3P5 ELE PEC - Communication Disorders PDF

3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot includes one’s articulation, fluency, voice, and resonance...

3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot includes one’s articulation, fluency, voice, and resonance OUTLINE quality (the overall tone and I Communication Disorders A Nature of Communication Disorders quality of the voice, affected by The “Big Nine” Areas of Communication how airflow and sound Disorders vibrations are directed through B Characteristics of Communication Disorders II Language Disorders the oral and nasal cavity during A Nature of Language Disorders speech) Classification of Public Schools ○ Communication B encompasses any nonverbal or III Speech Sound Disorders A Nature of Speech Sound Disorders verbal behavior Functional Speech Sound Disorders is said to have the potential to · Articulation Disorders influence behavior, ideas, or · Phonological Disorders Organic Speech Sound Disorders attitudes of others. language, IV Child Onset Fluency Disorder speech, and communication. A Nature of Child Onset Fluency Disorder are more prevalent in boys than in girls due V Social (Pragmatic) Communication Disorder to sex differences in the early development A Nature of Social (Pragmatic) Communication Disorder of communication Social Communication Is often comorbid with neurodevelopmental VI Voice and Resonance Disorders disorders–such as autism spectrum A Nature of Voice and Resonance Disorders B Characteristics of Voice and Resonance disorder and attention-deficit/hyperactivity Disorders disorder–and with mental disorders, such as anxiety disorders. COMMUNICATION DISORDERS THE “BIG NINE” AREAS OF COMMUNICATION DISORDERS NATURE OF COMMUNICATION DISORDERS 1. Articulation 2. Fluency Communication disorders are a group of 3. Voice and resonance disorders that is characterized by an 4. Receptive and expressive language impairment in one’s ability to receive, 5. Hearing comprehend, send, and process concepts 6. Swallowing or verbal, nonverbal, and graphic symbol 7. Cognitive assessments of communication systems a. e.g. attention These include deficits in: b. memory ○ Language 8. Social aspects of communication encompasses the form, function, a. e.g. challenging behavior and use of a conventional b. ineffective social skills system of symbols in a 9. Communication modalities rule-governed manner to a. oral communication modality communicate with others. b. manual communication ○ Speech modality is the expressive production of c. assistive technology sounds 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot CHARACTERISTICS OF development and increase the risk of COMMUNICATION DISORDERS communication disorders. Communication disorders are characterized by Prematurity or Low Birth Weight persistent difficulty in language learning and ○ Premature birth: Babies born usage and other forms of communication. This prematurely may have a higher risk of can manifest as: developing communication problems, Problems with vocabulary especially if they require intensive care. Difficulty in stringing words to form ○ Low birth weight: Babies born with low sentences birth weight are more likely to Difficulty in comprehension of the experience developmental delays, message including communication difficulties. Problem with social communication, making it hard to maintain friendships NEUROLOGICAL Brain Injury ETIOLOGY OF ○ Traumatic brain injuries (TBIs) or COMMUNICATION DISORDERS strokes can damage areas of the brain responsible for communication, leading Communication Disorders begin for many to disorders like aphasia or dysarthria. different reasons. Many people are born with Neurological Diseases them, and they begin during their early ○ Conditions such as Parkinson's disease, childhood development. Still, there are a multiple sclerosis, or cerebral palsy can variety of reasons a person may have or affect speech and language. develop a Communication Disorder. ○ Cerebral palsy: A neurological condition that affects movement and DEVELOPMENTAL coordination can also impact speech Genetic Predisposition and language development. ○ Family history can play a role in the ○ Multiple Sclerosis (MS): Damage to the development of certain communication myelin sheath surrounding nerve fibers disorders, it can increase the risk of can disrupt communication between having a child with such impairments different brain regions, affecting such as stuttering or language language and speech. impairments. Neurodevelopmental Disorders ○ Communication disorders are thought ○ Autism spectrum disorder (ASD), to have a significant genetic intellectual disability, and Attention component and frequently run in deficit hyperactivity disorder (ADHD) families. Some studies have found that can often involve communication as many as 70 percent of children with challenges. a language disorder, for example, have ○ ASD: While the exact causes are a family member who also has the unknown, neurological differences in disorder. brain structure and function are often Prenatal Factors implicated. ○ Exposure to toxins, infections, or ○ ADHD: While primarily a behavioral maternal health conditions during disorder, ADHD can sometimes have pregnancy can impact fetal neurological underpinnings that may affect communication skills. 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot ENVIRONMENTAL STRUCTURAL Early childhood experiences Cleft Lip or Palate ○ Limited exposure to language, ○ These birth defects can affect the inadequate stimulation, or neglect can structures involved in speech hinder language development and production, leading to articulation lead to communication difficulties. difficulties. ○ Play a crucial role in the etiology or ○ Openings or splits in the upper lip, the cause of communication disorders. roof of the mouth (palate) or both. These experiences can set the ○ Researchers believe that most cases of foundation for language development cleft lip and cleft palate are caused by and communication skills. Positive an interaction of genetic and experiences, such as exposure to environmental factors. In many babies, language, stimulation, and secure a definite cause isn't discovered. attachments, can support healthy ○ The mother or the father can pass on language development. Conversely, genes that cause clefting, either alone negative experiences, such as neglect or as part of a genetic syndrome that or limited exposure to language, can includes a cleft lip or cleft palate as one increase the risk of communication of its signs. In some cases, babies disorders. inherit a gene that makes them more likely to develop a cleft, and then an Social and Cultural factors environmental trigger actually causes ○ Socioeconomic status, cultural the cleft to occur. background, and educational ○ These conditions affect the physical opportunities can influence language structure of the mouth and face, acquisition and communication skills. leading to difficulties with speech ○ Things like family income, where you production, articulation, and voice live, and what your culture values can quality. Individuals with cleft lip or all play a role. For example, children palate may also experience challenges from poor families might not have with feeding, hearing, and dental access to the same educational development. resources as children from wealthy Hearing Loss families. And different cultures have ○ Hearing impairment can impact different ways of talking and language development and speech communicating. All of these factors can production. influence how well a child develops ○ When individuals cannot hear clearly, it language skills. can lead to difficulties understanding speech, reduced vocabulary, social withdrawal, and academic challenges. ASSESSMENT OF COMMUNICATION Oral-Motor Dysfunction DISORDERS (STUTTERING) ○ Problems with the muscles involved in Role of Parents and other caregivers speech production, such as the tongue, (potentially including grandparents, lips, and jaw, can contribute to babysitters, and family day care providers) communication disorders. ○ helps to monitor the development and health of their child 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot ○ the richest source of information development based on child's age about a child's development corrected for the prematurity ○ Information provided by the parents Comprehensive Assessment: and other caregivers may lead to the ○ Case history early identification of possible ○ Initial clinical interview problems. ○ Hearing screening ○ Parents are often present during the help rule out hearing loss as a assessment sessions, and observation factor of child-parent interactions is an Ex. Pure-tone screenings , important aspect of assessment. audiometry Cultural Considerations ○ Orofacial examination ○ Bilingual or multilingual children’s assesses the structural and early expression of language is likely to functional adequacy of the vary from that of monolingual children speech mechanisms. distinguishing between typical This includes evaluating development, second language strength, range, coordination, influence, and actual disorders and consistency of movements requires understanding their ○ Diadochokinetic Tasks cultural and linguistic context assesses the child’s accurate Appropriate assessment of a and consistent production of child's communication rapidly alternating speech development will take into sounds called ‘tokens’ account the languages and ○ Speech-Language Sample dialects spoken within the child's child’s naturalistic home and other places of care communication behavior as well as the culture of the child obtained through observing and the family. spontaneous conversations in Normal language milestones various settings ○ there is some variation in the timing at assess the child’s speech, which typically developing children language, fluency, and voice achieve specific language milestones production ○ when the child has not achieved a ○ Standardized assessment instrument particular milestone by a certain age, assess speech production, this is considered a clinical clue of a receptive and expressive possible communication disorder language, and literacy, ○ if the child has not achieved all particularly for speech sound age-appropriate normal language and language disorders milestones, this is not by itself less useful for fluency or voice diagnostic of a communication disorders disorder, but is only an indication that ○ Alternative assessments further screening or assessment may For ethnoculturally diverse and be needed nonverbal children ○ If a child was born prematurely and is Ex. behavioral assessment under the age of 24 months, it is ○ Stimulability important to evaluate the child's 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot can be used to evaluate how a adult-child interaction that promotes child responds to trial treatment language acquisition. strategies The professional must consider having adequate knowledge about normal language acquisition and be aware of the INTERVENTION OF COMMUNICATION child's needs. DISORDERS An essential component of naturalistic therapies is the professional's capacity to DIRECTIVE INTERVENTION recognize, interpret, and respond When directive intervention is administered, appropriately to the child's cue. the professional controls the antecedents Characteristics of Naturalistic and consequences provided to the child. Intervention: Directive approaches utilize specific ○ provides distributed learning techniques such as modeling and opportunities prompting to obtain targeted language ○ the child's focus of attention or interest structures from the child. For example: is the priority ○ In modeling, the professional names ○ antecedent and consequent stimuli are the object shown to the child and then associated with a particular prompts the child to name that object, communication response. too. ○ In prompting, the professional presents a verbal command, a question, or a LANGUAGE DISORDERS nonverbal cue to the child and tries to elicit a desired verbal response. NATURE OF LANGUAGE DISORDERS Directive Interventions are A language disorder is a usually conducted using blocks neurodevelopmental condition where of discrete trials or drills in a individuals have ongoing challenges in controlled environment. learning and using language in different Characteristics of Directive Intervention: forms, such as speaking, writing, or using ○ provides massed blocks of trials sign language. ○ the professional controls the According to the DSM-5, these challenges antecedents (stimuli) and the involve difficulties with understanding or consequences (reinforcers)a verbal producing language, which may show up command, a question, or a nonverbal as a smaller vocabulary, simpler sentence cue to the child and tries to elicit a structures, and problems with having desired verbal response. conversations. ○ consequences are displayed as verbal These language difficulties are much below praise or tokens unrelated to the child's what is typical for their age and can impact current activities. their ability to communicate, participate in social activities, succeed academically, or NATURALISTIC INTERVENTION perform at work. Language disorders are often In naturalistic interventions, the professional developmental disorders that start in early uses specific techniques that create childhood and continue into adulthood. opportunities for the child to use the desired language structures. This method involves 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot ○ About 5% of young children are An essential feature of language disorders is diagnosed with language disorders persistent challenges in acquiring and using between the ages of 3 and 5, and they language with various modalities, such as are twice more common in boys than spoken, written, and sign language. This can in girls. be due to deficits in comprehension or Language Delay occurs when the normal production of vocabulary, grammar, rate of developmental progress is sentence structure, and discourse. interrupted but the systematic sequence of EXPRESSIVE LANGUAGE DISORDER development remains essentially intact Difficulty in language production, formulating, and using spoken or written CLASSIFICATION IN PUBLIC SCHOOLS language. Language disorders are classified under the Children with this may have limited federal Individuals with Disabilities vocabulary and will use the same Education Act (IDEA). arrangement of words regardless of the According to IDEA, the relevant classification situation for students with communication disorders ○ It may manifest as immature speech, is "Speech or Language Impairment" (SLI). often resulting in interaction difficulties This classification involve: Write ○ Impaired Articulation: Difficulties in RECEPTIVE LANGUAGE DISORDER producing clear and accurate speech difficulty in comprehending what others sounds. say. This may appear as ○ Language Impairment: Problems with “inattentiveness” in children. A understanding and/or using language manifestation of this can be not appropriately. following instructions from an adult. ○ Stuttering: Disruptions in the fluency of Children are usually slow in responding speech. and process only a part of what is said. ○ Voice Impairment: Issues with the It is not uncommon for students with quality, pitch, or volume of the voice specific learning disabilities to have Students experiencing communication receptive language problems. disorders, such as those involving language Children with RLD are high-risk impairment, stuttering, or voice impairment, indicators of emotional and behavioral may be considered eligible for disorders speech-language therapy and other ○ manifest through echolalia, supportive services under the classification inability to follow directions, of “Speech-Language Impairment.” re-auditorization, “inattentiveness” when spoken CHARACTERISTICS OF to, lack of interest when reading LANGUAGE DISORDERS story books, inability to Language disorders are considered understand complicated significant difficulties in one’s ability to sentences, and delayed understand or express ideas in his/her language skills (below their native communication system. It results expected age level) from disrupting language acquisition at a MIXED RECEPTIVE AND EXPRESSIVE young age. LANGUAGE DISORDER 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot There is a delay in comprehending and whatever deficits present may be using the rules related to combining predictive for other outcomes during elements of words. There is also adulthood difficulty in forming their own questions People with a family history of language and inferring meaning from what disorders are more likely to have it someone says to them DSM-5 CRITERIA ○ This may manifest in improper using of “a” and “the”, or incorrect usage of verb tenses (e.g., He runned) or using third-person singular verbs incorrectly (e.g., He want) APHASIA (DEVELOPMENT APHASIA) caused by brain damage results in complete or partial loss of the ability to speak, comprehend, and formulate language. It can affect all language modalities (speech, comprehension, writing, reading) In children, the term developmental ASSESSMENT OF LANGUAGE DISORDERS aphasia is more widely used and can Parents as a source of referrals as well as refer to having an expressive language teachers or other educational professionals disorder. Children with developmental who regularly interact with the child aphasia struggle to acquire and use Sociocultural approach words to express their needs and wants ○ dynamic assessment to others. (test-teach-retest format), ○ Broca’s Aphasia- broken words, ○ ethnographic interviewing, and also known as non-fluent or ○ direct observation expressive aphasia in various communicative ○ Wernicke’s Aphasia- word contexts to gather salad, also known as sensory Speech-language samples aphasia or fluent aphasia Speech-language AGE AT ONSET pathologist observes Language disorder usually occurs in the quantity and quality of early developmental period utterances It must be noted however that up until formal and informal interaction age 4, there is much variation in with the child vocabulary acquisition parent-report measures It is commonly diagnosed with children Standardized tests from ages 3-5. ○ Clinical Evaluation of Language Speech and language impairments are Fundamentals (CELF) identified more in kindergarten through ○ for children younger than 24 months middle grades children. Bayley Scales of Infant and By age 4, individual differences in Toddler Development language begin to stabilize and 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot children not meeting expected Helping the child expand their vocabulary developmental milestones, deviation may and sentence complexity in order to express indicate the possibility of other physical or their wants, needs, and ideas clearly developmental problems that manifest first Teaching new words and naming objects as language problems The use of alternative communication forms also applies in this disorder Reading is highly encouraged to enhance their expressive language skills INTERVENTION OF LANGUAGE DISORDERS Allow the child ample time to talk without Language Intervention Activities - In this interruptions approach, the speech-language pathologist will engage and interact with the child FOR MIXED-RECEPTIVE LANGUAGE through playing and talking, using pictures, DISORDERS books, or other activities to stimulate A tailor-made one-on-one treatment language development. The therapist may program that focuses on the child’s specific employ repetition exercises and model needs through different approaches is a way proper vocabulary and grammar to improve to improve language skills. the child's language skills. Articulation Therapy - In Articulation, or sound production, exercises, the SLP shows SPEECH SOUND DISORDERS proper sounds and syllables in words and sentences for a child during their play NATURE OF SPEECH SOUND DISORDERS activities. The level and type of play are appropriate for the child's age and needs. Speech Sound Disorders pertain to any difficulty or difficulties with regards to: FOR RECEPTIVE LANGUAGE DISORDERS ○ speech perception Develop the child’s receptive vocabulary how one’s brain makes sense of which is understanding the words and the speech sounds function of specific words. ○ motor production Develop the child’s understanding of the physical movements figurative language and how to construct required to produce speech inferences. sounds The SLP may also work with the family to ○ phonological representation of speech identify appropriate alternative means of sounds and segments communication (AAC) such as gestures, how an individual organizes or picture boards or computer devices to maps the sounds that make up facilitate communication. words to recognize how they are Children younger than 6 to 7 can read structured and used within a picture books with the therapist or guardian language and label items in the story. Speech Sound Disorders is an umbrella term For children older than 6 to 7 years old, they that can be classified into two categories can read short stories and ask them about depending on its nature the text. FUNCTIONAL SPEECH SOUND DISORDERS FOR EXPRESSIVE LANGUAGE DISORDERS 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot Do not have an identifiable cause (idiopathic) have an identifiable cause Either articulation disorders or underlying motor/neurological, structural, or phonological disorders sensory/perceptual cause. ○ In terms of the characteristics of the ○ Motor/neurological causes errors itself, there is no clear distinction include apraxia of speech between the two dysarthria ○ it can sometimes overlap ○ Structural abnormalities include cleft palate or lip, in ARTICULATION DISORDERS which there is an opening or split related to the motor production of individual in the upper lip or the palate, or speech sounds and errors associated with it both, and are among the most Associated errors are more random and common birth defects. variable ○ Sensory/perceptual causes include substitution, omission, distortion, and include hearing impairment addition specific areas of the brain that are used for communication may not develop appropriately. PHONOLOGICAL DISORDERS ETIOLOGY OF SPEECH SOUND DISORDERS focus primarily on predictable, rule-based errors errors are more systematic and consistent FOUR ORGANIC CAUSES FOR SSD Include: ○ Fronting STRUCTURAL ABNORMALITIES when sounds produced at the Physiological problems back end of the mouth like ‘k’ or ○ Pre- and perinatal issues: It has been ‘g’ is produced at the front of the observed that certain factors, including mouth instead, turning them into low birth weight, preterm delivery, ‘t’ or ‘d’ sounds complications during delivery, maternal e.g. saying ‘tat’ instead of ‘cat’ or stress or infections throughout ‘doe’ instead of ‘go’ pregnancy, and problems during ○ Stopping delivery, are linked to speech sound when sounds that have a impairments and delayed speech continuous airflow, such as ‘s’ or sound acquisition. ‘ch’ sounds, are replaced by stop Cleft Palate sounds such as ‘t’ or ‘d’ ○ A gap in the soft palate and roof of the e.g. saying ‘tip’ instead of ‘chip mouth, sometimes extending through ○ Final consonant deletion the hard palate and upper lip. omission of the final consonant ○ It lessens the separation between the of a word mouth and nasal chambers. e.g. saying ‘sa’ instead of ‘sat’, or ○ Congenital abnormalities that affect ‘lo’ instead of ‘log’ around one in every 700 babies. ○ It is brought on by problems with fetal ORGANIC SPEECH SOUND DISORDERS development and is frequently treated with surgery. 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot Dental Structure the precise movements ○ Many noises are produced by the necessary for speech due to tongue, lips, and teeth in sync; some of damage to the nervous system. these sounds are result of cleft palates, Still, there is no effect on while others are not. language comprehension. ○ Occlusion A closure and fitting together of SENSORY/PERCEPTUAL ABNORMALITIES dental structures In terms, Hearing loss, as certain brain ○ Several factors contribute: regions that are involved in communication Teeth positioning could not grow properly. Alignment of teeth in the upper and lower jaws FUNCTIONAL ABNORMALITIES Nature of curves in upper and Gender lower jaws ○ Males are more likely than females to Biting height of the teeth when experience speech sound jaws are closed abnormalities. ○ Normal Adult Occlusion Family history Usually, the upper teeth protrude ○ Children were more likely to develop a a little over the lower jaw's teeth. speech issue if they had parents or When the jaw is closed, the siblings who had speech and/or biting overlap of the bottom language disorders. teeth is approximately one-third “Parentese” or “Motherese” that of the upper front teeth. ○ When speaking to younger children or ○ Malocclusion adults, parents use different language Abnormal fit between the upper than when speaking to newborns and and lower dental structures toddlers. Exaggerated Overbites and ○ It encourage babies' and toddlers' Underbites language development and Atypical teeth positions vocalization. Atypical jaw alignment ○ This can harm a child's speech, language, and social development if it NEUROLOGICAL ABNORMALITIES is continued as they become older. Brain damage, like cerebral palsy or a head Modeling injury, may cause impairments in speech. ○ By imitating and encouraging such ○ Apraxia speech, adults can help promote baby It is a motor speech disorder talk among youngsters and young wherein the brain struggles to people. coordinate the movements ○ A strong instrument for influencing necessary for speech, as it language and speech patterns. struggles to translate conscious ○ It is utilized in treatments and is speech plans into motor plans. believed to have an impact on verbal ○ Dysarthria development naturally. It pertains to the inability of the muscles, such as the tongue, CHARACTERISTICS OF voice box, and jaw, to perform 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot SPEECH SOUND DISORDERS By the age of 7, most speech sounds Also known as phonological disorder, it and pronunciations are more accurate is characterized by problems with and clearer. articulation (making sounds) and Sounds that are most misarticulated sound patterns (phonological are called the late eight sounds. processing), resulting in inaccurate or ○ L, R, Z, S, TH, CH, DZH, and ZH inappropriate speaking execution. Children up to 8 years of age may ○ It may manifest through have difficulty in pronouncing these persistent challenges with sounds which is still considered normal. speech sound production and May improve over time with treatment difficulties interfering with speech intelligibility. Individuals DSM-5 CRITERIA tend to make certain types of errors or distribute errors incorrectly **SSD represents the largest category of all speech problems ERROR TYPES (SODA) Substitution- substituting one phoneme for another. Examples: ASSESSMENT OF SPEECH SOUND ○ right → wight DISORDERS ○ follow → fowo Comprehensive Assessment: ○ stop → thtop ○ Case history ○ soup → thoup ○ Initial clinical interview Omission- also known as deletions, ○ Hearing screening involves dropping consonants at the ○ Standardized assessment instrument ends of the words but may also occur Tagalog Articulation Test in any position in a word. Cebuano Articulation Test ○ Ex. From lost to los ○ Stimulability Distortions- producing an unfamiliar a child being assessed for sound speech-sound disorder might ○ Ex. nasalized, where /p/ may be asked to say the sounds sound like /m/ they're struggling with while Additions- adding an extra sound receiving clear instructions, ○ Ex. From dog to dog-uh demonstrations, and praise for Articulation Errors- may involve correct attempts transitional lisps, where a /th/ sound precedes an /s/ sound ○ Ex. From yes to yeth INTERVENTION OF SPEECH SOUND AGE AT ONSET DISORDERS By age 2 speech becomes 50% Articulation Therapy - IIn articulation intelligible and at age 4, speech is therapy, the SLP focuses on teaching the overall intelligible. 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot child the proper and correct way to produce The use of alternative communication forms specific sounds. also applies in this disorder Phonological Therapy - The SLP targets a Reading is highly encouraged to enhance group of sounds with similar error patterns, their expressive language skills helps the child with phonological rules, and Allow the child ample time to talk without applies these rules to other sounds. interruptions Metaphon Therapy - is used to teach metaphonological awareness or the FOR MIXED-RECEPTIVE LANGUAGE awareness of the phonological structure of a DISORDERS language. A tailor-made one-on-one treatment Naturalist Speech Intelligibility Intervention program that focuses on the child’s specific - aims to achieve the target sound in needs through different approaches is a way naturalistic activities, which allows the sound to improve language skills. to occur frequently. Speech Sound Perception Training - helps children develop stable perceptual CHILDHOOD-ONSET FLUENCY representations of target phoneme or DISORDER (STUTTERING) phonological structure NATURE OF CHILDHOOD-ONSET FLUENCY FOR RECEPTIVE LANGUAGE DISORDERS DISORDER (STUTTERING) Develop the child’s receptive vocabulary Is a symptom of child-onset fluency disorder which is understanding the words and the that occurs when the flow of speech is function of specific words. abnormally interrupted by repetitions, Develop the child’s understanding of blocking, or prolongations of sounds, figurative language and how to construct syllables, words, or phrases inferences. disturbance in the normal fluency and time The SLP may also work with the family to patterning of speech that is inappropriate identify appropriate alternative means of for the individual’s age communication (AAC) such as gestures, Fluency in Speech - reasonably smooth flow picture boards or computer devices to of words and sentences has a rhythm and facilitate communication. timing that is steady, regular and rapid with Children younger than 6 to 7 can read respect to speed and continuity picture books with the therapist or guardian repeated interruptions, hesitations or and label items in the story. repetitions that seriously interfere with the For children older than 6 to 7 years old, they flow of communication can read short stories and ask them about individual’s normal fluency and time the text. patterning of speech is disturbed causes anxiety about speaking FOR EXPRESSIVE LANGUAGE DISORDERS onset is in the child’s early developmental Helping the child expand their vocabulary period and sentence complexity in order to express ○ Stuttering is not caused by medical their wants, needs, and ideas clearly conditions such as strokes or Teaching new words and naming objects neurological disorders. It is a developmental issue rather than one 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot resulting from a specific medical event HOWEVER, researchers haven’t or injury. pinpointed a specific gene that’s deficits may occur as social communication solely responsible for stuttering. demands increase However, it’s possible that if you carry certain genetic material, ETIOLOGY OF you may be more likely to CHILD-ONSET FLUENCY DISORDER stutter. ○ According to (Cincinnati Children's, The exact cause of child-onset fluency 2019), the likelihood of recovery within a disorder, commonly known as stuttering, is family that has a history of recovered not fully understood, but a combination of stuttering is as significant as the factors is believed to contribute to its likelihood of persistence in those development. These factors can be broadly families where recovery has not categorized into: occurred. ○ Emotional problems and parenting GENETICS style do not cause stuttering. However, sensitive temperament (individual Family histories of stuttering demonstrate behavioral characteristics or reactions) that stuttering runs in families and is and emotion are commonly seen as influenced by genetic factors. traits associated with stuttering in ○ Children who stutter, for example, often young children. have relatives who stutter. ○ It's also more common in boys than in DEVELOPMENTAL FACTORS (EMOTIONS girls, which is why some geneticists used to think it might be linked to AND THE ENVIRONMENT) sex-specific chromosomes. According to Dr. Jasmine Shaikh of ○ You are three times more likely to Medicinenet, Developmental stuttering stutter if you have a first-degree occurs in young children while they are still relative (a parent or sibling) who learning speech, and researchers are still stutters. studying what exactly causes However, twin and adoption developmental stuttering. Possible cause of studies suggest that genetic this type of stuttering includes: Problems in factors interact with speech control and negative reactions. environmental factors for ○ Problems in speech control stuttering to occur, and many When children’s speech and stutterers have no family history language abilities are unable to of the disorder. meet the child’s verbal ○ It was also mentioned that identical demands, stuttering may twins sharing the exact same genetic develop. makeup have more similar patterns of ○ Negative reactions stuttering than fraternal twins. If parents or friends are always ○ There is evidence that stuttering is criticizing or making fun of a more common in children who also child's speech, it can make the have concurrent speech, language, child feel bad and less likely to learning, or motor difficulties. try to talk. This can create a negative cycle where the child 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot talks less because they are sides of your brain-- is a bit afraid of being made fun of, and bigger in some people who then they become even worse at stutter. talking because they don't practice enough. It is important for adults to be supportive and encouraging of children's INTERVENTION OF SCD communication efforts. Although emotional factors, Intervention (Therapy) nervousness, and anxiety This disorder is trained by a do not cause stuttering, they may place an health-care professional, such as a additional cognitive burden speech-language pathologist. on children who stutter during a critical period of ○ Treatment is multifaceted, language development. focusing on reducing or eliminating fluency issues, NEUROGENIC Most experts agree that stuttering has a building effective neurological basis, affecting areas of the communication skills, and brain that control how speech and language encouraging involvement in are processed. Neurogenic stuttering is caused by a stroke, school, work, and social traumatic brain injury or other brain settings. disorders. These conditions cause problems in those parts of the brain that are involved Speech therapy can help an individual in the coordination of speech and fluency. learn to speak slowly and clearly. Scientists have also found some Small electronic gadgets, such as a neurological differences between people who stutter and those who don't. delayed auditory feedback tool that ○ Scientists have also found some requires the user to slow their speech, neurological differences between people who stutter and those who don't. can also aid improve speech fluency. ○ There are also regions on the right side Cognitive-behavioral therapy may be of the brain that you usually don't use used to discover cognitive patterns to talk, but that are overly active in people who stutter. that exacerbate stuttering and to help This could mean that when you cope or overcome stuttering related to stutter, the right side of your brain is interfering with normal or caused by stress or anxiety. speech production on the left side. That idea is also supported SOCIAL (PRAGMATIC) by the fact that the corpus callosum-- the bundle of COMMUNICATION DISORDER neurons that connects the two 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot NATURE OF SOCIAL (PRAGMATIC) ○ e.g. “Can you pass the salt?” is a polite COMMUNICATION DISORDER request instead of a question of capability Social (Pragmatic) Communication Disorder Social interaction (SCD) is a disorder that was newly ○ is the communication between at least introduced in the DSM-V two people. included under the category of Social cognition communication disorders ○ is an understanding of the mental and involves marked challenges in both verbal emotional states of other people, and and nonverbal communication in social ○ one’s self, social schemes, and social settings knowledge that beliefs and values an impairment in pragmatics, which cause social events, expected socially include: appropriate behavior, and ○ not using appropriate language in consequences of inappropriate certain situations behavior. ○ misunderstanding verbal and Language processing nonverbal cues ○ internal generation of language ○ experiencing difficulty in (expressive) comprehending nonliteral language ○ understanding and interpretation of so much so that it starts to language (receptive) significantly hinder one’s Demonstrations of good social interpersonal relationships, communication skills include: academic and occupational ○ adjusting speech style to make it performance, rendering appropriate for the specific context communication ineffective ○ being able to understand others’ Individuals with SCD may still have normal perspectives and the rules for verbal phonological processing, vocabulary, and and nonverbal communication higher-order grammatical and semantic ○ using the structural aspects of skills language appropriately Symptoms tend to manifest early, but it may People diagnosed with SCD typically remain undetected until the demands of struggle with these particular aspects of social communication exceed the person’s communication. limited capabilities INTERVENTION OF SCD SOCIAL COMMUNICATION The approach depends on the cause (is it a structural, neurological, or functional Pragmatics ○ pertains to a branch of linguistics that cause?) primarily focuses on goal-consistent Surgery language use with emphasis on the ○ Unusual voice production caused social context ○ it studies how context influenced the by abnormal tissue development interpretation of meaning and/or dental structures ○ RemovalofLarynX 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot Management Intervention Attention Deficit/Hyperactivity Disorder (ADHD) ○ Prosthetic Management ○ Similar to those with SCD, they could Involves relearning struggle with social communication communication and social involvement. Social Anxiety Disorder ○ Pharmacologic Management ○ Symptoms are caused by anxiety or Therapy fear of social situations and appear after adequate development. ○ BehavioralSpeechTherapy ○ It has similar characteristics. ○ RelearningCommunication Intellectual Disability or Global Prostheses Developmental Delay ○ With deteriorated social Learning communication communication abilities. techniques (replacing ○ When considering the intellectual limitations, SCD is not the right laryngeal verbalizations) diagnosis until the social ○ DirectInstruction communication deficits are markedly Enhancement of affected increased. learning of the child VOICE AND RESONANCE DISORDERS Relearn what voice production is acceptable and NATURE OF VOICE AND RESONANCE right DISORDERS Voice and resonance disorders are not ○ Active Participation included in the DSM-5, as they are ○ Home Implementation physiological rather than developmental or mental disorders. ○ individual habitually speaks with a voice that differs in pitch, loudness, or ETIOLOGY OF SCD quality from the voices of his or her peer group It is uncertain what causes SCD as a primary Voice Disorders diagnosis. SCD is frequently described in ○ unusual or abnormal acoustical terms of the particular ailment that it is qualities linked to. ○ involve acoustical qualities that are so Neurodevelopmental disorder affecting the different that they are noticeable and right hemisphere of the brain is the theory. divert attention away from the content People may find it more challenging to ○ 0.12% of elementary school-aged simultaneously digest verbal and visual students have voice disorders information as a result. It could also have to Resonance Disorders do with difficulties with executive functioning. ○ abnormal sound vibration in the oral, Family history of communication disorders, nasal, or pharyngeal cavities while ASD, and specific learning disabilities speaking ○ It appears to increase the risk for SCD 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot ○ leads to too little or too much nasality in one’s speech VOICE DISORDER CHARACTERISTICS OF STRUCTURAL VOICE AND RESONANCE DISORDERS vocal fold abnormalities such as All voices differ greatly in pitch, volume, and other characteristics. However, voice ○ vocal nodules, cysts, or polyps disorders entail acoustic characteristics that ○ edema are so distinct that they draw attention away from the content. ○ glottal stenosis The main factors of voice disorders are: ○ recurrent respiratory papilloma ○ Pitch ○ sarcopenia (muscle atrophy ○ Quality ○ Volume associated with aging) An individual with a voice disorder may exhibit abnormality with a single factor or in inflammation of the larynx due to issues combination. such as Differences in pitch can be recognised by: ○ arthritis of the cricoarytenoid or ○ Abnormally high or low pitch ○ Pitch breaks (voice cracks) cricothyroid, ○ Restricted pitch range ○ laryngitis, or ○ Monotonic pitch Quality of voice and resonance include ○ laryngopharyngeal reflux factors such as: 1. Nasality trauma to the larynx such as Hypernasality is identifiable by ○ intubation trauma sounding as if speech is coming from the nose. High vowels (/u, ○ chemical exposure i/) are the most affected. ○ external trauma Hyponasality or denasality is the type of voice quality that has too little nasality, causing NEUROLOGICAL speech to sound congested or recurrent laryngeal nerve paralysis "stopped up." This happens adductor/abductor spasmodic particularly in the nasal consonants (/m/, /n/, and /ng/). dysphonia Mixed Resonance Disorder is a Parkinson’s disease mix of hypernasality and hyponasality multiple sclerosis 2. Breathy speech pseudobulbar palsy 3. Hoarse-sounding speech ETIOLOGY OF FUNCTIONAL VOICE RESONANCE DISORDERS phonotrauma such as 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot ○ yelling ○ Cancer of the soft palate ○ screaming (palatal tumors) ○ excessive throat ○ Disorders associated with clearing/coughing genetic syndromes, such as: ○ speaking in too high or too low 22q11.2 Deletion Syndrome pitch Neurofibromatosis muscle tension dysphonia Kabuki syndrome ventricular phonation ○ VPD may also be present from vocal fatigue due to birth (congenital). The size and ○ effort shape of the throat and roof of ○ Overuse the mouth (palate), or the way these structures can move, can PSYCHOGENIC cause VPD. chronic stress disorders HYPONASALITY anxiety lack of resonance for words which are depression resonated in the nasal cavity eg. m, n , conversion reaction such as ng ○ conversion aphonia Due to decreased airflow through the ○ conversion dysphonia nose during speech Large tonsils or glands between your RESONANCE DISORDER HYPERNASALITY child’s airway and the back of their throat (adenoids) causes abnormal resonance in voice Allergies or common colds due to increased airflow through nose Deviated septum during speech Velopharyngeal dysfunction (VPD) may CUL-DE-SAC RESONANCE cause hypernasality Small mouth opening ○ Cleft palate Large tonsils or adenoids ○ Submucous cleft palate Difficulty hearing speech sounds ○ Adenoidectomy or MIXED RESONANCE tonsillectomy 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot Problems with motor planning for speech. This can cause abnormal or uncoordinated opening and closing of the soft palate, nose and mouth. Difficulty hearing speech sounds Hypernasality related to congestion, nasal obstruction, or corrective palate surgery that doesn’t go away most common cause of a resonance disorder is cleft palate but children with a submucous cleft palate childhood apraxia of speech enlarged adenoids neurological disorders may also have a resonance disorder. 3P5 | ELE PEC - COMMUNICATION DISORDERS Prof. Aromin and Prof. Cuambot MAJOR TOPIC HEADINGS SUBHEADING TOPIC Write ○ Write Write 💭 Personal insights, reflections, notes, etc. Table No. Title (italicized) PARAMETER (all caps) PARAMETER Term (bold) Insert description here Term (bold) Insert description here Term (bold) Insert description here