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?**