A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others. This can make the child's speech difficult to understand. Common speech disorders are: 1. Articulation disorders 2. Phonological disorders 3. Disfluency 4. Voice disorders or resonance disorders

1. Under the Guidance of
Rahul SIR
Lecturer
IGSCON
Presented by
Muskan Jaiswal
BSc Nursing 3rd Year
IGSCON

2. Speech is the process of producing specific sounds that
convey meaning to the listener. A speech disorder refers
to any condition that affects a person’s ability to produce
sounds that create words.
Speech is one of the main ways in which people
communicate their thoughts, feelings, and ideas with
others. The act of speaking requires the precise
coordination of multiple body parts, including the head,
neck , chest, and abdomen .
 Speech disorders can affect the way a person creates
sounds to form words. Certain voice disorders may also
be considered speech disorders.

3. 1. Stuttering
2. Apraxia
3. Dysarthria
4. Spasmodic dysphonia
5. Articulation errors
6. Ankyloglossia (Tongue-tie)
7. Selective mutism
8. Aphasia

4. Stuttering also known as Stammering , is a speech disorder in
which the flow of speech is disrupted by involuntary
repetitions and prolongation of sounds, words or syllables.
Also ,there are involuntary silent pauses or blocks.
Clinical features:
Problem in starting a word or phase
Hesitation before certain sound has to be uttered.
Repetition of a sound , word or syllable.
Trembling lips and jaws
Causes:
Developmental factors
Neurogenic stuttering
Psychological factor

5. Is a neurological disorder that makes it difficult for someone with the
condition to say what they want to say correctly. It happens when a
brain can’t coordinate the muscles that enable speech.
Clinical features:
Difficulty moving smoothly from one sound to another
Vowel distortions, such as attempting to use the correct vowel, but
saying it incorrectly.
Separation of syllables, such as putting a pause or gap between
syllables
Inconsistent voicing errors, such as saying “down” instead of “
town”
Causes:
Neurodegenerative illness
Brain tumor
Dementia
hydrocephalus

6. Dysarthria occurs when the
muscles you use for speech are
weak or you have difficulty
controlling them.
Causes:
Amyotrophic lateral sclerosis
Brain injury
Brain tumor
Cerebral palsy
Guillain –barre syndrome
 head injury
 Huntington's disease
Myasthenia gravis
Parkinson’s disease
Wilson’s disease
Clinical features:
Slurred, nasal sounding or breathy
speech
Strained and hoarse voice
Very loud and quiet speech
Gurgly or monotone speech

7. Is a voice disorder. It causes involuntary spasms in the muscles of
the voice box or larynx. This causes the voice to break and have a
tight, strained or strangled sound.
Is a lifelong condition. It most often women, with symptoms
starting between the ages of 30 and 50.
3 types of Spasmodic Dysphonia
1. Adductor spasmodic dysphonia
2. Abductor spasmodic dysphonia
3. Mixed spasmodic dysphonia
Clinical features:
Voice breaks up
Voice sound breathy,
whispery, strangled or tight
Vocal tremor
Hoarse voice
Jerky voice
Failure to maintain voice

8. The inability to produce sounds correctly in speech is referred
to as an articulation disorder, there is no known cause of an
articulation disorder.
Examples of articulation errors include substituting one
sound for another (e.g., saying wed for red ), or leaving out
sounds, ( e.g., nana instead of banana )

9. This is a physical condition that makes it hard for
children to move their tongues, or restricts the
tongue’s range of motion

10. It’s a severe anxiety disorder where a person is
unable to speak in certain social situations.

11. Acquired impairment in the use of language due to damage to certain part of
brain affecting the production or comprehension speech and the ability to
read and write
It’s a two type:
1. FLUENT APHASIA : Speech is present but contains little meaningful
communication.
2. NON-FLUENT APHASIA : Minimal speech, difficulty with slow speech
that requires obvious effort.
TYPES OF FLUENT APHASIA
i. Wernicke’s fluent aphasia
ii. Transcortical sensory aphasia
iii. Conduction or Associative aphasia
iv. Amnesic aphasia
TYPES OF NON-FLUENT APHASIA
i. Broca’s aphasia
ii. Transcortical aphasia
iii. Global aphasia

12. Vocal cord damage
Brain damage
Muscle weakness
Respiratory weakness
Strokes
Polyps or nodules on the vocal cords
Vocal cord paralysis
People with have certain medical or developmental conditions may also have
speech disorders.
I. Autism
II. Attention deficit hyperactivity(ADHD)
III. Strokes
IV. Oral cancer
V. Laryngeal cancer
VI. Huntington’s disease
VII. Dementia
VIII.Amyotrophic lateral sclerosis (ALS)

13. 1. History collection
2. Physical examination
3. Laryngoscopy
4. Mirror examination: To visualize interior of the larynx
especially vocal folds.
5. Videostroboscopy: A test that can diagnose certain
conditions that affect your vocal cords or swallowing.
6. Laryngeal electromyography: Electrical activity in the
laryngeal muscle
7. Oral motor examination procedure
8. RSST: Repetitive Saliva Swallowing Test
9. Fluorography: Photography of X-ray images from a
fluoresecent screen.

15. Speech therapy assess and treats speech disorders and communication
problem. It helps develop skills like comprehension , clarity , voice , fluency
and sound.
Speech therapy is a rehabilitative procedure undertaken in order to help the
people having any kind of communication disorders or problems and some
swallowing problems.
Needs of Speech Therapy
Hearing impairement
Aphasia
Apraxia
Articulation disorders
Cognitive-communication disorders
Dysarthria
Expressive disorders
Fluency disorders
Receptive disorders
Resonance disorders

16. HOME EXERCISE
Speech therapy technique for CHILD
oSpeak to them as much as possible
oUse short and simple words
oTell stories at bedtime
oRead children’s books
oReduce scream time
oPlay games with child
oSign language
oUse mirror
oTurn everyday situations into something new
For ADULTS:
oTongue exercise
Tongue in
and out
Tongue
side to side
Tongue up
and down

17. Say Cheese
Practice
Kissy Face
Consonant and
Vowel Pairing
Repetition
Sentence
Production
Phonological
Processing
Word
Games

18. SPEECH THERAPY EXERCISE
TONGUE IN AND OUT This exercise train the tongue to move with a
coordination pattern to help to produce better speech. The pattern is
asked to take out their tongue for at least two seconds, then pull it
back , hold for 2 seconds, and repeat.
TONGUE SIDE TO SIDE Ask the patient to open the mouth and move
the tongue to touch the right corner of the mouth ; hold for 2 seconds,
and repeat.
TONGUE UP AND DOWN Ask the patient to open the mouth and stick
the tongue out ; then try to take the tongue up toward the nose , hold
2 seconds . Then take your tongue down toward chin, hold 2 seconds,
and repeat.
SAY CHEESE This exercise is used to improve oral motor skills.Ask the
patient to smile in front of a mirror; smile and relax. Repeat several
times.
PRACTICE KISSY FACE Ask the patient to pucker lips together and then
relax. Repeat as often as s/he can do.

19. CONSTANT AND VOWEL PAIRING REPETITION It’s complex exercise,
the patient is asked to take a constant that s/he has trouble saying
and then pair it with each of five vowels (a, e, i, o, u), example; if s/he
trouble with the “r” sound, then practice saying (ra, re, ri, ro, ru) over
and over.
SENTENCE PRODUCTION It’s helpful in a patient with a normal
cognitive side of language but has impaired lips and tongue
coordination. Ask the patient to practice a sentence or two for one or
two minutes.
PHONOLOGICAL PROCESSING It’s improves the ability of patient to
produce speech. A caregivers says different words, and the patient is
guess the number of syllables in that word. Caregiver will provide
feedback to tell whether the patient is right or wrong . The feedback
is a part of the therapeutic exercise.
WORD GAMES These exercise for adults patients used to improve
language processing skills. Computer games, word searches, or
crossword puzzles are the example to practice regularly to improve
speech.

20. Speech disorders affect a person’s ability to produce
sounds that create words. They are not the same as
language disorders, which make it more difficult for
people to learn words or understand what others are
saying to them.
Types of speech disorder include Stuttering , Apraxia,
Dysarthria, Spasmodic dysphonia, Articulation errors,
Ankyloglossia (Tongue-tie), Selective mutism,
Aphasia.
Speech disorders can affect a person’s self- esteem
and their overall quality of life, speech therapy,
breathing exercise , speech therapy exercise etc. can
help improve speech and reduce symptoms.