Disorders of speech and language

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  • 1. Smile - 6 weeks 2. Laugh- 3-4 months 3. Babble – 4-6 months 4. Copies sound – 6-9 months
  • Disorders of speech and language

    1. 1. Disorders of speech & Language Dr T Balasubramanian
    2. 2. Introduction <ul><li>Communication is a fundamental part in the developmental process
    3. 3. ENT surgeons are commonly involved in diagnosing and treating patients with communication disorders
    4. 4. Speech language therapists play a vital role in managing children with communication problems </li></ul>
    5. 5. Normal speech development essentials <ul><li>Sensory stimulation – normal
    6. 6. Imitation
    7. 7. Experimentation
    8. 8. Feedback </li></ul>
    9. 9. Sensory stimulation <ul><li>Normal hearing is a must for normal speech
    10. 10. Hearing diability is the commonest cause of speech disturbance
    11. 11. Earlier hearing disability is identified and corrected chances of normal speech development is bright
    12. 12. Augmentation devices should be prescribed at a very early age – under the age of 1 in patients with deafness </li></ul>
    13. 13. Imitation <ul><li>Speech is learnt by imitation
    14. 14. Child loves to imitate its mother
    15. 15. More the mother talks to the child – faster the speech develops </li></ul>
    16. 16. Experimentation <ul><li>Child loves to experiment
    17. 17. Control and generation of speech is largely gained through experimentation
    18. 18. Drooling is one feature of experimentation
    19. 19. Drooling stops as soon as the child comes out of this phase </li></ul>
    20. 20. Feed back <ul><li>Encouragement
    21. 21. Emotions – mother
    22. 22. Response to sounds generated by the child </li></ul>
    23. 23. Stages of speech development
    24. 24. Stages of phonation <ul><li>Phonation stage
    25. 25. Primitive articulation stage
    26. 26. Expansion phase
    27. 27. Canonical babbling phase </li></ul>
    28. 28. Phonation stage <ul><li>Occurs during the first 2-3 months
    29. 29. Infant raises vowel like sounds
    30. 30. Sounds produced are known as cooing </li></ul>
    31. 31. Primitive articulation stage <ul><li>This is also referred as gooing
    32. 32. Wide variety of sounds are produced by the infant in this stage
    33. 33. This phase is a must before the child can migrate to the expansion phase </li></ul>
    34. 34. Expansion phase <ul><li>In this phase the infant combines vowels with consonents
    35. 35. Infant needs to be encouraged during this stage </li></ul>
    36. 36. Canonical babbling phase <ul><li>In this stage the infant learns to string syllables to form complex sounds
    37. 37. In this phase child learns to speak works like mamma, dadda etc. </li></ul>
    38. 38. Classification of speech disorders <ul><li>Receptive disorders
    39. 39. Expressive disorders
    40. 40. Mixed disorders </li></ul>
    41. 41. Receptive disorders <ul><li>Neurological – secondary to cognitive impairment
    42. 42. Sensory – Secondary to hearing / visual impairment
    43. 43. Environmental – Poor sensory stimulation </li></ul>
    44. 44. Expressive disorders <ul><li>Voice disorders
    45. 45. Oropharyngeal structural disorders – cleft palate, rhinolalia
    46. 46. Motor nerve and cortical disorders (dysarthria)
    47. 47. Fluency disorders (stuttering) </li></ul>
    48. 48. Combined disorders <ul><li>Psycological morbidity (Autism)
    49. 49. Developmental disorders (cerebral palsy) </li></ul>
    50. 50. Speech / language delay <ul><li>Commonest problem
    51. 51. Parental anxiety
    52. 52. Rescorla criteria – Children at 24 months who speak less than 50 single words and use no two words combination belong to this group
    53. 53. Incidence is about 15% of normal population </li></ul>
    54. 54. Problems of delayed speech <ul><li>Literacy problems
    55. 55. Socializing problems
    56. 56. Behavioral problems
    57. 57. Learning difficulties
    58. 58. Antisocial activities </li></ul>
    59. 59. Importance of history in diagnosis of delayed speech <ul><li>Details of pregnancy
    60. 60. Details of delivery
    61. 61. Developmental milestones
    62. 62. Feeding history of the child </li></ul>
    63. 63. Normal speech development depends on <ul><li>Respiration
    64. 64. Phonation
    65. 65. Articulation
    66. 66. Resonance
    67. 67. Velopharyngeal sphincter </li></ul>
    68. 68. Nasal speech <ul><li>Rhinolalia clausa
    69. 69. Rhinolalia aperta </li></ul>
    70. 70. Thank you

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