PSY345: Communication (Lecture 6)

What are Communication Disorders?

• Communication is one of the most complicated and vital processes we undertake, yet we seldom think about it unless there is a problem

• Interchange of ideas, opinions, or facts between people

• Communication is an extremely important too

What is Speech and Language?

• Part of communication.

• Some components of communication involve language but not speech.

• Speech is one means of expressing language but not the only one.

• Language represents the message that is contained in speech.

• In humans, the development of communication, language, and speech overlap to some degree.

What is the structure of language?

• Phonology represents the system of speech sounds.

• Syntax involves the rules governing sentence structure.

• Morphology is concerned with the form and internal structure of words.

• Semantics represents the understanding of language.

• Pragmatics are concerned with the use of language in social contexts.

Language Development

• The development of language is complex.

• Young children normally progress through several stages in developing language.

What are the Groups of Communication Disorders?

• Medical Model

• Be careful about over diagnostic

  • Over time can get better

  • Not just medical diagnostic procedure

4 Key Groups

1) Language Disorders

• Cognitive, affect persons speech, reading, writing, multiple modalities

2) Speech Disorders

• Affects one modality: speech

• More about pronunciation, late, speach, stuttering

3) Articulation

• Heavily involved in that

• Right phonemes

4) Voice Disorders

• In the throat, where vocal cords are

1) What are Language Disorders?

• Language disorders occur when there is a serious disruption of language process, including memory, learning, message reception & processing & expressive skills

  • Serious important word, most of us don’t speech, read or write perfectly, has to be serious disruption 

  • Memory may be loss of certain words, taught word, what firetruck is but don’t remember what it is

  • Trouble learning new concept, classically condition bottle, cannot learn association, associated with each other cannot associate bottle with label bottle

  • Message reception: receiving the message, communicating goes both ways, speech, hearing 

  • Expressive skills: ability to express self, tell people, outputs

  • Serious problem, serious disruption 

  • Affects ability to communicate using language

  • Can arise as language delays & language disorders

Language Delays

• Sequence intact but rate interrupted

• Kid babbling, then one word sentences, telegraphic sentences

• Particular sequence involved, language delays that sequence there but its slower

  • Kid babbles later, first words later, hard time reading and writing

  • Sequence the same, rate is slower

  • Not as clear, kid not saying mama by 1, babbling, less worried about this, have baby charts, know when to start worrying, when language delay becomes language disorders 

vs.

Language disorders

• Sequence of language acquisition is interrupted

• Kids may not be babbling or developing vocabulary

• If has hearing impairment know what bottle is (can see and touch it) but won’t associate to arbitrary sound bottle, missing a step, not developing vocabulary, not making that connection between objects

• Much more problematic than language delays 

What are the classifications of language disorders?

Receptive Language Disorders

• Difficulty in comprehending what other people say

• Any issue receiving message, through speech, writing, signalling to you & don’t understand what they are trying to say

Expressive Language Disorders

• In formulating & using language

• Not just speaking, can be nonverbal

• Elderly individuals semantic retrieval know what I want to say but can’t come up with it, cannot come up with name

• Cannot come up with names or words need to communicate idea with someone else

• Through speech, writing, any one of those output modalities

Aphasia

• Can result in either receptive or expressive

• In aphasia, we know the cause, impairment of language comprehension, receptive, formulation of expression use, DUE to injury, disease of maldevelopment of the brain

• Receptive language problem and/or expressive, difficulty formulating and using language

• We know the cause- due to brain injury, Wernike & Broca associate brain region with particular function, individual injured in particular area experienced same deficits, patients experienced brain injury in certain area experience same cognitive deficits

• Know the cause, cause can be brain injury, disease (encephalitis, meningitis degenerative diseases of the brain may be responsible for cognitive deficits that relate to operation of brain & nervous system)

• Stroke, aneurysm, blot clot or bleeding in the brain can cause these problems

  • Elderly or stroke have some language description

• Maldevelopment of the brain

  • Kid born with maldeveloped brain

  • Low functioning ASD never had ability to speech, even though constantly exposed to meaning and sound, not able to connect the two 

  • Implies 3 separate categories but not

  • Aphasia deals with the reason, the cause.

What are the causes of Language Disorders?

1) Defective or deficient sensory systems

• Like hearing, if cannot hear classical condition sound and meaning do not develop language

• If don't have vision, hear the sound ‘bottle’, feel it, won’t be able to see it

  • Different types of bottles? Will they associate, generalize, discriminate, exposed kid to 10 different bottles, different shapes

  • Going to have language difficulties overgeneralize, sometimes difficult discriminating between different concepts 

  • Different tables, each looks and feels different- child have hard time with semantic issues of understanding what is what

  • Affect them in speech, reading, writing, more cognitive semantic problem of understanding what language is about 

• Old people lose hearing and vision but don’t experience this. 

  • Have properly learned language

  • Difference between learning, prelinguistic and post linguistic loses, prelinguistic much more problematic 

  • Organic cause 

2) Neurological Damage

• Through physical problem or accident

• Language disorders like aphasia due to neurological damage

• Brocas area, Wernike area, trauma to vocal cords, mouth, neurological or physical damage may affect ability to community 

• Physical mouth and teeth more likely to affect speech and not other things, neurological affecting everything, many different modalities

3) Deficient or disrupted learning opportunites

• If baby brought up in family, dad took off, mom single mom, teen mom, no resources, statistically high risk, kid cries, mom doesn’t go, when mom feeds child, mom shovels food and puts in kids mouth and thats all, not interactive, when mom does that child exposed to language, when mom not talking to child not exposed to language, moms actions being associated with arbitrary sounds, when child not spoken to won’t learn language

• Born with ability to learn language but need opportunity by being with people who talk to us

What are Intervention approaches to language disorders?

• Always individualized, do assessment, figure out what's wrong, had to be determined by nature of disorder, whats wrong with kid (aphasia, expressive), based upon severity of disorder, age of person and whether pre or post linguistic, kid with hearing impairment maybe cochlear implant, old adult get hearing aid, different solution

• Matter in which individual effected, how are they effected, two people may have same diagnosis but affects two people differently even though have same diagnosis

  • How individual effected, what are their goals, what do they want to achieve, 

  • People affected differently through a combination of nature of disability, severity, what done throughout their lives

Children-addresses initial acquisition or learning of language

• Bottle, bottle have to address and ensure kid acquiring language, if cant see tactile needs, if cant hear medically fix ears or ASL, something to associate arbitrary language with objects and actions so develop language

• Pre-linguistic

Adults-involves relearning or re-acquiring language function

• Fixing sensory systems surgically or prosthetic devices (hearing, seeing) glasses, hearing aids

• Post stroke may have hard time talking at all, 1 year recover 90%

Individuals with severe physical or cognitive disabilities - may involve alternative or augmentative communication.

• Many individuals born with disabilities like CP cerebral palsy, characterized by inability of brain to control muscles in body, cannot walk, talk

• Alternative and augmentative devices that try to provide different type of way to connect individuals communication abilities with some technology 

• Ipads, programmable, app or platform, app might be communicate app all can do is select between one half of screen by putting hand on it for yes or no (augmentative)

2) What are Speech Disorders?

• Speech that is sufficiently deviant from normal or accepted speaking patterns that it attracts attention and adversely affects communication for the speaker and/or listener.

  • Judgment call, doesn't have to be perfect, bad enough that is attracts attention but affects communication for speaker or listener 

  • Flow of ideas is disrupted

  • Semantically problem

  • Broad category 

  • Different types of speech disorders & diversity in theoretical explanations regarding causes & treatments

  • We don’t necessarily know why, try many different things and see what words

  
  Types:

  • Fluency disorders

    • Stuttering

    • Cluttering

  • Delayed speech

a) What are Fluency Disorders?

• Normal speech characterized by reasonably smooth flow of words and sentences speech, fluency, um hesitation, interruption, “you know what i mean”, lack of fluency

• Most of time get through it,

• Fluency disorders characterized by repeated interruption, hesitations (um)stopping in middle of sentence, repetitions, saying same word twice, i told you so, i told you so, has to seriously interrupt flow of community, if it doesn’t NOT a disorder

• Interrupt mean not understanding what certain is saying 

• Some talk very slowly, long pauses, hesitation

• Repetition that seriously interrupts flow of communication

Cluttering

• Characterized by speech overly rapid, disorganized, occasionally filled with unrelated insertions

• Fast speech, rapid speech, disorganized, running/jumping to one idea to the next

• Unnecessarily words & insertions

• E.g., Hanoi article speech impediment from cluttering, 

• Bar Mitzvah: be kind, whisper in ear can help

Stuttering

• Slower than what people accept as normal speech

• Flow of speech abnormally disrupted by interruptions, blocking of speech- consonants, for e.g., k or t gets stuck and cannot continue 

• Prolongation of sounds,making sounds longer, vowels, “so so so”

• All of us do these things

What’s the causation of stuttering?

• Symptoms of an emotional disturbance

• Caused by a person’s biological makeup or neurological health

  • Research in behavioural genetics everything has some biological cause, no single cause

• Learned behaviour.

  • Competition for attention, do anything to get attention 

• Heredity and gender.

  • Genetically inherited it 

  • Speech impediments or fluency disorders run in families 

  • More prevalent in boys than girls 

  • ADHD

Intervention

• Don’t know what problem is, have to try different things

b) What is Delayed Speech?

• Speaks like someone much younger, adult speaking like a 10 year old

• Associated with other maturational delays (learning how to read late) 

What are the Causes of Delayed Speech?

• Partial or complete hearing loss

  • Wont have vocabulary, won’t be able to use for speech

• Little opportunity to learn speech

  • May get the vocabulary but if parents don't encourage them or not reinforced

  • For e.g., bottle bottle bottle, do i ever ask child to express what is is? One way affair, 

  • Little opportunity to learn language, will affect speech
    
    

• Cerebral Palsy, mental retardation, emotional disturbance, or brain injury

  • Lack of control over vocal cords, muscles in tongue CP

  • Mental retardation low intellectual ability whether DS, low functioning ASD 

  • Emotional disturbances: 

  • Brain injury:

• Severe conflict between parents’ expectations and a child’s ability or choice to communicate

  • Kid says ‘mama’ for the first time, kids first birthday invite 50 people and put kid in front of everyone, kid cries

  • For kid threatening environment

Intervention of Delayed Speech

• Focus on teaching appropriate speaking proficiency for child:

• Surgery and/or prosthetic devices

  • If physiological issues causing it

  • If child has cleft pallet medical intervention in that case is very good, if don’t have teeth, medical intervention, fix, make child feel good

• Behaviour modification

  • Any behaviour that is reinforced, not speaking reinforced stop giving child attention

  • Skinner, watson

• Direct instruction

  • If talking about person talking like someone younger, 17 year old, speaks to mom in 5 kids, tell kid is inappropriate, dyadic approach 

3) What are Articulation Disorders?

-largest category of speech problems

- error in pronunciation 

• Definition: abnormality in the speech sound production process resulting in inaccurate or otherwise inappropriate execution of the speaking act.

  • Speech errors focused primarily on sounds 

  • Articulating wrong sounds

  • Can include omissions, substitutions, key focus on distortion of sounds 

  • Possible have delayed speech, and difficulty in pronunciation 

  • Focusing on inappropriate, incorrect pronunciation of speech sounds 

Articulation performance deficits are examined according to two general categories:

• Articulation problems due to structural physiological abnormalities

  • Not pronouncing sounds properly because physiological structural problems we can identity, diagnose and see

  • Not aphasia, neurological

  • Structural problems in the mouth 

  • E.g., pronouncing “L” 

  • If bite incorrect, occlusion problem, mouth occlusion, no teeth

  • Know exactly why kid cannot pronounce words, not bc of ESL or immaturity, cannot do it, hardware in mouth does not work way it needs to to properly pronounce

• Functional articulation disorders

  • Larger categories

  • For most part due to causes we do not know: 

    • More common 

    • Refer to problems likely result of environmental or psychological influences

    • Or simply immaturity

    • Lazy pronunciation

    • Slurring words

    • Most kids grow out of them

What are Interventions for Articulation Disorders?

• Surgical repair of cleft palates

• Surgery to alter jaw structure and alignment

• Prosthetic appliances

• Interventions to teach proper articulation

  • Bring tongue to roof of mouth 

  • How to use software

  • Might be laziness, learned behaviour: teaching lets practice it together. 

• Many professionals are reluctant to treat functional articulation disorders in young school children because of:

  • Functional not structural, don’t know real reason 

  • structural need surgery, functional don’t know the cause

• (1) Developmental immaturity

  • Kid grow out of it 

• (2) Resources for treatment

4) What are Voice Disorders?

Definition: Voice disorders involve unusual or abnormal acoustical qualities in a person’s speech

• Deviations in pitch, quality, loudness or combination of these factors

• Voice disorders voice comes from throat, articulation happens in the mouth (DISTINCTION) 

• Deviation in pitch

  • Grown man in high pitch voice, little women

  • Young boy having cracks, high pitched voice not abnormal, puberty 

  • Girl with low voice, uncharacteristic to bell curve, voice disorder in terms of pitch

  • Pitch problems may relate to consistency of the pitch in voice 

• Deviations in loudness

  • Colleague speaks very quietly 

• Quality

  • If voice too nasally or too hoarse

  • May have these at times

• Can be combination of all these factors together

What’s the cause of voice disorders?

• Paralysis of vocal cords or diseases of the sound production system

  • Any problem with vocal cord, or sickness that related to paralysis of vocal cords

• Imitation

  • Attention

  • Bejees, looked up to them, wanted to be like them, male with high pitched, all looking for attention and success

  • Learned behaviour initiating respective individuals 

• Organic conditions

  • Medical conditions 

  • Any type of disease, illness, malnutrition, not drinking enough

  • hormonal imbalance- trans gender purposeful hormonal imbalance, 

• Improper tissue movement

  • Rusty instrument, accord

What are the Interventions for Voice Disorders?

• Surgical intervention

  • To repair abnormal tissue, if thats indeed the case

  • Tissue in sound production in throat or sinuses, cavities if someone voice to nasally 
    
    

• Direct instruction

  • Help individual affected to learn acceptable or unacceptable