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Speech Disorders Presented by:

Speech Disorder vs Language Disorder When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder

Speech Disorder vs Language Disorder Difficulties pronouncing sounds (articulation) and stuttering are examples of speech disorders

Speech Disorder vs Language Disorder When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.

Language is different from speech Language is made up of socially shared rules that include the following: What words mean (e.g., "star" can refer to a bright object in the night sky or a celebrity) How to make new words (e.g., friend, friendly, unfriendly)

Language is different from speech Speech is the verbal means of communicating. Speech consists of the following: Articulation Voice Fluency

Language is different from speech Articulation: How speech sounds are made (e.g., children must learn how to produce the "r" sound in order to say "rabbit" instead of "wabbit").

Language is different from speech Voice: Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).

Language is different from speech Fluency: The rhythm of speech (e.g., hesitations or stuttering can affect fluency).

Speech Disorders There are many types of Speech Disorders. These include: Apraxia Dysarthria Stuttering Voice

Apraxia

Apraxia Apraxia of speech is a motor speech disorder. The messages from the brain to the mouth are disrupted, and the person cannot move his or her lips or tongue to the right place to say sounds correctly, even though the muscles are not weak. The severity of apraxia depends on the nature of the brain damage.

Apraxia Apraxia can occur in conjunction with dysarthria (muscle weakness affecting speech production) or aphasia (language difficulties related to neurological damage). Apraxia of speech is also known as acquired apraxia of speech, verbal apraxia, and dyspraxia. Children can also have apraxia, referred to as childhood apraxia of speech.

Apraxia Signs and Symptoms: Individuals with apraxia of speech know what words they want to say, but their brains have difficulty coordinating the muscle movements necessary to say all the sounds in the words. As a result, they may say something completely different or make up words (e.g., "bipem" or "chicken" for “kitchen").

Apraxia Signs and Symptoms: The person may recognize the error and try again— sometimes getting it right, but sometimes saying something else entirely. This situation can become quite frustrating for the person.

Apraxia Individuals with apraxia may demonstrate: difficulty imitating and producing speech sounds, marked by speech errors such as sound distortions, substitutions, and/or omissions inconsistent speech errors groping of the tongue and lips to make specific sounds and words

Apraxia Individuals with apraxia may demonstrate: slow speech rate impaired rhythm and prosody (intonation) of speech better automatic speech (e.g., greetings) than purposeful speech inability to produce any sound at all in severe cases.

Apraxia Causes: Apraxia of speech is caused by damage to the parts of the brain that control coordinated muscle movement. A common cause of acquired apraxia is stroke. Other causes include traumatic brain injury, dementia, brain tumors, and progressive neurological disorders.

Apraxia Diagnosis: A speech-language pathologist (SLP) uses a combination of formal and informal assessment tools to diagnose apraxia of speech and determine the nature and severity of the condition. The assessment typically includes examinations of the individual’s oral-motor abilities, melody of speech, and speech sound production in a variety of contexts

Apraxia Treatment: An SLP can work with people with apraxia of speech to improve speech abilities and overall communication skills. The focus of intervention is on improving the planning, sequencing, and coordination of muscle movements for speech production. The muscles of speech often need to be "retrained" to produce sounds correctly and sequence sounds into words. Exercises are designed to allow the person to repeat sounds over and over and to practice correct mouth movements for sounds.

Apraxia Treatment: The person with apraxia of speech may need to slow his or her speech rate or work on "pacing" speech so that he or she can produce all necessary sounds. In severe cases, augmentative and alternative communication may be necessary (e.g., the use of simple gestures or more sophisticated electronic equipment).

Dysarthria

Dysarthria Dysarthria is a motor speech disorder. It results from impaired movement of the muscles used for speech production, including the lips, tongue, vocal folds, and/or diaphragm. The type and severity of dysarthria depend on which area of the nervous system is affected

Dysarthria Signs & Symptoms: A person with dysarthria may demonstrate the following speech characteristics: "Slurred," "choppy," or "mumbled" speech that may be difficult to understand Slow rate of speech

Dysarthria Signs & Symptoms: Rapid rate of speech with a "mumbling" quality Limited tongue, lip, and jaw movement Abnormal pitch and rhythm when speaking Changes in voice quality, such as hoarse or breathy voice or speech that sounds "nasal" or "stuffy"

Dysarthria Causes: Dysarthria is caused by damage to the brain. This may occur at birth, as in cerebral palsy or muscular dystrophy, or may occur later in life due to one of many different conditions that involve the nervous system, including:

Dysarthria Causes: stroke brain injury tumors Parkinson's disease Lou Gehrig's disease/amyotrophic lateral sclerosis (ALS) Huntington's disease multiple sclerosis

Dysarthria Diagnosis: A speech-language pathologist (SLP) can evaluate a person with speech difficulties and determine the nature and severity of the problem. The SLP will look at movement of the lips, tongue, and face, as well as breath support for speech and voice quality. The assessment will also include an examination of speech production in a variety of contexts

Dysarthria Treatment: Treatment depends on the cause, type, and severity of the symptoms. An SLP works with the individual to improve communication abilities. Some possible goals of treatment include: Slowing the rate of speech Improving the breath support so the person can speak more loudly Strengthening muscles

Dysarthria Increasing tongue and lip movement Treatment: Increasing tongue and lip movement Improving speech sound production so that speech is more clear Teaching caregivers, family members, and teachers strategies to better communicate with the person with dysarthria In severe cases, learning to use alternative means of communication (e.g., simple gestures, alphabet boards, or electronic or computer-based equipment)

Dysarthria Communication Tips for the Person with Dysarthria Introduce your topic with a single word or short phrase before beginning to speak in more complete sentences. Check with the listeners to make sure that they understand you. Speak slowly and loudly and pause frequently. Try to limit conversations when you feel tired—when your speech will be harder to understand. If you become frustrated, try to use other methods, such as pointing or gesturing, to get your message across or take a rest and try again later.

Dysarthria Communication Tips for the Listener Reduce distractions and background noise. Pay attention to the speaker. Watch the person as he or she talks. Let the speaker know when you have difficulty understanding him or her. Repeat only the part of the message that you understood so that the speaker does not have to repeat the entire message. If you still don't understand the message, ask yes/no questions or have the speaker write his or her message to you.

Stuttering

Stuttering Stuttering affects the fluency of speech. It begins during childhood and, in some cases, lasts throughout life. The disorder is characterized by disruptions in the production of speech sounds, also called "disfluencies." Most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by "um" or "uh." Disfluencies are not necessarily a problem; however, they can impede communication when a person produces too many of them. In most cases, stuttering has an impact on at least some daily activities. The specific activities that a person finds challenging to perform vary across individuals. For some people, communication difficulties only happen during specific activities, for example, talking on the telephone or talking before large groups. For most others, however, communication difficulties occur across a number of activities at home, school, or work. Some people may limit their participation in certain activities. Such "participation restrictions" often occur because the person is concerned about how others might react to disfluent speech. Other people may try to hide their disfluent speech from others by rearranging the words in their sentence (circumlocution), pretending to forget what they wanted to say, or declining to speak. Other people may find that they are excluded from participating in certain activities because of stuttering. Clearly, the impact of stuttering on daily life can be affected by how the person and others react to the disorder.

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