COMMUNICATION DISORDER

LANGUAGE DISORDEREXPRESSIVE & MIXED EXPRESSIVE-RECEPTIVE

LANGUAGE DISORDER

SPEECH DISORDERPHOLOGICAL DISORDER & STUTTERING

COMMUNICATION DISORDER

Communication- is the exchange of ideas , opinions and facts between people interacting with each other.

Communicative competence- is the ability of the child develops to use speech and language to uncover how the world works.

Speech- is the systematic use of sounds and sound combinations to produce meaningful words, phrases and sentences.

Language- puts meaning into speech and is used to express and receive meaning.

Terminologies:

THE MAJOR COMPONENTS OF THE LANGUAGE1. PHONOLOGY-is the sound system of language,

combinations of sounds are permissible I language to form meaningful words.

2. GRAMAR- designates the organization of r words and the rules for placing words in an order that makes the sense in the language.

3. SYNTAX-is the rule system that governs the order and combination of word to from phrases and sentences.

4. SEMANTICS- is the meaning of the language5. PRAGMATICS- is the social aspect of language;

knowledge and understanding rules of turn taking, starting and ending conversations.

LANGUAGE

Language have:1. Form2. Content3. Function

---- AMERICAN SPEECH LANGUAGE-HEARING ASSOCIATION, 1993----

There are two types of expressive language disorder: the developmental type and the acquired type

BELOW THE EXPECTED LEVELS OF:vocabulary, use of correct tenses, production of complex

sentences, recall of words.

EXPRESSIVE LANGUAGE DISORDER

Expressive language disorder is a relatively common childhood disorder. Language delays occur in 10–15% of children under age three, and in 3–7% of school-age children.

Expressive language disorder is more common in boys that in girls.

Studies suggest that developmental expressive language disorder occurs two to five times more often in boys as girls.

The developmental form of the disorder is far more common than the acquired type.

EPIDEMIOLOGY

ADHD (19%) ANXIETY DISORDER ( 10%) OPPOSITIONAL DEFIANT DISORDER ( 7%)

Children with expressive language disorder are also at higher risk for a speech disorder, receptive difficulties and other learning disorder.

COMORBID

There is no known cause of developmental expressive language disorder. Research is ongoing to determine which biological or environmental factors may be the cause.

Genetic factor Left-handedness

ETIOLOGY

A. The scores obtained from a standardized individually administered measures of expressive language development are substantially below those obtained from standardized measures of both nonverbal intellectual capacity and receptive language development the disturbance maybe manifest clinically by symptoms that include having a , making markedly limited vocabulary making errors in tense, or having difficulty recalling words or producing sentences with developmentally appropriate length or complexity.

DIAGNOSTIC CRITERIA

B. The difficulties with expressive language interfere with academic or occupational achievement or with social communication

C. Criteria are not met for mixed receptive-expressive language disorder or a PDD.

D. If a mental retardation, a speech motor or sensory deficit or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.

CODING NOTE

The developmental form of expressive language disorder generally has a good prognosis. Most children develop normal or nearly normal language skills by high school.

In some cases, minor problems with expressive language may never resolve.

The acquired type of expressive language disorder has a prognosis that depends on the nature and location of the brain injury.

Some people get their language skills back over days or months. For others it takes years, and some people never fully recover expressive language function.

PROGNOSIS

There are two types of treatment used for expressive language disorder. The first involves the child working one-on-one with a speech therapist on a regular schedule and practicing speech and communication skills.

The second type of treatment involves the child's parents and teachers working together to incorporate spoken language that the child needs into everyday activities and play. Both of these kinds of treatment can be effective, and are often used together.

PSYCHOTHERAPY

TREATMENT

Mixed receptive-expressive language disorder is diagnosed when a child has problems expressing him-or herself using spoken language, and also has problems understanding what people say to him or her.

MIXED RECEPTIVE-EXPRESSIVE DISORDER

There is no known cause of developmental mixed receptive-expressive language disorder. Researchers are conducting ongoing studies to determine whether biological or environmental factors may be involved. The acquired form of the disorder results from direct damage to the brain.

CAUSES

signs and symptoms of mixed receptive-expressive language disorder are for the most part the same as the symptoms of expressive language disorder

not able to communicate thoughts, needs, or wants at the same level or with the same complexity as his or her peers. In addition, the child often has a smaller vocabulary than his or her peers.

This lack of comprehension may result in inappropriate responses or failure to follow directions. Some people think these children are being deliberately stubborn or obnoxious, but this is not the case.

SYMPTOMS

3% of school age children Less common than the expressive disorder Twice prevalent in boys than girls

EPIDEMIOLOGY

Additional speech and language disorders Learning Disorder Half children with this disorder have

pronunciation difficulties leading to PHONOLOGICAL DISORDER

ADHD

COMORBIDITY

The first criterion states that the child communicates using speech and appears to understand spoken language at a level that is lower than expected for the child's general level of intelligence.

Second, the child's problems with self-expression and comprehension must create difficulties for him or her in everyday life or in achieving his or her academic goals. If the child understands what is being said at a level that is normal for his or her age or stage of development, then the diagnosis would be expressive language disorder.

If the child is mentally retarded, hard of hearing, or has other physical problems, the difficulties with speech must be greater than generally occurs with the other handicaps the child may have in order for the child to be diagnosed with this disorder.

DIAGNOSIS

The disorder is usually diagnosed in children because a parent or teacher expresses concern about the child's problems with spoken communication. The child's pediatrician may give the child a physical examination to rule out such medical problems as hearing loss. Specific testing for mixed expressive-receptive language disorder requires the examiner to demonstrate that the child not only communicates less well than expected, but also understands speech less well. It can be hard, however, to determine what a child understands.

most examiners will use non-verbal tests in addition to tests that require spoken questions and answers in order to assess the child's condition as accurately as possible.

Children who speak a language other than English (or the dominant language of their society) at home should be tested in that language if possible

The developmental form of mixed receptive-expressive language disorder is less likely to resolve well than the developmental form of expressive language disorder. Most children with the disorder continue to have problems with language skills. They develop them at a much slower rate than their peers, which puts them at a growing disadvantage throughout their educational career. Some persons diagnosed with the disorder as children have significant problems with expressing themselves and understanding others in adult life.

PROGNOSIS

mixed receptive-expressive language disorder should be treated as soon as it is identified. Early intervention is the key to a successful outcome. Treatment involves teachers, siblings, parents, and anyone else who interacts regularly with the child.

Regularly scheduled one-on-one treatment that focuses on specific language skills can also be effective, especially when combined with a more general approach involving family members and caregiver

Teaching children with this disorder specific communication skills so that they can interact with their peers is important

TREATMENT

PHONOLOGICAL DISORDERPhonological disorder occurs when a child does not develop the

ability to produce some or all sounds necessary for speech that are normally used at his or her age.

No known cause-developmental phonological disorder

neurological origin-dysarthria" – slurred speech "dyspraxia-difficulty in planning and executing speech

SPEECH DISORDER

SPEECH DISORDER is characterized by any impairment of vocal production, speech sound production, fluency, or any combination of these impairments

-AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION

Specific parts of the body coordinate to produce sounds and modify the speech.

SPEECH

Prevalence rate: 7-8% in children under 12 years.

2-3 times more common to boys More common among first degree relatives

EPIDEMIOLOGY

MULTIPLE VARIABLES:1. Perinatal problems2. Genetic factors3. Auditory processing problems4. Hearing impairment5. Abnormalities related to speech6. Developmental lag7. Neurological impairment : dysarthria &

apraxia8. Environmental factors

ETIOLOGY

Child’s delay or failure to produce expected speech sounds.

P pig 3M man 3N nose 3W water 3H hat 3B bag 4D dog 4K,c cat 4G go 4

DIAGNOSIS

F, ph fun 4Ng long 6Sh shoes 7V voice 8Wh where 8

4 TYPES OF ERRORS IN PRODUCING SOUNDS SUBSTITUTION-replacing one sound with

one another. DISTORTION- Producing a sound in an

unfamiliar way. OMISSION- omitting a sound in a word ADDITION- inserting an extra sound in a

word.

FEATURES

A. Failure to use developmentally expected speech sounds that are appropriate age and dialect.

B. The difficulties in speech sound production interfere with academic or occupational achievement.

C. If a mental retardation, a speech motor or sensory deficit or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.

Coding note

DIAGNOSTIC CRITERIA

Spontaneous recovery is rare after the age of 8 years.

Course and Prognosis

Speech therapy

Treatment

blockages, discoordination, or fragmentations of the forward flow of speech (fluency

These types of disfluencies include repetitions of sounds and syllables, prolongation of sounds, and blockages of airflow. Individuals who stutter are often aware of their stuttering and feel a loss of control when they are disfluent

STUTTERING

First, there is a genetic predisposition to stutter, as evidenced by studies of families and twins

factor in the onset of stuttering is the physiological makeup of people who stutter.

environmental issues have a significant impact on the development of stuttering behaviors. An environment that is overly stressful or demanding, may cause children to have difficulties developing fluent speech

Causes and symptoms

Stuttering is a relatively low-prevalence disorder. Across all cultures, roughly 1% of people currently has a stuttering disorder

Research suggests that roughly 50-80% of all children who begin to stutter will stop stuttering. In addition, approximately three times as many men stutter as women. This ratio seems to be lower early in childhood, with a similar number of girls and boys stuttering

A. Disturbance in the normal fluency and time patterning of speech characterized by frequent occurrences of one or more of the following:

1. Sound and syllable repetitions2. Sound prolongations3. Interjections4. Broken words5. Circumlocutions6. Words produced with an excess of physical

tension7. Monosyllabic whole word repetitions

DIAGNOSTIC CRITERIA IN STUTTERING

B. The disturbance in fluency interferes with academic

C. If a speech motor sensory is present, the speech difficulties are in excess of those usually associated with these problems.

Coding Note

Speech Therapy Breathing exercises Relaxation techniques

Treatment

Disorder that do not meet diagnostic criteria for any specific disorder fall into the category of communication disorder not otherwise specified.

COMMUNCATION DISORDER NOT OTHERWISE SPECIFIED

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