Speech disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at July 24, 2016
StartDiseasesSpeech disorder

Speech disorders obstruct a person's ability to speak and communicate with others. They come in a variety of different forms and can be classified as disorders of articulation, disfluency, or voice. Professionals, including speech-language pathologists, are dedicated specifically to diagnosing and treating speech disorders of different types. 

Contents

Definition & Facts

Speech disorders are distinct from language disorders in that they do not involve the misunderstanding or inability to convey meaning through language. Rather they involve impairment in various aspects of how the body produces speech. Examples of common speech disorders include stuttering, childhood apraxia of speech, and dysarthria.

Speech disorders can be congenital disorders, developmental disorders, or acquired disorders. The cause of a speech disorder determines the manner in which it is treated. A congenital speech disorder is one that is present from birth. There exist a number of different congenital causes for speech disorders. Although present from birth, a congenital speech disorder may not be immediately recognizable if unaccompanied by a physical abnormality.

A developmental speech disorder is a type of disorder recognized at some juncture after a child reaches the typical age at which language use begins. Autism commonly is associated with developmental disabilities including developmental speech disorders.

Finally, an acquired speed disorder occurs because of a disease, ailment, or trauma at any point in a person's life. The disease, ailment or trauma impacts a person's ability to engage appropriately in speaking. Muscular dystrophy, brain tumors, and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease) are all underlying sources of certain speech disorders.

Symptoms & Complaints

The symptoms and complaints associated with speech disorders are manifold and are linked to the underlying cause of a particular speech disorder.

Articulation speech disorders involve leaving out certain consonants which may may make a person's speech unintelligible. Certain sounds may also be abnormal; slurred speech may be a symptom.

Stuttering, which is a type of disfluency and the most common of its type, involves interruptions in speech, prolongation of certain sounds, and repetitive of words. Voice speech disorders may involve hoarseness.

Childhood apraxia of speech involves a child in most cases knowing what he or she wants to say but being unable to produce the sounds to say it. There may be unnatural and long pauses between sounds.

Causes

Causes of speech disorders vary. Congenital speech disorders are associated with genetic mutations or problems during pregnancy. Cleft lip and cleft palate is an example of a birth defect that can cause disorders of articulation if left untreated.

Developmental speech disorders are caused by a range of different factors. These include an abusive environment and neglect. Lack of appropriate language development support essentially means an absence of appropriate stimulation, education and communication opportunities designed to enhance a child's ability to advance in the use of language.

The causes of acquired speech disorders include disease. For example, certain types of cancer occur in a part of the body that impact a person's ability to speak. Other types of health conditions or ailments can result in speech disorders. A stroke is a primary example of this type of medical ailment.

Traumatic brain injury can also be the underlying cause of a speech disorder. A motor vehicle accident is an example of a traumatic event that has the potential for causing physical injury that results in a speech disorder. Other types of accidents that damage the throat, neck, vocal cords, mouth or face can cause speech disorders. 

Diagnosis & Tests

Diagnosing a speech disorder tends to be a multifaceted process. Congenital speech disorders or developmental speech disorders may be first indicated by the inability of a child to reach appropriate early speech-related developmental milestones.

Diagnosis of a speech disorder typically includes analysis of a patient's medical history. A case history includes everything from a review of medical records to a consideration of educational experiences and background of a patient. Cultural and socioeconomic considerations play a role in diagnosis.

The diagnostic process oftentimes incorporates interviews with family members or other individuals in close proximity to the patient. Beyond family members, people interviewed might include teachers and colleagues, depending on the suspected nature of the underlying speech disorder.

Standardized testing of spoken and unspoken communication is undertaken as part of the diagnostic process. This includes testing of cognitive-communication and a patient's swallowing function to assess if a patient has dysphagia. Finally, testing typically includes visual, auditory, motor, and cognitive status of the individual suspected of suffering from some sort of speech disorder.

Neuroimaging scans are crucial for detecting and diagnosing any underlying neurological disorders. Such scans include computed tomography (CT) scans, positron emission tomography (PET) scans, and magnetic resonance imaging (MRI) scans. Electroencephalograms also examine any abnormalities in the electrical processes of the brain.

Treatment & Therapy

The treatment regimen recommended for a particular patient depends upon the nature and extent of the speech disorder at issue. In general, a comprehensive therapy program is recommended. This is a course of therapy that includes a number of different treatment modalities. Different professionals may be involved in the treatment and therapy process. 

Mild speech disorders may not require any specific course of treatment of therapy. They simply resolve over time. On the other hand, even a person afflicted with some sort of mild speech disorder may benefit from speech therapy.

Speech therapy may include activities like guided exercises designed to enhance muscle strength in the throat and face. Speech therapy may also include controlled breathing exercises. Melodic intonation therapy is used to treat childhood apraxia of speech. Sign language may also be taught as alternative modes of communication.

Some patients afflicted with a speech disorder of certain types benefit from talk therapy or psychotherapy. Group therapy may also be recommended, and psychiatric medications may be prescribed to assist in resolving a speech disorder. This is oftentimes the case if a speech disorder has an emotional or psychological component associated with it.

If a speech disorder is the result of a disease or traumatic injury, addressing the ailment or repairing the physical damage arising from the trauma may work to abate the speech disorder. For example, if cancer is the cause, then chemotherapy and radiotherapy will be necessary.

Prevention & Prophylaxis

Some strategies exist that prove helpful in preventing certain types of speech disorders. Some congenital speech disorders are avoided when a pregnant woman follows proper prenatal health recommendations. These include avoiding the use of alcohol while pregnant.

Developmental speech disorders can be prevented in some instances when a child is exposed to appropriate educational and related opportunities designed to enhance language advancement.

Acquired speech disorders associated with diseases or medical conditions can be avoided through an overall healthier lifestyle. Paying attention to safety considerations when engaged in activities like driving a motor vehicle can reduce the odds of an accident that results in a trauma that causes a speech disorder. 

Early testing for the possibility of a speech disorder is crucial. Medical professionals maintain that many types of speech disorders are more successfully resolved through early professional intervention.