Speech: Verbal means of communicatingSpeech soundsFluency (rhythm of speech)Voice (using VFs and breathing to produce speech sounds)Language: Socially shared rules (Symbolic; meaningful)Word meanings
How to make different words (friend vs. friendly)
Putting words together (syntax)
Speech Disorder
Inability to produce sounds correctly or fluently
Language Disorder
Trouble understanding others (receptive language disorder)
Trouble expressing ideas, thoughts, and feelings (expressive language disorder)
Language disorders & speech disorders can exist together or separately
Motor speech disorder
Caused by neurological damage (typically from stroke). TBI, dementia, tumor, and progressive neurological disorders can also lead to Apraxia of Speech.)
Severity depends on nature of brain damage
Linguistic expression is in tact (people with apraxia know what they want to say)
Difficulty with muscle movement coordination (cannot say the words they want to say)
Make frequent tries and re-adjustments (motor plan is not in tact; constantly grope for correct set of movements for given word)
Difficulty imitating speech sounds
Difficulty imitating non-speech movements (whistling, sticking out tongue, blowing bubbles)
Groping for correct motor patterns when trying to produce sounds
Inconsistent errors
Slow speech rate
Preserved ability to produce automatic speech
Most severe cases: inability to produce any speech
Muscle retrainingCorrect production of soundsSequencing sounds into words
Intensive repetition
Awareness of correct mouth movements
Severe casesAugmentative and alternative communicationGesturesElectronic equipment
In most cases cause is unknown
Possible causes
Genetic component?
Stroke or brain injury
3 yr. old girl
Started therapy at 2 yrs.
http://www.youtube.com/watch?v=szjfC9K190U&feature=fvw4 yr. old (same girl)
Continued therapy
http://www.youtube.com/watch?v=Lvl78dcXGp8&feature=relatedhttp://www.youtube.com/watch?v=Lvl78dcXGp8&feature=relatedMore severe case:
Motor speech disorder
Results from neurologic injury
Characterized by poor articulation
A disorder of muscle weakness (muscle of face, mouth, and/or respiratory system may be affected)
"Slurred" speech
Speaking softly or barely able to whisper
Slow rate of speech
Rapid rate of speech with a "mumbling" quality
Limited tongue, lip, and jaw movement
Abnormal intonation (rhythm) when speaking
Changes in vocal quality ("nasal" speech or sounding "stuffy")
Hoarseness
Breathiness
Drooling or poor control of saliva
Chewing and swallowing difficulty
Slowing speech rate
Improving breath support
Strengthening muscles
Increasing mouth, tongue, and lip movement
Improving articulation (for clearer speech)
Educating family members and care givers
Severe cases: alternative means of communicationGestures, alphabet board, electronics
http://www.youtube.com/watch?v=EHNSBo3SsmYWhat do you notice?
A disorder of language
Neurological damageStroke, tbi, tumor
Understanding and expression of language impaired
May co-occur with dysarthria and/or AOS
Two broad types: fluent & nonfluent
Left temporal lobe damage (Wernickes area damaged)
Signs/symptomsLong sentences; no meaning
Addition of unnecessary words / non-words
You know that smoodle pinkered and that I want to get him round and take care of him like you want before.
Difficulty understanding speech
Unawareness of errors
http://www.youtube.com/watch?v=aVhYN7NTIKU&feature=relatedWhat do you notice?
Damage to frontal lobe of brain (including Brocas area)
Speak in short phrases (produced with great effort)
Omission of function words (is, and, the, etc.)
Usually fairly good language comprehension
Often aware of their difficulties
Ex: Walk dog meaning I will take the dog for a walk.
http://www.youtube.com/watch?v=f2IiMEbMnPM&feature=related
http://www.youtube.com/watch?v=1aplTvEQ6ew&feature=relatedWhat do you notice?
Abnormal prosody
Results from damage to right hemisphere (the non-dominant hemisphere for language)
Can be Expressive (produce inappropriate prosody)Receptive (cant interpret prosody of others)
Language tied to MEANING, speech is NOT.
Hesitation/stuttering can affect fluency*Automatic speech: how are you?**