SPEECH DISORDER
How speech is produced
• A person inhales and exhales air. The exhaled
air is sent upward through the larynx where it
passes through the vocal folds.
• As the air passes through the vocal folds, they
are set into rapid vibration which transforms
the air into sound.
Cont...
• The sound is modified by the shape and
configuration of an individual vocal tract.
• The sound is shaped into specific speech
sounds created by manipulation of the speech
articulators.( articulators include: lips, tongue ,
teeth, hard palate soft palate.
Speech and language controlled by
1. Central Nervous system
• :Brain
• Spinal cord
2. Peripheral nervous system
• The nervous system emerge from brain and
spinal cord to innervate the rest of body.
Cranial nerve; 12 pair cranial nerve, cranial
nerve involved in voice production:
• Trigeminal V- control facial muscles involved in
chewing
• Facial VII: muscle of facial expression
• AcousticVIII : hearing and equilibrium
• Vagus X : swallowing, coughing, speech
• Accessory XI : swallowing and movement of
head and shoulder
• Hypoglossal XII : tongue movement
Speech disorder
• Speech disorder are type of communication
disorders where normal speech is disrupted.
Classification
• Sluttering
• Cluttering
• Muteness
• Articulation disorder
• Dysarthia
• Apraxia
Sluttering
• Sluttering is most common fluency disorder is
an interuption in the flow of speaking.
• Ex: W....w...w...w....where are you going?
Cluttering
• Cluttering is a n extension of normal speech
disfluencies.
• Ex ‘’ I...i...iw...i...want to go to the ... I need...
The store is over.... To the store
• Muteness: complete inability to speak
Articulation disorder
• Articulation disorder is difficulty learning to
produce sound physically. Sound can be or
substituted left off, added or changed.
• Many person with these defect sound like
making a W sound for an R i.e, ‘’wabbit’’ for
an ‘’Rabbit’’.
Voice disorder( Dysphonia)
• Are impairments often physically that involve
the function of larynx or vocal resonance.
• Mostly characterized by:
- Hoarseness of voice
- vocal fold nodule( loud or excessive talking)
- -voice misuse and abuse ( soreness tightness
in the throat)
Dysarthia
• Defect in production of sound: It is weakness
or paralysis of speech muscles caused by
damaged to nerves and or brain.
Causes:
Laryngeal disease: laryngitis
Vocal cord lesion
X th Cranial nerve palsy
Apraxia
• A speech disorder in which a child's brain has
difficulty coordinating the complex oral
movements needed to create sounds into
syllables, syllables into words, and words into
phrases
• May result from stroke or development and
involve inconsistent production of speech
sounds and rearranging of sounds in words.
• Potato may become topato and next totapo
• People who live with apraxia have difficulty
putting words together in the correct order or
'reaching' for the correct word while
speaking. Dysarthria occurs when a patient's
muscles do not coordinate together to
produce speech
Aphasia
Aphasia is an impairment of language, affecting
the production or comprehension of speech
and the ability to read or write. Aphasia is
always due to injury to the brain-most
commonly from a stroke, particularly in older
individuals. But brain injuries resulting in
aphasia may also arise from head trauma,
from brain tumors, or from infections.
The three most common types of aphasia are:
• Broca's aphasia.
• Wernicke's aphasia.
• Global aphasia
• Wernicke's area is the region of the brain that
is important for language development. It is
located in the temporal lobe on the left side
of the brain and is responsible for the
comprehension of speech, while Broca's area
is related to the production of speech.
Cont...
• Global aphasia is a severe form of
nonfluent aphasia, caused by damage to the
left side of the brain, that affects receptive
and expressive language skills (needed for
both written and oral language) as well as
auditory and visual comprehension.
Causes of speech disorder
• Unknown
• Hearing loss
• Neurological disorder
• Brain injury., Drug abuse, Mental retardation
• Physical impairment( cleft lip or palate)
Symptoms
• Depending on cause:
• Common: repeating sounds
• Adding extra sounds
• Making jerky movements
• Blinking several time
• Visible frustration
• Hoarseness sounds
Diagnosis
• Deaver articulation test
• Early Language milestone scale 2
• Peabody picture vocalubary test revised
Treatment
• Speech therapy
Complication
• Untreated speech disorder may cause a
person to experience
• Anxiety
• A phobia in speaking
Prevention of complication
• Early treatment for anxiety can help to
prevent the development of anxiety disorder
phobias.
• The outlook improves for people who seek
early treatment. It helps to prevent speech
disorders from worsening.
Nursing diagnosis
• Impaired verbal communication
• Impaired function of muscles that produce
speech
Nursing Intervention
• Assess client for impaired verbal
communication.
• Implement measure to facilitate
communication: maintain a patient calm quiet
environment concentrate on communication
• ask question require short answers
• Schedule rest periods
• When speaking to client face him/her.
