Speech Disorders Childhood Disorder Part 1

Speech Sound Impairments

  • Delayed:

    • family history (genetic, biological, etc)

    • early & frequent ear infections (fluid built up, altering the way we hear sounds, vibration will be dampened)

    • personality factors (shy, easily frustrated, no motivation to meet their needs)

  • Disordered

    • childhood apraxia of speech (planning)

    • dysarthria (disruption in motor neurons to muscle/muscles attract too hard against one another) a.k.a neurological disorder

  • Premature representations

    • tried to learn later developing sounds (i.e. /r/) before motor development is complete, resulting in persistent errors (kid tried to learn sounds that are too difficult for their current development / this distortion gets stored & repeated)

Lifespan

  • 75% of preschool children normalize their speech by age 6, with or without treatment

  • still considered best practice to treat, why? - it might not be a delay but a disorder which is why early intervention is important

  • some maintain errors, even with intervention

  • persistent errors, even with intervention

  • persistent errors usually involve substitutions or distortions of /r/, /s/, /z/, or /l/

  • can be treated at any time, but harder as we get older

Correlates/ Predictors

Cognitive Function & Speech

  • Cognitive: attention, memory, & executive function (carry out tasks) (problem-solving abilities, thinking)

    • weak relationship between speech disorders & IQ (measure of cognitive function), but

    • populations with impaired intellectual function (e.g. Down syndrome) have a higher prevalence of speech disorders

      • differences between cognitively impaired & typically developing (TD) apparent at age 3

      • persistent errors akin to phonological processes may last into adulthood

      • but no clear relationship between the degree of cognitive impairment & speech sound disorders in IWDS (individuals with Down syndrome), so likely that other factors play a role (anatomical differences)

  • IQ does not predict speech development

Language Impairments

  • 10-15% of kids age 6 with speech production impairments also exhibit language impairments:

    • Morphology (internal structure of words & the rules by which words are formed) & Syntax (rules that govern the way words are put together)

    • Difficult to differentiate speech & language issues

      • morphological impairment vs persistent deletions

Lifespan issues:

  • weak phonological awareness ~ difficulties with reading, writing, & spelling

Y-Chromosome

  • Speech sound delays are more common

    • up to 3:1 difference (born with y-chromosome is more likely to express speech sound delay or disorder)

    • Brain development for fine motor areas different among sexes

    • XX chromosome generally develops speech sounds earlier

      • differences fade with age

    • higher risk of impact from extrinsic factors (outside the person)

    • some of the assessments have different normative data for each sex

Hearing Loss

  • perception of others (input less rich)

  • perception of self (monitoring)

  • many areas of speech are affected

    • phonology

    • voice quality

    • rate

    • pitch

    • (this will vary on the individual)

Structural Abnormalities

  • coordinating rapid, alternating movements is necessary for speech

  • craniofacial anomalies

    • congenital malformations, such as a cleft lip/palate (issues holding pressure in the oral cavity)

    • affect speech, swallowing, & feeding

  • stops, fricatives, & affricates are difficult (can’t produce due to pressure)

  • why?

    • because it requires pressure build-up

    • there is continuing air pressure in the nasal cavity