1. Communication Disorders

2. “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.

3. 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

4. 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

6. 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

7. 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

8. 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

9. 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

10. 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.

11. 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

12. 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

14. 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

15. 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.

16. 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

17. 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.