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Speech: Verbal means of communicating

Speech sounds

Language: Socially shared rules (Symbolic; meaningful)


Word meanings How to make different

Fluency (rhythm of

speech) Voice (using VFs and breathing to produce speech sounds)

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 retraining

Correct production of sounds Sequencing sounds into words

Intensive repetition Awareness of correct mouth movements Severe cases


Augmentative and alternative communication Gestures Electronic equipment

In most cases cause is unknown Possible causes Genetic component? Stroke or brain injury

3 yr. old girl Started therapy at 2 yrs.

4 yr. old (same girl) Continued therapy

http://www.youtube.c om/watch?v=szjfC9K 190U&feature=fvw


More severe case:

http://www.youtube.c om/watch?v=Lvl78d cXGp8&feature=rela ted

http://www.youtube.com/watch?v=Lvl78dcXGp8&feature=related

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 communication Gestures, alphabet board, electronics

http://www.youtube.com/watch?v=EHNSBo3SsmY

What do you notice?

A disorder of language Neurological damage Stroke, 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/symptoms Long 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=aVhYN 7NTIKU&feature=related

What 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=f2IiM EbMnPM&feature=related
http://www.youtube.com/watch?v=1apl TvEQ6ew&feature=related

What 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)

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