SPEECH DIFFICULTY

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Speech is the process of producing specific sounds that convey meaning to
the listener. A speech disorder refers to any condition that affects a
person’s ability to produce sounds that create words.
Speech is one of the main ways in which people communicate their
thoughts, feelings, and ideas with others. The act of speaking requires the
precise coordination of multiple body parts, including the head, neck , chest,
and abdomen .
Speech disorders can affect the way a person creates sounds to form
words. Certain voice disorders may also be considered speech disorde

In this slide all other information also mention like type of the speech difficulty and their sign and symptoms and also explained the treatment or promotion of normal speech

1. DISORDERS AND SPEECH THERAPY

2. 
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Speech is the process of producing specific sounds that convey meaning to
the listener. A speech disorder refers to any condition that affects a
person’s ability to produce sounds that create words.
Speech is one of the main ways in which people communicate their
thoughts, feelings, and ideas with others. The act of speaking requires the
precise coordination of multiple body parts, including the head, neck , chest,
and abdomen .
Speech disorders can affect the way a person creates sounds to form
words. Certain voice disorders may also be considered speech disorders.
INTRODUCTION

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Stuttering
Apraxia
Dysarthria
Spasmodic dysphonia
Articulation errors
Ankyloglossia (Tongue-tie)
Selective mutism
Aphasia

TYPES OF SPEECH DISORDER

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Stuttering also known as Stammering , is a speech disorder in which the
flow of speech is disrupted by involuntary repetitions and prolongation of
sounds, words or syllables. Also ,there are involuntary silent pauses or
blocks.

Clinical features-
Problem in starting a word or phase
Hesitation before certain sound has to be uttered.
Repetition of a sound , word or syllable.
Trembling lips and jaws
Causes-
Developmental factors
Neurogenic stuttering
Psychological factor


STUTTERING

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Is a neurological disorder that makes it difficult for someone with the condition to
say what they want to say correctly. It happens when a brain can’t coordinate the
muscles that enable speech.

Clinical features –
Difficulty moving smoothly from one sound to another
Vowel distortions, such as attempting to use the correct vowel, but saying it
incorrectly.
Separation of syllables, such as putting a pause or gap between syllables
Inconsistent voicing errors, such as saying “down” instead of “ town”

Causes-
Neurodegenerative illness
Brain tumor
Dementia
hydrocephalus

APRAXIA

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Dysarthria occurs when the muscles you use for speech are weak or you
have difficulty controlling them .
Causes –
Amyotrophic lateral sclerosis
Brain injury
Brain tumor
Cerebral palsy
Guillain –barre syndrome
head injury
huntington’s disease
Myasthenia gravis
Parkinson’s disease
Wilson’s disease
Clinical features –
Slurred, nasal sounding or breathy speech
Strained and hoarse voice
Very loud and quiet speech
Gurgly or monotone speech



DYSARTHRIA

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Is a voice disorder. It causes involuntary spasms in the muscles of the voice
box or larynx. This causes the voice to break and have a tight, strained or
strangled sound.
Is a lifelong condition .it most often women, with symptoms starting between
the ages of 30 and 50.
3 types of spasmodic dysphonia: 1- Adductor spasmodic dysphonia
2- Abductor spasmodic dysphonia
3- Mixed spasmodic dysphonia
Clinical features –
Voice breaks up
Voice sound breathy, whispery, strangled or tight
Vocal tremor
Hoarse voice
Jerky voice
Failure to maintain voice
SPASMODIC DYSPHONIA

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The inability to produce sounds correctly in speech is referred to as an
articulation disorder, there is no known cause of an articulation disorder.
Examples of articulation errors include substituting one sound for another (e.
g., saying wed for red ), or leaving out sounds, ( e.g., nana instead of banana )
ARTICULATION ERRORS

9. This is a physical condition that makes it hard for children to move their
tongues, or restricts the tongue’s range of motion

ANKYLOGLOSSIA( Tongue-tie)

10. It’s a severe anxiety disorder where a person is unable to speak in certain
social situations.
SELECTIVE MUTISM

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Acquired impairment in the use of language due to damage to certain part of brain
affecting the production or comprehension speech and the ability to read and write
It’s a two type- (a) Fluent aphasia
(b) Non-fluent aphasia

FLUENT APHASIA : Speech is present but contains little meaningful communication.
NON-FLUENT APHASIA : Minimal speech, difficulty with slow speech that requires
obvious effort.

TYPES OF FLUENT APHASIA
Wernicke’s fluent aphasia
Transcortical sensory aphasia
Conduction or Associative aphasia
Amnesic aphasia
TYPES OF NON-FLUENT APHASIA
Broca’s aphasia
Transcortical aphasia
Global aphasia

APHASIA

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Vocal cord damage
Brain damage
Muscle weakness
Respiratory weakness
Strokes
Polyps or nodules on the vocal cords
Vocal cord paralysis

People with have certain medical or developmental conditions may also have
speech disorders.
autism
Attention deficit hyperactivity(ADHD)
Strokes
Oral cancer
Laryngeal cancer
Huntington’s disease
Dementia
Amyotrophic lateral sclerosis (ALS)


CAUSES OF SPEECH DISORDERS

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History collection
Physical examination
Laryngoscopy
Mirror examination- ( to visualize interior of the larynx especially vocal
folds.)
Videostroboscopy -( a test that can diagnose certain conditions that
affect your vocal cords or swallowing.)
Laryngeal electromyography -( electrical activity in the laryngeal muscle)
Oral motor examination procedure
RSST ( Repetative saliva swallowing test)
Flourography ( photography of X-ray images from a fluoresecent screen.)
DIAGNOSTIC EVALUATION

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Speech therapy assess and treats speech disorders and communication
problem. It helps develop skills like comprehension , clarity , voice , fluency and
sound.
Speech therapy is a rehabilitative procedure undertaken in order to help the
people having any kind of communication disorders or problems and some
swallowing problems.

Needs of speech therapy ;
Hearing impairement
Aphasia
Apraxia
Articulation disorders
Cognitive-communication disorders
Dysarthria
Expressive disorders
Fluency disorders
Receptive disorders
Resonance disorders


SPEECH THERAPY

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HOME EXERCISE ;
Speech therapy technique for child
speak to them as much as possible
Use short and simple words
Tell stories at bedtime
Read children’s books
Reduce scream time
Play games with child
Sign language
Use mirror
Turn everyday situations into something new

For adults :
Tongue exercise –


conti……….
Tongue in
and out
Tongue
side to
side
Tongue up
and down

17. Cont…….
Say
cheese
Practice
kissy
face
Consonant
and vowel
pairing
repetition
Sentence
productio
n
Phonologic
al
processing
Word
games

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SPEECH THERAPY EXERCISE-
TONGUE IN AND OUT- This exercise train the tongue to move with a coordination
pattern to help to produce better speech. The pattern is asked to take out their tongue
for at least two seconds, then pull it back , hold for 2 seconds, and repeat.

TONGUE SIDE TO SIDE – Ask the patient to open the mouth and move the tongue to
touch the right corner of the mouth ; hold for 2 seconds, and repeat.

TONGUE UP AND DOWN – Ask the patient to open the mouth and stick the tongue out ;
then try to take the tongue up toward the nose , hold 2 seconds . Then take your tongue
down toward chin, hold 2 seconds, and repeat.

SAY CHEESE – This exercise is used to improve oral motor skills.Ask the patient to
smile in front of a mirror; smile and relax. Repeat several times.

PRACTICE KISSY FACE – Ask the patient to pucker lips together and then relax.
Repeat as often as s/he can do.

CONSTANT AND VOWEL PAIRING REPETITION – It’s complex exercise , the patient is
asked to take a constant that s/he has trouble saying and then pair it with each of five
vowels ( a, e, i, o, u ), example ; if s/he trouble with the “r” sound, then practice saying (
ra, re, ri, ro, ru ) over and over.

SENTENCE PRODUCTION - It’s helpful in a patient with a normal cognitive side of
language but has impaired lips and tongue coordination. Ask the patient to practice a
sentence or two for one or two minutes.
CONT……..

19. 8) PHONOLOGICAL PROCESSING – It’s improves the ability of patient to
produce speech. A caregivers says different words, and the patient is guess the
number of syllables in that word. Caregiver will provide feedback to tell
whether the patient is right or wrong . The feedback is a part of the therapeutic
exercise.
9) WORD GAMES- These exercise for adults patients used to improve
language processing skills. Computer games, word searches, or crossword
puzzles are the example to practice regularly to improve speech.
Cont……

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Speech disorders affect a person’s ability to produce sounds that create words.
They are not the same as language disorders, which make it more difficult for
people to learn words or understand what others are saying to them.
Types of speech disorder include Stuttering , Apraxia , Dysarthria, Spasmodic
dysphonia, Articulation errors , Ankyloglossia (Tongue-tie), Selective mutism,
Aphasia.
Speech disorders can affect a person’s self- esteem and their overall quality of
life, speech therapy, breathing exercise , speech therapy exercise etc. can help
improve speech and reduce symptoms.

SUMMARY