Speech or Language Impairment

DISBILITY CATEGORY: Speech or Language Impairment

TYPES:

Augmentative and Alternative Communication(AAC),Amyotrophic lateral sclerosis (ALS), Aphasia, Apraxia, Dementia, Dysarthria, Head and Neck Cancer / Oral Cancer,
 laryngeal cancer, Huntingtons Disease, Paradoxical Vocal Fold Movement, Right Hemisphere Brain Damage, Selective Mutism, Spasmodic Dysphonia, Stuttering, Traumatic Brain Injury(TBI), Vocal Fold Nodules and Polyps, Vocal Fold Paralysis
 (Source:ASHA)

DEFINITION

Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines Speech or Language Impairment as …

            “… a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.” 

[34 Code of Federal Regulations § 300.7(c) (11)]

Other Definition: Speech and language disorders refer to problems in communication and related areas such as oral motor function. These delays and disorders range from simple sound substitutions to the inability to understand or use language or use the oral-motor mechanism for functional speech and feeding. (Source: NICHCY)

FACTS AND STATS:More than one million of the students served in the public schools’ special education programs in the 2000-2001 school year were categorized as having a speech or language impairment. This estimate does not include children who have speech/language problems secondary to other conditions such as deafness. Language disorders may be related to other disabilities such as mental retardation, autism, or cerebral palsy. It is estimated that communication disorders (including speech, language, and hearing disorders) affect one of every 10 people in the United States. (Source: NICHCY)

CAUSES: Some causes of speech and language disorders include hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical impairments (cleft lip or palate), and vocal abuse or misuse. Frequently, however, the cause is unknown. (Source: NICHCY)

Causes of speech-language impairment may include: Cerebral palsy, Spina bifida, Hydrocephalus, Traumatic brain injury, Cerebrovascular accidents (stroke), Dysautonomia, Spinal cord injuries and diseases, Brain and spinal cord tumors , Pervasive developmental disorders, General developmental delay (Source: NYU Medical Center)

PREVENTION:

Since mental retardation and hearing loss are predisposing factors for speech disorders, at-risk infants should be referred to an audiologist for an audiology exam. Audiological and speech therapy can then be started if necessary.

Stuttering can best be prevented by parents withholding undue attention to dysfluency in their young child. As young children begin to speak, some dysfluency is common. They lack a large vocabulary and have difficulty expressing themselves. This results in broken or dysfluent speech. If parents place excessive attention on the dysfluency, a pattern may develop. (Source: Medline Plus)

CHARACTERTISTICS:

A child's communication is considered delayed when the child is noticeably behind his or her peers in the acquisition of speech and/or language skills. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills, but this is not always the case.

Speech disorders refer to difficulties producing speech sounds or problems with voice quality. They might be characterized by an interruption in the flow or rhythm of speech, such as stuttering, which is called dysfluency. Speech disorders may be problems with the way sounds are formed, called articulation or phonological disorders, or they may be difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. People with speech disorders have trouble using some speech sounds, which can also be a symptom of a delay. They may say "see" when they mean "ski" or they may have trouble using other sounds like "l" or "r." Listeners may have trouble understanding what someone with a speech disorder is trying to say. People with voice disorders may have trouble with the way their voices sound.

A language disorder is impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary and inability to follow directions. One or a combination of these characteristics may occur in children who are affected by language learning disabilities or developmental language delay. Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate. (Source: NICHCY)

Within the areas below some children may have difficulties in understanding language (receptive difficulties), some in using language (expressive difficulties), and some in both understanding and using language:

• speech apparatus—the mouth, tongue, nose, breathing and how they are coordinated and operated by muscles

• phonology—the sounds that make up language

• syntax or grammar—the way that words and parts of words combine in phrases and sentences

• semantics—the meaning of sentences, words, and bits of words

• pragmatics—how language is used in different situations and how feelings are conveyed 

• intonation and stress (prosody)—the rhythm and music of the way we speak

Semantic-pragmatic disorders:

Semantic refers to the meanings of words and phrases.

Pragmatic refers to the use of language in a social context (knowing what to say and when and how to say it to other people).

Children with semantic difficulties struggle to understand the meaning of sentences or words.  Words that refer to abstract concepts such as feelings (sad, puzzled, jealous) or status (important, official) can be especially hard for these children to understand. They misinterpret and take literally phrases such as "Cut it out!,""Stop it!," or "He's a push-over." Often it can be difficult for children with a semantic disorder to work out the topic or key information in a sentence.

Children with pragmatic difficulties struggle to use language socially. They do not understand how we take turns when we talk. They interrupt more than is acceptable. Their conversation often seems inappropriate or irrelevant. They can seem to be unaware of what their conversational partner needs to know and can therefore say too much or too little about a subject.

Some children have both semantic and pragmatic difficulties.

(Source: Afasic, Apraxia-kids)

MEDICAL TREATMENT: The best treatment is prevention and early intervention by a speech pathologist. Speech training is an involved and time consuming endeavor that can have profound results with consistent treatment. (Source: Medline Plus)

PROGNOSIS: The prognosis depends on the cause of the disorder. Usually, speech can be improved with speech therapy. Prognosis improves with early intervention. (Source: Medline Plus)

EDUCATIONAL IMPLICATIONS:

Students learn through the process of communication, whatever the mode of communication (e.g. whether it is spoken, signed, written, etc.) and the direction of the communication (e.g. teacher to student, student to student, textbook to student, student to teacher). A speech-language impairment results in a communication disability and can affect the student's ability to:

• understand and express information

• relate to others, including teachers and peers

• express needs, abilities and interests

• acquire adequate literacy and numeracy skills

• participate in group activities

• develop a positive self concept

• learn appropriate behaviors and social skills

• problem solve, and

• acquire and demonstrate knowledge in key learning areas.

Speech-language impairment can affect a student's participation in and achievement of learning outcomes from all areas of the curriculum. The effect is not restricted to obvious areas such as communication in the preschool curriculum, or English curriculum. (Source: Queensland)

Because all communication disorders carry the potential to isolate individuals from their social and educational surroundings, it is essential to find appropriate timely intervention. While many speech and language patterns can be called "baby talk" and are part of a young child's normal development, they can become problems if they are not outgrown as expected. In this way an initial delay in speech and language or an initial speech pattern can become a disorder which can cause difficulties in learning. Because of the way the brain develops, it is easier to learn language and communication skills before the age of 5. When children have muscular disorders, hearing problems or developmental delays, their acquisition of speech, language and related skills is often affected.

Speech-language pathologists assist children who have communication disorders in various ways. They provide individual therapy for the child; consult with the child’s teacher about the most effective ways to facilitate the child’s communication in the class setting; and work closely with the family to develop goals and techniques for effective therapy in class and at home. The speech-language pathologist may assist vocational teachers and counselors in establishing communication goals related to the work experiences of students and suggest strategies that are effective for the important transition from school to employment and adult life.

Technology can help children whose physical conditions make communication difficult. The use of electronic communication systems allow nonspeaking people and people with severe physical disabilities to engage in the give and take of shared thought.

Vocabulary and concept growth continues during the years children are in school. Reading and writing are taught and, as students get older, the understanding and use of language becomes more complex. Communication skills are at the heart of the education experience. Speech and/or language therapy may continue throughout a student’s school years either in the form of direct therapy or on a consultant basis. (Source : NICHCY)

Assistive Technologies

People who have language or speech difficulties and impairments may be interested in the following assistive technologies:

Keyboard filters include typing aids such as word prediction utilities and add-on spelling checkers. These products reduce the required number of keystrokes. Certain keyboard filters enable users to quickly access the letters they need and to avoid inadvertently selecting keys they don't want.

Speech recognition systems, also called voice recognition programs, allow people to give commands and enter data using their voices rather than a mouse or keyboard.

Screen review utilities make on-screen information available as synthesized speech and pairs the speech with a visual representation of a word, for example, highlighting a word as it is spoken. Screen review utilities convert the text that appears on screen into a computer voice. This helps some people with language difficulties and impairments by giving them information visually and aurally at the same time.

Touch screens are devices placed on the computer monitor (or built into it) that allow direct selection or activation of the computer by touching the screen.

Speech synthesizers (often referred to as text-to-speech (TTS) systems) receive information going to the screen in the form of letters, numbers, and punctuation marks, and then "speak" it out loud.

(Source: http://www.microsoft.com/enable/guides/language.aspx)

ORGANIZATIONS:

American Speech-Language-Hearing Association (ASHA)
10801 Rockville Pike
Rockville, MD 20852
301.897.5700 (V/TTY); 800.638.8255
http://www.asha.org

ASHA is the professional, scientific, and credentialing association for more than 123,000 members and affiliates who are speech-language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally. The purpose of ASHA is to promote the interests of and provide the highest quality services for professionals in audiologist, speech-language pathology, and speech and hearing science, and to advocate for people with communication disabilities.

Childhood Apraxia of Speech Association of North America (CASANA)
123 Eisele Road
Cheswick, PA 15024
412.767.6589
http://www.apraxia-kids.org

The Childhood Apraxia of Speech Association is a non-profit publicly funded charity whose mission is to strengthen the support systems in the lives of children with apraxia so that each child is afforded their best opportunity to develop speech: to provide electronic and print information to families, professionals, policy-makers and other members of the public; to support and educate parents and professionals as advocates for children with apraxia; to facilitate better public policy and services for children affected by the disorder; to provide training opportunities for families and professionals; to encourage research to further understanding about childhood apraxia and to co-sponsor a biennial scientific research symposium.

Cleft Palate Foundation
104 South Estes Drive, Suite 204
Chapel Hill, NC 27514
800.242.5338; 919.933.9044
Email: info@cleftline.org
Web: http://www.cleftline.org

The Cleft Palate Foundation (CPF) is a non-profit organization dedicated to optimizing the quality of life for individuals affected by facial birth defects. It was founded by the American Cleft Palate-Craniofacial Association in 1973 to be the public service arm of the professional Association. 

International Society for Augmentative and Alternative Communication (ISAAC)

http://www.isaac-online.org/select_language.html

ISAAC—the International Society for AAC—works to improve the life of every child and adult with speech difficulties. ISAAC provides publications, researches, and events. It describes the many ways to help people who cannot speak or write - things like electronic talking boxes, computers, books and boards with pictures or letters, or sign language. The ISAAC website can display Bliss, PCS or Rebus symbols so that people who use one of these symbol systems instead of text, or who have learning difficulties, will be able to read it.

National Institute on Deafness & Other Communication Disorders

http:/www.nidcd.nih.gov/

The National Institute on Deafness and Other Communication Disorders (NIDCD) is to provide new knowledge to help prevent, detect, diagnose, and treat disease and disability.

 NIDCD conducts research in laboratories at the NIH, and the Extramural Research Program, a program of research grants, career development awards, individual and institutional research training awards, center grants, and contracts to public and private research institutions and organizations. The Institute also conducts and supports research and research training in disease prevention and health promotion and the special biomedical and behavioral problems associated with people having communication impairments and disorders.

The Stuttering Foundation of America

 http://www.stutteringhelp.org

The Stuttering Foundation provides free online resources, services and support to those who stutter and their families, as well as support for research into the causes of stuttering.

There are several video clips for kids, youth, and teachers. The web site is well organized kids, young, and adult with stuttering. Moreover, they provides visual and research information for teachers and parents.

International Stuttering Association

http://www.stutterisa.org/

ISAis a worldwide network of people who stutter, a non-profit umbrella association dedicated to close cooperation among independent national and international self-help organizations of people who stutter. ISA was founded in 1995. It is to provide people who stutter, their family and friends, speech-language pathologists, academics, students and the general public with information on stuttering resources available in world.

RESOURCES:

General web sites:

http://www.childspeech.net

The Children’s Speech Care Center web site has been designed as a comprehensive resource ofimportant information for parents, patients, and professionals. It assists people with many of the Speech and Language issues you have, as well as provide links to other valuable resources.

http://dpi.wi.gov/sped/speech.html

The Wisconsin Department of Public Instruction has developed a technical assistance guide to assist IEP teams in evaluating children to determine if they have speech and language impairment and need for special education due to the impairment.

http://seriweb.com/speech.htm

Special Education Resources on the Internet (SERI) is a collection of Internet accessible information resources of interest to those involved in the fields related to Special Education. This collection exists in order to make on-line Special Education resources more easily and readily available in one location. This site will continually modify, update, and add additional informative links.

Web sites for Professionals:

http://www.herring.org/speech.html

Speech language Pathology/ Speech Therapy Resources.

This web site provides pointers to where speech therapists can find information in the field of Speech Language Pathology. There are lists of organization, general information, children with speech impairments, specific communication disorders, and technology for SLP.

http://childhoodsl.com/resources.php

This web site provides a list of resources regarding speech disorders, language disorders, learning disorders, medical disorders, therapy, workshops, and programs relating to childhood speech and language issues.

http://speakingofspeech.com

The Improving Communication Skills in Schools web site is for and by school-based speech language pathologists and teachers. It is a place to share ideas, techniques, and materials that work with students who have communication disorders.

http://www.mnsu.edu/comdis/kuster2/welcome.html

Net Connections to Communication Disorders and Sciences: Internet Guide provided by Judith Maginnis Kuster. This site includes valuable resources for professionals and students in communication disorders and sciences as well as for persons with communication disorders. It provides links to information and therapy material regarding  speech and language disorders, foundations and library of communication disorders and science, discussion forums and electronic newsletters, and stuttering home pate.

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