Areas of Need

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Areas of Need

Descriptions of Speech and Language Disorders

What is an articulation disorder?

An articulation disorder is a breakdown in the ability to clearly produce speech sounds. Many times awkward sounding speech sounds in children is typical based on the child’s age. An impairment needing professional attention is based on age, amount of misformed speech sounds, and overall clarity or intelligibility. A speech or language disorder can be determined by a licensed speech-language pathologist through diagnostic testing (see diagnostic testing). Following a determination of speech impairment, speech therapy is indicated based on the individual’s specific needs and the results of the testing. An articulation impairment may look different for different age children. A two-year old who is less than 50% intelligible may need individual speech therapy, whereas a three year old who is less than 75% intelligible may need to be seen by a speech-language pathologist and a four year old who is less than 100% intelligible may require a diagnostic evaluation to determine which speech sounds are interfering with full spoken clarity. In the school age population, full spoken clarity is expected and speech therapy is available for articulation impairments of many levels.

How does a phonological disorder differ from an articulation disorder?

Phonological disorders sound like articulation disorders however they are diagnosed differently by finding patterns in the errors rather than finding the same error for certain speech sounds. So if a developing child leaves off the ending sounds in all words spoken that would be considered a phonological disorder called “final consonant deletion.” An articulation disorder is one’s inability to pronounce a certain sound that is always mis-articulated when it is spoken by the person.

Please see; this is a fantastic resource for parents AND speech-language pathologists!

What is a language impairment?

Language develops from birth with listening to and responding to the communication in one’s environment. Caretakers and culture are an important component to an individual’s development of language skills. Sometimes, even in a typical environment, a child’s language skills don’t develop typically. When a person has difficulty understanding what other people say (Receptive Language) or sharing thoughts and feelings completely (Expressive Language) then he or she may have a language disorder. A person may exhibit difficulty in both receptive and expressive language. A stroke or a head injury can result in a language disorder at any age, even when typical language skills were experienced prior to the traumatic incident. See description of stroke and head injury.

Some signs of a language disorder include:

Expression of spoken ideas can be vague and difficult to understand

  • Overuse of unspecific vocabulary like thing, stuff, it
  • Overuse of filler words like um, uh and word and phrase repetition
  • Using a small variety of vocabulary words
  • Using short choppy sentences
  • using long verbose sentences that lack a clear message
  • frequent misuse of the mechanics of the language including syntax: plurals, verb tense, pronouns and prepositions
  • Difficulty learning to tell time and understanding the vocabulary involved including: minute, hour, day, week, month, year, etc.
  • Lacking skills in understanding and/or retelling a story at the person’s developmental level.
  • Lacking skills in understanding and/or expressing sequential steps in a process or story.
  • Lacking skills in processing and/or expressing the cause-effect relationships necessary for clear exchange of ideas.
  • lacking in reading comprehension or can’t remember what was read

Difficulty interpreting meaning such as:

  • Understanding and using figurative language including metaphors, similes, proverbs and expressions.
  • Understanding when meaning goes beyond what is stated to include information derived from personal experience or common knowledge.
  • Understanding inferred information not present or explicitly suggested by context.
  • Ability to personally evaluate an event or situation.
  • Knowing what to say in response to what another said and knowing when to start and end a conversation.

See: National Institute on Deafness and Other Communication Disorders

What is Stuttering?

Stuttering is an interruption in the forward flow of speech. A person is talking along and there is an involuntary hesitation, repetition, stop, or block, untimely breath, or a sound prolongation in the middle of his/her speaking. During childhood development, children may begin to show signs of stuttering as early as two years old. Stuttering may or may not last a lifetime depending on the amount and quality of early speech therapy. Also, early word and phrase repetition is typical for some children and children quickly grow out of that behavior. A speech-language evaluation is indicated if a young child is experiencing stuttering consistently for longer than six to nine months. Newer research shows with early speech therapy, young children who do not naturally grow out of their early disfluencies can find fluent speech with the help of a speech language pathologist and some minor environmental changes. At this early age, stuttering therapy is a full family endeavor. The speech-language pathologist educates the family members about how to shift their communication style in the home. This helps the young stutterer. Stuttering has a genetic component as well as a personality and developmental component. Since stuttering is common and typical with many children who eventually outgrow it naturally, a diagnostic evaluation is performed to determine risk factors for the possibility of not outgrowing stuttering naturally.

Factors that may contribute to a child’s development of stuttering:

  • The presence of a genetic component (a family member who stutters)
  • The child’s language development
  • The child’s temperament
  • The environment

School Age, Adolescent and Adult Stutterers: People of this age can benefit from stuttering therapy. It is important that the individual is prepared to participate fully in speech therapy. At this later developmental stage, there are strategies for coping with the disfluencies and the reactions of the individual. The speech-language pathologist can teach strategies to the individual to reduce the time it takes to get through a block. As with the early stutter, the individual’s family can be very helpful with treatment. Family knowledge and support is very helpful to reduce the impact of stuttering. For more information please go to The National Stuttering Foundation at National Stuttering Association

What is Autism and Autism Spectrum Disorders (ASD)?

Autism and Aspergers syndrome affect a person’s ability to socially connect with others through language. The core features of ASD include impairments in reciprocal social interaction, impairments in verbal and nonverbal communication, and restricted range of interests and activities, which are due to neurobiological factors. There is great heterogeneity in this population, evident in a broad range of cognitive, social, communication, motor, and adaptive abilities. Integral to the diagnostic criteria, all individuals with ASD are challenged in the area of social communication. Thus, many individuals with ASD have difficulty acquiring the form and content of language and/or augmentative and alternative communication systems, and all have needs in acquiring appropriate social use of communication. Therefore, there are problems in using language for communication and ASD is primarily a social communication disability. These challenges result in far reaching problems, including difficulties with joint attention, shared enjoyment, social reciprocity in nonverbal as well as verbal interactions, mutually satisfying play and peer interaction, comprehension of others’ intentions, and emotional regulation. Due to the nature of ASD, family members, peers, and other communication partners may encounter barriers in their efforts to communicate and interact with individuals with ASD. Therefore, the speech-language pathologist’s role is critical in supporting the individual, the environment, and the communication partner to maximize opportunities for interaction in order to overcome barriers that would lead to decreasing social opportunities and social isolation if left unmitigated. (Taken from ASHA website: American Speech-Language-Hearing Association (ASHA) )

What is Auditory Processing Disorder (APD)?

Auditory Processing: Auditory Processing Disorder is a neurological deficit that effects how the brain processes spoken language making it difficult for a child to process verbal instructions or filter out background noise in the classroom. Hearing ability is intact in APD. (From National Coalition of Auditory Processing Disorders, National Coalition of Auditory Processing Disorders )

What is a voice disorder?

Voice disorders originate in the vocal chords and affect the quality of one’s voice. Voice disorders result in hoarse, breathy, harsh or nasal sounding voice quality as a result of misuse or over use of the voice or due to a structural abnormality. Voice pathology can be diagnosed by a qualified Ears Nose and Throat (ENT) physician and may include vocal nodules, vocal polyps, vocal fold paralysis, spastic dysphonia and chronic laryngitis. Vocal quality may suffer due to a weak voice, a hoarse voice, or a voice with a lot of air emission. The Individual may become easily fatigued from speaking when suffering from vocal pathology. Following a diagnosis by the doctor, the treatment plan frequently involves speech therapy where the client is taught new ways of supporting the voice through breath, vocal pitch, loudness level, and increasing laryngeal strength. Through voice therapy, a client may find lifestyle changes which will positively effect change in the vocal folds.

How do Stroke and Head Injury result in communication impairments?

After a traumatic event to the brain from either a stroke or a closed or open head injury, there may be and typically is a decrease in physical or mental function, including the understanding and use of speech and language skills as were previously experienced by the individual. The individual may experience reduced functioning in speech where she cannot pronounce the words as she did previously. She may experience difficulty remembering information from reading, and there may be difficulty formulating sentences for expression of thoughts for communicating socially and at work. Also, organization skills may be affected where the individual notices more effort needed in scheduling her day or keeping appointments.

If stroke or head injury is your concern, please also see the section on Language Skills. For more information on Traumatic Brain Injury (TBI) please see Traumatic Brain Injury

What is Accent Modification Therapy?

Accent modification therapy involves a person with an accent working with a Speech-Language Pathologist (SLP) on specific consonant sounds, vowel sounds, syllable stress, and pitch variations of a certain language or region of a language.

Why would a person seek accent modification therapy?

A person may seek accent modification therapy to learn the native pronunciations for speech sounds and reduce communication breakdowns. Also, a person may want to sound more regional as not to stand out as being from a different area of the country.

What is an accent?

An accent is the unique way that speech is produced by a group of people speaking the same language. Accents are usually regional or foreign.

Can you change your accent?

Absolutely, with lots of hard work, practice and the help of a qualified speech-language pathologist, you can learn to change your speech pronunciation. Taken from ASHA

Please see The Speech Accent Archive for further information about accents!

How are speech and language impairments diagnosed?

A speech or language disorder is diagnosed by a licensed speech-language pathologist using standardized measures as well as observations, interviews, and transcribed language samples of the person’s actual speaking. For children, the parent interview is extremely important and is combined with the results of any standardized measures used. For adults, personal experiences as well as close family or friends reporting is important to combine with any standardized measures used. The licensed speech pathologist reviews the testing results, interviews, and language samples then determines the level of impairment and assigns a diagnostic code for medical purposes when necessary.