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Disorders of speech and language

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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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