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Speech disorders

Speech and language disorders refer to problems in communication and related areas such as oral motor function. These delays and disorders range from simple sound substitutions to the inability to understand or use language or use the oral-motor mechanism for functional speech and feeding. Some causes of speech and language disorders include hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical impairments such as cleft lip or palate, and vocal abuse or misuse. Frequently, however, the cause is unknown.

A child's communication is considered delayed when the child is noticeably behind his or her peers in the acquisition of speech and/or language skills. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills, but this is not always the case.

Speech disorders refer to difficulties producing speech sounds or problems with voice quality. They might be characterized by an interruption in the flow or rhythm of speech, such as stuttering, which is called dysfluency. Speech disorders may be problems with the way sounds are formed, called articulation or phonological disorders, or they may be difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. People with speech disorders have trouble using some speech sounds, which can also be a symptom of a delay. They may say "see" when they mean "ski" or they may have trouble using other sounds like "l" or "r." Listeners may have trouble understanding what someone with a speech disorder is trying to say. People with voice disorders may have trouble with the way their voices sound.

A language disorder is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary and inability to follow directions. One or a combination of these characteristics may occur in children who are affected by language learning disabilities or developmental language delay. Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate.

Educational Implications
Because all communication disorders carry the potential to isolate individuals from their social and educational surroundings, it is essential to find appropriate timely intervention. While many speech and language patterns can be called "baby talk" and are part of a young child's normal development, they can become problems if they are not outgrown as expected. In this way an initial delay in speech and language or an initial speech pattern can become a disorder which can cause difficulties in learning. Because of the way the brain develops, it is easier to learn language and communication skills before the age of 5. When children have muscular disorders, hearing problems or developmental delays, their acquisition of speech, language and related skills is often affected.

Speech-language pathologists assist children who have communication disorders in various ways. They provide individual therapy for the child; consult with the child's teacher about the most effective ways to facilitate the child's communication in the class setting; and work closely with the family to develop goals and techniques for effective therapy in class and at home. The speech-language pathologist may assist vocational teachers and counselors in establishing communication goals related to the work experiences of students and suggest strategies that are effective for the important transition from school to employment and adult life.

How Are Speech Problems Treated?
The good news is that treatments like speech therapy can help people of any age overcome some speech problems.

If you are concerned about your speech, it's important to let your doctor know. If hearing tests and physical exams don't reveal any problems, some doctors arrange a consultation with a speech-language pathologist (pronounced: puh-tha-luh-jist).

A speech-language pathologist is trained to observe people as they speak and to identify their speech problems. Speech-language pathologists look for the type of problem (such as a lack of fluency, articulation, or motor skills) someone has. For example, if you stutter, the pathologist will examine how and when you do so.

Speech-language pathologists may evaluate their clients' speech either by recording them on audio or videotape or by listening during conversation. A few clinics that specialize in fluency disorders may use computerized analysis. By gathering as much information as possible about the way someone speaks, the pathologist can develop a treatment plan that meets each individual's needs. The plan will depend on things like age and the type of speech disorder a person has.

If you're being treated for a speech disorder, part of your treatment plan may include seeing a speech therapist, a person who is trained to treat speech disorders.

How often you have to see the speech therapist will vary - you'll probably start out seeing him or her more frequently at first, then your visits may decrease over time. Most treatment plans include breathing techniques, relaxation strategies that are designed to help you relax your muscles when you speak, posture control, and a type of voice exercise called oral-motor exercises. You'll probably have to do these exercises each day on your own to help make your treatment plan as successful as possible.

Dealing With Speech Problems
Only people with speech problems know how frustrating it can be. People who stutter, for example, often complain that others try to finish their sentences or fill in words for them. Some feel like people treat them as if they're stupid, especially when a listener says things like "slow down" or "take it easy." (People who stutter are just as intelligent as people who don't.) People who stutter report that listeners often avoid eye contact and refuse to wait patiently for them to finish speaking. If you have a speech problem, don't hesitate to let others know how you like to be treated when speaking.

Some people look to their speech therapists for advice and resources on issues of stuttering. Speech therapists can often connect you with others in similar situations, such as support groups in your area for teens who stutter.

Before referral to speech therapy an ENT evaluation is necessary together with flexible laryngo-video-scopy. Some problems can be treated with operation.

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