Speech and Language Disorders

Speech and Language Disorders

• These disorders involve the inability to speak, understand, read, or write
• Speech and language disorders can occur at any age
• They should not be confused with the inability to understand another language

Causes of Speech and Language Disorders

• Genetic problems can cause speech and language disorders.
• Brain injury can cause speech and language disorders
• Accidents can cause speech and language disorders
• Infections can cause speech and language disorders
• Drug use can cause speech and language disorders.
• Stroke can cause speech and language disorders.
• Disease can cause speech and language disorders
• Hearing loss can cause speech and language disorders.
• Brain tumors can cause speech and language disorders
• Problems with body structures used for speech can cause speech and language disorders

Aphasia

• Aphasia is the partial or total loss of speech and language skills, caused by brain injury
• Aphasia can result from cerebral vascular accidents (CVA), commonly called stroke
• Aphasia can result from head injuries
• Aphasia can result from brain infections
• Aphasia can result from cancer (tumors in the brain)

Types of Aphasia

• Receptive (Fluent) Aphasia
• Expressive (Non-Fluent) Aphasia
• Global (both receptive and expressive) Aphasia

Expressive vs Receptive Aphasia

• Receptive Aphasia involves difficulty understanding written and spoken words
• Receptive Aphasia involves the inability to understand their own words
• Receptive Aphasia involves difficulty understanding what is said or read
• Receptive Aphasia involves speech being mixed up or "muddled"
• Receptive Aphasia involves making up or using wrong words without knowing or being aware of their mistakes
• Expressive Aphasia includes difficulty speaking and writing
• with Expressive Aphasia client understands spoken and written words
• With Expressive Aphasia includes speech is jumbled or slurred and difficult to understand
• With Expressive Aphasia client "thinks one thing but says another"
• With Expressive Aphasia clients cannot think of the right word or form the right sounds to form words or sentences
• With Expressive Aphasia clients may leave out connecting words
• With Expressive Aphasia clients are very aware and understand their mistakes
• Expressive Aphasia can be very frustrating for the client

Global Aphasia

• Global Aphasia is a combination of both Expressive and Receptive Aphasia
• Global Aphasia is the most severe type of Aphasia
• Global Aphasia involves difficulty speaking and understanding written and spoken language, and an inability to read or write
• Some clients with Global Aphasia can only say "yes" or "no", and make sounds such as "da da"
• Some clients with global aphasia may have lost all speech and language skills

Apraxia of Speech

• With Apraxia of Speech the client cannot use speech muscles to produce understandable speech (tongue, lips, jaw)
• With Apraxia of Speech the client understands speech and knows what to say
• With Apraxia of Speech the brain cannot coordinate the speech muscles to make the words (movements)
• Apraxia of Speech is caused by damage to the motor speech area in the brain
• Clients with Apraxia of Speech are difficult to understand and speech is usually slow
• A symptom of Apraxia of Speech is Inconsistent speech
• Clients with Apraxia of Speech have difficulty putting words in right order, or finding words

Dysarthria

• Dysarthria is a speech disorder marked by difficulty speaking clearly
• It is caused by weakness or paralysis in the muscles used for speech
• Common causes of Dysarthria: Cerebral palsy and Multiple sclerosis
• Other common causes of Dysarthria: Head Injury, tumor, infection, stroke (CVA)
• People with Dysarthria may have slurred speech and speak in flat, harsh, or nasal tones
• They have problems forming words, spacing their words
• Their speech errors are usually consistent and predictable - you can become familiar with the client's speech

Emotional Effects of Speech and Language Disorders

• Verbal communication is important for functioning and for maintaining relationships with others
• Difficulty communicating may lead to avoiding social situations
• Difficulty communicating may lead to avoiding friends and family
• Difficulty communicating may lead to extreme stress – in relationships, with family
• Difficulty communicating may lead to loss of employment
• Difficulty communicating may lead to difficulty doing routine tasks ex: shopping and paying bills
• Difficulty communicating may lead to frustration, depression, anger
• Difficulty communicating may lead to low self esteem, shame, guilt

Treatment for Speech and Language Disorders

• The goal is to improve a person’s ability to communicate
• Treatment depends on many factors
• These factors include: the cause, amount, and area of brain damage
• These factors include: client’s age and health
• These factors include: client’s willingness and ability to learn
• A speech language pathologist (speech therapist) and other health care team members can help
• Treatment includes improving affected language skills
• Treatment includes using remaining abilities
• Treatment includes restoring language abilities to the extent possible
• Treatment includes learning other methods of communication
• Treatment includes strengthening the muscles of speech

Communication Tools for Language Disorders

• Communication boards contain pictures or words that show functions or tasks
• They relate to ADL’s, such as sleep, food, drink, medicine, and eyeglasses
• Tools depend on client needs
• Mechanical and electronic devices range in complexity and cost
• Some devices are portable, some are not
• If available, the client touches a picture, and the message will be be voiced or printed on a screen
• Screen readers can be used on computers or tablets
• Magnification systems can be used on computers or tablets
• Computers or tablets might be customizable
• Voice synthesizers might be included
• Computers and tablets can be expensive

Supporting and Communicating with Clients with Speech and Language Disorders

• The PSW should follow the care plan with DIPPS
• The PSW should use communication methods that are best for the client
• The PSW should be mindful of facial expression because they can reflect impatience or frustration
• The PSW should consider the communication techniques you have learned in the course and adapt them to help communicate with the client
• The PSW should be aware of their own feelings and frustrations
• The PSW should be alert for signs of client fatigue, such as drooping shoulder, irritability, lack of interest, and decline in understanding
• The PSW should always include the client in conversation

Hearing and Vision Disorders

• Senses of sight and hearing are important for communicating, learning, moving about, and performing ADL’s
• The senses of sight and hearing keeps the client safe by alerting the client to danger
• People who are dying are believed to hear up until their death
• Conditions are challenges and common among all age groups

Common Causes of Hearing and Vision Disorders

• Genetic defects
• Birth complications
• Diseases
• Accidents
• Aging

Ear Disorders and Hearing Impairment

• Ear disorders and hearing impairment affect hearing and balance
• Ranges from slight to complete deafness
• Onset is usually gradual
• Can affect one ear or both
• Most common causes: Aging, Prolonged exposure to loud noise
• Other causes: Accident, illness, Exposure to certain drugs or chemicals, Genetics

Signs of Ear Disorders and Hearing Impairment

• Speaking too loudly
• Leaning forward to hear
• Turning and cupping the unaffected ear toward the speaker
• Responding inappropriately
• Asking for words to be repeated

Eye Disorders and Vision Impairment

• Vision impairment can occur at all ages
• Varies in severity
• Maybe be sudden or gradual
• Causes: Health conditions, Accidents, Eye diseases, Congenital (genetics)

Effects of Eye Disorders and Vision Impairment

• Physical, emotional, social, intellectual, and spiritual health can be affected
• Clients Loss of independence and self-esteem
• Decreased ability to complete ADL’s
• Effects of eye disorders: Social isolation, More at risk for injury

Safety for Clients with Eye Disorders and Vision Impairment

• Keep outdoor sidewalks etc clear
• Keep rooms and hallways free of clutter
• When walking with someone who is blind, walk slightly ahead, their arm resting on yours
• Don't partially open Keep doors open or closed
• Arrange furniture to suit client needs and keep it the same
• Orient client to new setting
• Keep Call bell within client reach