Chapter 8

Communication Disorders

Definitions

• Communication involves encoding, transmitting, and decoding messages – Communication involves

• A message• A sender who expresses the message• A receiver who responds to the message

– Functions of communication• Narrating• Explaining/informing• Requesting• Expressing

Definitions (cont.)• Language is a formalized code that a group of people use

to communicate

• Speech is the oral production of language– Speech sounds are the product of four related processes:

•Respiration-Breathing that provides power•Phonation-Production of sound by muscle contraction•Resonation-Sound quality shaped by throat•Articulation-Formation of recognizable speech by the mouth

Normal Development of Speech and Language

• Most children follow a relatively predictable sequence in their acquisition of speech and language

– Birth to 6 months: Communication by smiling, crying, and babbling– 7 months to 1 year: Babbling becomes differentiated– 1 to 1.6 years: Learns to say several words– 1.6 to 2 years: Word “spurt” begins– 2 to 3 years: Talks in sentences, vocabulary grows– 3 years on: Vocabulary grows

• Knowledge of normal language development can help determine whether a child is developing language at a slower-than-normal rate or whether the child shows an abnormal pattern of language development

Communication Disorders Defined

• ASHA definition– An impairment in the ability to receive, send, process, and

comprehend concepts of verbal, nonverbal and graphic symbols systems

• IDEA definition – A communication disorder, such as stuttering, impaired

articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance

– To be eligible for special ed a child’s learning must be affected

Speech Impairments

• Types of speech impairments– Deviates from the speech of other people that 1) it calls

attention to itself, 2) Interferes with communication, 3) provokes distress

– Articulation disorders: Not able to physically produce certain sounds “Do foop is dood”

– Phonological: Produces the correct sound in some situation (omitting t in “post”, but using it in “time”)

– Fluency disorders: Stuttering– Voice disorders: Dynamic properties –may be caused by

swollen nasal tissues, hearing impairment

Language Disorders

• Language disorders– Impaired comprehension and or use of spoken, written and/or

other symbol system. May include how and what you say.– Children who have difficulty understanding language have a

receptive language disorder• May not be able to understand directions

– Children who have difficulty producing language have an expressive language disorder

• May not speak, have a limited vocabulary, etc.

Communication differences are not disorders

– The way each of us speaks is the result of a complex mix of influences

– Delay does not mean disorder• Difficulty responding to Wh questions

Prevalence

• A little more than 2% of school-age children receive special education for speech and language impairments

• Over 21% of all children receiving special education services are served in this category– The second largest disability category under IDEA

• Nearly twice as many boys as girls have speech impairments

• Children with articulation and spoken language problems represent the largest category of speech-language impairments.

Causes

• Causes of Speech Disorders – Cleft palate– Paralysis of the speech muscles– Absence of teeth– Craniofacial abnormalities– Enlarged adenoids– Traumatic brain injury– Neuromuscular impairments

• Causes of Language Disorders– Cognitive limitations or mental retardation– Hearing impairments– Behavioral disorders– Environmental deprivation

The two plates of the skull that form the roof of the mouth are not completely joined. Cleft

palate occurs in about one in 700 live births worldwide

Adenoids: Mass of lymphoid tissue situated at the very back of the nose, in the roof of the nasopharynx, where

the nose blends into the mouth.

Identification and Assessment

• Communication disorders are usually first identified by teacher observations

• The speech-language pathologist is the professional with the primary responsibility for identifying, evaluating, and providing services

• Evaluation components include a physical examination and testing

Educational Approaches

• Treating speech sound errors– Articulation errors and phonological errors:

• Discrimination and production activities

– Fluency disorders:

• Behavioral principles and self-monitoring

– Voice disorders

• Direct vocal rehabilitation or surgery

– Language disorders:

• Exploration of expressive language, naturalistic interventions

– Augmentative and alternative communication

Educational Placement Alternatives

• The vast majority of children with speech and language impairments are served in regular classrooms

• Some examples of service delivery models:– Monitoring– Pullout– Collaborative consultation– Classroom-based– Self-contained classroom– Community-based

Current Issues and Future Trends

• SLP or LREC– Controversy as to whether services should take a therapeutic

versus educational focus

• Changing populations mean growing caseloads and more children with severe and multiple disabilities

• The changing role of SLPs means that they will have to develop interventions applicable not only in the classroom but by teachers and parents

Wanagaman et al.

• Participants

• Operational Definition

• Simplified Treatment– Awareness training

– Competing response training

• Results