Communication Disorders
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- Created by: MollyNobbs
- Created on: 08-01-18 15:17
Importance of speech
- Opportunities to interact are reduced
- Speech is a part of our identity
- Speech is:
- How we recieve messages from others
- A vehicle for self expression
- A window into a persons thoughts
- A personal signature
- Superimposed on the normal pattern of exhalation and inhalation
- We breath in about 20 times a minute when not speaking and only 10 times a minute when speaking
- Must be able to control breathing pattern
- Primary function of vocal folds is that of protecting the lungs and their access, the tracheae, from the invasion of food and other foreign bodies
- Problems typically occur with disorders of:
- Fluency
- Voice
- Articulation
- Processing (phonological impairment)
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Fluency
- Dysrhythmia
- Phonetic interference with the normal rhythms of speech
- Stuttering and cluttering
- Stuttering
- 1 % of the population
- Developmental problem
- More likely to affect younger population
- Boys out number girls 4:1
- 85% of all cases start in the pre-school year
- Characteristics of Stuttering
- Create non typical presentation of speech
- Abnormal amount of segment, syllable, word/phrase repetition
- Long pauses, sudden head and body movements
- Stop cycle: stop what they are doing
- Abnormal prolongation of sound segments
- Great use of fillers
- Erratic stress pattern
- Unfinished words
- Awkward circumlocutions
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Causes of Stuttering
- Great controversy about whether stuttering is a problem of speech, personality, neurology or psychology in childhood or occuring throughout life
- Lack of cerebral dominance
- Dont have clear distinction between left and right hemisphere
- Overlap between brain functioning
- Inheristed predisposition
- Genetic makeup
- Environmental pressures
- Something has made speech an unpleasant experience
- Psychoneurotic pressure
- Learning
- Defect in auditory feedback mechanism
- Can create a stutter causing a delay here
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Characteristics of Cluttering
- Opposite to stuttering
- Rapid, staccato speech so utterances come out in short bursts
- Many distortions in rhythm, often monotone presentation
- Poor articulation, sounds are misarticulated and omitted
- Words and syllables are telescoped to the point of unintelligibility
- Words on top of eachother
- Person has emotional reactions to their type of talking and often cope by not talking
- Selective mutism
- Speech too fast: distorted
- Causes of Cluttering
- Few cues about origin
- May be a disorder of thought process preparatory to speech and is based on a heriditary disposition
- Cluttering is the verbal manifestation of Central Language Imbalance which affect all channels of communication; reading, writing, rhythm and music
- Stuttering; speech only
- Cluttering; language disorder
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Helping those with fluency problems
- No known cure
- Have to help them to cope
- Calm anxieties about speech, adapt to abilities, increase quality of life
- Fluency problems can be helped with therapy programmes
- More readily available for adults
- Language Awareness Exercises
- Prevention
- Children
- Introduce good linguistic model
- Reduce communicative pressure
- Keep them rested and healthy
- Seek professional help if needed
- Empower them in other ways
- Not pressurise them
- Adult
- Psychotherapy
- See counsellor and work through insecurities
- Work with delayed auditory mechanism
- Psychotherapy
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Voice Disorders
- Disorders of phonation arise when something interferes with the functioning of the larynx
- Hoarse or breathiness
- Disorders of resonance arise when something interferes with the functioning of the adjoining cavities (upper airway) so that the abnormal timbres are introduced (nasal voice)
- These difficulties are often caused through contact or abuse and can normally be treated by rest, therapy, drugs and/or surgery
- Disorders of Phonation
- Dysphonia
- Persistent huskiness, hoarseness, harshness, breathiness and vocal inefficiency
- Dysphonia
- Causes
- Faulty use of the voice: no demonstrable disease or structural disorder
- Traumatic laryngitis: rest
- Vocal fold thickening: voice therapy
- Vocal nodules and polyps: voice therapy
- Laryngeal trauma
- Neurological or sstemis disorder: radiotherapy or laryngectomy
- Psychological problems: anxiety
- Hormone problems: puberphonia - boys voices dont break + androphonia - girls voice do break
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Management of Voice Disorders
- Voice therapy
- Laryngectomy
- Larynx removed and replaced with artificial substitute
- New voice source
- Esophageal voice
- Voice screening
- Collect vioce samples
- Consider control groups
- How they typically speak
- Address causes
- Current voice use/misuse
- Where is the problem?
- Why could it be happening?
- Respiratory performance
- Voice problems help
- Rest voice
- Medication
- Voice therapy/psychotherapy
- Surgery eg if nodules are cancerous
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Articulation Disorders
- An individual may possess a completely misarticulated sound system so that the person is largely unintelligible or the individual may just experience difficulty with a particular sound
- Problems may be caused by mis-aligned teeth, cleft lip and/or partial paralysis of the vocal tract associated with conditions such as Parkinson's Disease and Dysarthria
- Problems may be helped by speech therapy, drugs and/or surgical intervention
- Cleft Palate
- 1 in 750 live births
- What is it?
- A cleft is an elongated opening originated in the very early stages of pre-natal development
- Vocal apparatus is primarily involved
- Person has a congenital fissure in the middle of the palate which may extend throughout the whole palate or effect the uvula and/or soft palate
- Twice as frequent in males than females
- Cleft Lip
- Upper lip is split and often includes the whole of the alveolar process
- Problems occur in the womb during the process of early formation
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Cleft Palate
- Cause
- Multifactorial aetiology
- Associated difficulties
- Feeding problems
- Middle ear infection
- Psycho social problems
- Language development will be at a slower rate
- Nasalisation
- Incorrect air flow
- Articulations involving lips and palate will fail
- Sloppy sounds
- Connected speech is difficult to follow
- Phonation disturbances
- Husky voice
- Infection may lead to hearing difficulties
- Early surgery can eliminate many of these problems
- Intervention recommended for infants in first year of their life
- Early Language Programmes, Parent Counselling, good success in reconstructions, few have long term problems
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Dyslexia
- What?
- Specific reading disability due to a defect in the brains processing of graphic symbols
- It is a learning difficulty that alters the way the brain processes written material and is typically characterised by difficulties in word recognition, spelling and decoding
- Pathways to Reading
- Direct Route: visual route, ready by eye; most effective
- Dissect shape, recognise it and read without meaning
- DIssect shape, recognise it and read with meaning
- Indirect Route: phonological route, read by ear
- Recognise shape, break it down into letters
- Sounds access meaning and read
- We use both routes
- If something goes wrong, likely dyslexia
- More you read = larger visual store
- Direct Route: visual route, ready by eye; most effective
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Acquired Dyslexia
- Peripheral Dyslexia
- Problems with the visual analysis system
- Neglect Dyslexia
- Visually based Dyslexia
- Approximate visual access
- Letter by Letter Dyslexia
- Problems with the visual analysis system
- Central Dyslexia
- Problem with one/some of the routes
- A difficulty with words
- Where the difficulty is affects the type of Dyslexia
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Reading without meaning
- Damage to the semantic system
- Only ready surface level
- No activation of semantics
- Person can read words
- Person can read words but not understand what is read
- Makes no different whether the word is regular or irregular
- Cant form logical groups from lists of words
- Semantic representation isnt activated
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Dyslexia 2
- Surface Dyslexia
- Cant use visual route
- Spell out - phonic mediation
- Regular words are read more accurately than irregular words
- Mispronunciation errors
- Sounds activate meaning
- Phonological Dyslexia
- Cant use phonic route
- Read by sight so can only read known words
- Reading store is intact
- Make visual mistakes
- Less disabling for the adult reader than surface dyslexia
- Deep Dyslexia
- Everything in one
- Reading without meaning/visual/phonic route
- Left hemisohere for reading has been destroyed; any reading takes place via the right hemisphere
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Dyslexia 3
- Developmental Dyslexia
- Difficulties with accurate and/or fluent word recognition and spelling despite adequate instruction and intelligence and intact sensory abilities
- Same range of conditions
- More common in boys
- Early detection is important
- Must be typical in all except reading and writing
- Typical cognitive abilities
- Extreme difficulties in learning to read and write
- Recognising Dyslexia
- Under 5
- Delay in initial speech development
- Rambling speech, difficulty with sentences
- Clumsiness, pen control
- Unusual laterality
- Lack of control
- Under 5
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Dyslexia 4
- Recognising Dyslexia
- Two years onwards
- Problems with puttnig things in order
- Sequencing issues
- Problems with memory tasks - digit recall
- School related problems
- Poor reading and writing compared with verbal skills
- Messy work, slow, lots of crossing out
- More slips of the tongue
- Slower with some interpretation
- Two years onwards
- Dyslexia diagnosed
- Literacy ability is 2 years behind age
- Other areas of development are age appropriate
- Cause
- No 1 unitary cause
- General neurological weakness for left hemisphere activity
- Genetics
- Differing neural pathways
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Developmental Dyslexia
- Same range of difficulty as acquired dyslexia
- Much greater variation
- Acquired
- Consistent errors
- Trauma, damage
- Developmental
- More variation
- No brain damage
- More scope for intervention
- Dominantly surface or phonological dyslexia
- Not pure
- Elements of both
- Spelling
- Cant guess
- More problematic than reading
- Same range of spelling errors as reading errors
- Some spelt as said, some spelt as thought should look
- Children will respond with carefully designed programmes which start with attainment and progress
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