Language disorders

A form and methods of treatment

Authored by: Dr. Bouzwega Raouf

Content
the page

Introduction 1
Firstly General concepts about language
The concept of language 4 .I
The nature of communication 4 .1
Terms of communication process 4 .2
levels of communication 5 .3

language development 7 .II

Stages of language development 8 .1
Hearing development 8 .2
Characteristics of early speech 8 .3
Guidelines to encourage language development in children 9 .4

Conditions for language acquisition 10 .III

Physiological foundations 10 .1
Relationship with the ocean 11 .2
Language Tools 11 .3
Other terms 12 .4

Language function 13 .IV

Animal communication system 13 .1
Human communication system 13 .2
Conclusion 14 .3
Language function 14 .4
secondly General concepts about language disorders
language disorders 17 .I
Stages of development of therapeutic services 17 .1
language pathologist 17 -.2
Define the field of study of language disorders 18 .3
Attempts to explain language disorders 18.4

Characteristics of language disorders 20 .II

Causes of language disorders 20 .1
Prevalence of language disorders 21 .2
Effects of language disorders 21 .3
Assessment of Language Disorders 22 .4

Classification of language disorders 24 .III

Define the concept of language 24 .1
Define the concept of language disorders 24 .2
The most important classifications of language disorders 25 .3

Third : spoken language disorders

Dysphasia 29 .I
1. Definition of dysarthria 29
2. Causes of dysarthria 29
3. Symptoms of dysarthria 29
4. Diagnosis of dysarthria 30
5. Treatment of dysarthria 30

stuttering 31 .II
 Definition of stuttering .1
31
Diagnosis of stuttering 31 .2
Interpretation of stuttering 31 .3
Stuttering treatment .4

III. selective silence 34

1. Definition of selective mutism 34
2. Symptoms of selective mutism 34
3. Selective mutism treatment 35

aphasia _ .IV
39
Definition of aphasia 9 3 .1
Causes of aphasia 9 3 .2
Diagnosis of aphasia 9 3 .3
Aphasia treatment 0 4 .4
Aphasia 0 4 .5
Fourthly : Written language disorders
Dyslexia 43 .I
Definition of dyslexia 43 .1
The nature of dyslexia 43 .2
Diagnosis of dyslexia 43 .3
Causes of dyslexia 44 .4
Therapeutic strategy 44 .5

dysgraphia 46 .II

1. Definition of dysgraphia 46
2. Causes of dysgraphia 46
3. Diagnosis of dysgraphia 47
4. Dysgraphia treatment 48

Dyscalculia 49 .III
1. Definition of dyscalculia 49
2. Types of dyscalculia 51
3. Treatment of dyscalculia 51

Fifth Speech disturbances _ _

Speech disorder 54
Define a speech disorder 54 .1
The nature of the speech disorder .2
54
Interpretation of a speech disorder .3
55
Diagnosing a speech disorder .4
56
Evaluation of the mechanism of speech 57 .5
Speech disorder treatment .6
58

Sixthly Speech disorders _ _

Speech disorder 61
Definition of speech disorder 61 .1
Causes of speech disorder .2
62
 Treatment of speech disorder .3
62

Seventh: language delay

Language delay 65
Definition of language delay .1
65
the language delay 65 .2
language delay 66 .3
Reasons for language delay 67 .4
Principles of therapeutic practice 67 .5

Eighth : voice disorder

voice disorder 70
Definition of voice disorder 70 .1
Causes of voice disorder 70 .2
Diagnosing a voice disorder 71 .3
Voice disorder treatment 72 .4

ix : language for people with special needs

76
learning difficulties 76 .1
Mental retardation 76 .2
autism 77 .3
 Hearing disability 77 .4
Visual disability 78 .5
and emotional disorders 78 .6
Therapeutic interventions 78 .7

tenth Supportive and alternative communication 82

Elements of supportive and alternative communication .1
82
and alternative communication strategies .2
83
Assess supportive and alternative communication .3
84

eleventh _ : Teaching students with language disorders

78
Adapting the learning environment 87 .1
Adapting teaching methods 8 8 .2
Class adjustments for communicatively disturbed students .3
89

Conclusion 92
References 94
 introduction
Verbal communication is the ability to compose and use language, the
ability to speak clearly and be understood by others, and also the ability to
hear and understand what others are saying; And when the communication
process is hindered either by speech, language or hearing disorders, the
results are harmful and negative. The pathology of verbal communication is
concerned with the study of theoretical and applied knowledge of human
communication .

The physical and behavioral foundations of the communication -

.process
. Disorder of speech and language processes -
Accurate description of natural communication and the factors -
.affecting it
.Treatment of communication disorders -

Speech and language disorders are studied and interpreted from a

variety of perspectives, including anatomy, physiology, psychology,
sociology, and neuroscience, to build a deeper understanding of these
disorders.

Verbal communication is an essential element in solving problems,

expanding knowledge, integrating it, analyzing it, and accumulating it. The
use of language is affected by how quickly a person absorbs words or
ideas and keeps them in memory. A child who stumbles to find the right

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 word is exposed to many obstacles in the social environment and As he
stumbles in order to retrieve a word, his peers progress and move on to
new learning, and the person who suffers from language deficiencies
loses vital parts of knowledge and is unable to link information to each
other in memory properly, and he also does not have a means to transfer
what he knows others

These problems can lead to lower levels of cognitive achievement and to

feelings of confusion, loss of support and frustration. Language is a vital
means of successful communication with the social environment.
Language is that complex multi-dimensional system that gives the
individual the ability to learn , deal and interact effectively and confidently
with the world. Verbal communication disorders may appear in the form of
difficulty in:

Effective use of voice.

- Producing the sounds of the language from its correct exits.

Words flow smoothly while speaking.

Acquisition of complex linguistic accumulation.

Use of grammar.

Learn written language.

In the framework of this research, I tried to get acquainted with the various
aspects that affect the subject of verbal communication disorders, through
Displaying the types of spoken and written language disorders, then
articulation disorders, speech disorders, language delay and voice

2
disorders, then presenting some general concepts about language and its
disorders .

3
First: general concepts about language
The concept of language .I
The nature of communication 1
Terms of the communication process 2
communication levels 3

stages of language development .II

Stages of language development 1
Hearing development 2
Characteristics of early speech 3
Guidelines for encouraging language development in 4
children

lll language acquisition terms .

Physiological foundations 1
relationship with the ocean 2
Language tools 3
Other conditions 4

IV. The language function

animal communication system 1
Human communication system 2
conclusion 3
language function 4

4
 concept of language
Preface
To better understand verbal communication disorders, we must first
understand the communication process that individuals use in their
interactions with others. Human communication includes all the means used
to transfer information between the sender and the receiver , and the human
being is distinguished by the peculiarity of his development of the symbolic
communication device, which may be spoken, written, or indicative, and we
use all these forms to communicate our ideas to others.

The nature of communication .1

Communication is an activity that involves sending and receiving what living
things want from each other; It is the use of symbols to express ideas,
feelings and needs between individuals, and it is a behavior that concerns
.all living beings
To carry out the process of communication, there must be a sender , a
receiver , and a message. The sender has ideas that turn into symbols that
can be understood by the receiver. And communication appears only when
there is a common understanding of the message between the sender and
the receiver. The coding of ideas into signals is an important part of
communication. Communication signals refer to some immediate event.
These signals may be in the form of gestures, social edicts, or vocal
patterns.
Speech sounds represent phonetic symbols. Alphabets refer to written
symbols. Sign language also uses suggestive symbols. Communication
symbols may relate to events that occurred in the past or will occur in the
present or in the future, or they may be associated with an object, action,
concept, or emotion.
When ideas are encoded, the sender must choose the mechanism to
present the message, and here he may choose from a number of
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 mechanisms such as voice, sign language, gestures, or writing tools, and this
choice must be beneficial to the receiver, for example, choosing a voice is
not suitable for conveying a message to a deaf person. .

Terms of the communication process .2

Communication requires the receiver to use the senses of sight , hearing ,
and sometimes touch, as is the case with the blind who use the language of
April, in order to receive the message and transfer it to the brain to give it
meaning, and he must be able to understand and interpret the symbols of the
sender, and communication fails in When both the sender and the receiver
are unable to use symbols or signals appropriately, or when the sender and
receiver have defects in sending or receiving information.

communication levels .3
There are three levels of communication which are as follows :

.Technical level: This level reflects the accuracy of code exchange 

.Semantic level: It reflects the accuracy of the symbols used for meaning 
Effectiveness level: It reflects the accuracy of the receiver's response to 
.what the sender intended
These levels are of paramount importance in verbal and non-verbal
communication. There are two types of communication: non-verbal and
.verbal communication

:Nonverbal communication .‫أ‬

If the symbol is any stimulus that represents something, then the non-verbal
symbol is any symbol other than the written or spoken language, which adds
meanings to both the sender and the receiver, so it supports the verbal
meaning and does not cancel it. There are three methods of non-verbal
:communication, which are
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Metalinguistics: Regulates the quality of the sound and changes in its pitch, -
adding to the meaning of the message. It also includes screaming, crying,
laughing, pronunciation style...etc that may reinforce or contradict the
.verbal message
Body movements: They include visual signals that are sent through body -
movements , which may be iconic and carry with them some representation
or analogy of what we mean, such as the letter v to symbolize victory. It
.may be as substantial as the body movements that cause crying
Body positions and spatial relationships : which may reflect many meanings -
that require experience in perceiving them. They may mean openness ,
tolerance, or acceptance. The distance between the speaker and the
.listener has an impact on communication

Non-verbal messages vary among individuals in terms of their subject

matter , degree of awareness and degree of control over them. Compared to
verbal messages, the functional range of this message is limited. Non-verbal
messages may be used to support or negate verbal messages, provided that
there is consistency between the quality of the voice. And its height,
movements and positions of the body, and the support varies in terms of its
type and amount and from one person to another, and a person is sometimes
able to express himself and his feelings through movements, suggestions
.and body positions more than words
:verbal communication .‫ب‬
It is the process of exchanging knowledge , ideas , opinions, and feelings
through verbal language that is based on sound, pronunciation,
.understanding, and the use of grammar

a summary

7
To carry out the communication process, there must be a sender , a
receiver , and a message. Communication requires the receiver to use the
senses of sight, hearing, and sometimes touch, in order to receive the
message and understand and interpret the sender’s symbols.
Communication has two levels: non-verbal communication, if the symbol is
other than language. Written or spoken, which adds meanings to both the
sender and the receiver, such as the pitch of the voice, the style of
pronunciation, body movements and positions, while verbal communication
.uses the spoken or written language

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 stages of language development
Preface
Language is seen as a communicative system based on words and grammar , which
affects the cognitive development of children, so children use words to represent
things, topics, and actions resulting from their observations and experiences, and
they communicate with their needs, feelings, and thoughts, so that they can control
their lives. the language?

Stages of language development .1

Early pronunciation:

The screaming of newborns refers to a means of communication only. It may

indicate the severity of hunger, the need for sleep, or anger. Between 3 and 6
months, the child begins to play with verbal sounds and match the sounds he hears.
In the 6th to 10th month, the slurred speech appears . It carries a meaning for the
child, except that it begins to take forms that resemble the word, and when he has a
stock of sounds, he organizes them with each other in the form of sound patterns
.that resemble language and have no meaning
:Gesture stage
A 9-month-old may point to things he wants, and then start learning some social
gestures such as waving (goodbye), nodding his head to say yes, and shaking his
head to say no. Gestures are of great importance in strengthening the development
.of words

:First word stage

At that time, the one-year-old child becomes able to pronounce the first word ,
link it to some things, use some words, and show some understanding of grammar,

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declension, intonation, and rhythm, so that his verbal stock can say “mama,”
.“dada,” “dada,” and more early spoken words. Verb nouns

First sentence stage:

The other linguistic development comes when young children move to the stage of
putting two words together to express one idea at the age of 18 to 24 months. Up
to 30 months, children show increasing proficiency in morphology and syntax , that
is, in the rules of sentence formation in the language used.

Hearing development .2
The development of hearing in children follows a behavioral sequence from birth
to the age of 12 months, and despite the simple experience of children at the age of
two months, they are able to distinguish between sounds and the sounds they make
during the first year of life are described as random, and those early sounds are like
Exercises to reach the stage of oral pronunciation, as the sounds emitted here do
not constitute sounds for any known language, and talking about the development
of hearing leads us to the following question: To what extent do the audible sounds
contribute to language learning? And how do environmental factors affect language
learning? And we have to realize that the newborn child responds to sound hours
after his birth, especially if it is his mother's voice. The auditory characteristics of
infants between the ages of 4 to 14 months develop according to expected auditory
responses that can be easily observed and provoked through sound stimuli. The
child responds to these stimuli depending on the development of his hearing and
.his mental age and maturity

Generally By the age of 6 months, the infant begins to understand the basic sounds
or phonemic units of the mother tongue used and to adapt to the nuances of the
different ways in which individuals speak. Before the infant begins to associate
sounds with meanings, he becomes aware of the phonemic patterns that he hears
.repeatedly

10
 Characteristics of early speech .3
Regardless of the language a child uses , early speech has its own characteristics
which appear as follows:

. Use the telegraphic style of expression -

.Using grammatical relationships automatically before realizing them -
.Poor comprehension of the meanings of words -
.Expand the meanings of the words -
. Generalize the rules -

Piaggi J. _ It is impossible for a child to understand a linguistic expression without

reaching the stage of logical operations, as he may not be able to use the word
greater, smaller, the same amount, some, unless he can perform memorization
tasks, such as realizing that the amount of liquid in a short and wide container
does not increase if what was poured into a tall and narrow vessel; And he cannot
understand words or sentences such as: next week, money, gratitude, before he
understands their meanings and is able to understand the idea behind them, as he
believes that intelligence is the basis for language acquisition.

Guidelines to encourage language development in children .4

Here are some tips for parents to encourage speech and language
development:

.Talk to the child as he imitates what he hears -

Look directly at your child's face , get his attention, and then start talking to -
.him
.Be close to your child while you are talking to him -
.Raise your voice while talking to your son -
.Talk to the child in a quiet place -

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 Be a good model for speaking by describing daily activities and expanding on -
.what the child says
.Teach the child new words and concepts through daily activities -
.Repeat the child's words using the adult's pronunciation -
Set aside time to play with your child and select some useful games because -
.the child learns through that
.Read to your son and remember that you are modeling for him -

a summary
The cry of a newborn child refers to a means of communication only, and after that
the infant begins to play with verbal sounds and utterances that do not carry any
meaning to him, and by the age of six months he is able to perceive the phonemic
units of the mother language used and the phonetic patterns that he hears
repeatedly, then he begins He refers to the things he wants and learns some social
gestures, and then the one-year-old child becomes able to pronounce the word and
associate it with some things, then he moves to the stage of putting two words
together to express one idea, at the age of 18 to 24 months.

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 Conditions for language
acquisition
Preface
In this lesson, we discuss the conditions that must be met in order to
acquire the language, and the information on this subject is considered as
the bases on which to evaluate people with speech and language disorders ,
by identifying the defect that occurred at the level of those conditions, and
then developing a plan Therapeutic to fix that imbalance, and language
acquisition is subject to three forms of determinants: the physiological
foundations , the child's relationship with his surroundings, and language
tools, and we will briefly touch on each element.

_ Physiological foundations .1
When a person pronounces a word, he uses a whole series of nerves,
: muscles, and organs of the body, above all
:The central nervous system -‫أ‬
Language comprehension and production occur in the left hemisphere and
the right hemisphere has a role in processing linguistic information. Broca's
area located in the middle of the left hemisphere is responsible for speech
. . production

:The auditory system -‫ب‬

The verbal sound that we learn to produce is after hearing it, and the
auditory system consists of four parts: the outer ear, the middle ear, the
inner ear , and the nervous ear. Any injury to this organ that may lose 70
decibels or more will inevitably affect the acquisition of sounds. the
.language

13
 :Pronunciation members -‫ت‬
The vocal system , the respiratory system , the vibrational system, and the
resonance system play dual roles in humans: a biological role for the
continuation of life and a social role represented in speech, and this is not
done unless the organs associated with these systems are healthy, which
include the oral cavity, nasal cavity, roof Throat, larynx, trachea, pharynx,
.uvula, tongue , lips, vocal cords and lungs

conclusion
Understanding the mechanism through which speech is produced helps us
to better understand the nature of communication disorders. When we want
to speak, the brain sends messages that activate and activate other body
mechanisms . The respiratory system works to transfer oxygen to the body
and rid it of gases, and the muscles of the diaphragm and chest And the
throat activates the vocal apparatus, where the sound is produced from the
larynx, which is located at the top of the trachea, and it includes the vocal
cords. A prominent role in the pitch of the voice, and as the sound continues
to pass through the throat, oral, and nasal cavities, the sound is transformed
into speech sounds through articulation mechanisms , and these cavities
are called the vocal resonance system , and the speech mechanism
.includes the tongue, the soft and hard palate, and the lips and jaw

relationship with the ocean .2

see pune f. R. That at the beginning of life, there is no thought, but there
are only sensations associated with the body, which the infant projects on
his mother due to the impossibility of stabilizing them . R. The "beta"
elements are converted into "alpha" elements that are subject to thought,
and the performance of this function does not take place except through
the compatibility of the mother's responses with the internal pressure
signals that appear in the infant, thanks to her ability to receive, digest and
translate the raw sensory stimuli emanating from her son into male

14
 elements . She reaches out to connect physical sensations with thought
and give meaning to what her son is feeling.
So this bonding work, which the mother does , which Peon W. calls. R.
The alpha function, which the child gradually internalizes , makes him able
to communicate and associate sounds with meanings.
Interacting with adults provides the child with a communicative
environment and his emotional relationships develop in him the desire to
speak, and the linguistic alerts he receives are considered essential
elements in language acquisition. And there are those who say that the
culture in which the child is born is parallel to the influence on the
development of his language, the mental and physical factors, as the
interaction of the child with his environment leads to the growth of his
language or to its delay, and the results of many research confirmed the
influence of the mother’s relationship with the child on the extent of his
language progress, and that Neighbors and society are of great importance
in the development of the child's language. Social, cultural and economic
factors affect the growth of verbal communication. Studies have indicated
that the son of the rich class acquires vocabulary that exceeds that of the
son of the poor class, and that there are individual differences between the
educated class and the uncultured class. It represents a difference in
.children's vocabulary by eight months in favor of the educated class

Language tools .3
Verbal language has common tools that individuals use in the cultural
context to understand the speaker who wants to communicate. There must
be agreement on the meanings of words (verbal semantics) and sounds
(how do we pronounce words). All children have a linguistic mechanism
that enables them to understand grammar (the grammatical level) and
sounds. (phonetic level) of their language. This mechanism enables infants
to identify the sounds of their language around the sixth month. As for the
mechanism that enables them to understand the rules of language at the

15
morphological, grammatical and pragmatic levels, it begins before reaching
the age of two. These mechanisms are similar to other mechanisms.
.Cognitive development

Sees Shamsky N. Language learning does not depend on memorization,

but rather on learning the general laws that control the language, which
allows the child to use audible names and sentences and create new
meanings by employing these laws . As for Martini A. It assumes that the
language is built on two levels: the phonological level that pertains to the
structure between sounds, and the grammatical level that pertains to the
structure between words within the sentence, in addition to a higher level
.pertaining to learning and using words

Other conditions .4
Language may be affected by a number of factors, the most important of
which are: good food, health, glandular secretion , the sensorimotor
system, and intelligence as a general mental ability that has an impact on
the child’s linguistic development and personal adaptation. No one knows yet
why children learn language, but it is known that its acquisition and development
is linked to physical maturity, cognitive growth, and socialization. The details of
how language learning occurs physiologically, cognitively and socially are still
. under discussion and research

a summary
Language acquisition is subject to three forms of determinants:
physiological foundations, the child's relationship with his surroundings,
and language tools.
Physiological foundations: The central nervous system , the auditory -
system , and the organs of speech have an important role in processing
linguistic information, transmitting sensory stimuli from the environment
.to the brain, and producing linguistic sounds

16
Relationship with the surroundings: The interaction of the child with -
adults and the formation of emotional relationships with them provides
him with a communicative environment and develops in him the desire to
.speak
Language Tools: Individuals use common tools in the cultural context to -
understand the speaker. There must be agreement on the rules of
language formation, the meanings of words, and how they are
.pronounced

language function
Preface
Some contemporary scholars have tried to define the function of language.
Specialists in anatomy and physiology believe that language responds to a purely
biological necessity. As for psychologists and linguists, they believe that it responds
to a psychological necessity. In order to realize the validity of these observations,
we have to stand on the one hand on the characteristics of the animal
communication system and on the other hand on the characteristics of the human
communication system.

animal communication system .1

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 There is no doubt that animals as a whole have means of communication, but these
means, no matter how much we admire them, do not and will not reach the
amount of language in humans, for several considerations that can be drawn from
observing and cohabiting with animals , so their communication is about:

Pure emotions that occur spontaneously, including visual responses such as -

spreading the ears and grimacing of the canines of a dog, and including auditory
.responses such as the neighing of opportunity and the braying of a donkey
Expressions used for a purpose that does not exceed a physiological requirement, it -
may be visual, auditory, or related to the sense of smell, such as a bee informing its
.companions of the exact location of food sources through dance
Instinctive, innate, rigid signals that do not grow or develop, represent the present -
moment only as the animal lives it. Some birds' song may improve during their life
.automatically without there being a goal or purpose behind that
Movements resulting from the animal's fear or pleasure, which it performs without -
any thinking, and even if it learns some symbols, it remains unable to transfer it to
. others, and its awareness of it does not exceed the conditional relations
Initial response to sensory stimuli, where the animal does not distinguish between -
.the stimulus and the subject that expresses it

Human communication system .2

Higher animals may have the same vocal cords as humans, and some of them may
tend to imitate all the sounds that humans make, but this will not make them talking
animals. What enabled humans to devise verbal signs for indication and use them
intentionally is their possession of:

A sophisticated brain contains a great wealth of neurons and intense activity at the -
.level of these cells. The human brain is four times the size of the monkey's brain
A group of higher mental functions such as memory, perception, attention, which -
contribute to linking words to each other and endow each word with expressive
.properties that we discover from the context of sentences

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Rules for language, underlying the ability to communicate, that we learn gradually -
.during the first stages of life, that we use automatically without realizing it
A symbolic function, that is, the ability to perceive symbols , use them , and create -
new symbols to express the course of thought, which cannot be defined by purely
.physical boundaries
Think, which is the essence of language, as the child learns the language by learning -
to think, that is, he proceeds in his linguistic ascent according to his cognitive
.ascension

conclusion .3
Verbal communication reflects the interaction between all aspects of development.
Physical structures are necessary for the production of sounds and neural connections
that link sounds and meanings. Interaction with others provides a person with a
communicative environment. The most important characteristic of speech is that it is
a set of signals that respond to a psychological necessity, not a biological necessity.
For this reason, anatomists and physiologists did not present before the mystery of
language only partial explanations far from the truth about the reception and
response devices.

language function .4
Presumably Whorf S. ( Whorf s. ) That is the language Determines thought, the
language that a person speaks inevitably leads to an analysis of reality in a completely
different way depending on the characteristics of that language, and this is evidenced
by the inability of the Zuni Indians to distinguish between yellow and orange because
there is no term for each color in their language system, and confirms that the matter
is related By perceiving things in different ways and not just talking about them in
different ways, this researcher thinks that the basic function of language is to shape
and refine thought, but most researchers believe that there is extremism in this
opinion.

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 Most linguists , led by Vygotsky , see R. ( Vigotsky r. ) that language has two functions:
the first is for external communication with others and the second is for internal use
of ideas, and both systems use the same linguistic code, which allows translating one
into the other, so a person can put his thoughts in the form of speech, and he can also
access Inferences about other people's thoughts from what they say.

Language has two aspects: an external aspect that allows us to communicate, and an
internal aspect that preserves our reflective thought and feeling from extinction and
dispersion . It is the best container for preserving human heritage and the most
effective tool for spreading it from one generation to the next. It is the best link to link
the past with the future. It is the memory of humanity that preserves its gains. And it
is considered the strongest support for thought, as it provides ready templates for it,
which enables it to express itself without trouble and protects it from psychological
and social disturbances.

a summary
written syllables devoid of any intellectual context. Organizing, clarifying, growing
and enriching, and the deficit that afflicts language should not suggest its rejection
as a means of communication; If the intellectual, psychological and social life of
people has changed significantly from the primitive stage to the present stage, then
.the merit is attributed to the language. Communicate and infect influence

20
secondly General concepts about language
disorders
language disorders .I

Stages of development of therapeutic services.1

language pathologist-.2
Define the field of study of language disorders.3
Attempts to explain language disorders.4

Characteristics of language disorders .II

Causes of language disorders 1

prevalence of language disorders 2
Effects of language disorders 3
Assessment of language disorders 4

III. Classification of Language Disorders

21
 Define the concept of language 1
Define the concept of language disorders 2
major classifications of language disorders 3

language disorders
Preface
Communities give a high value to verbal communication, which is the main
method in their interaction with others. We speak with each other for various
purposes, including exchanging information and feelings , etc., in addition to
that we prefer oral speech more than writing in communication, and many
individuals suffer from difficulties in speech and language, which
significantly affects their skills in communication, interaction and learning; In
this lesson, we will discuss the history of verbal communication disorders,
the stages of development of therapeutic services, and the field of study of
these disorders.

Stages of development of therapeutic services .1

Since about a thousand years BC, disabled individuals have been the
subject of mockery, ridicule, and a source of entertainment, as they have
been described as stupid, and this is often due to language problems, and in
the middle of the nineteenth century, interest in verbal communication
disorders began in Europe, and the application of concepts of psychology

22
and linguistics from on the one hand , and anatomy and neuroscience on
the other hand, on verbal behavior, and recording cases of speech disorders
through the ages, and The development of therapeutic programs in various
circles, and in the United States , services began to be provided in schools
at the beginning of the twentieth century, by appointing at the public school
level a mobile teacher to help stuttering students , and developing speech
training programs to help children who suffer from stuttering. Speech
disorders, at that time therapeutic clinics were opened and the first academy
for speech correction was established in 1925 ; From there, programs
began to be organized at the national level, and this field became a
specialization independent of medicine and psychology.
In the first half of the twentieth century, public schools in America
appointed speech specialists to help students with language disorders, but
services at that time were limited. During World War II, tools for evaluation
and detection of speech disorders developed, and after the war, many
universities sought to establish training programs for language pathologists.

language pathologist- .2
During the historical development of this field, many labels were given to the
speech pathologist. In the beginning, he was called a speech orthodontist or
speech teachers. Efforts were focused on treating stuttering, voice and
articulation problems. In the period between 1950-1960, he was called a
speech therapist . or a speech pathologist, and many children with moderate
to severe disabilities did not receive speech therapy services because of the
lack of training of the pathologists. And at the beginning of the seventies of
the last century, the name of the speech pathologist was given, and at the
end of the same decade, the American Speech, Language, and Hearing
Association issued the name of the speech and language pathologist to
expand the services provided.

23
 The seventies of the last century witnessed a period of qualitative transition
in the services provided to children, as the data indicated that most of the
speech problems are developmental and were treated with age, so this field
witnessed a remarkable change in dealing with the phenomenon, as it
necessitated focusing on the young in the treatment of severe disorders.
And cooperation with regular class teachers to treat verbal communication
problems.

Define the field of study of language disorders .3

Nowadays, this specialization has become concerned with the study of
theoretical and applied knowledge of human communication. It includes the
study of the following :
The physical and behavioral foundations of communication -
.processes
. Disorder of speech and language processes -
Accurate description of natural communication and the factors -
.affecting it
.Treatment of communication disorders -

These disorders are studied from different perspectives, including anatomy,

physiology, psychology, sociology, and neuroscience, in order to build a
.deeper understanding of these disorders

He also became a speech and language pathologist Responsible for the

detection, assessment, interpretation, diagnosis, rehabilitation and
. prevention of verbal communication disorders

Attempts to explain language disorders .4

24
At the beginning of the twentieth century, some theorists tried to explain the
disorder of verbal communication, and V In the following, I will present briefly the
most important of what was said in this regard:

- The direction of biological maturity: language learning according to this

direction depends on the development and growth of the brain , and the disorder
at this level results from the dysfunction of the brain, and the treatment is based
on compensating the dysfunction.

- The direction of behavioral psychology: language learning in this direction is

affected by the results of language behavior, and from this perspective, the
disorder results from inappropriate learning, and the treatment is to correct the
disturbed language.

- The direction of information processing: the language analyzes here into inputs
and outputs related to the way in which information is processed, and the error in
processing leads to a disorder in the language, and the treatment focuses on
teaching effective processing skills.

Direction of eliciting linguistic rules: The language here depends on the linguistic
rules, and the disorder is due to an error in using the appropriate rules for coding
and decoding the language, and treatment is done through teaching the use of
those rules.

The direction of cognitive development: where language is viewed as one of the

cognitive skills, and the disorder reflects major problems in thinking and learning,
and is addressed by teaching specific cognitive skills.

- The direction of social interaction : the language here arises from the need to
communicate in the context of social interactions, and the disorder appears in the
form of a failure in the ability to interact with the environment and focuses in
treatment on teaching social interactions.

All of these theories include scientific characteristics, but there is no single theory
that fully explains the growth and disorder of verbal communication. All of these
25
 theories have their negatives and positives in evaluating and treating disorders.
Language includes listening, speaking, reading, writing, social interaction, and the
conversational mechanism.

a summary
In the United States, services were not provided in schools until the
twentieth century, when it began to appoint a traveling teacher to help
stuttering students , and to develop speech training programs to help
children with speech disorders, but services at that time were limited; During
the Second World War, tools for evaluation and detection of communication
disorders developed, and after the war, many universities sought to
establish training programs for language pathologists. Nowadays, this
specialty is interested in studying theoretical and applied knowledge of
.human communication

Characteristics of language
disorders
Preface

26
Human communication includes a wide range of activities , most of which are
non-verbal, and verbal communication works on exchanging feelings,
experiences, and knowledge between two or more, by issuing sounds and mixing
them to form words and mixing words to form sentences according to agreed
rules, and If the person shows difficulty in producing correct linguistic sounds,
pronouncing sound words, constructing complete sentences, or understanding
the meaning of the speech addressed to him, then he suffers from a disorder in
verbal communication, that is, difficulty in speech or language.

Causes of language disorders .1

Although many of the causes and factors responsible for speech and language
disorders are not identified, many of them are known, and the following are these
reasons: Speech disorders may result from many different conditions such as
brain injuries, dysfunction of the speech or breathing mechanism, and Distortions
of the members of the articulation, as some children mispronounce because of
the failure to perform the correct motor response to form sounds, and their
incorrect use of the members of the tongue, lips, teeth and palate, and the
problem may be organic as in the case of cleft lips, and stuttering may also result
from psychological pressure, While sound problems occur due to damage to the
vocal cords.

Language disorders may result from various factors, brain injuries may lead to
aphasia, chronic ear infections and injuries at that level may lead to hearing loss,

27
and this certainly leads to difficulties in the development and acquisition of
language, and many language disorders have factors Genetic, and the quality of
the amount of input has a clear impact on the development of vocabulary, the
poor environment of vocabulary may lead to weakness in the development of
language, and some children may develop language disorders due to the lack of
an appropriate model for education, some may be left alone for a long time and
others may not They talk frequently, and some are punished for their words and
others are ignored for their communication

prevalence of language disorders .2

It is difficult to determine the prevalence rates of verbal communication

disorder, due to its diversity and difficulty in determining it, and its appearance
sometimes as part of disabilities, as is the case with mental retardation, brain
injuries, learning difficulties, hearing disabilities, and people with special needs.

The prevalence of speech disorders is estimated at 10 to 15 percent among

children under school age, and 6 percent among primary, intermediate and
secondary students. As for language disorders, they spread by about 2 to 3
percent among children under school age and 1 percent among school-age
students. The relationship between the student’s age and classification of
disability is clear in the prevalence rate. Functional speech problems, for example,
are more prevalent among primary school students and children under the age of
School, and language disorders are more prevalent in the ages of 6-7-8 years, and
this raises the following questions:

28
Do these problems disappear with age?

Were the therapeutic services effective and led to improvement?

Have these students been reclassified into other disabilities?

The prevalence of verbal communication disorder reflects the increasing

importance of orthopedics services And the need to inform the teacher and
education specialist of all information related to communication disorders and
ways to get rid of them and treat them, in order to enable him to help the student
in achieving effective communication.

Raised language disorders .3

Communication disorders affect a person's interactions with others in all kinds of

situations, and they affect an individual's success in school, in establishing and
participating in social relationships, and at work.

For example, stuttering leads to emotional problems as a reaction to lack of

fluency in speech, confusion , frustration, pain, anger, feelings of helplessness,
and low self-concept . Effects for some people with withdrawal and avoidance of
social situations that require talking.

Language disorders lead to more serious effects than those resulting from a
speech disorder, because they affect all aspects of experiences such as the ability
to speak, write, and understand what is written and spoken. Language is a
complex system that is difficult to master, and it is a key element for learning to

29
read, write, and think. In general, individuals who cannot communicate are
affected by their relationships and interactions at work. For example, the
receptionist in the office must be able to talk, deliver messages to fellow workers,
and give instructions to visitors. Hence the importance of providing services to
individuals with verbal communication disorders. so that they can interact with
others. The reactions of the peer group determine the severity of the effects, as
the sufferer responds with behavioral responses depending on or as a result of it.

Assessment of language disorders .4

To evaluate verbal communication disorders, the orthodontist must measure

the three aspects of language, namely : form, content, and use. The evaluation is
also conducted by a multidisciplinary team, and this team includes a psychologist,
pediatrician, neurologist, and audiologist. This team works collaboratively to meet
the special needs of the troubled child.

When the referral occurs, the orthopedist must determine whether the child has
a disorder or not, and if he does, multiple sources of information must be
collected that include the child's caregiver (often the parents), the child, and
other specialists. The orthoponist follows several steps . In the process of
collecting information about the child, these procedures are:

- Conduct a case history.

- Note the child.

30
Evaluate the child's communication skills.

Referral to other specialists.

a summary

It is difficult to determine the prevalence rates of verbal communication disorder

because of its diversity and difficulty in determining it, and its appearance
sometimes as secondary symptoms of primary disabilities, and the impact of
these disorders on the interactions of the affected person with others in all
situations, such as study, occupation and social relations, and the causes of their
occurrence may be due to brain injuries. , impaired function of the mechanism of
speech or breathing, deformation of the organs of speech, injury at the level of
the auditory system, or to psychological, environmental or educational factors,
and the disorder is evaluated by a multidisciplinary team that includes a
psychologist, pediatrician, neurologist, An audiologist, and an orthopedist who
relies on collecting information about the patient through case history,
observation, and assessment of present communication skills.

31
 Classification of language disorders
Preface
Speech and language are tools used for communication purposes.
Communication requires coding, transmission and decoding (receiving and
understanding) of the message. It also includes a sender and receiver of the
message. For various reasons, speech and language suffer from various disorders
that require specialized services in order to treat them. And help those who suffer
from it, and verbal communication disorders are classified into two main groups:
speech disorder and language disorder.

Define the concept of language .1

Verbal communication consists of two elements: speech and language , and in
.the following I will explain each element
Definition of speech .‫أ‬

Speech is an agreed symbolic communicative system that organizes sounds in a

coordinated series to produce or form words that express specific things, ideas
and feelings. It is:

.Motor activity produced through the organs of breathing , voting and speech -
.The behavior of the formation and sequence of sounds of oral language -

32
A medium for expressing ideas and feelings and understanding the feelings of -
.others who use the same language symbols
Definition of language .‫ب‬

Language is the communication of ideas, and it is called encoding or sending the

message in the expressive language and decoding the symbols and understanding
the message in the receptive language , and when we think in the language we
employ the oral language, the language is:

grammatical and semantic elements that were composed with the aim of , -
.communicating ideas and feelings
Those symbols and sounds that were formed according to grammatical, -
.morphological and semantic rules
An organized set of symbols used to communicate , receive , integrate and -
.express information

Define the concept of language .2

As we have seen, verbal communication disorder is divided into a speech
disorder and a language disorder, and here it is necessary to distinguish between
them as there are different causes for each type, and each disorder requires
different treatment interventions. That is, speech deviates from the acceptable
range in the individual’s environment. Speech is seen as disordered if it is
:characterized by any of the following characteristics

difficulty hearing -
.Blurred -
.Inappropriate acoustic characteristics -
.Inability to produce specific sounds -
.Stress in producing sounds -
.Defects in rhythm and speech tone -
.Words inappropriate for age , gender and physical development -
.Dysfunction in sound production and speech unit -
33
 As for a language disorder, it is a disability or deviation that affects the
understanding or use of spoken language, written language, or the verbal
symbolic communication system, occurring or existing in isolation from other
disabilities such as deafness, mental retardation, motor disabilities, or personality
imbalances, as it may occur with all of these disabilities. mentioned.

.Any difficulty in producing or receiving linguistic units -

A language with little content and a limited vocabulary that is poor in articles, -
.prepositions, plural signs, and adverbs
.Inability or limited ability to receive linguistic symbols in communication -
Any interference with the ability to communicate effectively in any community -
.according to that community's standards

Major classifications of language disorders .3

The researchers divided language processing into three general domains:
template , content , and usage.

:Template .‫أ‬
The template consists of speech phonology, which refers to the knowledge that a
person possesses of the sounds of the language, and morphology, which includes
a group of phonemic units that are composed together to form a meaningful
sound clip, and grammar, which refers to the rules used in composing words to
form a sentence. A person's knowledge of the linguistic template does not
guarantee his ability to convey the correct meaning. The sentence "I saw the
house flying over the trees" may be grammatically correct, but it is wrong in
.terms of the meaning it carries
:Content .‫ب‬
Knowledge of the linguistic content includes the meanings of words, the
relationships between words, and the relationship between time and event. In
this context, the child's ability to load words with correct environmental
experiences is included. When the child shows an ability to express information

34
greater than his ability to receive and understand, it is assumed He has difficulty
.in processing sounds
:c. the use
It is the use of language for various benefits and in different situations by
choosing words and sentences purposefully, to bring about the effect that the
speaker seeks to achieve with the listener, and to re-present what he says in a
way that brings him closer to the mind of the recipient, when he feels that the
latter did not understand his message and Ignoring how language is used means
ignoring an essential element of it, because individuals communicate in a specific
.context and for specific purposes

Based on this classification, verbal communication disorder can be understood

and the problem identified, which may be difficulty in producing speech sounds,
in pronouncing words, in flowing speech syllables, in recalling vocabulary, in using
.grammar, or in learning written language

may be classified according to the causative factors, which are:

.hyperactivity disorder , brain injury, and other disabilities -

Surrounding factors: hearing impairments, visual impairments, deafness, and -
.motor impairments
Environmental and emotional factors : rejection and abuse, behavioral -
.problems and developmental emotions

Three classes of verbal communication disorders can be distinguished according

to linguistic and non-linguistic criteria, as follows :

Speech disorder: It is associated with injuries to the transmitter and receiver, .‫أ‬
.including voice disorder, articulation disorder, stuttering, and dyslexia
.‫ب‬
Language disorder: It relates to neurological injuries that occur at the level of .‫ت‬
.areas of language production and comprehension, such as aphasia
.‫ث‬

35
 Secondary verbal communication disorder: which may appear as a result of .‫ج‬
primary psychological or physiological disabilities such as mental retardation,
.autism, personality disorder...etc

ASHA ) has presented a classification system that includes five types of verbal
communication: phonological (vocal), morphological (morphological), and
grammatical (word order and syntax). , the semantic (the meanings of words and
sentences), and the pragmatic (the social use of language); Another way to
classify disorders is those that depend on the health conditions associated with
them, such as autism, brain injuries, and mental retardation. Disabilities may also
be classified based on specific difficulties in the following areas:

making sounds, articulating letters, fluency, perception, attention, use of symbols,

use of grammar, general mental ability, overall interaction related to
communication; Each diagnostic system is characterized by specific problems in
the presented system. Speech disabilities produce disturbances in the level of
sound, pronunciation, or fluency. As for language disabilities, they may result in
language delay, aphasia, or dyslexia. Despite the development of classification
systems for verbal communication disorders, only It is not easy to classify them,
as every classification system permeates with a kind of ambiguity, and it is not
possible to adopt a specific system for all cases.

a summary
Verbal communication disorders are classified into two main groups: a speech
disorder, which is a defect that affects sound, pronunciation, or fluency, and a
language disorder, which is a disability that affects the understanding or use of
spoken or written language. Researchers have divided language processing into
three domains: template, content. In light of this division, it became possible to
understand the mechanisms of verbal communication and classify disorders that
may occur at its level. Disorders may be classified according to the causes of their

36
occurrence and related health conditions such as autism, brain injuries, mental
retardation, and may be classified depending on the difficulty. Specific areas in
the following areas: sound production, pronunciation of letters, fluency, and the
use of grammar.

Third: spoken language disorders

dysarthria .I
1. Define dysarthria
2. Causes of dysarthria
3. Symptoms of dysarthria
4. Diagnosis of dysarthria
5. Treatment of dysarthria

stuttering .II
Definition of stuttering 1
Diagnosis of stuttering 2
Interpretation of stuttering 3
37
 Stuttering treatment 4
Excessive speed of speech 5

III. Selective silence

1. Definition of selective mutism
2. Symptoms of selective mutism
3. Selective mutism treatment

.IV aphasia _
Definition of aphasia .1
Causes of aphasia 2
Diagnosis of aphasia 3
Treatment of aphasia 4
apraskia speech 5

dysarthria
1. Definition of dysarthria
Dysphasia is a condition caused by a defect in the central nervous
system or in a nerve or muscle responsible for speech, which leads
to weakness in the muscles responsible for speech, such as the
muscles of the mouth, throat, and vocal cords.
Letter exits become clear and speech becomes difficult to
understand.

2. Causes of dysarthria
clots .
Brain injury
Brain tumors
- dementia

38
 - Multiple sclerosis
Duchenne muscular dystrophy ( Muscular dystrophy ) is a genetic
disorder that damages skeletal muscle fibers and causes muscular
weakness.
Myasthenia _ Gravis ) is an autoimmune disorder in the human
body that affects the nerves responsible for sensing muscles,
causing a breakdown in the natural connections between nerves
and muscles, which causes involuntary and abnormal movements,
especially in the facial muscles.
Parkinson's disease disease ).
- Cerebral palsy.
As complications of the head and neck operation as a result of the
controlling nerve injury during the operation.
Alcohol poisoning intoxication ) .
Using improper dentures fitting dentures ).
Some drugs that affect the nervous system, such as phenytoin and
carbamazepine .

3. Dysarthria symptoms:
- Inability to express.
Involuntary salivation .
Speak slowly and in a low voice, such as whispering and
whispering.
It may be associated with paralysis in another part of the body,
especially if the cause is a stroke.
A change in the strength and pitch of the voice.
Difficulty breathing and swallowing.

4. Diagnosis of dysarthria
Detailed medical history of the patient.
Magnetic and tomography of the brain.
- Doing blood and urine tests .
Taking a sample of spinal fluid and another from the brain.
39
 5. Treatment of dysarthria
Among the therapeutic procedures used to treat dysarthria :

- Treating the cause if it is a stroke or a specific disease.

Refer the patient to an audiologist and speech therapist who trains
the patient and improves his ability to speak.
- Teaching the patient to use signs to speak if he did not succeed in
improving his ability to speak.
Some cases benefit from surgery.
- Stopping the drugs that cause dyslexia.

Tips for living with dysarthria

It is preferable to follow the following instructions to mitigate and
cope with dysarthria:
Follow-up training that may take a long time.
Not speaking for long periods
Speak slowly and use clear words.
- Using writing and paintings for expression and modern computer
programs that pronounce the words that are printed.

stuttering
Definition of stuttering .1
With the multiplicity of theories, researches, and points of view on stuttering, its
definitions have multiplied. Some definitions emphasize describing what happens
40
during stuttering, while focusing on Others focus on the alleged dynamism,
functions, and assumptions of TDS , while some emphasize the effects of the
phenomenon on the speaker and listener, and some definitions focus on the
causes and origins of the phenomenon, but most definitions agree that it is
repeated ruptures in the fluency of verbal expression . , and resistive behaviors in
the case of speaking and silence , with the presence of emotional states that may
or may not be related to talking , It is everything related to the way speech is
organized, its duration, speed, tone, and fluency . The stutterer repeats the first
letter of the word several times or hesitates in pronouncing it, and this is
accompanied by unusual physical and emotional manifestations such as facial
expressions or movement of the hands.

2. Diagnosis of stuttering
The performance of the person who stutters shows a wide range of apparent and
non- apparent symptoms. The apparent symptoms include: repetition of linguistic
sounds, preventing the vocal cords from vibrating, resulting in a pause in the
sounds, abnormal lengthening of sounds, and associated secondary behaviors such
as blinking of the eyes, shaking the head, and frowning. Facial and muscle tension,
great effort when speaking.

Subtle symptoms include: substituting words, indirectly talking about the topic,
responding with incorrect information to avoid specific words, giving incorrect
names when asking for something.

Many phenomena are associated with stuttering, such as its disappearance in

some verbal situations (singing, speaking in a soft voice, or talking to children), its
appearance in males more than females, its prevalence in twins more, its
appearance between the ages of 2 to 5 years, its prevalence in the stuttering
family, and its severity in some Situations (talking on the phone, with officials, or in
listening rooms) are more sought after by bilingual children.

41
 Interpretation of stuttering .3
A number of theories explaining stuttering can be classified , depending on its
interests , and these theories are limited to heredity, child development, neurosis,
and conditioning. The neurosis theory focuses on personal characteristics and
psychological factors in explaining the phenomenon, through interviews, projective
tests , and Paper and pen, it is possible to understand the personality,
psychological dynamics, social adaptation, and the subconscious needs of the
affected person. Stuttering is seen as a need for oral and anal gratification, latent
expression of hostility, suppression of threatening feelings, fear of castration,
aggression, and repressed hostility. However, research at the present time focuses
little on the importance of psychological factors, and tries to link the deviations of
the central nervous system and stuttering , and the differences in brain functions
between people who stutter and who speak fluently.

4. Stuttering treatment
Stuttering treatment aims to achieve change In the way the person speaks and a
change in the feelings of the stuttering person and in his interaction with his
environment . Parents.....etc.

A psychologist is used to deal with or maintain the emotional problems that cause
stuttering, who gives little importance to speech symptoms compared to the
psychological problems and difficulties that the patient is exposed to, and focuses
on the means of defense used, the level of personality development, feelings of
anxiety and fear, and if If these problems are addressed, stuttering symptoms may
decrease .

: Excessive speed of speech

42
Excessive speed of speech is a fluency problem characterized by a rapid pace of
speech and a single tone, which makes speech unclear, characterized by a short
attention span and disturbances in repetitions, pronunciation and word formation;
Individuals who are characterized by excessive speed of speech are described as
having abnormally high frequencies in repeating words and phrases, and fluency
imbalance appears in this disorder in a few sounds or syllables, unlike what we find
in stuttering, and excessive speed of speech appears without signs of resistance
and tension . the avoidance that appears in cases of stuttering; A specific
percentage of the prevalence of excessive speed of speech is not yet known, but
clinical reports of speech-language pathologists in the United States indicate that it
is more common in children than in adults.

The person who suffers from excessive speed is characterized by speed of speech
compared to the person who stutters , without realizing the characteristics of his
speech, so he does not avoid it or feel any disturbance from it, and he has errors in
intellectual processes and special problems in language and in auditory
comprehension, and difficulties in reading and writing. During the school years,
these problems require special services.

This disorder is associated with a poor ability to control the vocal, grammatical,
and semantic aspects of the spoken language. Children who suffer from excessive
speed of speech can increase fluency by decreasing the speed of speech during
discussions and various conversations, as well as maintaining different rates of
speech and thinking. In advance of the subject that will be spoken about, recording
the person’s speech rate and re-hearing what has been recorded increases his
awareness of the rate of speech rate, and it can also be provided with immediate
visual feedback such as using signs indicating the speed of his speech.

a summary

43
 Stuttering is recurring ruptures in the fluency of verbal expression and resistance
behaviors in the case of speech, the most important symptoms of which are:
repetition, pausing or prolongation of sounds, secondary related behaviors such as
blinking of eyes and shaking of the head, and non-apparent symptoms may appear
such as replacing words, indirect speech on the subject Responding with incorrect
information to avoid specific words. Psychological factors focus on personality
traits in explaining stuttering. As for organic factors, they try to link central nervous
system deviations and stuttering. The therapeutic strategy includes controlling the
variables in the child's environment that are responsible for maintaining stuttering.

Selective silence
1. Definition of selective mutism
Selective mutism is an anxiety disorder in which a person is usually
unable to speak in specific situations, specific places, or to certain

44
 people if triggered. Selective mutism often coexists with social
anxiety disorder. People with selective mutism remain silent even
when the consequences of their silence include shame, social
ostracism, or punishment.

2.Symptoms of selective mutism

Children and adults with selective mutism are fully able to speak
and understand language but are physically unable to speak in
certain situations, even though speech is expected of them. Others
may view the behavior as shyness or rudeness. A child with
selective mutism may remain completely silent at school for years
but speak very freely or even excessively at home. There is a
hierarchical variance among people with this disorder: some people
will fully participate in activities and appear sociable but not talk,
others will talk only to peers but not to adults, and still others will
talk to adults when asked questions that require short answers but
never speak. Peers, and still others do not talk to anyone and
participate in few, if any, activities provided to them. In a severe
form known as "progressive mutism ," the disorder progresses until
the person with the condition stops talking to anyone in any
situation, even close family members.

Persistent failure to speak in specific social situations (where there

is an expectation to speak, for example, at school) despite
speaking in other situations.
The disorder interferes with academic or occupational achievement
or social communication.
The duration of the disruption is at least one month (not limited to
the first month of school).
The lack of speaking is not due to a lack of knowledge of the
spoken language required in the marital situation.
The disturbance is not better explained by a communication
disorder (eg , childhood fluency disorder) and does not occur
45
 exclusively in people with autism spectrum disorders or psychotic
disorders such as schizophrenia.

Selective mutism is closely associated with other anxiety disorders,

particularly social anxiety disorder. In fact, the majority of children
diagnosed with selective mutism also have a social anxiety
disorder (100% of participants in two studies and 97% in another).
Some researchers therefore speculate that selective mutism may
be an avoidance strategy used by a subset of children with social
anxiety disorder to reduce their stress in social situations.

Particularly in young children, SM can sometimes be confused with

an autism spectrum disorder, especially if the child is acting
particularly private around the diagnosing physician, which can
lead to incorrect diagnosis and treatment. Although people with
autism may also be selectively mute , they often display other
behaviors—hand flapping, repetitive behaviors, and social isolation
even among family members (they don't always answer to name,
for example)—that set them apart from The child with selective
mutism. Some autistic people may be selectively silent due to
anxiety in social situations that they do not fully understand. If the
mutism is caused entirely by an autism spectrum disorder, it cannot
be diagnosed as selective mutism as mentioned in the last item in
the list above.

The former name Selective Mutism refers to a widespread

misconception among psychologists that selective mute people
choose to be silent in certain situations, when in reality they often
would like to speak but are unable to do so. To reflect the
autonomic nature of this disorder, the name was changed to
selective mutism in 1994.

46
 In cases of elective muteness it is not certain. Because of the
general public's misunderstanding of this condition, it is likely that
many cases go undiagnosed. Based on the number of reported
cases , the number is generally estimated to be 1 in 1,000, 0.1%.
However , a 2002 study in the Journal of the American Academy of
Child and Adolescent Psychiatry put the incidence at 0.71%.

3. Selective mutism treatment

Contrary to popular belief, people with selective mutism do not
necessarily improve with age. Effective treatment is essential for a
child to develop properly. Without treatment, selective mutism can
contribute to chronic depression and further anxiety and other
social and emotional problems.
Thus, treatment at an early age is important. If not addressed,
selective mutism tends to be self-reinforcing. Others may
eventually expect the affected child not to speak and so stop trying
to initiate verbal communication. Alternatively , they may pressure
the child to speak, which increases their levels of anxiety in
situations where speech is expected. Because of these problems,
changing the environment may be a viable consideration.
However , a change of school is only worth considering if the
alternative environment is very supportive, otherwise the whole
new environment can also be a social trauma for the individual or
deprive them of any friends or support they currently have.
Regardless of the cause, raising awareness and ensuring an
adequate and supportive environment are the first steps toward
effective treatment.
Affected children often do not have to change schools or classes
and find it difficult to keep up except on the communication and
social front. Treatment in adolescence or adult years may be more
difficult because the affected person is used to being mute.

47
 The exact treatment depends on the person's age, any co-
morbidities, and a number of other factors. For example, vanishing
stimulation is usually used with younger children because older
children and teens perceive a situation as an attempt to get them to
talk, and older adults with the condition and people with depression
are more likely to need medication.

Like other disabilities, appropriate accommodations are needed for

the sufferer to succeed at school, work, and home. Under US
federal law and the Individuals with Disabilities Education Act
( IDEA ), those with this disorder are eligible for services based on
the fact that they have a disability that impairs their ability to speak,
thus disrupting their lives. This assistance is usually documented in
the form of an Individualized Education Plan ( IEP ). Post-
secondary accommodations for people with disabilities are also
available.

Under another law, Section 504 of the Rehabilitation Act of 1973,

public school districts are required to provide a free, appropriate
public education to every "qualified disabled person" residing in
their jurisdiction. If a child is found to have disabilities that
significantly limit a major life activity (in this case, learning), the
education agency needs to decide what related aids or services are
required to provide equal access to the learning environment.

Social Communication Anxiety Treatment ( S-CAT ) is a treatment

approach that is popular with professionals and has proven
successful. S-CAT integrates components of behavioral therapy,
cognitive behavioral therapy ( CBT ), and insight-guided
approaches to increase social connection and enhance social
confidence. Tactics such as systemic desensitization , Modeling ,
fading, and positive reinforcement enable individuals to develop
social engagement skills and initiate step-by-step communicative
48
 progression. There are many treatment plans out there and it is
recommended that families do thorough research before deciding
on a treatment approach.

Self modeling
The affected child is brought into the classroom or environment
where the child will not speak and is videotaped. First, the teacher
or another adult prompts the child with questions that are likely to
go unanswered. A parent, or someone the child feels comfortable
talking to, substitutes for the prompter and asks the child the same
questions, this time eliciting a verbal response. The two videos of
the conversations are then edited together to show the child
directly answering questions asked by the teacher or another adult.
This video is then shown to the child over several weeks, and each
time the child sees himself or herself answering verbally to the
teacher/another adult, the tape is stopped and the child is given
positive reinforcement.
Classmates of affected children may also be shown these videos to
predict in their peers that they can speak. The classmates thus
learn the child's voice and, albeit through editing, have the
opportunity to see the child speaking with the teacher.

Ambiguity stimuli
Mysterious motivation is often associated with self-modeling. An
envelope is placed in the child's classroom in a visible place. On
the envelope, the child's name is written with a question mark.
Inside is an item that the child's father has decided is desirable for
the child. The child is told that when he asks for the envelope
loudly enough to be heard by the teacher and others in the class,
the child will receive the fuzzy impulse. The class is also told to
expect the child to ask for the envelope loudly enough that the
class can hear it.
Motivation fades
49
 Infected persons may be brought into a controlled environment with
someone they feel comfortable with and with whom they can
communicate. Gradually, another person is introduced to the
situation. One example of excitatory fade is the slide-in technique ,
in which a new person is slowly introduced to the speaking group.
This may take a long time for the first one or two faints but may get
faster as the patient becomes more comfortable with the technique.

For example, a child might play a board game with a loved one in a
class at school. Gradually, the teacher is also brought in to play. As
the child adjusts to the teacher's presence, a classmate is brought
in to be part of the game. Everyone is only brought in if the child
continues to be involved verbally and positively.

allergy
The subject communicates indirectly with the person they fear
talking to through means such as email, instant messaging (text,
audio, or video), online chat, audio or video recordings, and
speaking or whispering to a medium in the presence of the target
person. This can make the subject more comfortable with the idea
of connecting with this person.

formation
The subject is slowly encouraged to speak. The subject is
reinforced first for non- verbal interaction, then for saying certain
sounds (such as the sound each letter of the alphabet makes) in
place of words, then for whispering, and finally uttering one or more
words.

spacing
Spacing is important for integration, especially with self- modeling .
Frequent and spaced use of interventions has been shown to be

50
 most beneficial in the long term for learning. Self -modeling videos
should be viewed over a time interval of approximately 6 weeks.

Verbal love
Definition of aphasia .1

Aphasia is one of the difficult speech disorders that is often acquired in

adulthood, and it is a disability in the ability to interpret and form language
symbols, as a result of brain damage, and in addition to its effect on spoken
language, it also causes problems in understanding the words of others and in
reading and writing. A person with aphasia may respond with fear, frustration,
anger, anxiety, and depression.

Causes of aphasia .2

Most cases of aphasia result from injury at the level of:

51
The posterior region of the cerebral cortex, which is responsible for receiving -
and analyzing stimuli from the outside world, includes the temporal lobe and the
.parietal region, which is associated with language input or understanding speech
The frontal area responsible for movement, and therefore responsible for -
speech, and the resulting damage here interferes slightly with understanding, as
.the effect appears on fluency and spoken speech

Diagnosis of aphasia .3

Aphasia is classified into two types: non-shot aphasia and shot aphasia.

- Non-fluent aphasia: It includes Broca's aphasia, non- motor cortical aphasia , and
universal aphasia. This type is often associated with damage to the frontal parts of
the left hemisphere, so that symptoms appear in non-fluent grammatical
telegraphic speech, and difficulty in naming and repetition. And often the
understanding is correct.

- Fluent aphasia: It includes Wernicke's aphasia, non- cortical aphasia ,

communicative aphasia, and anonymity aphasia , resulting from damage to the
posterior parts of the left cerebral hemisphere, which belongs to the hearing area
in the temporal lobe. Mixing speech, using unintended words, replacing words,
and difficulty naming.

The case history is considered an important process in the assessment, in addition

to the direct linguistic assessment of the language, which includes an analysis of
the linguistic performance of the affected individual with the aim of describing
the type of aphasia.

Aphasia treatment .4
Rehabilitation procedures are determined and planned based on evaluation, the
patient's lifestyle, motivation and medical needs. Treatment methods differ

52
according to the type of aphasia. Some methods focus on therapeutic activities
within clinics and on comprehension, hearing and memory skills. Memory is
based on the use of sensory stimuli such as writing numbers and letters on the
sand with the fingers of the hand. The goal is to reorganize the cerebral cortex
and develop new pathways for receiving and interacting with stimuli.

Comprehension development methods are also keen on auditory reorganization

by using auditory activities within the clinic, and the use of existing sound
linguistic abilities to stimulate other areas.

The treatment of melodic intonation is one of the most used methods, as it

employs the unhindered intonation ability, and trains the patient to gradually
intonation words and then sentences, then the intonation fades gradually
through the production of non-tonal words and semi-sentences, and then
transfer the words to verbal context .

Speech apraxia .5
apraxia refers to a disability in the ability to perform sequential muscular
movements to achieve voluntary verbal goals, which leads to weakness,
slowness , or lack of muscle coordination. Praxia is of two types. The first type is
related to the speech muscular system, as it arises from difficulty in the voluntary
production of phonemes or phonemes . And its sequence, and therefore patients
with apraxia of speech show articulation problems that appear in the form of
distortion, omission, repetition, or addition of pronunciation, abnormal vocal
tones, slow rate of speech rate, and inappropriate speech pauses.

And the second type of apraxia is due to the weakness of the ability to perform
the necessary and voluntary movements of the fingers, elbow, and shoulder that
is not associated with motor, sensory, or vocal defects, which accompanies cases
of aphasia, so that patients show difficulties in performing distal movements
versus proximal ones, and transitional movements versus nontransitive ones.

53
People with this disorder may show errors in performing wrong movements or
actions.

At the present time, many procedures are used to evaluate speech apraxia , and
the nature of the disorder is judged through the speech sample and the diversity
of pronunciation. The evaluation is carried out through special tasks that include:

Imitation of single-syllable words.

Imitation of long words.

- imitating sentences.

Reading aloud.

Spontaneous speech.

Evaluation of oral movements may provide us with more information about the
disorder of voluntary movement in a person with apraxia of speech. Diagnostic
indicators include:

Increased number of errors in long responses.

Associated oral apraxia .

- Prominent hamzah and aloud errors .

The orthopedist must design an appropriate and specific treatment plan to meet
the special needs of each patient, and this plan is designed based on the
evaluation results and their interpretation, and the method differs from one
situation to another. disorder in a person, and the following are these goals:

- Helping the patient to be productive and directing him and his family on the
importance of speaking.

- Modify pronunciation by changing the rate of speech speed and temporal

changes factors.

54
- Modify rhythm , tone and intonation.

Use a form of alternative or supportive communication in severe cases, such as a

computer And the electronic board.

a summary
Aphasia is a disability in the ability to interpret and form language symbols as a
result of damage in the posterior region of the cerebral cortex, which is
responsible for receiving and analyzing stimuli coming from the outside world.
Where understanding is sound and speech is not fluent, while absolute aphasia
results from damage to the posterior parts of the left cerebral hemisphere, the
patient appears fluent in speech and the disability is limited to understanding;
The diagnosis of aphasia depends on the history of the case and the analysis of
the linguistic performance of the patient, and the treatment is based on methods
of stimulating memory and the use of sensory stimuli.

Fourthly Written language disorders

Dyslexia .I
Definition of dyslexia 1
The nature of dyslexia 2
Diagnosis of dyslexia 3
Causes of dyslexia 4
Therapeutic strategy 5

dysgraphia .II

55
 1. Definition of dysgraphia
2. Causes of dysgraphia
3. Diagnosis of dysgraphia
4. Dysgraphia treatment

III. Dyscalculia
1. Definition of dyscalculia
2. Types of dyscalculia
3. Dyscalculia treatment

Dyslexia
Definition of dyslexia .1
Language is considered one of the complex systems that we use to communicate and
convey our ideas to others around us. Oral language is expressed through verbal
sounds that unite with each other to produce and form words and sentences. Sounds,
letters, words, symbols and grammar also affect on the way we speak, write, read or
spell; In order for a child to be ready to learn to read, he must possess some
prerequisites such as the awareness that words can be read, that print corresponds to
speech, and that words consist of phonemes, and he must perform a simultaneous set
of mental functions that include:

56
 Focusing attention on the printed symbols and controlling eye movement across -
.the page
.Understanding the sounds associated with letters -
.Understanding of words and grammar -
.Store ideas in memory -

may fail to perform one of the functions involved in the reading process, resulting in
.difficulty in learning to read or dyslexia

The nature of dyslexia .2

: Dyslexia manifests as difficulty in performing the following tasks
Connect phonemic symbols with written symbols and recognize words by analyzing -
.them into their sounds
Distinguishing letters that are similar in terms of shape, such as: h , k , and j, and in -
.terms of pronunciation, such as: t and d
Respect the order of the letters of the word, such as flipping the letters of the word -
.or adding or deleting a letter from the word
reading of characters displayed horizontally and reading diacritics displayed -
.vertically
.Recognizing words with similar weights such as: banana, almond, walnut -
Respect the direction of reading (from right to left in Arabic), and move from line to -
.line regularly
Recognizing words if their writing is different, and the letters of the alphabet have -
.sounds and drawings
Cut the discourse elements , stop at points and commas, and read question and -
.exclamation marks
.Give meaning to what is read -

Diagnosis of dyslexia .3

57
A diagnosis of dyslexia can be made for every student who suffers from difficulty
:deciphering written language codes and does not suffer from
.Visual or hearing impairment -
.Mental retardation -
personality disorder -
.Deficiencies in verbal communication -
Any difficulty in learning to read with the absence of organic and psychological
.disorders that could explain this difficulty

The causes of dyslexia .4

:phonemic units that make up the word . In the word, it is as follows
The skill of comparing sounds: using a number of different formulas that require .1
the student to compare sounds in different words, he may be asked to produce
.words that agree in the first or last letter with the target word
The skill of phonemic units segmentation: it includes counting , pronouncing , .2
deleting, adding or reversing phonemic units within a word, such as requesting the
pronunciation of phonetic units in the word cat one after the other, or pronouncing
.a monkey without a sound d
The skill of blending sounds: it is measured through the task of merging sounds, .3
where the examinee pronounces a series of phonetic units individually, one after
the other, for example, the child is asked to mention the word that consists of the
.following sounds: F-T-H
Deficiencies in the development of the phonemic side of the language can be
measured through these skills that do not require reading, which contributes to the
diagnosis of children at risk of failing to read before teaching reading begins, based
on testing the ability to recognize and process the individual sounds that make up
the word , considering This ability is linked to the development of early word-
.reading skills

The therapeutic strategy .5

58
 The steps for teaching phonological awareness and understanding the letters of the
alphabet can be summarized as follows :

Teaching distinguishing sounds explicitly and directly : using clear strategies, by -

.mixing sounds and asking the student to reproduce them
Starting from easy to difficult to distinguish sounds: starting with easy words and -
.gradually progressing to more difficult ones
:Providing the support and assistance needed by the novice reader, including -
.Provide a sample voice and explanation The strategy used to perform the voice .‫أ‬
.Have the pupil use the strategy to produce the sound .‫ب‬
‫ت‬. Repeat steps a and b using a variety of .‫ت‬
.sounds for each pattern and difficulty level
.Motivate the student to use the strategy during guided practice .‫ث‬
.Use steps a through d to provide more difficult examples .‫ج‬
Developing a table that responds to the needs of each student, for the purpose of .‫ح‬
.application and achieving familiarity and ease of sound output and distinction

a summary
Dyslexia is the difficulty of learning written language. The process of reading requires
a simultaneous set of mental processes that include attention, perception,
comprehension, perception, storage and retrieval. All of these mental tasks require a
rich network of neurons that connect the brain centers of vision and Language and
memory, and the person may suffer from problems in any of the tasks involved in the
reading process, and scientists have found that a significant number of people with
dyslexia share the inability to distinguish or separate the phonemic units that make
up the word, This led to the development of methods that can help dyslexic children
.acquire these skills

59
 dysgraphia
1. Definition of dysgraphia
Dysgraphia is a learning disability that affects Acquisition of
writing and pen handling skills. It is a neurological disorder that
can affect children or adults alike, and causes people to write
incomprehensible texts or wrong words.
So far, the cause of dysgraphia is not known , but for adults it is
often due to a traumatic event.
Symptoms appear as follows :
Incorrect spelling and capital letters -
Mix of cursive and printed letters -
Improper sizing and spacing of characters
Difficulty copying words -
slow or laborious typing -
Difficulty imagining words before writing them .
Unusual body or hand position when writing
60
 Gripping tightly with a pen, which leads to cramps in the hand .
hand control while writing -
Say the words out loud while writing -
Delete letters and words from sentences
Other effects of dysgraphia -
People with dysgraphia often have trouble focusing on other
things while writing, which makes it difficult to take notes during
class .
Also, dysgraphics may be thought of as messy or lazy due to
poor handwriting, which affects self-esteem and leads to anxiety,
lack of confidence, and negative attitudes toward school.
.
2. The causes of dysgraphia
If dysgraphia appears in childhood, it is usually the result of a
problem with understanding spelling or the alphabet, an aspect
of memory that allows written words to be remembered
permanently and the way the hands or fingers must move to
write these words
Children or adults with dyslexia have difficulty planning and
executing writing sentences, words, and even individual letters.
But this does not mean that you do not know how to read, spell,
or identify letters and words, but rather that the brain has
problems dealing with words and writing . When dysgraphia
affects adults, the cause is usually a stroke or a certain brain
injury. For example, an injury to the left parietal lobe of the brain
may lead to dysgraphia
Research is still ongoing to find out what causes some children
to have learning disabilities such as dysgraphia. But dysgraphia
and learning disabilities often run in the family for genetic
reasons or for reasons related to prenatal development or
preterm birth
Children with dysgraphia often have other learning difficulties.
For example, having attention deficit hyperactivity disorder
61
 (ADHD) may increase your risk of dysgraphia. This is because
attention is closely related to both writing and reading abilities.
Dysgraphia is usually viewed in two ways
degenerative condition that causes an individual (usually as an
adult) to lose previously acquired writing skills
Developmental dysgraphia is associated with difficulties in
acquiring writing skills during development. This type of
dysgraphia is the most common in childhood and its causes are
unknown, but researchers have identified some subtypes that
are compatible with certain neurological mechanisms, namely:

Motor dysgraphia: manifested in poor coordination between

motor performance and visual perception, which results in
unreadable text.
Spatial dysgraphia: It is associated with a defect in spatial
perception, which affects the accuracy of letter spacing and the
ability to draw .
- - Linguistic dysgraphia : affects the skills of dealing with the
language required in the writing process, and most affects the
written text without tracking or copying it.

3. Diagnosis of dysgraphia
Dysgraphia is usually diagnosed by a licensed psychologist who
specializes in learning disorders and may sometimes include a
team of specialists, including occupational therapists, special
education teachers, and educational psychologists . The team
can use a variety of tools to diagnose dysgraphia, including:
school reports -
Psychoeducational measures -
A review of the medical history and details of the child's
development
Review the family medical history
Written assignment assessments -
62
 Dysgraphia tests usually include a writing section such as
copying sentences or answering brief writing questions, as well
as a fine motor component that tests the individual's reflexes and
movement speed. The diagnostician works to understand both
the quality of writing, the extent to which the patient organizes
and conveys thoughts, the process of writing itself, and whether
writing is painful or not.
The importance of diagnosing dysgraphia
Even in the digital age, handwriting is an important and
necessary skill for success in childhood and beyond. In the
presence of dysgraphia, writing and other basic writing skills
become more difficult, making the student more likely to fall
behind peers who do not have learning disabilities. Dysgraphia
also affects academic performance in general and leads to low
self-confidence, which can continue into adulthood.
The writing process itself helps the brain to remember, organize
and process information. But when writing is stressful and
difficult work, the child cannot effectively 'show what they know'.
A dysgraphic student may fail an exam simply because he
cannot translate his thoughts and answers onto paper.
4. Dysgraphia treatment
Dysgraphia and other learning disorders are lifelong conditions
for which there is no cure yet. Dysgraphia treatment focuses on
support through modifications or additional lessons and
exercises designed to improve writing abilities.

63
 Dyscalculia
1. Definition of dyscalculia
Dyscalculia is a diagnosis used to describe learning difficulties
related to understanding and dealing with mathematics. It is
sometimes called "arithmic dyslexia." Dyslexia relates to difficulty
in reading and writing, while dyscalculia relates specifically to
mathematics
Studies show that 3 to 7 percent of adults and children suffer
from dyscalculia, in which a sufferer of this disorder has difficulty
understanding mathematical concepts and rules, such as
whether one amount is greater than another or how to calculate
a particular equation
Symptoms of dyscalculia
Symptoms of dyscalculia may look different depending on age
and stage of development. Common symptoms of dyscalculia
include :

Symptoms of dyscalculia in early childhood

Difficulty learning to count
Difficulty making connections between a number and what it
represents, such as knowing that the number "3" applies to
groups of things such as 3 apples , 3 cars, or 3 bananas
Difficulty recognizing sizes as smallest to largest or longest to
shortest
Symptoms of dyscalculia in the primary school stage

64
 Difficulty learning and remembering basic number facts such as
number links, eg 6 + 4 = 10.
Continue to use fingers to count instead of using more advanced
strategies such as mental math
Poor understanding of signs for mathematical symbols such as
(+), (-), (X), and (÷) or may make mistakes when using these
symbols in their appropriate place.

Difficulty recognizing that 3 + 5 is the same as 5 + 3 or being

unable to solve 3 + 26 – 26 without arithmetic
Difficulty identifying a place value and placing numbers in the
appropriate boxes, often placing numbers in the wrong column
Inability to understand the language of mathematics or to come
up with a plan to solve a math problem Difficulty understanding
mathematical expressions such as greater than and less than
Difficulty remembering the result in sports or competitive games
Difficulty calculating the total cost of the things he buys
Avoid situations that require understanding or working with
numbers, such as playing games that involve math
Symptoms of dyscalculia in secondary school
Difficulty understanding information on charts and graphs
Difficulty finding different ways to solve the same math problem,
such as adding the length and width of a rectangle and doubling
the answer to solve the perimeter rather than adding all the
sides Difficulty learning and understanding ways of reasoning
and multi-step calculation procedures
Difficulty measuring such as measuring volumes or weights in a
simple recipe or liquids in a bottle
Lack of confidence in executing exercises that require an
understanding of speed, distance, and directions .
Difficulty applying math concepts to money, such as calculating
payments and balances. Symptoms of adult dyscalculia
Difficulty counting backwards or forwards
65
 Slow performance of calculations
Poor mental arithmetic skills
Poor sense of numbers and appreciation
Difficulty understanding place value
Adding numbers is often the default operation
High levels of anxiety from mathematics, what are the causes of
dyscalculia?
Some researchers believe that dyscalculia results from a lack of
early concrete instruction in mathematics. Children who are
taught that mathematical concepts are just a series of rules that
must be followed rather than being guided in practical and
analytical thinking about those rules may not develop the neural
pathways in the brain that they need to understand more
complex mathematics. Thus a child who has never been taught
to count with an abacus or who has not learned to multiply by
using tangible objects that increase in amounts visible to them
may be more likely to develop dyscalculia
But dyscalculia may occur on its own or it may occur alongside
other developmental delays, learning disabilities, or other
neurological conditions. Children and adults may be more likely
to be diagnosed with dyscalculia if they have other disorders
such as:
Dyslexia
- Hyperactivity and distraction
-the blues
- Worrying
Motor coordination disorder
Dyscalculia may also have a genetic component, as
mathematical aptitude tends to run in families, as does learning
disabilities. For example, if you grew up with a mom who always
said math was hard and so she couldn't help you learn math,
chances are you will have difficulty with math as well.

66
 2. Types of dyscalculia
Dyscalculia usually appears in five main types:
Verbal dyscalculia: This type of dyscalculia is characterized by
difficulty naming and understanding mathematical concepts
presented orally. Children with this type can read or write
numbers, but have difficulty recognizing them when presented
orally
Practical dyscalculia: This type of dyscalculia is characterized by
the difficulty of translating abstract mathematical concepts into
realistic and practical concepts. These children can understand
mathematical concepts but have difficulty listing, comparing and
manipulating mathematical equations
Lexical dyscalculia: Trouble reading and understanding
mathematical symbols and numbers, as well as mathematical
expressions or equations. Children with this type can understand
concepts when they are spoken, but may have difficulty writing
and understanding them as they are written
Graphic dyscalculia : Difficulty writing mathematical symbols.
Children with this type can understand mathematical concepts
but do not have the ability to read, write, or use appropriate
symbols or drawings that match words.

Cognitive dyscalculia: Children with this type have difficulty

carrying out mental operations without using numbers to answer
math problems and understand mathematical concepts. They
may also have difficulty remembering mathematical concepts
after learning them.
Operational dyscalculia: Children with this type of dyscalculia
find it difficult to complete written or spoken arithmetic operations
or general calculations. Despite their ability to understand
numbers and the relationships between them, they have trouble
adjusting numbers and mathematical symbols in calculations.

67
 3. Dyscalculia treatment
If left untreated, dyscalculia can lead to difficulties at work and
difficulty managing finances in adults and problems with studies
and academics in children and young adults. However, there are
treatment strategies for children and adults through which this
disorder can be controlled
Strategies for treating dyscalculia in children
Frequent practice of basic math concepts such as counting,
addition, subtraction, multiplication and division Divide subject
material into smaller units to facilitate comprehension of
information
Use small groups of other children to teach math
Frequent review of basic math concepts in practical, concrete
exercises
In all cases, the best treatment plan is one that takes into
account the individual talents, needs and interests of the child
Strategies for treating dyscalculia in adults
Dyscalculia in adults can be difficult to treat if it is not within an
academic or educational setting in which special educational
resources can be used. But sometimes a therapist can help with
exercises designed to strengthen the nerve pathways used in
mathematics. Training or tutoring can also help treat dyscalculia
in adults, as well as benefit from strategies such as:

Write the mathematical problem

Math and number concepts are just marks on the page for a
student with dyscalculia. Therefore, it may help to talk about the
mathematical problem or write it in the form of a sentence in
order to see the relationships between the elements
Draw the mathematical problem
Drawing matter can also help visual learners see relationships
and understand concepts. Students can draw the problem with

68
 pictures that reflect their understanding of the problem and show
ways to solve it
Divide tasks into subgroups .
Students with dyscalculia can easily become overwhelmed by a
complex problem or concept, especially if it relies on prior
knowledge - which they may not have memorized. So separating
a problem into its component parts and working through them
one by one may help students focus and see the relationships
between them
Use real life and material objects -
Connecting mathematics to practical applications of everyday life
can help students with dyscalculia understand concepts and see
relationships between numbers.

Fifth Speech disturbances _ _

Speech disorder
Define a speech disorder .7
The nature of the speech disorder .8
Interpretation of a speech disorder .9
10. Diagnosing a speech disorder
11. Evaluation of the mechanism of speech
12. Treatment of speech disorders

69
 Speech disorder
Definition of disorder pronunciation 1 .
Articulation is the total motor processes used in the planning and production
of speech . A , what is a speech disorder is difficulties in the manifestations of the
motor production of speech or the inability to produce specific verbal sounds , as
the disability occurs at the level of motor processes and not in the language
ability.

A speech disorder is defined as a problem or difficulty producing the sounds

needed to speak in the correct way. Pronunciation defects can occur in vowels,
consonants, or groupings of consonants as well. The disorder can include some
sounds or all sounds, at any position in a word. So far, speech defects are the
most common form of speech disorders, and therefore the vast majority of cases
of speech disorders that we can encounter in classrooms or in treatment centers .

70
2. The nature of the speech disorder
Three main types of speech defects can be distinguished: deletion, substitution,
and distortion. There is also a fourth type of these disorders that some specialists
and researchers distinguish from other disorders and call it addition disorder.
Below we discuss these four types of speech defects in some detail and to clarify
a.

Deletion :

In this type of pronunciation defect, the child deletes one of the sounds included
in the word, and then pronounces only part of the word. The deletion may
include multiple sounds, and the child’s speech in this case becomes completely
incomprehensible even for people who are accustomed to listening to it, such as
parents. and others, ellipses tend to occur more commonly in young children than
are observed among older children. Also, these defects tend to appear in the
pronunciation of consonants that fall at the end of a word more than in
consonants at the beginning or in the middle of a word.

B. substitution

Substitution errors exist in pronunciation when an inappropriate sound is

produced instead of the desired one , for example a child may replace the letter
(s) with the letter (u) or replace the letter (r) with the letter (and) Again,
substitution defects seem to be more common in speech Young children than
older children, this type of speech disorder leads to a decrease in the ability of
others to understand the child's speech when it occurs repeatedly.

C. Distortion

Distortion errors exist when the sound is produced in a special way, but the
new sound remains
close to the desired sound. The distorted sounds cannot be distinguished or

71
 matched with the specific sounds known in the language, so they are not
classified by most clinicians as commutative defects . The sound is soft, because
the air comes from the wrong place, or because the tongue is not in the correct
position during the pronunciation. It seems that defects in distortion of speech
are common among older children. age and between adults more Than spread
between Junior children .

Dr.. add

Additive defects exist when a person pronounces a word with an increase in a

sound or a syllable to the correct pronunciation. This defect is anyway - the
least common of all pronunciation defects.

3. Interpretation of speech disorder

Speech errors may be accompanied by physical anomalies such as cleft lip or
neurological defects that may be responsible for speech errors , but there is no
clear reason attributed to it , as it may be caused by variables. like: Intelligence
level , movement skills , auditory discrimination , auditory memory , economic
and social status , gender , personality , academic performance , teeth.

Since no causal relationship has been discovered, points of view have emerged
as an attempt to explain the speech disorder, the most important of which are:

Discriminatory approaches: You see that pronunciation errors result from a -

weakness in the ability of auditory discrimination, as a person cannot
differentiate between the pronunciation errors that he produces and the
.correct production of sounds emanating from others
Speech production approaches: You see that articulation consists of precise -
and coordinated movements with each other to produce speech, and children
who suffer from errors in pronunciation stop developmentally in the stage of
.sensorimotor development
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Phonological approaches: the child tends to simplify the sounds that he is -
unable to produce correctly, and this leads to pronunciation errors, such as
deleting the silent sound at the end of the word to make it easier for him to
.produce it

4. Diagnosing a disorder pronunciation

The task of the specialist at this stage is to note specific characteristics of the
conversation , then gather them together to get an idea of the problem , by
checking the degree of clarity in speech and single word responses , the extent
of clarity of continuous speech , the affected consonants , the affected
consonants , and other factors . Influencing the degree of clarity of speech ,
parents' responses to pronunciation errors , the child's response to parents'
reactions , and if the impression is that the child's speech is unclear, other data
collection procedures should be used such as: Tests and sample spontaneous
speech.

The number , type , and continuity of errors are the variables that are used in
diagnosing the degree of severity of the disorder.

Speech defects range from mild to severe defects. In cases where the speech
defects are of the severe type, it is difficult to understand the child’s speech. On
the other hand, the child suffers greatly when he tries to express his ideas or
special needs in the family or school environment or in his relations with
colleagues. However, the extent of the disability in the clarity of the child’s
speech is not the only factor that affects the judgment on the degree of severity
of the disturbance. The chronological age of the child – without a doubt – is
considered an important factor, especially in light of the developmental nature
of speech and speech mentioned above . When a seven-year-old child makes
mistakes in pronouncing the early developmental speech sounds, he suffers

73
from a more severe disorder than another child of the same year, but he only
makes mistakes in pronouncing the late developmental sounds only. Likewise,
fixed and well-established speech defects in the older child usually are more
difficult to treat than non-established errors in another, younger child. Generally,
fixed errors can be said to be less The ability to treat emergency or temporary

errors . On the other hand, the number of speech defects and the types of these
defects are also an influential factor in determining the degree of severity of the
disorder, bearing in mind that deletion defects are considered more childlike
than substitution defects. Or distortion, as well as the defects that include
sounds that are frequently repeated in the language are more noticeable, and
they are reflected in the clarity of speech to a greater degree than the errors
that include rare or few repetition sounds in the language, and when the child is
able to correct the defects of pronunciation if the stimulation is available
necessary audio-visual, and this is usually considered a good therapeutic
indication that the child will be able to learn the version The correct sounds
needed for speech, and the wrong sounds that are not amenable to correction
(i.e. speech defects that persist in the child even with the provision of additional
stimulation and indications provided by the therapist), it is usually difficult to
train the child to correct them.

5. Evaluation of the mechanism of speech

During the stages of normal speech development and the acquisition of
articulation skills, children usually omit, replace or distort the sounds
necessary for speech. It is noted that substitution errors are the most
common defects among developmental articulation defects. Therefore, it is
not surprising that a four-year-old child errs in pronouncing Some letters,
such as the letter (Th) or the letter (R), but if a seven-year-old child
mispronounces some letters such as the letter (B) or the letter (K), then

74
there is no doubt that this child suffers from one of the difficulties in
pronunciation.

Any of the four types of speech defects - previously referred to - can occur
with any degree of recurrence, and with any pattern. Likewise , a child's
speech may include one speech defect, or it may include a group of these
defects as well. Pronunciation in children is often unstable and changes from
one stage of development to another. In addition to all that, the child may
pronounce one sound correctly at some times or situations, but he omits,
alters or distorts the same sound . at other times or situations

It is very important for the clinical specialist in speech defects to determine

whether a speech error is considered a real speech defect or a linguistic
error. The importance of this distinction is due to the fact that the goals and
methods of the therapeutic process are completely different for the two
cases.

considered an evaluation structure f function Mechanisms are a major

requirement for any comprehensive evaluation, as speech disorders arise from
difficulty in motor production, and here we have to make sure of the integrity of
the structure of the peripheral motor system associated with the production of
verbal sounds, and this procedure gives great importance to assessing the
structure of the speech mechanism, and the evaluation includes the following :

- Examination of the structural structure of the head and face: where the initial
impression is formed by sitting opposite the patient and observing the size and
shape of the head and its proportionality with the size of the body, and
examining the characteristics of the face such as the shape of the eyes, nose,
and mouth .

75
- Examination of breathing: by examining and evaluating aerobic respiration
patterns during relaxation and in the state of speech, and measuring the amount
of time between the phase of inhalation and exhalation, which should be equal.

- Examination of the structural structures of the oral and pharyngeal cavity:

Here, the teeth must be examined in terms of consistency of regularity and the
gaps between them should be noted, and the size of the tongue should be
determined in terms of its relationship with the oral cavity, and the extent of the
safety of the pharyngeal cavity should be assessed.

The specialist should pay attention to the following:

Can the patient do the task?

Is the range of motion adequate?

Are the movements correct?

Is the speed of movements appropriate for age?

6. Treatment of speech disorders

Treatment of speech disorders is viewed from the perspective of learning
principles. It is a training in learning movement skills, discrimination skills ,
articulatory responses, and phonological rules. Learning is an essential part of
the treatment process.

The treatment includes two main stages: Acquisition and generalization . In the
first stage, the focus is on the person's awareness of how to produce sounds
correctly, through conscious training. The second stage is concerned with how
sounds are produced in various contexts. A child who suffers from speech
disorders is not able to produce specific speech sounds, and therefore the goal in
treatment is those sounds that are not produced properly.

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 During the treatment processes, the specialist follows a set of specific
procedures through which he can modify the speech behavior. Clearly defines
the pressure actions that constitute the correct response, and gives great
importance to the events that follow the response, the correct response is
reinforced and the incorrect is ignored.

Speech therapy aims to correct the wrong speech responses and use the correct
ones in all daily life situations after training them. The goal of correction is to
practice the correct sounds in various contexts and in multiple situations. The
specialist may work to achieve generalization by moving from the organized steps
to the least. Organizing, including reading and verbal conversation. The therapist
may allow others to participate in therapy to encourage the practice of correct
responses with other people. The teacher or family members may be asked to
remind the child of the correct responses for the purposes of generalization in the
child's different contexts and situations.

a summary
A speech disorder is the inability to produce specific speech sounds, resulting in
symptoms such as phoneme substitution Another phoneme , distorting sound
production, deleting a sound in a word, adding a sound to a word, the number,
type, and persistence of errors determine the degree of severity of the disorder,
and pronunciation errors may be accompanied by physical anomalies such as cleft
lips that can be responsible for this disorder, However, there is no clear cause
attributed to it, and the diagnosis is made by observing specific characteristics of
the conversation and checking the degree of clarity in speech, while the
treatment is in the form of training movement skills, discrimination skills and
verbal responses.

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Sixthly Speech disorders _ _

Speech disorder
Define a speech disorder .1
Causes of speech disorder .2
Treatment of speech disorder .3

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 speech disorder

1. Define a speech disorder

Speech disorders are defined by the inability to articulate some
words, whether there is an inability to produce sounds correctly or
fluently, or because of problems in the person’s own voice, such
as: speech disorders or stuttering, as well as disorders may result
from some related problems by hearing. It is also mentioned that
speech disorders may affect both children and adults, and this can
occur as a result of a medical problem, or without a known cause.

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 Types of Speech Disorder When researching, we find that speech
disorders have many different divisions that may depend on the
form of the disorder itself, and according to its presence in adults,
children, or both. Speech disorders are divided into: apraxia,
slurred speech, dysphonia, stuttering, muteness, voice disorders,
and difficulty in articulating.
Speech apraxia is a speech motor disorder , in which the
messages from the brain to the mouth are defective, and therefore
the person cannot move his lips or tongue properly to pronounce
speech, although the muscles controlling the lips and tongue are
not weak, and the extent of the inability to speak depends here.
Depending on the nature of the brain defect , apraxia may be
associated with weakness of the muscles involved in word
production or with difficulties associated with neurological
impairment.

Apraxia may also be defined as acquired apraxia of speech, verbal

apraxia, or dyspraxia, and verbal apraxia may also be classified as
a speech apraxia occurring in childhood
Scattering: It is a form of communication disorder, and it is mainly
related to the speed of speech, which prevents proper
pronunciation, and since it is highly disorganized, it may eventually
lead to a lack of understanding of speech.
Dysphonia is one of the rare and relatively unknown disorders
among the public, and individuals with this problem can speak

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 somewhat fluently, but the problem lies in the rhythm of the speech
itself , so dysphonia may be classified as a false * foreign accent
syndrome, due to the similarity. between him and that situation
Dumbness: is the inability to speak at all.

2. Causes of speech disorder

As mentioned above, the causes may vary from hearing loss and
neurological problems, brain injury and cognitive impairment, drug
abuse, physical disabilities such as cleft lip and palate, and
mistreatment or misuse of voice.

3. Treatment of speech disorders

be treated with speech therapy , but others require medical
attention by a phoniatrics doctor . Other treatments include
correcting organic problems as well as psychotherapy. It is also
mentioned that the earlier the diagnosis, the more effective the
treatment
Foreign Accent Syndrome: This usually occurs as a side effect of a
serious brain injury such as a stroke or acute traumatic brain injury.
What happens is that the person speaks in his mother tongue, but
with an accent that the listeners think is foreign or controversial,
and those with foreign accent syndrome may tend to speak in real
foreign languages with their accent., Prosody: are the weights of

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 words, and poets rely on what is called prosody in adjusting the
weights of poetry
Speech disorders, including delayed speech, stuttering and
stuttering, as they appear in the form of repetition or lengthening of
letters or words, as well as excessive speed of speech.
What is dysarthria
Dysarthria , which is difficulty speaking; With the inability to
coordinate words and arrange them in an understandable way and
weakness in producing a specific speech. The condition is caused
by a defect in the central nervous system or in a nerve or muscle
responsible for speech. The infected person can understand and
analyze speech, but he cannot express it.

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VII language delay

Language delay

Definition of language delay 1

the language delay 2
language delay 3
Reasons for language delay 4
Principles of therapeutic practice 5

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 Language delay
Definition of language delay .1
The ability to use language and follow its rules increases with age, and children
acquire language at different age stages. The average child develops language
during the first 18 months of life, and acquires skills naturally after the age of 40
months, thus fulfilling the requirements of natural language. As for the
linguistically late child, he acquires the same linguistic crop compared to his
peers, but slowly. In this case, the child's first word does not appear at the normal
age of its appearance, which is the first year of the child's life. These are problems
in social contact with others, in the child's linguistic output, and in reading and
writing later on. Many of these children do not have other disabilities, but their
language development remains below the average achievement of their peers of
.normal or normal intelligence who are developing within expected rates

The nature of the language delay .2

: delay appears at one of the following levels

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 1- The morphological level: the delay at this level includes problems at the end
of words , unstressed words and semi-sentences, not understanding the rules
that are used to apply and choose words such as verbs, prepositions and
conjunctions , and focusing only on remembering words and nouns in Camel.

2- The grammatical level: where there are many difficulties in learning and using
rules to form sentences, in understanding, remembering and using sentences, in
interpreting and producing questions, in using pronouns, and difficulty in
repeating sentences with complex grammatical characteristics.

The semantic level: appears in the form of slowness in word knowledge and -3
use, difficulty in acquiring appropriate meanings for the selected word
classifications and in the multiplicity of meanings of words, verbs, adjectives,
pronouns and prepositions, and problems in interpretation and remembering
.terms related to time and place and relationships Cause, effect and conclusion

4- The pragmatic level: This aspect of the delay reflects the inability of the
individual to use language for communication purposes in different social
contexts , and the difficulty in defining the meaning and significance of
communication . The child must realize this .

Diagnosis of language delay .3

85
 Symptoms of language delay may appear in the form of a limited vocabulary,
difficulty recalling words in all situations, or producing sentences appropriate to
the age stage, in terms of their length or complexity; Children who suffer from
an early language delay compared to normal children have a noticeable
slowdown in the development of expressive language, with the absence of
morphological defects such as those that we find in mentally retarded children
and those with general developmental disorders. Intermediate receptive
language .

And about 2.2 % of children at the age of three have a language delay, that is,
they do not have 50 words and cannot use and pronounce two words, and half
of these may reach the developmental stages of their peers, while the other half
develop language problems throughout their school years, and Language delay is
five times more prevalent among males than females, and may result in
behaviors such as aggression and disobedience, and may interfere with
academic achievement, occupational performance, and social communication.

To evaluate language delay , the specialist must measure the three aspects of
language, which are as follows:

- Language form: by determining the extent to which language rules are used,
errors in language form cause errors in sentence formation.

- Language content: through poor assessment of the meaning of what was said,
inappropriate choice of words in oral communication, and difficulty in
understanding written language.

86
Language use: by determining the appropriate child's use of language in -
. conversations and social contexts

4. Reasons for language delay

Language delay may result from various factors, the most important of which are
mental retardation and personality disorders such as autism and psychosis.
Middle ear infections may lead to hearing loss, which results in a delay in the
acquisition and development of language, and many language disorders have a
genetic origin . The quality and quantity of inputs has an impact on the
development of vocabulary, the lack of environment of stimuli may lead to a
delay in language development, and the absence of appropriate models of
education may develop some language disorders in children.

The causes of language delay may be due to a disorder in the areas responsible
for thinking , hearing , comprehending, and language formation in the brain,
which leads to a defect in these functions, and this often occurs before or during
pregnancy and childbirth, and may be related to the presence of a family history
of language delay, These reasons may also be due to family upbringing and
corporal punishment methods, which in turn lead to a delay in the emergence of
language, and children's imitation of parents who suffer from language disorders
plays an important role.

The family and cultural deprivation, such as the absence of appropriate training
for the child and living in shelters and places where socialization factors and an

87
 appropriate educational environment are not available, may affect the child's
linguistic output; The child's deprivation of parental sympathy or neglect of him,
psychological insecurity and emotional compatibility inevitably reflects on his
linguistic development.

5. Principles of therapeutic practice

There are five elements that reflect the stages of service delivery for children with
language delays :

Work to identify all the special needs of the child and satisfy them , and -1
provide an easy environment With the aim of developing the different skills
.of the child
Evaluation of services on an individual and collective basis , and this is -2
necessary to achieve a variety of contexts in the practice of communication
.skills
Parents' participation in the treatment process to observe the development -3
of treatment on a regular basis, develop the child's skills and improve his
.language development
Integrating children who are linguistically delayed with normal children of the -4
same age, to provide opportunities for interaction and the acquisition of
.social skills
Enhancing language skills in natural environments and strengthening -5
.communication abilities with others in all daily life situations

88
 behaviors in therapy are arranged as follows:

Learn concrete words such as the names of things and animals, then -
.verbs, then adjectives
.Learn the phrasal verbs of two and then three words -
. Learn morphological and grammatical tools -
Learn functional units and their pragmatic uses , such as speaking to attract -
attention, asking for and giving information, asking for actions, and responding to
. commands

a summary
Language delay is a difficulty in recalling words in all situations and producing
sentences appropriate to the age stage in terms of their length or complexity.
The semantic level may be manifested in the difficulty of recognizing and using
the word, but at the pragmatic level, the difficulty in defining the meaning of
communication; The diagnosis of language delay depends on examining the
form, content and use of the language, and the cause of the disorder may be
due to organic or psychological factors. As for the treatment, it is through
providing a different environment to facilitate the development of the child’s
.communication skills

Eighth Voice disorder

89
voice disorder

Definition of a voice disorder 1

Causes of voice disorder 2
Diagnosing a voice disorder 3
Voice disorder treatment 4

90
 voice disorder
Definition of a voice disorder .1

Voice disorder means imbalances related to the degree of the voice in terms
of its intensity, highness, lowness or quality, and its effects appear in social
contact with others.

Most patients with a voice disorder display nine main symptoms , which often
do not appear alone, but combine with each other, and they include the
: following

Hoarseness - vocal stress - expiratory sound - low vocal range - loss of voice - -
pitch cutting - voice resistance - voice tremor - pain at the level of the larynx,
and many voice disorders produce disturbances in vocal resonance, either
very high or low nasal resonance It may also result in a disorder called nasal
.escape and nasal sounds coming out of the mouth

And many vocal problems result from organic disabilities, and their treatment
is the responsibility of doctors such as an ear, nose and throat specialist,
neurologist, and endocrinologist . The artefouni must be sufficiently familiar
with the types of common diseases, disabilities, and medical treatments related
to the mechanism of sound production, as he is considered one of the medical
.work team

91
 Causes of voice disorder .2
The vocal disorder may be organic , resulting from physiological or anatomical
diseases at the level of the larynx , which protects the airway during eating. And
these functional disorders may be the result of a personality disorder or wrong
habits in the use of the voice, so the voice is abnormal even though the
anatomical structure of the larynx is normal, and among the diseases that affect
the production of sounds, we mention vocal cord paralysis, obstruction of
cartilage movement resulting from trauma, Asthenic disease that results in non-
. closure of the glottis, tumors at the level of the vocal cords

The audible sound is specifically related to the function of the vocal cords and
the resonant organs of speech. The problems may be related to inorganic
factors, so that the voice disorder appears without observed diseases or organic
defects. It is assumed that they are caused by psychological problems or
situations that lead to abnormal behavior of the sound production mechanism.
Aphonia appears when a person does not want to speak or sing. Aphonia and
inorganic dysphonia are unconsciously associated with stress and anxiety;
Emotional problems associated with situations at home, school, and work affect
laryngeal functions and voice production, and thus cases of loss of voice or
dysarthria occur as a result. Dysphonia may appear as a result of complex
conditions related to the voice, as the type of speech can become habitual as it
may It is caused by the pressure of the vocal cords against each other and their
.inability to vibrate normally

92
 Diagnosing a voice disorder .3
:Procedures for evaluating and diagnosing voice disorders include
Listening : where the specialist practices active listening, and here he must
have the skill to listen to the patient’s voice and determine the extent of the
discrepancies in it, and thus the speech and language specialist can determine
when the pitch of the voice rises or falls and when the quality of the voice
deviates from the normal level, and through That can describe the
.characteristics of sound

look: This is done by observing the size, color, shape, and movement of the
face, lips, teeth, tongue, palate, pharynx, and larynx using a mirror, to
.determine the weakness or paralysis associated with the voice

Case history: Information gathered about the history of voice disorders helps
in planning and designing treatment programs, during which information is
collected about the individual’s medical history, health problems he
experienced, parents’ attitudes towards the problem, the need for treatment,
. motivation, and the ability to tolerate the treatment program

Voice disorder treatment .4

The treatment of voice disorder includes three main approaches: the medical
approach , which deals with surgery, radiation, and medical and psychiatric
medications. The second approach is the environmental approach, which

93
includes appropriate environmental modifications and helping the child or
adult to adapt a suitable environment. The third curriculum focuses on direct
vocal rehabilitation methods through training activities designed to produce
: appropriate vocal changes, by training on the following skills

:Listening skills -‫أ‬

It is not easy for a person to realize the characteristics of his voice as others
perceive it or as they hear it, and for this reason we are often surprised by our
voices when we hear them recorded, and these characteristics, if they are
inappropriate, can be treated appropriately by teaching the individual how to
listen and listen, and training him to identify The pitch of his voice and its
characteristics, and distinguishing and determining the differences between
.the layers, as a first step on the road to vocal rehabilitation

: health -‫ب‬
A person must be able to face life problems and make decisions about them in
order to solve them. Achieving an appropriate level of mental health is an
important factor in facing anxiety and frustration, because the latter interferes
.with the treatment of voice problems

:c- Physical health

A person who enjoys good health is more able to learn and respond to events
faster, and from here the child must be encouraged to follow healthy feeding
habits, maintain body rest, and do appropriate exercises. Many people who
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suffer from voice disorders do not realize the relationship between Voice and
.mental health

Some activities may also help improve the quality of the voice, we summarize
:the most important of them in the following points
. Body shape and movement
.Breathing training
.muscle relaxation -
.Voice training
.Eliminate harmful behaviors of the voice -
.Eliminate misuse of sound
.Reduce excessive stress of voting
.Adjust the pitch of the voice -
.Relaxing the voice

95
 a summary

Damage to the larynx causes voice problems that may manifest as

hoarseness, vocal strain, expiratory sound, low or loss of voice; This may be
the result of physiological diseases at the level of the structure of the
larynx, and may be the result of functional disorders such as a personality
disorder or wrong habits in using the voice. The evaluation procedures
include listening, looking, and case history; As for the treatment, it depends
on the medical approach that deals with surgery, radiation, and the
environmental approach, and it contains auxiliary modifications, in addition
to the behavioral approach that works to bring about appropriate vocal
changes.

And then he learns some social gestures, and then the one-year-old child becomes
able to pronounce the word and associate it with some things, then he moves to the
stage of putting two words together to express one idea, at the age of 18 to 24
months.

96
ix Linguistic characteristics of people with special
needs

Linguistic characteristics of people with special needs

learning difficulties 1
Mental retardation 2

3 autism

4 Hearing impairment

. 5 visual impairment

. 6 Behavioral and emotional disorders

. 7 therapeutic interventions

97
 Linguistic characteristics of people with
special needs
Preface

Language includes listening, speaking, reading, writing, social interaction, and the
mechanism of conversation. Therefore, verbal communication problems are
major in many disabilities such as hearing impairment, mental retardation,
learning difficulties, and severe and complex disorders. We limit the discussion in
this lesson to : Introducing the special category briefly , and by discussing the
linguistic characteristics within the phonological, morphological, grammatical,
semantic and pragmatic levels , for each of the categories of learning difficulties,
mental retardation, autism, hearing impairment and visual impairment,
Behavioral and emotional disorders.

learning difficulties .1
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 Learning disabilities are difficulties in using written language . It manifests itself
in the inability to listen, think, speak, read, write, spell, or do mathematical
operations.

Language characteristics in learning difficulties:

The deficiencies show difficulty in processing phonemic information ,

phonological awareness , and vocal production, and difficulty in understanding
and using the grammatical elements of the language , in addition to problems in
verbal semantic concepts and in conversational expression .

Mental retardation .2

Mental retardation is a disability in both intellectual and functional abilities And

in the adaptive behavior that arises before the age of 18 years , and the
retardation may be simple, moderate, severe, or very severe.

Characteristics of language in mental retardation :

Difficulties in speech production , phonemic decoding and word formation ,

deficiencies in grammatical skills, understanding words and interpreting figurative
expressions are the result of delayed development of semantic abilities, deficits in
understanding messages and in verbal response.

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 3. Autism

Autism is a developmental disability characterized by specific deficits in social

interactions and communication , and the presence of restricted, stereotypical
patterns of behavior, interests, and repetitive activities.

Characteristics of language in autism:

Problems are reflected in the tone of voice and intonation (fluctuation in vocal
intensity: too high or too low, inappropriate intonation for the meaning of the
sentence, speaking in one tone of voice) , delay in morphological and grammatical
development, difficulty in organizing information according to categories and the
use of semantic concepts in Normal attitudes, starting and ending a conversation
and keeping it on topic.

4. Hearing disability

Hearing impaired individuals are classified as hearing impaired if they can use
audio amplifiers to use the sense of hearing, while the deaf are those who cannot
use hearing in processing linguistic information whether or not they use audio
amplifiers.

Language characteristics in the hearing impaired:

Difficulty in acquiring the beginnings and endings of words and their emphasis, a
delay in the use of morphological and grammatical rules and semantic skills , and a

100
marked inability to understand abstract language and comprehend social aspects
of language.

5. Visual disability

Visually impaired individuals are classified as visually impaired if they can use
sight in learning despite their poor visual ability. As for the blind, they are those
who use touch and hearing to learn without seeing.

Language characteristics in visual impairment:

The characteristics of the language appear in the little use of different sentences
and pronouns , and the difficulty in producing gestures that help to understand
the message , as well as differences in the tone and quality of the voice, the
formation of inappropriate physical signs , and the lack of awareness of the
necessity of adapting speech to the needs of the listener.

6. Behavioral and emotional disorders

It is a severe, chronic , and unacceptable behavioral disorder that results in

difficulty forming and maintaining social relationships , feelings of depression, and
a tendency to develop physical symptoms and fears.

Language characteristics in behavioral and emotional disorders :

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 Difficulty is limited to maintaining the topic , inappropriate responses, failure to
take into account the needs of the listener, and the presence of language problems
in the event that the type of disorder is internal (withdrawal), but if it is external
(aggressive), it may lead to problems in communication .

7. Therapeutic interventions

It is clear from the foregoing the necessity of conducting early interventions

targeting the language and speech of the child with special needs in the first
interactions between him and his mother, and the growth of the ability to
communicate cannot be excluded from the growth in other manifestations, and
this reflects the role of the artefoni and the multidisciplinary team in planning
programs Family and individual. Early intervention programs also include parents,
and their active role is not excluded from early intervention services for their
children. The programs may include educating parents to carry out different forms
of conversations with their children, which may include talking about various
topics and activities to be the focus of the conversation. with the child.

It must be noted the importance of pre-linguistic interventions in linguistic

development, and this means that early intervention can begin before the
development of the language of a child with special needs, and early interventions
in early childhood depend on evaluating the child's behavior related to the
content, form and use of language. In social contexts, and for a child who has not

102
yet learned language, assessment and intervention depend on imitation, ritual and
imaginative games, playing with objects, and their functional use.

Artefoni works directly with the children in the classroom, and gives advice to the
teacher about the nature of the interactions that should take place and the nature
of the systems to help develop communication in the child with special needs; And
companions can be used for this purpose. Language is a social activity that requires
the participation of others in the child's social environment. Children with normal
development learn how to help facilitate the linguistic development of children
with disabilities by: establishing eye contact, describing their own or others' play,
clarifying, expanding and Re-what the disabled say. Also, comrades can help
improve the speech and language of their classmates. Social drama play is a helpful
means, as it teaches children in special groups and the training includes
determining what the child should say and do.

Providing a comfortable and encouraging atmosphere may motivate the person to

express fluently and correct his pronunciation and linguistic errors. Psychological
approaches have contributed to the treatment of communication disorders of all
kinds, increasing Artefuni awareness of psychological dimensions, giving people
with special needs respect and acceptance, and establishing an interactive
relationship based on warm communication. .

103
a summary

Language characteristics appear in learning difficulties in the form of defects in

phonological awareness and in vocal production, and the difficulty is in mental
retardation in producing speech and decoding phonetic symbols, while in autism
the problems are reflected in the tone of voice, intonation, and morphological and
grammatical performance, and the problems are In the auditory disability in
acquiring the beginnings and endings of words and in their emphasis, while the
linguistic characteristics appear in the visual disability in the lack of use of different
sentences and the difficulty of producing gestures, while the difficulty is limited to
behavioral and emotional disorders in maintaining the topic and inappropriate
responses.

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 Tenth : supportive and alternative communication
Supportive and alternative communication

Elements of supportive and alternative communication 1

and alternative communication strategies 2
Assess supportive and alternative communication 3

105
 Supportive and alternative communication
Preface

Effective communication requires the use of appropriate words to express needs, and
these words are selected until they form the sentences that we want to say, and the
production of these words depends on the integrity of our devices, and when we
cannot speak naturally, there are reliable methods for selecting the words that we
would like to use, This is what is known as supportive and alternative communication.
Supportive communication is the methods that are used with the aim of
strengthening and enhancing the communication skills that the individual possesses.
Alternative communication is the methods that replace oral communication for
individuals who are unable to develop verbal language skills.

Elements of supportive and alternative communication .1

Supportive and alternative communication consists of three necessary elements that

must be considered when designing supportive or alternative communication
programmes:

106
 :Communicative styles .‫أ‬
There are two basic types of Supportive and alternative communication methods are
the assistive and non-helpful methods, and the non-helpful methods do not require
external support tools or auxiliary procedures for their work, as they include methods
such as speech, sign language, and facial expressions, and they are characterized by
their ease of use. It includes simple communication tools such as a communication
. board or a programmed computer

:Symbol systems .‫ب‬

Pictures have illusions in presenting clear topics in a way that is aware of the
disabled, and pictures that include contextual backgrounds are among the most
useful, as well as color pictures that are better perceived than black and white
pictures, and there are a number of abstract symbolic systems available that include
symbols Voice communication, and non-verbal language consumption programs that
rely on geometric shapes to express words. Shapes also combine with each other to
.form sentences

:c. communication skills

Assistive communication uses useful procedures and tools , which open the way for
the person who cannot speak with others, and one of the most important issues for
specialists in the field of supportive and alternative communication is the problem of
how to help individuals who are unable to speak to facilitate their daily interactions
.in educational settings and professional and societal

107
 and alternative communication strategies .2
:and alternative communication include many techniques, including
Written choice communication: which is based on the principle that individuals with -
oral communication disorders understand better when information is presented
through multiple models, and this method is implemented with the agreement of
.both the patient and his communication partner on the subject of the conversation
Gestures and gestures : These include facial expressions, eye movements, body -
.positions, and hand and arm movements, which aim to convey a specific message
Electronic communication tools: through which the injured person can express -
.himself
Drawing: which may be used for expression purposes , and it includes a drawing of -
.the patient and the communication partner
In addition to communication book, alphabet board, word dictionary, picture -
.dictionary

are measured by collecting and analyzing data on communication performance,

through which we can identify the areas that still need training and work. Language
samples can also be collected and analyzed to compare the results after application
with the data before application. And judging by it the effectiveness of the program.

and alternative communication strategies :

.Simplicity of the symbolic input used -

.Using signs and symbols requires less complex motor skills -
.Cognitive abilities and the use of visual aids to maintain attention span for symbols -
108
 .and auditory processing capabilities and displaying appropriate symbols -

In general, the supportive and alternative communication program includes the

following five elements:

.pre-assessment stage 
 Develop goals that enhance the individual's ability to participate in all 
.environments
.Choose an auxiliary contact form 
.Choose a positive symbolic system 
Choosing ways to strengthen communication for both the user and the participant 
.in the assistive communication system

Assess supportive and alternative communication .3

Effective use of supportive and alternative communication requires comprehensive

assessment procedures, which include the following :

. Assess current and future communication needs .‫أ‬

.The communication style currently used .‫ب‬
.The possibility of using different types of standards in assistive communication .‫ت‬
.Evaluation of physical , mental , social, educational and vocational abilities .‫ث‬

To achieve the goals of a comprehensive assessment, information must be gathered

from a multidisciplinary team, which may include:

109
The person using supportive and alternative communication and the family, by -
gathering information about desired outcomes, the person's motivation to achieve
.results, and the capabilities of team members
Speech and language specialist : gathers information about understanding written -
and spoken language, language use and patterns of interaction with others,
muscular control of speech, articulation of speech sounds, use of nonverbal
.communication, and special types and styles of communication
Doctors specializing in children, neurology, ear, nose and throat: to collect -
.information about general health and appropriate health treatment
Teacher: To collect information about class performance and academic -
achievement , communication skills needed for learning and interaction within the
.department
Psychologist: who collects information about the learning potential of the -
. individual, the need for individual and family counseling

After completing the assessment, the following questions must be answered:

?What type of communication methods are suggested -

?What is the method used -
.Paraphrases, short sentences, expressing feelings -
.Giving and taking information -
.Conversations with family , friends and teachers -
.Written communication with oneself and with others -
?What is the use of assistive communication -
. Tools used and type of symbols (letters, pictures, words, objects, sentences) -

110
 a summary
Supportive and alternative communication strategies are used by many individuals,
who share the characteristic of the inability to communicate with others, which may
result from multiple types of cognitive, motor, and physical disabilities. Supportive
and alternative communication is also used by people with developmental disabilities.
such as autism, mental disability, and developmental apraxia of speech, as well as
people with acquired disabilities such as brain injuries and Parkinson 's disease, and
supportive and alternative communication is the methods that are used with the aim
of strengthening and enhancing the communication skills that a person possesses, and
methods that replace spoken communication in individuals Unable to develop
.language skills

eleventh _ : Teaching students with language disorders

Teaching students with language disorders

Adapting the learning environment .1

Adapting teaching methods .2
Class adjustments for communicatively disturbed students .3

111
 Teaching students with verbal
communication disorders
Preface

Language and speech are considered important elements in classroom

communication, which includes all aspects of verbal and non-verbal interaction

112
between the teacher and the students and the students among themselves. In this
section, we discuss educational considerations in teaching this group of students.

Adapting the learning environment .1

The organization of educational programs for the communicatively disturbed

students in schools depends on the size of the problem and the extent of its
appearance. These students learn in ordinary schools, where the alternative to
comprehensive integration provides an opportunity for them if special assistance is
provided. Al- Artefuni works directly with the communicationally disturbed
children in the regular classes. Providing support to educational programs, helping
students direct their attention towards verbal and written instructions, and
encouraging them to ask questions, with the aim of involving them in class
discussions.

The mobile teacher works to move from one group to another, or to take the
child out of class and move from one school to another to work with children in
private and organized classes.

Achieving the verbal and linguistic objectives within the classroom requires a clear
definition of the role of Al-Artefuni , as he is primarily responsible for the
therapeutic services provided to students who need help to fulfill their special
needs. The teacher can develop a stock of strategies that preserve the work of Al-
Artefuni , and among these strategies:

113
 . Vocabulary development by encouraging naming and description -
. Encourage comprehension through strategies of summarization and retelling -
Preparing a list of words associated with pronunciation errors to be among the -
.targets
Connecting verbal and written language by identifying and writing students' -
.responses
Providing practical exercises in naming things , following instructions, and -
.answering questions
.Develop compensatory language skills such as the use of gestures -
Encouraging language skills such as conversation initiation , role playing , and -
.clarifying communication needs

Language must be understood as a way to solve problems by making others

understand us, and to give meaning to what others say, and the class teacher can
provide many facilities and possibilities for learning the language. Opportunities
should always be available for students to use their language and get feedback.
Constructive through the forms of interactions that can be brought about.
Language plays a major component in academic aspects and social learning. The
language of the school, whether in the classroom or in textbooks, is of constant
interest to both students and teachers. Because it is organized according to
specific rules, the speaker and listener are able to express themselves and
interpret key information quickly and easily, and children's lack of school
language skills leads to academic and social failure.

114
 Adapting teaching methods .2

: and language therapy .‫أ‬

and linguistic therapy is provided by the Ortofoni , who trains communicationally

disturbed children on specific skills. This type of therapy is based on assessing the
child's special needs. The therapist may use play as a special procedure with
young children during therapy sessions, model children and correct their language
behavior.

:Interactive curricula .‫ب‬

These curricula focus on the social use of language and emphasize functional
communication in natural language environments, where the communicatively
disturbed child is encouraged to talk about whatever he wants, and to encourage
the use of correct words and language use, specialists provide therapy sessions
during the child's normal activities: while eating, playing Visiting restaurants, with
.the aim of fulfilling the child's special needs

:Concentrated agitation .‫ج‬

It is one of the therapeutic methods in the natural environment, which focuses on
the desired language, especially the grammatical aspects, as the natural
.environment provides opportunities to play and stimulate the language
:Vocal training .‫ح‬
Phonological awareness plays an important role in predicting reading
achievement, which is the ability to recognize that words can be broken down
115
into small units such as syllables and phonemes. Children who have difficulties
.recognizing and mastering phonemes also have difficulties learning to read

:Slow auditory processing .‫خ‬

This treatment may be provided through the computer, where the phonemic
units are displayed at a rate slower than the normal speed of speech, and this
procedure allows the child to distinguish the phonemic units and store the correct
ones, and this is reflected in a better reading performance.

:Curriculum adaptation .‫د‬

School systems must provide appropriate services for all students. Decisions can
be made about the types of services and the place to provide them. To achieve
this, a number of specialists cooperate within one team to provide speech and
.language services within educational programs

Class adjustments for communicatively disturbed students .3

The class teacher makes classroom adjustments to strengthen the communication

skills of students who are unable to develop verbal language skills, through the
following :

Building a positive classroom climate, and here it is the responsibility of the -

.teacher in the regular class to make the necessary effort to provide that

116
Help the student monitor his or her speech. Through simple communication -
models, the teacher can help students focus on using the skills they have
.learned in speech therapy
Arrange the pupils in pairs to practice. Mastering the articulation skills requires -
the pupils to practice the skills they learned from the Artefuni with another
.partner
Teaching students positive self-talk, and this procedure helps to gain self- -
.confidence and teach specific skills
Modifying and adapting education and educational tools, through setting up a -
system of motivations and reinforcers to encourage students' efforts, and using
.special tools to identify words and syllables
Encouraging parents to work with their children, through many opportunities -
in which parents can participate in organized activities with their children at
.home
Teaching students effective and successful learning strategies and methods , to -
.enable them to do their best and invest their strengths
Teaching some traditional skills by showing pictures and talking about them -
and asking the student to repeat the similarity of the used sentence and
.reinforce the correct responses and present examples
Providing pupils with opportunities for facilitated play , such as presenting the -
self-talk model in the play activity, eliciting comments from pupils and
.expanding their ideas
Stimulating language from students, for example naming something contrary -
.to what is shown or giving difficult tasks that need help
117
Using stimulated natural methods to increase the use of language, where -
activities are used that enable the teacher to employ them and the students to
.generalize them in daily life
Encouraging conversations among pupils by reading the stories in small groups -
.or individually
Use musical play to improve language by playing musical instruments with -
.words

a summary

The process of helping students who are communicatively disturbed is not related
to a specific profession and not to others. Rather, Artefuni , the class teacher, and
parents participate in achieving better assistance. The teacher can help them by
listening to them when they speak and presenting models of speech and language
for them to follow , and encouraging them to use appropriate communication
skills; The role of the class teacher is not only limited to improving pronunciation
and teaching grammar, but also works to prevent verbal communication disorders.
The role of the teacher is manifested in facilitating the social use of the language,
providing an appropriate environment for learning, adapting teaching methods
and curricula, and making classroom modifications.

118
 Conclusion
Verbal communication is the ability to form and use language and to speak clearly
and understandably by others. It also includes the ability to hear and understand
what others say. Oral language is seen as a spoken or written language with
common tools used by individuals in a cultural context. To understand the speaker
or writer who wants to communicate, there must be an agreement on the
meanings of words and sounds, and if the language is written, then the words must
be pronounced and spelled in a manner consistent with the orthographic and
119
phonetic system. All children have a linguistic mechanism that enables them to
understand sounds (phonological level ) and understanding the rules (the
grammatical level) so that they can identify the sounds of their language at the age
of about six months, and the mechanism that helps them understand the rules of
the language is acquired by the child before reaching the age of two years, and this
mechanism is similar to the mechanisms of cognitive development.

The production of a spoken or written language that is understandable and

meaningful depends on the biological system of the human being, and also
requires the child to learn the rules of pronunciation, grammar and usage rules,
and normal children (without disabilities) show language development and
complex language from the age of three, as Our culture places great value on
verbal communication.

And when the communication process is hindered, either by a speech disorder

(voice disorder, articulation disorder, stuttering) or a language disorder (language
delay, aphasia, dyslexia), the results are harmful and negative. These disorders can
be diagnosed by conducting a case history and hearing, speech and language tests
to determine the type and severity of the disorder; As for the therapeutic services,
they aim to help the patient to achieve communication as close to normal as
possible, and provide him with compensatory strategies for untreated disability
and reduce the determinants and obstacles that prevent the establishment of
effective communication. These services are provided, especially at the level of
schools, health sectors, medical interests, Psychological and pedagogical centers,
clinics for artifacts and psychologists.

120
 Here are some facts about verbal communication disorder:

Most of the language disturbed children have speech disorders.

Some children with communicative disorders have normal cognitive , social and
emotional development.

Determining how children learn language is still ambiguous.

- Communication disorder appears more in individuals with low levels of

intelligence , and may also appear in individuals with high levels.

Learning difficulties (reading , listening and writing) may be associated with

language difficulties.

Early articulation is important for language development.

Many measures have been taken to prevent verbal communication disorder, most
of which are medical, that occurs before birth, such as preventing rubella infection,
as well as providing folic acid during pregnancy to the mother. Good nutrition
strongly affects the development of children in the early stages of their lives. The
link has become clear. between poverty and language disorders, and medical care
before and after childbirth is important and necessary to prevent diseases and
viruses, and if prevention and treatment do not occur, some brain diseases may
form, and thus language and cognitive disorders occur; Poverty leads to a lack of
access to appropriate information and appropriate medical treatment, so health
education programs play an important role in educating individuals and providing

121
them with appropriate medical and nutritional care, and Al-Artfoni and the teacher
play a prominent role in this regard .

the reviewer
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