Speech disorder

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Speech disorders or speech impairments are a type of communication disorder in which normal speech is disrupted. [1] This can mean fluency disorders like stuttering, cluttering or lisps. Someone who is unable to speak due to a speech disorder is considered mute. [2] Speech skills are vital to social relationships and learning, and delays or disorders that relate to developing these skills can impact individuals function. [3] For many children and adolescents, this can present as issues with academics. [4] Speech disorders affect roughly 11.5% of the US population, and 5% of the primary school population. [5] Speech is a complex process that requires precise timing, nerve and muscle control, and as a result is susceptible to impairments. A person who has a stroke, an accident or birth defect may have speech and language problems. [6]

Contents

Classification

Classifying speech into normal and disordered is more problematic than it first seems. By strict classification,[ citation needed ] only 5% to 10% of the population has a completely normal manner of speaking (with respect to all parameters) and healthy voice; all others have one disorder or another.

There are three different levels of classification when determining the magnitude and type of a speech disorder and the proper treatment or therapy: [7]

  1. Sounds the patient can produce
    1. Phonemic – can be produced easily; used meaningfully and constructively
    2. Phonetic – produced only upon request; not used consistently, meaningfully, or constructively; not used in connected speech
  2. Stimulate sounds
    1. Easily stimulated
    2. Stimulate after demonstration and probing (i.e. with a tongue depressor)
  3. Cannot produce the sound
    1. Cannot be produced voluntarily
    2. No production ever observed

Types of disorder

Causes

In some cases the cause is unknown. However, there are various known causes of speech impairments, such as hearing loss, neurological disorders, brain injury, an increase in mental strain, constant bullying, intellectual disability, substance use disorder, physical impairments such as cleft lip and palate, and vocal abuse or misuse. [12] After strokes, there is known to be a higher incidence of apraxia of speech, which is a disorder affecting neurological pathways involved with speech. [13] Poor motor function is also suggested to be highly associated with speech disorders, especially in children. [14] Hereditary causes have also been suggested, as many times children of individuals with speech disorders will develop them as well. [15] 20-40% individuals with a family history of a specific language impairment are likely to be diagnosed, whereas only 4% of the population overall is likely to be diagnosed. [16] There are also language disorders that are known to be genetic, such as hereditary ataxia, which can cause slow and unclear speech. [17]

Treatment

Many of these types of disorders can be treated by speech therapy, but others require medical attention by a doctor in phoniatrics. Other treatments include correction of organic conditions and psychotherapy. [18]

In the United States, school-age children with a speech disorder are often placed in special education programs. Children who struggle to learn to talk often experience persistent communication difficulties in addition to academic struggles. [19] More than 700,000 of the students served in the public schools' special education programs in the 2000–2001 school year were categorized as having a speech or language impairment. This estimate does not include children who have speech and language impairments secondary to other conditions such as deafness". [12] Many school districts provide the students with speech therapy during school hours, although extended day and summer services may be appropriate under certain circumstances.

Patients will be treated in teams, depending on the type of disorder they have.[ clarification needed ] A team can include speech–language pathologists, specialists, family doctors, teachers, and family members.

Student doing speech therapy Student doing speech therapy(GN08932).jpg
Student doing speech therapy

Social effects

Having a speech disorder can have negative social effects, especially among young children. Those with a speech disorder can be targets of bullying because of their disorder. This bullying can result in decreased self-esteem. [20] Religion and culture also play a large role in the social effects of speech disorders. For example, in many African countries like Kenya cleft palates are largely considered to be caused by a curse from God. This can cause people with cleft palates to not receive care in early childhood, and end in rejection from society. [6] For those with speech disorders, listeners reactions are often negative, which may correlate negative effects to self-esteem. It has also been shown that adults tend to view individuals with stutters in more negative ways than those without them. [21]

Language disorders

Language disorders are usually considered distinct from speech disorders, although they are often used synonymously.

Speech disorders refer to problems in producing the sounds of speech or with the quality of voice, where language disorders are usually an impairment of either understanding words or being able to use words and do not have to do with speech production. [22]

See also

Related Research Articles

Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements, that indicates dysfunction of parts of the nervous system that coordinate movement, such as the cerebellum.

Stuttering, also known as stammering, is a speech disorder characterized externally by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses or blocks in which the person who stutters is unable to produce sounds.

A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in dialogue effectively with others. This also encompasses deficiencies in verbal and non-verbal communication styles. The delays and disorders can range from simple sound substitution to the inability to understand or use one's native language. This article covers subjects such as diagnosis, the DSM-IV, the DSM-V, and examples like sensory impairments, aphasia, learning disabilities, and speech disorders.

<span class="mw-page-title-main">Apraxia</span> Medical condition

Apraxia is a motor disorder caused by damage to the brain, which causes difficulty with motor planning to perform tasks or movements. The nature of the damage determines the disorder's severity, and the absence of sensory loss or paralysis helps to explain the level of difficulty. Children may be born with apraxia; its cause is unknown, and symptoms are usually noticed in the early stages of development. Apraxia occurring later in life, known as acquired apraxia, is typically caused by traumatic brain injury, stroke, dementia, Alzheimer's disease, brain tumor, or other neurodegenerative disorders. The multiple types of apraxia are categorized by the specific ability and/or body part affected.

Agraphia is an acquired neurological disorder causing a loss in the ability to communicate through writing, either due to some form of motor dysfunction or an inability to spell. The loss of writing ability may present with other language or neurological disorders; disorders appearing commonly with agraphia are alexia, aphasia, dysarthria, agnosia, acalculia and apraxia. The study of individuals with agraphia may provide more information about the pathways involved in writing, both language related and motoric. Agraphia cannot be directly treated, but individuals can learn techniques to help regain and rehabilitate some of their previous writing abilities. These techniques differ depending on the type of agraphia.

<span class="mw-page-title-main">Global aphasia</span> Medical condition

Global aphasia is a severe form of nonfluent aphasia, caused by damage to the left side of the brain, that affects receptive and expressive language skills as well as auditory and visual comprehension. Acquired impairments of communicative abilities are present across all language modalities, impacting language production, comprehension, and repetition. Patients with global aphasia may be able to verbalize a few short utterances and use non-word neologisms, but their overall production ability is limited. Their ability to repeat words, utterances, or phrases is also affected. Due to the preservation of the right hemisphere, an individual with global aphasia may still be able to express themselves through facial expressions, gestures, and intonation. This type of aphasia often results from a large lesion of the left perisylvian cortex. The lesion is caused by an occlusion of the left middle cerebral artery and is associated with damage to Broca's area, Wernicke's area, and insular regions which are associated with aspects of language.

Dysarthria is a speech sound disorder resulting from neurological injury of the motor component of the motor–speech system and is characterized by poor articulation of phonemes. In other words, it is a condition in which problems effectively occur with the muscles that help produce speech, often making it very difficult to pronounce words. It is unrelated to problems with understanding language, although a person can have both. Any of the speech subsystems can be affected, leading to impairments in intelligibility, audibility, naturalness, and efficiency of vocal communication. Dysarthria that has progressed to a total loss of speech is referred to as anarthria. The term dysarthria was formed from the Greek components dys- "dysfunctional, impaired" and arthr- "joint, vocal articulation".

<span class="mw-page-title-main">Bálint's syndrome</span> Medical condition

Bálint's syndrome is an uncommon and incompletely understood triad of severe neuropsychological impairments: inability to perceive the visual field as a whole (simultanagnosia), difficulty in fixating the eyes, and inability to move the hand to a specific object by using vision. It was named in 1909 for the Austro-Hungarian neurologist and psychiatrist Rezső Bálint who first identified it.

Progressive nonfluent aphasia (PNFA) is one of three clinical syndromes associated with frontotemporal lobar degeneration. PNFA has an insidious onset of language deficits over time as opposed to other stroke-based aphasias, which occur acutely following trauma to the brain. The specific degeneration of the frontal and temporal lobes in PNFA creates hallmark language deficits differentiating this disorder from other Alzheimer-type disorders by the initial absence of other cognitive and memory deficits. This disorder commonly has a primary effect on the left hemisphere, causing the symptomatic display of expressive language deficits and sometimes may disrupt receptive abilities in comprehending grammatically complex language.

<span class="mw-page-title-main">Speech</span> Human vocal communication using spoken language

Speech is a human vocal communication using language. Each language uses phonetic combinations of vowel and consonant sounds that form the sound of its words, and using those words in their semantic character as words in the lexicon of a language according to the syntactic constraints that govern lexical words' function in a sentence. In speaking, speakers perform many different intentional speech acts, e.g., informing, declaring, asking, persuading, directing, and can use enunciation, intonation, degrees of loudness, tempo, and other non-representational or paralinguistic aspects of vocalization to convey meaning. In their speech, speakers also unintentionally communicate many aspects of their social position such as sex, age, place of origin, physical states, psychological states, physico-psychological states, education or experience, and the like.

Language disorders or language impairments are disorders that involve the processing of linguistic information. Problems that may be experienced can involve grammar, semantics (meaning), or other aspects of language. These problems may be receptive, expressive, or a combination of both. Examples include specific language impairment, better defined as developmental language disorder, or DLD, and aphasia, among others. Language disorders can affect both spoken and written language, and can also affect sign language; typically, all forms of language will be impaired.

<span class="mw-page-title-main">Speech–language pathology</span> Disability therapy profession

Speech–language pathology (also known as speech and language pathology or logopedics) is a healthcare and academic discipline concerning the evaluation, treatment, and prevention of communication disorders, including expressive and mixed receptive-expressive language disorders, voice disorders, speech sound disorders, speech disfluency, pragmatic language impairments, and social communication difficulties, as well as swallowing disorders across the lifespan. It is an allied health profession regulated by professional bodies including the American Speech-Language-Hearing Association (ASHA) and Speech Pathology Australia. The field of speech-language pathology is practiced by a clinician known as a speech-language pathologist (SLP) or a speech and language therapist (SLT). SLPs also play an important role in the screening, diagnosis, and treatment of autism spectrum disorder (ASD), often in collaboration with pediatricians and psychologists.

Dysprosody, which may manifest as pseudo-foreign accent syndrome, refers to a disorder in which one or more of the prosodic functions are either compromised or eliminated.

In human development, muteness or mutism is defined as an absence of speech, with or without an ability to hear the speech of others. Mutism is typically understood as a person's inability to speak, and commonly observed by their family members, caregivers, teachers, doctors or speech and language pathologists. It may not be a permanent condition, as muteness can be caused or manifest due to several different phenomena, such as physiological injury, illness, medical side effects, psychological trauma, developmental disorders, or neurological disorders. A specific physical disability or communication disorder can be more easily diagnosed. Loss of previously normal speech (aphasia) can be due to accidents, disease, or surgical complication; it is rarely for psychological reasons.

A speech sound disorder (SSD) is a speech disorder affecting the ability to pronounce speech sounds, which includes speech articulation disorders and phonemic disorders, the latter referring to some sounds (phonemes) not being produced or used correctly. The term "protracted phonological development" is sometimes preferred when describing children's speech, to emphasize the continuing development while acknowledging the delay.

<span class="mw-page-title-main">Neurological disorder</span> Any disorder of the nervous system

A neurological disorder is any disorder of the nervous system. Structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves can result in a range of symptoms. Examples of symptoms include paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain, tauopathies, and altered levels of consciousness. There are many recognized neurological disorders, some relatively common, but many rare. They may be assessed by neurological examination, and studied and treated within the specialties of neurology and clinical neuropsychology.

Apraxia of speech (AOS), also called verbal apraxia, is a speech sound disorder affecting an individual's ability to translate conscious speech plans into motor plans, which results in limited and difficult speech ability. By the definition of apraxia, AOS affects volitional movement pattern. However, AOS usually also affects automatic speech.

Speech and language impairment are basic categories that might be drawn in issues of communication involve hearing, speech, language, and fluency.

<span class="mw-page-title-main">Hypernasal speech</span> Medical condition

Hypernasal speech is a disorder that causes abnormal resonance in a human's voice due to increased airflow through the nose during speech. It is caused by an open nasal cavity resulting from an incomplete closure of the soft palate and/or velopharyngeal sphincter. In normal speech, nasality is referred to as nasalization and is a linguistic category that can apply to vowels or consonants in a specific language. The primary underlying physical variable determining the degree of nasality in normal speech is the opening and closing of a velopharyngeal passage way between the oral vocal tract and the nasal vocal tract. In the normal vocal tract anatomy, this opening is controlled by lowering and raising the velum or soft palate, to open or close, respectively, the velopharyngeal passageway.

Developmental verbal dyspraxia (DVD), also known as childhood apraxia of speech (CAS) and developmental apraxia of speech (DAS), is a condition in which an individual has problems saying sounds, syllables and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts needed for speech. The individual knows what they want to say, but their brain has difficulty coordinating the muscle movements necessary to say those words.

References

  1. ↑ Sheikh, Shakeel; Sahidullah, Md; Hirsch, Fabrice; Ouni, Slim (July 2021). "Machine Learning for Stuttering Identification: Review, Challenges & Future Directions". arXiv: 2107.04057 [cs.SD].
  2. 1 2 Kennison, Shelia M. (2014). Introduction to language development. Los Angeles. ISBN   978-1-4129-9606-8. OCLC   830837502.{{cite book}}: CS1 maint: location missing publisher (link)
  3. ↑ Feldman, Heidi M. (2006-04-26). "Evaluation and Management of Language and Speech Disorders in Preschool Children". Pediatrics in Review. 26 (4): 131–142. doi:10.1542/pir.26-4-131. PMID   15805236. S2CID   28457530 . Retrieved 2022-10-06.
  4. ↑ Bakken, Jeffrey P.; Obiakor, Festus E., eds. (2016-10-24). General and Special Education Inclusion in an Age of Change: Impact on Students with Disabilities. Advances in Special Education. Vol. 31. Emerald Group Publishing Limited. doi:10.1108/s0270-4013201631. ISBN   978-1-78635-542-3.
  5. ↑ Fox, A. V.; Dodd, Barbara; Howard, David (2009-03-07). "Risk factors for speech disorders in children". International Journal of Language & Communication Disorders. 37 (2): 117–131. doi:10.1080/13682820110116776. ISSN   1368-2822. PMID   12012611.
  6. 1 2 Ndung'u, Ruth; Kinyua, Mathew (2009-11-05). "Cultural Perspectives in Language and Speech Disorders". Disability Studies Quarterly. 29 (4). doi: 10.18061/dsq.v29i4.986 . ISSN   2159-8371.
  7. ↑ Deputy, Paul; Human Communication Disorders; March 10, 2008
  8. ↑ "Apraxia of Speech". NIDCD. 2015-08-18. Archived from the original on 2016-02-03. Retrieved 2021-03-31.
  9. ↑ "Dysarthria: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 2021-03-18. Retrieved 2021-03-31.
  10. ↑ Pinto JA, Corso RJ, Guilherme AC, Pinho SR, Nóbrega Mde O (March 2004). "Dysprosody nonassociated with neurological diseases--a case report". J Voice. 18 (1): 90–6. doi:10.1016/j.jvoice.2003.07.005. PMID   15070228.
  11. ↑ "Stuttering". medlineplus.gov. Archived from the original on 2021-03-18. Retrieved 2021-03-31.
  12. 1 2 "Disability Info: Speech and Language Disorders Fact Sheet (FS11)." National Dissemination Center for Children with Disabilities. http://www.nichcy.org/pubs/factshe/fs11txt.htm Archived 2008-05-09 at the Wayback Machine
  13. ↑ Basilakos, Alexandra (2018-02-22). "Contemporary Approaches to the Management of Post-stroke Apraxia of Speech". Seminars in Speech and Language. 39 (1): 025–036. doi:10.1055/s-0037-1608853. ISSN   0734-0478. PMC   5834303 . PMID   29359303.
  14. ↑ Robinson, Roger J. (2008-11-12). "Causes and Associations of Severe and Persistent Specific Speech and Language Disorders in Children". Developmental Medicine & Child Neurology. 33 (11): 943–962. doi:10.1111/j.1469-8749.1991.tb14811.x. PMID   1720749. S2CID   7412606.
  15. ↑ Kang, Changsoo; Drayna, Dennis (2011-09-22). "Genetics of Speech and Language Disorders". Annual Review of Genomics and Human Genetics. 12 (1): 145–164. doi:10.1146/annurev-genom-090810-183119. ISSN   1527-8204. PMID   21663442.
  16. ↑ Choudhury, Naseem; Benasich, April Ann (2003-04-21). "A Family Aggregation Study: The Influence of Family History and Other Risk Factors on Language Development". Journal of Speech, Language, and Hearing Research. 46 (2): 261–272. doi:10.1044/1092-4388(2003/021). ISSN   1092-4388. PMC   1569819 . PMID   14700370.
  17. ↑ Vogel, Adam P; Folker, Joanne; Poole, Matthew L (2014-10-28). Cochrane Neuromuscular Group (ed.). "Treatment for speech disorder in Friedreich ataxia and other hereditary ataxia syndromes". Cochrane Database of Systematic Reviews (10): CD008953. doi:10.1002/14651858.CD008953.pub2. PMID   25348587.
  18. ↑ "Speech Defect". Encyclopedia.com. http://www.encyclopedia.com/doc/1E1-speechde.html Archived 2007-02-21 at the Wayback Machine
  19. ↑ Scott G. G.; O'Donnell P. J.; Sereno S. C. (May 2012). "Emotion words affect eye fixations during reading". Journal of Experimental Psychology: Learning, Memory, and Cognition. 38 (3): 783–792. doi:10.1037/a0027209. PMID   22329788.
  20. ↑ Krueger, Breanna I. (2019-02-26). "Eligibility and Speech Sound Disorders: Assessment of Social Impact". Perspectives of the ASHA Special Interest Groups. 4 (1): 85–90. doi: 10.1044/2018_PERS-SIG1-2018-0016 . S2CID   150998147.
  21. ↑ Williams, Dale F.; Dietrich, Susan (1996-01-01). "Effects of speech and language disorders on raters' perceptions". Journal of Communication Disorders. 29 (1): 1–12. doi:10.1016/0021-9924(94)00014-X. ISSN   0021-9924. PMID   8722526.
  22. ↑ "NICHCY's New Home". nichcy.org. Archived from the original on 2008-05-09. Retrieved 2005-06-05.
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