often caused by slow physical or psychological maturation. Dysarthria, generalized sound substitutions and distortions, is caused by lesions in the peripheral or central nervous system.

Disorders of rhythm are characterized by disruptions of the normal rate of speech. Two common disorders of rhythm are stuttering or stammering and cluttering.

Voice disorders are usually described as defects of pitch, loudness, and voice quality. Improper use of the voice may cause an injury to the vocal folds and intensify an existing voice disorder. Disorders of pitch are characterized as too high, too low, monotonous, and repeated pitch patterns. A high-pitched voice is most often caused by psychological tension. The muscles of the larynx are contracted so that the pitch is raised beyond its normal range. Voice quality disorders are usually described as hoarseness, nasality, denasality, and similar conditions. Hoarseness may be caused by pharyngeal or laryngeal pathologies. Cleft palate speech is a striking example of nasality. Nasal speech may also follow a paralysis of the palatal muscles. The nasal speech results because the palate is unable to aid in achieving nasopharyngeal closure.

Symbolization disorders involve an impairment of language formulation and expression. They may occur without a concomitant impairment of speech production. Common types of these disorders are aphasia and delayed speech. See also Speech.

Definition

Speech disorders are characterized by a difficulty in producing normal speech patterns.

Description

Children go through many stages of speech production while they are learning to communicate. What is normal in the speech of a child of one age may be a sign of a problem in an older child. Speech disorders include voice disorders (abnormalities in pitch, volume, vocal quality, resonance, or duration of sounds), articulation disorders (problems producing speech sounds), and fluency disorders (impairment in the normal rate or rhythm of speech, such as stuttering.

Demographics

Speech disorders are common. More than a million children in the public schools' special education programs have been diagnosed with a speech disorder. One in 10 people in the United States is affected by a communication disorder (speech, language, or hearing disorders).

Causes and Symptoms

The causes of most speech disorders are not known. Deafness and hearing loss are significant causes of speech delays and disorders. The symptoms of a speech disorder depend heavily on the age of the child. There are no symptoms of speech disorders that apply to all ages of children. Basic guidelines about what kind of speech is normal at what age can be helpful in determining if a child is missing significant speech milestones.

• Twelve months: By this time babies should respond nonverbally, have different types of cries, and may know one or a few simple words (e.g. "mama" or "dada"). At this age babies should coo and babble.
• Eighteen months: Children of this age should be increasing their vocabularies slowly and be able to produce five to 20 common words.
• Twenty-four months: At this point vocabulary building should begin to speed up. At this age children should be able to produce simple sentences made up of two words.
• Three years: Children should begin to be able to produce speech that is understood by those outside immediate caretakers. Sentences become longer and more complex, and vocabulary increases drastically.

When to Call the Doctor

If a child continuously misses speech milestones, or is significantly behind what is generally considered average for his or her age, a doctor should be consulted. If hearing loss is ever suspected, such as if a child only responds when the parent speaking is in eyesight, the doctor should be consulted without delay.

Diagnosis

A doctor will do a hearing test on the child to ensure that a hearing problem is not responsible for the speech delay. The doctor may interact with the child to determine linguistic competence. In addition, he or she will interview the parents or other caregivers or have them fill out a list indicating the child's verbal skills. The doctor will typically refer the child to a speech pathologist—a professional specializing in treating speech problems. The speech pathologist will work with the child, the child's family, and any other caregivers to develop a plan to help the child.

Treatment

Children with isolated speech disorders are often helped by articulation therapy, in which they practice repeating specific sounds, words, phrases, and sentences. For stuttering and other fluency disorders, a popular treatment method is fluency training, which develops coordination between speech and breathing, slows down the rate of speech, and develops the ability to prolong syllables. A child may practice saying a single word fluently and then gradually add more words, slowly increasing the amount and difficulty of speech that can be mastered without stuttering. The speaking situations can gradually be made more challenging as well, beginning with speaking alone to the pathologist and ending with speaking to a group of people.

Delayed auditory feedback (DAF), in which stutterers hear an echo of their own speech sounds, has also been effective in treating stuttering. When a speech problem is caused by serious or multiple disabilities, a neurodevelopmental approach, which inhibits certain reflexes to promote normal movement, is often preferred. Other techniques used in speech therapy include the motor-kinesthetic approach and biofeedback, which helps children know whether the sounds they are producing are faulty or correct. For children with severe communication disorders, speech pathologists can assist with alternate means of communication, such as manual signing and computer-synthesized speech.

Prognosis

When speech disorders are detected and treated early, the prognosis is generally very good. Many speech disorders that are not caused by other underlying problems resolve themselves, and most others can be resolved completely or nearly completely with prompt treatment. Stuttering resolves itself without treatment in about 50–80 percent of children.

Prevention

There is no known way to prevent most speech disorders, although making sure that children have a language-rich environment is thought to help disorders related to lack of input.

Parental Concerns

Speech disorders and significant speech delays can have a lasting negative impact on children. Children who have speech disorders may not want to communicate with their peers or even adults which may adversely affect their performance in school and social development.

See also Language delay; Language disorders.

Resources

Books

Bahr, Diane Chapman. Oral Motor Assessment and Treatment: Ages and Stages. Boston: Allyn and Bacon, 2001.

Freed, Donald B. Motor Speech Disorders: Diagnosis & Treatment. San Diego: Singular Pub. Group, 2000.

Merritt, Donna D. and Barbara Culatta. Language Intervention in the Classroom. San Diego, Calif.: Singular Pub. Group, 1998.

Organizations

American Speech-Language-Hearing Association. 10801 Rockville Pike, Rockville, MD 20852. (800) 638–8255. Web site: www.asha.org.

[Article by: Tish Davidson]

The noun has one meaning:

Meaning #1: a disorder of oral speech
  Synonym: speech defect

This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (February 2008)

Speech disorder
Classification and external resources
MeSH	D013064

Speech disorders or speech impediments, as they are also called, are a type of communication disorders where 'normal' speech is disrupted. This can mean stuttering, lisps, etc. Someone who is totally unable to speak due to a speech disorder is considered mute.

Contents 1 Classification 2 Causes 3 Treatment 4 Social effects of speech disorders 5 Language disorders 6 See also 7 References 8 External links

Classification

Classifying speech into normal and disordered is more problematic than it first seems. By a strict classification, only 5% to 10% of the population has a completely normal manner of speaking (with respect to all parameters) and healthy voice; all others suffer from one disorder or another.

• Stuttering is quite common.

• Cluttering, a speech disorder that has similarities to stuttering.

• Dysprosody is the rarest neurological speech disorder. It is characterized by alterations in intensity, in the timing of utterance segments, and in rhythm, cadency, and intonation of words. The changes to the duration, the fundamental frequency, and the intensity of tonic and atonic syllables of the sentences spoken, deprive an individual's particular speech of its characteristics. The cause of dysprosody is usually associated with neurological pathologies such as brain vascular accidents, cranioencephalic traumatisms, and brain tumors.^[1]

• Speech sound disorders involve difficulty in producing specific speech sounds (most often certain consonant, such as /s/ or /r/), and are subdivided into articulation disorders (also called phonetic disorders) and phonemic disorders. Phonetic disorders are characterized by difficulty learning to physically produce sounds. Phonemic disorders are characterized by difficulty in learning the sound distinctions of a language, so that one sound may be used in place of many. However, it is not uncommon for a single person to have a mixed speech sound disorder with both phonemic and phonetic components.

• Voice disorders are impairments, often physical, that involve the function of the larynx or vocal resonance.

• Dysarthria is a weakness or paralysis of speech muscles caused by damage to the nerves and/or brain. Dysarthria is often cause by strokes, parkinsons disease, ALS, head or neck injuries, surgical accident, or cerebral palsy.

• Apraxia of speech may result from stroke or be developmental, and involves inconsistent production speech sounds and rearranging of sounds in a word ("potato" may become "topato" and next "totapo"). Production of words becomes more difficult with effort, but common phrases may sometimes be spoken spontaneously without effort. It is now considered unlikely the childhood apraxia of speech and acquired apraxia of speech are the same thing, though they share many characteristics.

There are three different levels of classification when determining the magnitude and type of a speech disorder and the proper treatment or therapy:^[2]

1. Sounds the patient can produce
   1. A: Phonemic- can be produced easily; used meaningfully and contrastively
   2. B: Phonetic- produced only upon request; not used consistently, meaningfully, or contrastively; not used in connected speech
2. Stimulable sounds
   1. A: Easily stimulable
   2. B: Stimulable after demonstration and probing (i.e. with a tongue depressor)
3. Cannot produce the sound
   1. A: Cannot be produced voluntarily
   2. B: No production ever observed

Causes

In many cases the cause is unknown. However, there are various known causes of speech impediments, such as "hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical impairments such as Cleft lip and palate, and vocal abuse or misuse."^[3] Child abuse may also be a cause in some cases. ^[4]

Treatment

The examples and perspective in this article may not represent a worldwide view of the subject. Please improve this article and discuss the issue on the talk page.

Many of these types of disorders can be treated by speech therapy, but others require medical attention by a doctor in phoniatrics. Other treatments include correction of organic conditions and psychotherapy^[5].

In the United States, school-age children with a speech disorder are often placed in special education programs. More than 700,000 of the students served in the public schools’ special education programs in the 2000-2001 school year were categorized as having a speech or language impediment. This estimate does not include children who have speech/language problems secondary to other conditions such as deafness"^[3].Many school districts provide the students with speech therapy during school hours, although extended day and summer services may be appropriate under certain circumstances.

Patients will be treated in teams, depending on the type of disorder they have. A team can include; SLP's, specialists, family doctors, teachers,and parents/family members.

Social effects of speech disorders

Suffering from a speech disorder can have negative social effects, especially among young children. Those with a speech disorder can be targets of bullying because of their disorder. The bullying can result in decreased self-esteem. Later in life, bullying is experienced less by a general population, as the tables turn and bullying is seen as atypical and frowned upon.

Language disorders

Language disorders are usually considered distinct from speech disorders, even though they are often used synonymously.

Speech disorders refer to problems in producing the sounds of speech or with the quality of voice, where language disorders are usually an impairment of either understanding words or being able to use words and does not have to do with speech production^[6]

See also

• Language disorder
• List of video telecommunication services and product brands
• List of voice disorders
• Videophone

References

Richard Luchsinger and Godfrey E. Arnold: Voice — Speech — Language. Clinical Communicology: Its Physiology and Pathology. — 1965 Wadsworth Publishing Co., Belmont, California.

1. ^ Pinto JA, Corso RJ, Guilherme AC, Pinho SR, Nobrega Mde O.: Dysprosody nonassociated with neurological diseases—a case report (2004), found on: http://www.ncbi.nlm.nih.gov/pubmed/15070228
2. ^ Deputy, Paul; Human Communication Disorders; March 10, 2008
3. ^ ^{a b} "Disability Info: Speech and Language Disorders Fact Sheet (FS11)." National Dissemination Center for Children with Disabilities. http://www.nichcy.org/pubs/factshe/fs11txt.htm
4. ^ http://www.lbfdtraining.com/Pages/emt/sectiond/childabuse.html Long Beach (California) Fire Department
5. ^ "Speech Defect." Encyclopedia.com. http://www.encyclopedia.com/doc/1E1-speechde.html
6. ^ Disability Info: Speech and Language Disorders Fact Sheet (FS11)

External links

• Online voice and speech disorder community (VoiceMatters.net)
• Speech and Language Disorders
• Australian Speak Easy Association (Support Group For People Who Stutter)

v • d • e WHO ICD-10 mental and behavioral disorders (F · 290–319) Neurological/symptomatic Dementia (Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt–Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia, Sundowning, Wandering) · Delirium · Post-concussion syndrome · Organic brain syndrome Psychoactive substance alcohol (acute alcohol intoxication, drunkenness, alcohol dependence, alcoholic hallucinosis, Alcohol withdrawal, delirium tremens, Korsakoff's syndrome, alcohol abuse) · opioids (opioid overdose, opioid dependency) · sedative/hypnotic (benzodiazepine overdose, benzodiazepine dependence, benzodiazepine withdrawal) · cocaine (cocaine dependence) · general (Intoxication/Drug overdose, Drug abuse, Physical dependence, Rebound effect, Withdrawal) Schizophrenia, schizotypal and delusional Psychosis (Schizoaffective disorder, Schizophreniform disorder, Brief reactive psychosis) · Schizophrenia (Disorganized schizophrenia, Delusional disorder, Folie à deux) · Personality disorder (Schizotypal personality disorder) Mood (affective) Mania · Bipolar disorder (Bipolar I, Bipolar II, Cyclothymia) · Depression (Major depressive disorder, Dysthymia, Seasonal affective disorder, Atypical) Neurotic, stress-related and somatoform Anxiety disorder/ adjustment disorder phobic anxiety disorders: Agoraphobia · Social anxiety/Social phobia (Anthropophobia) · Specific phobia (Claustrophobia) Panic disorder/Panic attack · Generalized anxiety disorder · OCD · stress (Acute stress reaction, PTSD) Somatoform disorder Somatization disorder · Body dysmorphic disorder · Hypochondriasis · Nosophobia · Da Costa's syndrome · Psychalgia · Conversion disorder (Ganser syndrome, Globus pharyngis) · Neurasthenia Dissociative disorder Dissociative identity disorder · Psychogenic amnesia Physiological/physical behavioral Eating disorder Anorexia nervosa · Bulimia nervosa · Rumination syndrome · NOS Nonorganic sleep disorders Nonorganic hypersomnia, Nonorganic insomnia · Parasomnia (REM behavior disorder, Night terror) · Nightmare Sexual dysfunction Erectile dysfunction · Premature ejaculation · Vaginismus · Dyspareunia · Hypersexuality · Female sexual arousal disorder Postnatal Postpartum depression · Postnatal psychosis Adult personality and behavior Personality disorder · Impulse control disorder (Kleptomania, Trichotillomania, Pyromania) · Factitious disorder (Munchausen syndrome) · Sexual maturation disorder · Ego-dystonic sexual orientation · Sexual relationship disorder · Paraphilia (Voyeurism, Fetishism) Mental disorders diagnosed in childhood Mental retardation X-Linked mental retardation (Lujan-Fryns syndrome) Psychological development (developmental disorder) Specific speech and language (expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau–Kleffner syndrome, lisp) · Scholastic skills (dyslexia, dysgraphia, Gerstmann syndrome) · Motor function (developmental dyspraxia) Pervasive Autism · Rett syndrome · Asperger syndrome Behavioral and emotional ADHD · Conduct disorder (ODD) · emotional disorder (Separation anxiety disorder) · social functioning (Selective mutism, RAD, DAD) · Tic disorder (Tourette syndrome) · Speech (Stuttering, Cluttering) · Movement disorder (Stereotypic) psychology navs: mental processes, disorders, symptoms/signs, speech/voice, psychotherapy

v • d • e Symptoms and signs: Speech and voice / Symptoms involving head and neck (R47-R49, 784) Aphasia/Dysphasia Expressive aphasia · Receptive aphasia · Conduction aphasia Other speech disturbances Dysarthria · Schizophasia · Aprosodia/Dysprosody Thought disorder: Pressure of speech · Derailment · Clanging · Circumstantiality Symbolic dysfunctions Dyslexia/Alexia · Agnosia (Prosopagnosia, Astereognosis, Gerstmann syndrome) · Dyspraxia/Apraxia (Ideomotor apraxia) · Dyscalculia/Acalculia · Agraphia Voice disturbances Dysphonia/Aphonia Other Epistaxis · Headache · Post-nasal drip psychology navs: mental processes, disorders, symptoms/signs, speech/voice, psychotherapy mouth navs: anat/dev, noncongen/congen face/congen GI/neoplasia, symptoms, proc

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