Speech and Language Disorders

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Aphasia

Aphasia is a disorder that results from damage to language centers of the brain. For almost all right-handers and for about 1/2 of left-handers, damage to the left side of the brain causes aphasia. As a result, individuals who were previously able to communicate through speaking, listening, reading and writing become more limited in their ability to do so. The most common cause of aphasia is stroke, but gunshot wounds, blows to the head, other traumatic brain injury, brain tumor, and other sources of brain damage can also cause aphasia.

Apraxia

Apraxia (also referred to as dyspraxia, meaning a less severe form of the disorder) is a speech disorder of the nervous system that affects the ability to sequence and say sounds, syllables, and words. It is not due to muscular weakness or paralysis. The problem is in the brain's planning to move the body parts needed for speech (e.g., lips, jaw, tongue.)
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Articulation Disorders

Articulation disorders are speech sound errors, usually characterized by substituting one sound for another or distorting a sound. These errors may occur during the production of isolated speech sounds (phonemes) and at the syllable and word levels as well.

The following are a few examples of an articulatory disorder:

Frontal and lateral lisps /s, z/
Substituting /w/ for /r/ (wabbit for rabbit)
Substituting /w/ or the "y" sound for /l/ (wike for like)

Dysphagia

Dysphagia refers to difficulty swallowing and may be present in both children and adults. Swallowing difficulties can occur at different stages in the swallowing process:

oral phase-- sucking, chewing, and moving food or liquid into the throat

pharyngeal phase-- triggering the swallowing reflex, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway ( aspiration ) or to prevent choking

esophageal phase-- relaxing and tightening the openings at the top and bottom of the feeding tube in the throat ( esophagus ) and squeezing food through the esophagus into the stomach

Expressive Language Disorders

A person with an expressive language disorder understands language better than he/she is able to communicate. Expressive language disorders can be developmental, in which case a child may not learn language as quickly as his/her peers. Expressive language disorders can also be acquired later in life, occurring as a result of brain damage or injury. The developmental type is more common in children, whereas the acquired type is more common in the elderly. An expressive language disorder may occur in a child of normal intelligence, or it could be a component of a condition affecting mental functioning more broadly (i.e. mental retardation, autism).

Fluency Disorders/Stuttering

A Fluency Disorder, often referred to as "stuttering," is a communication disorder that affects the fluency of speech. It begins during childhood and, in some cases, persists throughout the life span. Most speakers produce brief dysfluencies in speech from time to time, but people with fluency disorders have frequent breakdowns in communication.
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Pragmatic Language Disorders

Pragmatic language disorders refer to difficulties with social language skills such as:

Poor eye contact
Excessively talking, providing too much detail
Talking about innappropriate subjects
Difficulty with conversational exchange
Difficulty with abstract language
Missing subtle language cues
Difficulty understanding jokes and non-literal language
Unable to read/interpret body language, facial expressions.
Unable to express feelings appropriately

Receptive Language Disorders

Receptive Language Disorders refer to difficulties in the ability to comprehend and process language. People with these disorders may have difficulty attending to spoken language and retaining information.

Characteristics of Receptive Language Disorders

Difficulty following directions
Difficulty responding appropriately to questions
High activity level and lack of attention to spoken language
"Tuning out" behaviors
Re-auditorization (repeating a question first and then responding to it.)

Voice Disorders

Patients may seek voice therapy for many reasons, such as the desire to change vocal pitch or intensity level. Other voice problems are caused by vocal abuse and misuse and include vocal nodules and polyps.
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