-Also known as Articulation and/or Phonology
Speech is how we say sounds and words. People with speech problems may:
not say sounds clearly
have a hoarse or raspy voice
repeat sounds or pause when speaking, called stuttering
-Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segments—including phonotactic rules governing permissible speech sound sequences in a language.
-Organic Speech Sound Disorders
Organic speech sound disorders include those resulting from motor/neurological disorders (e.g., childhood apraxia of speech and dysarthria), structural abnormalities (e.g., cleft lip/palate and other structural deficits or anomalies), and sensory/perceptual disorders (e.g., hearing impairment)
Functional Speech Sound Disorders
Functional speech sound disorders include those related to the motor production of speech sounds and those related to the linguistic aspects of speech production. Historically, these disorders are referred to as articulation disorders and phonological disorders, respectively. Articulation disorders focus on errors (e.g., distortions and substitutions) in production of individual speech sounds. Phonological disorders focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound. It is often difficult to cleanly differentiate between articulation and phonological disorders; therefore, many researchers and clinicians prefer to use the broader term, "speech sound disorder," when referring to speech errors of unknown cause.
Language is the words we use to share ideas and get what we want. A person with a language disorder may have problems:
understanding
talking
reading
writing
A spoken language disorder (SLD), also known as an oral language disorder, represents a significant impairment in the acquisition and use of language across modalities due to deficits in comprehension and/or production across any of the five language domains (i.e., phonology, morphology, syntax, semantics, pragmatics). Language disorders may persist across the lifespan, and symptoms may change over time.
When SLD is a primary disability—not accompanied by an intellectual disability, global developmental delay, hearing or other sensory impairment, motor dysfunction, or other mental disorder or medical condition—it is considered a specific language impairment (SLI).
An SLD may also occur in the presence of other conditions, such as
autism spectrum disorder (ASD),
intellectual disabilities (ID),
developmental disabilities (DD),
attention deficit hyperactivity disorder (ADHD),
traumatic brain injury (TBI),
psychological/emotional disorders,
hearing loss
The relationship between spoken and written language is well established (e.g., Hulme & Snowling, 2013). Children with spoken language problems frequently have difficulty learning to read and write. Additionally, children with reading and writing problems often have difficulty with spoken language, particularly as it relates to higher-order spoken language skills, such as expository discourse (Scott & Windsor, 2000). See language in brief and the Practice Portal page on Written Language Disorders.
Some children with language disorders may have social communication difficulty, because language processing, along with social interaction, social cognition, and pragmatics, comprise social communication. See social communication disorder.
Learning disabilities (LD) and language disorders are also closely linked, although the exact relationship between the two is not fully agreed upon. Language disorders are typically diagnosed before learning disabilities and frequently impact a child's academic performance. At that point, the child is often identified as having a learning disability, even though a language disorder often underpins the academic struggles, especially those associated with learning to read and write.
Fluency is the aspect of speech production that refers to continuity, smoothness, rate, and effort. Stuttering, the most common fluency disorder, is an interruption in the flow of speaking characterized by repetitions (sounds, syllables, words, phrases), sound prolongations, blocks, interjections, and revisions, which may affect the rate and rhythm of speech. These disfluencies may be accompanied by physical tension, negative reactions, secondary behaviors, and avoidance of sounds, words, or speaking situations (ASHA, 1993; Yaruss, 1998; Yaruss, 2004). Cluttering, another fluency disorder, is characterized by a perceived rapid and/or irregular speech rate, which results in breakdowns in speech clarity and/or fluency (St. Louis & Schulte, 2011).
Stuttering typically has its origins in childhood. Most children who stutter, begin to do so around 2 ½ years of age (e.g., Mansson, 2007; Yairi & Ambrose, 2005; Yaruss, LaSalle, & Conture, 1998). Approximately 95% of children who stutter start to do so before the age of 5 years (Yairi & Ambrose, 2005).
All speakers produce disfluencies, which may include hesitations, such as silent pauses, and interjections of word fillers (e.g., "The color is like red") and nonword fillers (e.g., "The color is uh red"). Other examples include whole-word repetitions (e.g., "But-but I don't want to go") and phrase repetitions or revisions (e.g., "This is a- this is a problem"). These are generally considered to be nonstuttered (typical) disfluencies (Ambrose & Yairi, 1999; Tumanova, Conture, Lambert, & Walden, 2014). When a child uses a high number of nonstuttered (typical) disfluencies, differential diagnosis is critical to distinguish between stuttering, avoidance, and a language disorder.
Less typical, stuttering-like disfluencies (Yairi, 2007) include part-word or sound/syllable repetitions (e.g., "Look at the b-b-baby"), prolongations (e.g., "Ssssssssometimes we stay home"), and blocks (i.e., inaudible or silent fixations or inability to initiate sounds). In addition, compared with typical disfluencies, stuttering-like disfluencies are usually accompanied by greater than average duration, effort, tension, or struggle. Aspects that factor into perception of severity include frequency and type of stuttering and the ability of the person who stutters to communicate effectively.
Children and adults with severe speech or language problems may need to find other ways to communicate. There are many types of AAC that they can use. Speech-language pathologists, or SLPs, can help.
A voice disorder occurs when voice quality, pitch, and loudness differ or are inappropriate for an individual's age, gender, cultural background, or geographic location