Communication Disorder
A speech disorder is characterized by difficulty with speech and sound production, voice, resonance, or fluency (the flow of speech). These are described below:
Speech Sound Disorders
A child with a speech sound disorder is unable to say all of the speech sounds in words. This can make the child’s speech hard to understand. People may not understand the child in everyday situations. For most children, the cause of the speech sound disorder is unknown. Other speech sound disorders can be linked to things such as a cleft palate, problems with the teeth, hearing loss, or difficulty controlling the movements of the mouth. Fluency Disorders (Stuttering)
Fluency is the natural “flow” or forward movement of speech. Stuttering is the most common type of fluency disorder. Stuttering happens when there are an abnormal number of repetitions, hesitations, prolongations, or blocks in this rhythm or flow of speech. Tension may also be seen in the face, neck, shoulders or fists. There are many theories about why children stutter. At present, the cause is most likely linked to underlying neurological differences in speech and language processing. Internal reactions from the person talking, and external reactions from other listeners, may impact stuttering, but they do not cause stuttering. Voice Disorders
The voice is produced as air from the lungs moves up through and vibrates the vocal folds. This is called phonation. With voice disorders, the voice may be harsh, hoarse, raspy, cut in and out, or show sudden changes in pitch. Voice disorders can be due to vocal nodules, cysts, papillomas, paralysis or weakness of the vocal folds. Resonance is the overall quality of the voice. A resonance disorder is when the quality of the voice changes as it travels through the different-shaped spaces of the throat, nose and mouth. Resonance disorders include the following:
Hyponasality (Denasality): This is when not enough sound comes through the nose, making the child sound “stopped up.” This might be caused by a blockage in the nose or by allergies.
Hypernasality: This happens when the movable, soft part of the palate (the velum) does not completely close off the nose from the back of the throat during speech. Because of this, too much sound escapes through the nose. This can be due to a history of cleft palate, a submucous cleft, a short palate, a wide nasopharynx, the removal of too much tissue during an adenoidectomy, or poor movement of the soft palate.
Cul-de-Sac Resonance: This is when there is a blockage of sound in the nose, mouth or throat. The voice sounds muffled or quiet as a result.
A language disorder is characterized by difficulty conveying meaning using speech, writing or even gestures. There are two main types of language disorders: receptive and expressive. Causes of language disorders are unknown in many children. Known causes may include hearing loss, intellectual disabilities, emotional disturbance, a lack of environmental exposure to language, or brain injury.
Receptive Language Disorders:
Difficulty understanding words and/or sentences
Difficulty attending to the speech of others
Difficulty with following directions and learning
Expressive Language Disorder
Difficulty using the right words when talking
Difficulty combining words to make sentences
Limited vocabulary
Difficulty putting sentences together correctly
Symptoms
DISFLUENCY
Stuttering is the most common type of disfluency.
Symptoms of disfluency can include:
Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my doll. I...I see you.)
Putting in (interjecting) extra sounds or words (We went to the...uh...store.)
Making words longer (I am Boooobbby Jones.)
Pausing during a sentence or words, often with the lips together
Tension in the voice or sounds
Frustration with attempts to communicate
Head jerking while talking
Eye blinking while talking
Embarrassment with speech
ARTICULATION DISORDER
The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."
Certain sounds (like "r", "l", or "s") may be consistently distorted or changed (such as making the 's' sound with a whistle).
Errors may make it hard for people to understand the person (only family members may be able to understand a child).
PHONOLOGICAL DISORDER
The child does not use some or all of the speech sounds to form words as expected for their age.
The last or first sound of words (most often consonants) may be left out or changed.
The child may have no problem pronouncing the same sound in other words (a child may say "boo" for "book" and "pi" for "pig", but may have no problem saying "key" or "go").
VOICE DISORDERS
Other speech problems include:
Hoarseness or raspiness to the voice
Voice may break in or out
Pitch of the voice may change suddenly
Voice may be too loud or too soft
Person may run out of air during a sentence
Speech may sound odd because too much air is escaping through the hose (hypernasality) or too little air is coming out through the nose (hyponasality)
Treatment Options
Early intervention is very important for children with communication disorders. Treatment is best started during the toddler or preschool years. These years are a critical period of normal language learning. The early skills needed for normal speech and language development can be evaluated even in infants. At that age, the speech-language pathologist works with the parents on stimulating speech and language development in the home. Active treatment in the form of individual therapy usually starts between the ages of 2 and 4 years.
If you have concerns with your child’s communication skills, discuss them with your child’s doctor. The doctor will likely refer the child to a speech-language pathologist for evaluation and treatment. All children with speech and language disorders should also have their hearing tested. Children learn speech and language skills by listening to the speech of others and practicing as they talk to others. Parents are the most important teachers for their child in their early years. They can help the child by giving lots of opportunities to listen and talk. This can be done by frequently pointing out and naming important people, places, and things. They can also read and talk to the child during the day, especially during daily routines, interactive play and favorite activities.
Parents can give the child models of words and sentences to repeat. Parents can also set up opportunities for the child to answer questions and talk. Listening to music, singing songs, and sharing nursery rhymes are also great ways to build speech and language skills while having fun with your child.