Communication Disorders

“Communication is a universal process by which human being exchange ideas, impact, feelings and express needs” (Adkins, 1991) Communication occurs in a variety of ways, Drama, literature, music and arts. It is verbal or nonverbal, and there are both sending and receiving components. Stroke, or cerebrovascular accident is the most common cause of impaired communication.

Stroke Most common occurrence in older adult men and in the African American population Perceptual deficits such as neglect and denial as well as spatial disturbances may also affect persons ability to communicate The most residual deficits of a stroke is a problem with language Language involves not only speaking but also conveying and comprehending thoughts and ideas

Aphasia A communication problem either with speaking, writing, or understanding It may be defined as a multiple-modality loss of language ability Usually caused by damage to the dominant hemisphere It is necessary to determine which type of aphasia- expressive or receptive-is present

Expressive Aphasia the function of language primarily resides in the left hemisphere of the brain Most often when an injury affects the dominant cerebral hemisphere the result is EA. It occurs when an injury damages the inferior frontal gyrus, just anterior to the facial and lingual areas of the motor cortex

Teaching strategies Working with EA, you might try having the person recall word images, first by naming commonly used objects and those objects in the immediate environment Let the person repeat words spoken by the nurse Keep the sessions short

Receptive Aphasia Wernicke’s area of the brain is located in the temporal bone and is needed for auditory and reading comprehension When this area affected, persons are left with Receptive Aphasia Their hearing is unimpaired, they are nevertheless unable to understand the significance of the spoken word. Speech therapy should be one of the earliest intervention

Teaching Strategies Working with RA you need to establish a means for nonverbal communication Speak more slowly and slightly louder to the person Keep your teaching session filled with praise and always acknowledge the client’s frustration Speak slowly Don’t use baby talk Speak in normal tones Speak in slow, short, and simple sentence Allow the person time to answer Be patient

Dysarthria Is a problem with voluntary muscle control of speech It occurs as a consequence of damage to the central or peripheral nervous system and affect the same muscles used in eating and speaking.

Teaching Strategy Be sure the environment is quiet Ask the speaker to repeat unclear parts of the message Do not simplify your message Ask question that need only short answer Encourage person to use more oral movement to produce each syllable and to speak more loudly Ask the patient who is unintelligible to gesture, write or point to messages on a communication board

Laryngectomy Cancer in the larynx is five times more common in men than in women Esophageal speech was the primary method in speaking after a laryngectomy ES involves taking air into the upper part of the esophagus and adopting its normal sphincters to vibrate like vocal chords Tracheosophageal speech is more rapid restoration of speech. The person must rely on prosthesis and the tracheosophageal fistula may undergo stenosis

Teaching Strategies Watch the speakers lips Do not alter your message If you don’t understand the speaker. Repeat what you think the person said, and ask for more information Seek a quiet environment

Articulation Disorders- impairment of the ability to articulate speech sounds. Fluency Disorders- interruption in the flow speaking characterized by atypical rate, rhythm and repetition of sounds, syllables, words and phrases. This may be accompanied by excessive tension, struggle behavior and secondary characteristics. Voice Disorders- abnormal production of vocal quality, pitch, loudness and resonance compared to an individual’s age or sex.

Phonological Disorders- abnormal development of sound system of the language and the rules that govern sound combinations. This results in difficulty producing age expected speech sounds. Language Disorders- impaired comprehension and/or use of spoken and written language. This disorder may include difficulty with Semitics- meaning of language Syntax- grammatical construction of language Pragmatics- social use of language, includes conversational skills Phonological awareness- knowledge of the sound structure of language, reading, spelling, and writing

Cleft Palate- birth defect in which there is an opening through the soft palate and the bony roof of the mouth. A cleft is surgically repaired in infancy. It may result in hypernasality and various articulation disorders.