Speech and Language Disorders

Speech and Language Disorders

• Affects ability to speak, understand, read, or write.
• It is not the same as being unable to understand another language.
• Can occur at any age.

Possible Causes of Speech and Language Disorders

• Genetic problems.
• Brain injury.
• Accident.
• Infection.
• Drug use.
• Stroke.
• Disease.
• Hearing loss.
• Brain tumor.
• Problems with body structures used for speech.

Aphasia

• This is the partial or total loss of speech and language skills caused by brain injury.
• Can be caused by a cerebral vascular accident (CVA), commonly called a stroke.
• May result from head injuries, brain infections or cancer (tumor in the brain).
• There are three types of Aphasia:
  • Receptive (Fluent)
  • Expressive (Non-Fluent)
  • Global (both receptive and expressive).

Receptive Aphasia

• The person has difficulty understanding written and spoken words.
• The person cannot understand their own words.
• The person has difficulty understanding what is said or read.
• Speech may be mixed up or “muddled”.
• The person may make up or use the wrong words unaware of the mistakes.

Expressive Aphasia

• The person has difficulty speaking and writing.
• The person understands spoken and written words.
• Speech may be jumbled or slurred and difficult to understand.
• The person may "think one thing but say another".
• The person cannot think of the right word or put the right sounds together to form words or sentences.
• The person may leave out connecting words.
• People are very aware of their mistakes, which can be frustrating.

Global Aphasia

• Global Aphasia is a combination of both types.
• It is the most severe type of aphasia.
• The person has difficulty speaking and understanding written and spoken language and can’t read or write
• The person may only say “yes”, “no”, and make sounds such as "da da.”
• They may have lost all speech and language skills.

Apraxia

• A person cannot use their speech muscles to produce understandable speech (tongue, lips, jaw).
• Understands speech and knows what to say.
• Their brain cannot coordinate the speech muscles to make the movements.
• It is caused by damage to the motor speech area in the brain.
• The person is difficult to understand and speech is usually slow.
• Inconsistent speech is common.
• The person finds it is difficult to put words in the right order, or find words.

Dysarthria

• The person has difficulty speaking clearly.
• It is caused by weakness or paralysis in the muscles used for speech.
• Common causes include cerebral palsy, multiple sclerosis, head injury, tumor, infection, or CVA (stroke).
• The person may have slurred speech and speak in flat, harsh or nasal tones.
• The person has problems forming words or spacing their words.
• Speech errors are usually consistent and predictable.

Emotional Effects of Speech and Language Disorders

• Verbal communication is important for functioning and maintaining relationships with others.
• Difficulty in communicating may lead to:
  • Avoiding social situations.
  • Avoiding friends, family.
  • Extreme stress in relationships with family.
  • Loss of employment.
  • Difficulty doing routine tasks, like shopping or paying bills.
  • Frustration, depression, or anger.
  • Low self-esteem, shame, or guilt.

Treatment of Speech and Language Disorders

• The goal of treatment aims to improve the person's ability to communicate.
• Depends on many factors:
  • The cause, amount, and area of brain damage
  • Client's age and health
  • Client's willingness and ability to learn
• A speech-language pathologist and other healthcare team members help the person to:
  • Improve affected language skills.
  • Use remaining abilities.
  • Restore language abilities to the extent possible.
  • Learn other methods of communication.
  • Strengthen the muscles of speech.

Communication Tools

• Communication boards hold pictures or words that show functions or tasks.
• Related to ADL’s such as sleep, food, drink, medicine, and eyeglasses.
• Selection depends on the client’s needs
• Mechanical and electronic devices offer a range of complexity and cost
• May or may not be portable.
• Client touches a picture, and the message is then voiced or printed on a screen
• Computers or tablets feature screen readers and magnification systems
• They may be customizable and have a voice synthesizer .
• They can be expensive.

Supporting and Communicating With Clients

• Follow the care plan – use DIPPS.
• Use communication methods that are best for the client.
• Be mindful of your facial expression and do not reflect impatience or frustration.
• Consider the communication techniques and adapt them to help communicate with the client.
• Be aware of your feelings and frustrations.
• Check for signs of client fatigue, like drooping shoulders, irritability, lack of interest, or decline in understanding.
• Always include the client in the conversation.

Hearing and Vision Disorders

• Senses of sight and hearing are important for communicating, learning, moving about, and performing ADL’s.
• Keep people safe by alerting them to danger.
• It is believed that People who are dying can hear up until their death.
• Challenges are common among all age groups,
• Common causes include:
• Genetic
• Birth complications
• Diseases
• Accidents
• Aging

Ear Disorders and Hearing Impairment

• Ears are used for hearing and balance.
• Ranges from slight to complete deafness.
• Onset is usually gradual.
• Can affect one ear or both.
• The most common causes include;
  • Aging
  • Prolonged exposure to loud noise
• Other causes;
  • Accident
  • Illness
  • Exposure to certain drugs or chemicals
  • Genetics
• Obvious signs
  • Speaking too loudly
  • Leaning forward to hear
  • Turning and cupping the unaffected ear toward the speaker
  • Responding inappropriately
  • Asking for words to be repeated
• May cause speech challenges
• Affects all aspects of a person's life.

Eye Disorders and Vision Impairment

• Can occur at all ages, varying in severity.
• Onset may be sudden or gradual.
• Causes;
  • Health conditions
  • Accidents
  • Eye diseases
  • Congenital (genetics)
• Effects;
  • Physical, emotional, social, intellectual, and spiritual health
  • Loss of independence and self-esteem
  • Decrease ability to complete ADL’s
  • Social isolation
  • Increased Risk for injury
• Outdoor sidewalks etc. must be kept clear
• Rooms and hallways should be free of clutter
• When walking with someone who is blind, walk slightly ahead, their arm resting on yours
• Keep doors fully open or fully closed, never partially open
• Arrange furniture to suit client needs and keep it the same.
• Orient client to new setting
• Ensure the call bell is within client reach