Speech sound disorder

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Speech sound disorder
Specialty Speech-language pathologist

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.

Contents

Classification

Speech sound disorders may be further subdivided into two primary types, articulation disorders (also called phonetic production disorders) and phonemic disorders (also called phonological disorders). However, some may have a mixed disorder in which both articulation and phonological problems exist. Though speech sound disorders are associated with childhood, some residual errors may persist into adulthood.

Articulation disorders

Articulation disorders (also called phonetic production disorders, or simply "artic disorders" for short) are based on difficulty learning to physically produce the intended phonemes. Articulation disorders have to do with the main articulators which are the lips, teeth, alveolar ridge, hard palate, velum, glottis, and the tongue. If the disorder has anything to do with any of these articulators, then it is an articulation disorder. There are usually fewer errors than with a phonemic disorder, and distortions are more likely (though any omissions, additions, and substitutions may also be present). They are often treated by teaching the child how to physically produce the sound and having them practice its production until it (hopefully) becomes natural. Articulation disorders should not be confused with motor speech disorders, such as dysarthria (in which there is actual paralysis of the speech musculature) or developmental verbal dyspraxia (in which motor planning is severely impaired).

Types

  • Deltacism (from the Greek letter Δ) is a difficulty in producing /d/ sound. [1]
  • Etacism is a difficulty in producing e sound. [1]
  • Gamacism is a difficulty in producing /ɡ/ sound. [1]
  • Hitism is a difficulty in producing /h/ sound. [2]
  • Iotacism is a difficulty in producing /j/ sound. [3]
  • Kapacism is a difficulty in producing /k/ sound. [1]
  • Lambdacism (from the Greek letter λ) is the difficulty in pronouncing lateral consonants. [1] [4]
  • Rhotacism is a difficulty producing rhotic consonants sounds in the respective language's standard pronunciation. [1] [4]
    • In Czech there is a specific type of rhotacism called rotacismus bohemicus which is an inability to pronounce the specific sound ř//. [5]
  • Sigmatism is a difficulty of producing /s/, /z/ and similar sounds. [1]
  • Tetacism is a difficulty of producing /t/ sound. [1]
    • Tetism is replacement of /s/, /k/ and similar sounds with /t/ and of /z/ and similar sounds with /d/. [1]

Phonemic disorders

In a phonemic disorder (also called a phonological disorder) the child is having trouble learning the sound system of the language, failing to recognize which sound-contrasts also contrast meaning. For example, the sounds /k/ and /t/ may not be recognized as having different meanings, so "call" and "tall" might be treated as homophones, both being pronounced as "tall." This is called phoneme collapse, and in some cases many sounds may all be represented by one — e.g., /d/ might replace /t/, /k/, and /ɡ/. As a result, the number of error sounds is often (though not always) greater than with articulation disorders and substitutions are usually the most common error. Phonemic disorders are often treated using minimal pairs (two words that differ by only one sound) to draw the child's attention to the difference and its effect on communication.

Some children with phonemic disorders can hear that two phonemes are different from each other when others speak, but are not aware that those phonemes sound the same when they themselves speak. This is called the fis phenomenon , after a scenario in which a speech pathologist says, "You said 'fis,' did you mean 'fish'?" And the child responds, "No, I didn't say 'fis,' I said 'fis'." In some cases, a child is making sounds, that, while similar, are acoustically distinct. Others don’t hear that difference, however, [6] because the two sounds are not treated as separate phonemes in the language being spoken.

Though phonemic disorders are often considered language disorders in that it is the language system that is affected, they are also speech sound disorders in that the errors relate to the use of phonemes. This makes them different from specific language impairment , which is primarily a disorder of the syntax (grammar) and usage of language rather than the sound system. However, the two can coexist, affecting the same person.

Other disorders can deal with a variety of different ways to pronounce consonants. Some examples are glides and liquids. Glides occur when the articulatory posture changes gradually from consonant to vowel. Liquids can include /l/ and /ɹ/.

Mixed speech sound disorders

In some cases phonetic and phonemic errors may coexist in the same person. In such case the primary focus is usually on the phonological component but articulation therapy may be needed as part of the process, since teaching a child how to use a sound is not practical if the child does not know how to produce it.

Residual errors

Even though most speech sound disorders can be successfully treated in childhood, and a few may even outgrow them on their own, errors may sometimes persist into adulthood rather than only being not age appropriate. Such persisting errors are referred to as "residual errors" and may remain for life.

Presentation

Errors produced by children with speech sound disorders are typically classified into four categories:

Sometimes, even for experts, telling exactly which type has been made is not obvious — some distorted forms of /ɹ/ may be mistaken for /w/ by a casual observer, yet may not actually be either sound but somewhere in between. Further, children with severe speech sound disorders may be difficult to understand, making it hard to tell what word was actually intended and thus what is actually wrong with it. Some terms can be used to describe more than one of the above categories, such as lisp, which is often the replacement of /s/ with /θ/ (a substitution), but can be a distortion, producing /s/ just behind the teeth resulting in a sound somewhere between /s/ and /θ/.

There are three different levels of classification when determining the magnitude and type of an error that is produced:

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

Note that omissions do not mean the sound cannot be produced, and some sounds may be produced more easily or frequently when appearing with certain other sounds: someone might be able to say "s" and "t" separately, but not "st," or may be able to produce a sound at the beginning of a word but not at the end. The magnitude of the problem will often vary between different sounds from the same speaker.

Causes

Most speech sound disorders occur without a known cause. A child may not learn how to produce sounds correctly or may not learn the rules of speech sounds on their own. These children may have a problem with speech development, which does not always mean that they will simply outgrow it by themselves. Many children do develop speech sounds over time but those who do not often need the services of a Speech-Language Pathologist to learn correct speech sounds.[ clarification needed ]

Some speech sound errors can result from other syndromes or disorders such as:

Diagnosis

According to the DSM-5, about 50% of speech from a typical 2-year-old child may be intelligible. A 4-year-old child's speech should be intelligible overall, and a 7-year-old should be able to clearly produce most words consistent with community norms for their age. Misarticulation of certain difficult sounds ([ l ], [ ɹ ], [ s ], [ z ], [ θ ], [ ð ], [ t͡ʃ ], [ d͡ʒ ], and [ ʒ ]) may be normal up to 8 years. Children with speech sound disorder have pronunciation difficulties inappropriate for their age, and the difficulties are not caused by hearing problems, congenital deformities, motor disorders or selective mutism. [7]

The DSM-5 diagnostic criteria for speech sound disorder require a persistent difficulty with speech sound production since an early developmental age. For diagnosis, this must lead to difficulty in effective communication and tangible negative social outcomes like reduced academic or occupational performance. Diagnosis is ruled out if the underlying cause is a birth defect or acquired condition such as cerebral palsy, cleft palate, deafness or hearing loss and traumatic brain injury. Other speech disorders can be diagnosed along with speech sound disorder, although differential diagnosis with selective mutism can be difficult due to normal speech being observed only in some settings. [7]

Treatment

For most children, the disorder is not lifelong and speech difficulties improve with time and speech-language treatment. Prognosis is poorer for children who also have a language disorder, as that may be indicative of a learning disorder. [7]

See also

Related Research Articles

In articulatory phonetics, a consonant is a speech sound that is articulated with complete or partial closure of the vocal tract, except for the h, which is pronounced without any stricture in the vocal tract. Examples are and [b], pronounced with the lips; and [d], pronounced with the front of the tongue; and [g], pronounced with the back of the tongue;, pronounced throughout the vocal tract;, [v], and, pronounced by forcing air through a narrow channel (fricatives); and and, which have air flowing through the nose (nasals). Contrasting with consonants are vowels.

<span class="mw-page-title-main">International Phonetic Alphabet</span> System of phonetic notation

The International Phonetic Alphabet (IPA) is an alphabetic system of phonetic notation based primarily on the Latin script. It was devised by the International Phonetic Association in the late 19th century as a standardized representation of speech sounds in written form. The IPA is used by lexicographers, foreign language students and teachers, linguists, speech–language pathologists, singers, actors, constructed language creators, and translators.

Liquids are a class of consonants that consists of rhotics and voiced lateral approximants, sometimes described as "r-like sounds" and "l-like sounds". The word liquid seems to be a calque of the Ancient Greek word ὑγρός initially used by grammarian Dionysius Thrax to describe Greek sonorants.

In phonology and linguistics, a phoneme is a set of phones that can distinguish one word from another in a particular language.

In phonetics, rhotic consonants, or "R-like" sounds, are liquid consonants that are traditionally represented orthographically by symbols derived from the Greek letter rho, including ⟨R⟩, ⟨r⟩ in the Latin script and ⟨Р⟩, ⟨p⟩ in the Cyrillic script. They are transcribed in the International Phonetic Alphabet by upper- or lower-case variants of Roman ⟨R⟩, ⟨r⟩: r, ɾ, ɹ, ɻ, ʀ, ʁ, ɽ, and ɺ. Transcriptions for vocalic or semivocalic realisations of underlying rhotics include the ə̯ and ɐ̯.

Velars are consonants articulated with the back part of the tongue against the soft palate, the back part of the roof of the mouth.

Fis phenomenon is a phenomenon during a child's language acquisition that demonstrates that perception of phonemes occurs earlier than a child's ability to produce the appropriate allophone. It is also illustrative of a larger theme in child language acquisition: that skills in linguistic comprehension generally precede corresponding skills in linguistic production. The name comes from an incident reported in 1960 by J. Berko and R. Brown, in which a child referred to his inflatable plastic fish as a fis. However, when adults asked him, "Is this your fis?" he rejected the statement. When he was asked, "Is this your fish?" he responded, "Yes, my fis." This shows that although the child could not produce the phoneme /ʃ/, he could perceive it as being different from the phoneme /s/. In some cases, the sounds produced by the child are actually acoustically different, but not significantly enough for others to distinguish since the language in question does not make such contrasts.

An affricate is a consonant that begins as a stop and releases as a fricative, generally with the same place of articulation. It is often difficult to decide if a stop and fricative form a single phoneme or a consonant pair. English has two affricate phonemes, and, often spelled ch and j, respectively.

Non-native pronunciations of English result from the common linguistic phenomenon in which non-native speakers of any language tend to transfer the intonation, phonological processes and pronunciation rules of their first language into their English speech. They may also create innovative pronunciations not found in the speaker's native language.

Phonetic transcription is the visual representation of speech sounds by means of symbols. The most common type of phonetic transcription uses a phonetic alphabet, such as the International Phonetic Alphabet.

In phonetics, palatalization or palatization is a way of pronouncing a consonant in which part of the tongue is moved close to the hard palate. Consonants pronounced this way are said to be palatalized and are transcribed in the International Phonetic Alphabet by affixing the letter ⟨ʲ⟩ to the base consonant. Palatalization cannot minimally distinguish words in most dialects of English, but it may do so in languages such as Russian, Japanese, Norwegian (dialects), Võro, Irish and Kashmiri.

Labialization is a secondary articulatory feature of sounds in some languages. Labialized sounds involve the lips while the remainder of the oral cavity produces another sound. The term is normally restricted to consonants. When vowels involve the lips, they are called rounded.

In phonetics, nasalization is the production of a sound while the velum is lowered, so that some air escapes through the nose during the production of the sound by the mouth. Examples of archetypal nasal sounds include and.

English phonology is the system of speech sounds used in spoken English. Like many other languages, English has wide variation in pronunciation, both historically and from dialect to dialect. In general, however, the regional dialects of English share a largely similar phonological system. Among other things, most dialects have vowel reduction in unstressed syllables and a complex set of phonological features that distinguish fortis and lenis consonants.

<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.

The phonology of Bengali, like that of its neighbouring Eastern Indo-Aryan languages, is characterised by a wide variety of diphthongs and inherent back vowels.

Speech acquisition focuses on the development of vocal, acoustic and oral language by a child. This includes motor planning and execution, pronunciation, phonological and articulation patterns.

This article is about the phonology of Egyptian Arabic, also known as Cairene Arabic or Masri. It deals with the phonology and phonetics of Egyptian Arabic as well as the phonological development of child native speakers of the dialect. To varying degrees, it affects the pronunciation of Literary Arabic by native Egyptian Arabic speakers, as is the case for speakers of all other varieties of Arabic.

Phonemic contrast refers to a minimal phonetic difference, that is, small differences in speech sounds, that makes a difference in how the sound is perceived by listeners, and can therefore lead to different mental lexical entries for words. For example, whether a sound is voiced or unvoiced matters for how a sound is perceived in many languages, such that changing this phonetic feature can yield a different word ; see Phoneme. Another example in English of a phonemic contrast would be the difference between leak and league; the minimal difference of voicing between [k] and [g] does lead to the two utterances being perceived as different words. On the other hand, an example that is not a phonemic contrast in English is the difference between and. In this case the minimal difference of vowel length is not a contrast in English and so those two forms would be perceived as different pronunciations of the same word seat.

A lisp is a speech impairment in which a person misarticulates sibilants. These misarticulations often result in unclear speech.

References

  1. 1 2 3 4 5 6 7 8 9 Georgievska-Jancheska, Tatjana (2019-02-09). "Lambdacism, Rhotacism and Sigmatism in Preschool Children: Frequency and Distribution". Open Access Macedonian Journal of Medical Sciences. 7 (3): 336–340. doi:10.3889/oamjms.2019.144. ISSN   1857-9655. PMC   6390136 . PMID   30833997.
  2. "Хитизм". Педагогическая энциклопедия (in Russian). Retrieved 2022-08-02.
  3. "Йотацизм". Педагогическая энциклопедия (in Russian). Retrieved 2022-08-02.
  4. 1 2 Stinchfield, Sara M (1933). Speech Disorders: A Psyhological Study of the Various Defects of Speech. Routledge. ISBN   9781136310256 . Retrieved 10 June 2019. rhotacism for difficulty on the r sounds
  5. Dostál, Miloslav. Bakalářská práce: Korekce rotacismu dětí předškolního věku v logopedické třídě běžné mateřské školy (PDF) (in Czech). Masarykova Univerzita v Brně.
  6. Fromkin, Victoria. (2000). "Phonology". Linguistics : an introduction to linguistic theory. Malden, Mass.; Oxford, U.K.: Blackwell. ISBN   978-0-631-19711-9. OCLC   43577669.
  7. 1 2 3 American Psychiatric Association, ed. (2013). "Speech Sound Disorder, 315.39 (F80.0)". Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing. pp. 44–45.

Further reading