Speech and Language Disorder

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The common speech and language disorders
are characterized by difficulty in understanding
language and limited ability in choosing
appropriate words and combining into correct
sentences
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It affects cognitive development and learning,
emotional development, social interaction and
job opportunities.
 Causes
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Functional- like environmental stress and can also
be organic in the case of cleft palate
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Congenital when the disorder is present at birth or
they can be adventitious or acquired after birth, in
infancy and early childhood and in later years
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Etiological factors- traced to brain damage or the
causes can be secondary to mental retardation,
CP, hearing loss, ADHD, LD, autism,
Schizophrenia, Cleft Palate, Vocal and cord injury
disorders of the palate and Gilles dela Tourette
syndrome
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Injury, accidents, diseases and trauma can
result in childhood aphasia or loss of language
function
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Damage of the left hemisphere of the brain can
cause language disturbances or aphasia
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Meningitis- bring complications that can result
in hearing loss and other problems related to
communication
 What is speech and language
impairment?
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Speech and language impairment varies from person to person and
can range from mild to severe. A learner may have difficulty with
speaking, ‘expressive language’ or understanding, ‘receptive
language’. They may have problems expressing feelings and
interacting with others. This can cause low self-esteem and frustration,
and may lead to behaviour problems in the class. As speech and
language problems are not always obvious, we have to think about
what lies behind the behaviour and the need the learner may be trying
to express.
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Most children with speech or language impairment are of average
intelligence, but may have other specific learning difficulties such as
dyslexia, dyspraxia or ADHD. Speech and language impairment is
sometimes linked with conditions such as hearing loss, Down
syndrome, cerebral palsy or autism. Chronic ear infections may also
be a cause. Some learners have difficulty with both language input and
output and need to be taught the communication skills that other
learners learn automatically.
 Expressive language difficulties
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Some learners have problems with the muscular movements
needed to form words. They may have trouble producing certain
sounds and simply leave them out, or substitute one sound for
another. This can make them difficult to understand and result in
delayed or unclear speech.
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Expressive language difficulties can also affect the ability to put
words in the right order in a sentence and tell stories with the
events in the right sequence. Their speech can be jumbled up
and hard to understand. Sometimes the learner will use
inappropriate grammatical structures and their speech may
sound immature for their age. They may also have trouble with
learning and accessing vocabulary. These problems occur in
their own language and will also appear when learning English.
Having trouble explaining and describing things makes it hard to
join in class discussions.
 Receptive language difficulties
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Some learners have problems with the way they hear and
process language. This can impact on the ability to
understand what others are saying and respond appropriately.
Learners with hearing impairment have a physical barrier to
understanding speech, but there are can also be ‘pragmatic
language’ difficulties where, although the learner can hear
what is being said, they do not understand the meaning. They
may not know how to use social language and lack an
intuitive understanding of social cues and conventions. There
can also be problems understanding ‘figurative language’,
which includes the use of irony, humour and metaphor. This
can lead to a tendency to take things too literally.
 A learner with receptive language
difficulties may have trouble in one
or more of these areas
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Following instructions
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Understanding abstract concepts
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Concentration
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Understanding stories, both written and spoken
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Understanding metaphorical language
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Making friends
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Listening to others
 Communication Disorders
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Speech Disorders
-voice disorders
- articulation disorders
- fluency disorders
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Language Disorders
- Delayed language
- Aphasia & related disorders
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Hearing Disorder
-Conductive hearing loss
-Sensorineural hearing loss
- Auditory Nerve& Central Auditory Nervous System Hearing
Loss
-Functional Hearing Loss
Criteria must be present to indicate
the presence of communication
disorder
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The transmission and or perception of messages is
faulty
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The person is placed at an economic disadvantage
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The person is placed at a learning disadvantage
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The person is placed at a social disadvantage
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There is negative impact on the person’s emotional
growth
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The problem causes physical damage or endangers the
health of the person.
 Speech Disorder
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Voice Disorders- are deviations in phonation
such as pitch (too high or too low), frequency
(too loud or too soft), and quality (pleasant or
irritating)
- Hypernasality results when there is too
much air flow and the vioice seems to come
from the nose or in the case of hyponasalilty the
air flow is too little and the voice seems to be
impeded by severe cold.
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Articulation disorders- are errors in the
formation of speech sound.
There are 4 basic errors of articulation
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Omission (see for seen)
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Substitution(wip for lip)
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Distortion (talt for salt)
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Addition of extra sounds (buhrown fro brown)
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Fluency Disorders- interrupt the natural smooth flow
of speech with inappropriate pauses, hesitations or
repetitions
Cluttering speech is very fast with extra sounds
and mispronounced sounds that make speech
garbled and unintelligible.
Stuttering speech marked by “rapid-fire repetitions
of consonant or vowel sounds especially at the
beginning or words and complete verbal blocks
 Language Disorder
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ASLA- American Speech Language Association
defines language disorders as the abnormal
acquisition, comprehension or expression of
spoken or written language.
Factors that contribute to language
disorders in children
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Cognitive limitations or mental retardation
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Environmental deprivation
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Hearing impairments
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Emotional deprivation or behavioral disorders
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Structural abnormalities of the speech
mechanism
 Examples of Language Disorders
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Central auditory processing disorder – is a problem in
processing sounds attributed to hearing loss or intellectual
capacity
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Aphasia- language disorder that results from damage to parts
of the brain responsible for language
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Apraxia- known as verbal apraxia or dyspraxia is a condition
where the child has trouble saying what he or she wants to
say correctly and consistently
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Dysarthria- speech condition where the weakening of the
muscles of the mouth, face, respiratory system affects the
production of oral language.
Assistive Technology for Speech
Disorders
 What types of assistive devices are available?

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Assistive listening devices (ALDs) help amplify the
sounds you want to hear, especially where there’s a lot
of background noise. ALDs can be used with a hearing
aid or cochlear implant to help a wearer hear certain
sounds better.
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Augmentative and alternative communication (AAC)
devices help people with communication disorders to
express themselves. These devices can range from a
simple picture board to a computer program that
synthesizes speech from text.
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Alerting devices connect to a doorbell, telephone, or
alarm that emits a loud sound or blinking light to let
someone with hearing loss know that an event is taking
place.
 What types of assistive listening devices are available?
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Several types of ALDs are available to improve sound transmission
for people with hearing loss. Some are designed for large facilities
such as classrooms, theaters, places of worship, and airports. Other
types are intended for personal use in small settings and for one-on-
one conversations. All can be used with or without hearing aids or a
cochlear implant. ALD systems for large facilities include hearing
loop systems, frequency-modulated (FM) systems, and infrared
systems.

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Hearing Loop (or induction loop) systems use
electromagnetic energy to transmit sound.
A hearing loop system involves four parts:
- A sound source, such as a public address system,
microphone, or home TV or telephone
- An amplifier
- A thin loop of wire that encircles a room or branches
out beneath carpeting
- A receiver worn in the ears or as a headset
FM systems use radio signals to transmit amplified
sounds. They are often used in classrooms, where
the instructor wears a small microphone connected
to a transmitter and the student wears the receiver,
which is tuned to a specific frequency, or channel.
People who have a telecoil inside their hearing aid
or cochlear implant may also wear a wire around
the neck (called a neckloop) or behind their aid or
implant (called a silhouette inductor) to convert the
signal into magnetic signals that can be picked up
directly by the telecoil. FM systems can transmit
signals up to 300 feet and are able to be used in
many public places.
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Infrared systems use infrared light to transmit sound.
A transmitter converts sound into a light signal and
beams it to a receiver that is worn by a listener. The
receiver decodes the infrared signal back to sound.
As with FM systems, people whose hearing aids or
cochlear implants have a telecoil may also wear a
neckloop or silhouette inductor to convert the infrared
signal into a magnetic signal, which can be picked up
through their telecoil. Unlike induction loop or FM
systems, the infrared signal cannot pass through
walls, making it particularly useful in courtrooms,
where confidential information is often discussed, and
in buildings where competing signals can be a
problem, such as classrooms or movie theaters.
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Personal amplifiers are useful in places in
which the above systems are unavailable or
when watching TV, being outdoors, or traveling
in a car. About the size of a cell phone, these
devices increase sound levels and reduce
background noise for a listener. Some have
directional microphones that can be angled
toward a speaker or other source of sound. As
with other ALDs, the amplified sound can be
picked up by a receiver that the listener is
wearing, either as a headset or as earbuds.
What types of augmentative and alternative
communication devices are available for
communicating face-to-face?
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The simplest AAC device is a picture board or
touch screen that uses pictures or symbols of
typical items and activities that make up a
person’s daily life. For example, a person might
touch the image of a glass to ask for a drink.
Many picture boards can be customized and
expanded based on a person’s age, education,
occupation, and interests.
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Keyboards, touch screens, and sometimes a person’s
limited speech may be used to communicate desired
words. Some devices employ a text display. The
display panel typically faces outward so that two
people can exchange information while facing each
other. Spelling and word prediction software can
make it faster and easier to enter information.
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Speech-generating devices go one step further by
translating words or pictures into speech. Some
models allow users to choose from several different
voices, such as male or female, child or adult, and
even some regional accents. Some devices employ a
vocabulary of prerecorded words while others have
an unlimited vocabulary, synthesizing speech as
words are typed in. Software programs that convert
personal computers into speaking devices are also
available.
 What augmentative and alternative
communication devices are available for
communicating by telephone?
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For many years, people with hearing loss have used text telephone or
telecommunications devices, called TTY or TDD machines, to
communicate by phone. This same technology also benefits people with
speech difficulties. A TTY machine consists of a typewriter
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keyboard that displays typed
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conversations onto a readout panel
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or printed on paper. Callers will either
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type messages to each other over the
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system or, if a call recipient does not
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have a TTY machine, use the national
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toll-free telecommunications relay
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service at 711 to communicate.
PCS/PECS