To understand speech or language impairments, we must first understand the communication process people use to interact with others. Think of communication in terms the sender and the receiver and a message. Communication occurs only when the message intended by the sender is understood by the receiver. The sender may have an idea or thought to share with someone else, but the sender's idea needs to be translated from thought to some code the other person can understand.
Communication is the process of exchanging knowledge, ideas, opinions, and feelings (Owens, 1994). This transfer is usually accomplished through the use of feelings. Sometimes, however, communication can occur with the glance of an eye, a gesture, or some other nonverbal behavior.
Speech sounds are vocal symbols. Letters of the alphabet are written symbols. Sign language uses gestural symbols. Symbols are used in combination with each other and are governed by rules. Signals, symbols, and the rules that must be followed constitute language and allow language to have meaning. Communication messages require the receiver to use eyes, ears, or even tactile (touch) senses (for example, those who use Braille) to take the message to the brain where it is understood. Receivers must understand the code the sender uses and be able to interpret the code so that it has meaning.
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Communication is unsuccessful if the sender or receiver cannot use the signals or symbols adequately. And if either person has a defective mechanism for sending or receiving the information, the communication process is ineffective.
At this point, it might be helpful for us to distinguish three terms-communication, language, and speech-that are different but related to one another.
Communication is the process of exchanging knowledge, ideas, opinions, and feelings (Owens, 1994). This transfer is usually accomplished through the use of language. Sometimes, however, communication can occur with the glance of an eye, a gesture, or some other nonverbal behavior.
Language is a formalized method of communication involving the comprehension and use of the signs and symbols by which ideas are represented. Language also has rules that govern the use of signs and symbols so that the intended message has the correct meaning.
Speech is the vocal production of language. In most instances, it is the fastest and most efficient means of communicating. Understanding how we produce speech requires knowledge of the neurological, respiratory, vocal, and speech mechanisms that work together in our bodies to produce speech and language.
Speech is abnormal when it is unintelligible, is unpleasant, or interferes with communication (Van Riper & Erickson, 1996). The three major types of speech impairments are voice, articulation, and fluency, for example, stuttering and cluttering. Any one of these three speech impairments is distracting to the listener and can negatively affect the communication process.
A) VOICE PROBLEMS.
One type of speech impairment, voice problems, is not very common in schoolchildren, but when this speech impairment does occur it needs immediate attention from a professional. A voice problem may mean the absence or abnormal production of voice quality, pitch, loudness, resonance and duration. Voice is a measure of self; it is part of one's identity. We can identify many of our friends, for example, simply by hearing their voices. Voice distinguishes each person from others, and we typically do not think about how it functions. But when it does not function as usual, such as when we have laryngitis, we find it frustrating. Our voices also mirror our emotions; we often can tell when people we know well are happy, sad, angry, or scared merely by hearing their voices.
Three aspects of voice are important: quality, pitch and loudness. A voice problem usually involves a problem with one or both of these aspects.
Pitch is the perceived high or low quality of voice. Men typically have lower voice pitch than women. A man's voice whose pitch is high or a woman's pitch that is low attracts attention. If the receiver of communication pays more attention to the voice than to the message, though, communication is impaired (Van Riper & Erickson, 1996). When young boys' voice pitch changes during puberty, attention is drawn to the boys and their unintentional changes in voice. Of course, this pitch change is a normal part of development and disappears as the boy's body grows and voice pitch becomes stabilized.
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Loudness is the other main aspect of voice. In some cases, people are labeled with certain personality traits because of the loudness of their voices: "She is such a soft-spoken individual." "He is loud and brash." Voice can communicate much of the intended message for delivery. In some cases, if the quality of voice is so distracting that the message is misunderstood or lost, speech therapy is probably necessary.
Quality disorder is called dysphonia. The voice can be hoarse, harsh or breathy.
Articulation problems are the most common speech impairments (Van Riper & Erickson, 1996). Articulation is the process of producing speech sounds. Articulation disorders refer to the abnormal production of speech sounds. The receiver of communication must understand the sounds of the words spoken to understand the full message. If speech sounds are incorrectly produced, one sound might be confused with another, changing the meaning of the message..
Articulation is related to the speaker's age, culture, and environment (Boone & Plante, 1993). Articulation disorders include substitution, omission, addition and distortion. Compare the speech of a 3-year-old child, a 10-year-old, and an adult. Some of the most common articulation errors young children make are substitutions and distortions of the s and z sounds and substituting a w for an l and a w for an r . About 2 to 3 percent of all children require professional help to overcome or compensate for their articulation errors.
Fluency is the flow of speech. Fluency and speech timing difficulties are associated with the rate and flow pattern of a person's speech. A fluency problem usually involves hesitations or repetitions that interrupt the flow of speech. Stuttering is one type of fluency problem. Some young children (ages 3 to 5) often demonstrate dysfluencies (nonfluencies) in the course of normal speech development, but they are not usually indicative of a fluency problem. Adult speech is not always smooth and fluent either. Even the best of speakers find times when they are dysfluent-when they hesitate in the middle of sentences, repeat parts of words, speak very quickly, or insert fillers such as "you know," "like," or "umm" in their speech. Dysfluencies are likely to occur in exciting, stressful, or uncommon situations.
As young children search for words or the rules to apply to their messages, they may become disfluent, and their manner of speech may suggest stuttering.
Individuals who have a stuttering problem persisting into childhood frequently experience some difficulty in speaking throughout their lives. Their ability to communicate, their interactions with other people, and their own self-concepts are affected, but their speech generally can be improved with professional help.
Language is the second major area within the special education category referred to as speech or language impairments. It is the complex system we use to communicate our thoughts to others. Oral language is expressed through the use of speech sounds that are combined to produce words and sentences. Other language systems, such as manual communication or sign language, use gestures or other means of communication, but not speech sounds .Language impairment Delayed or deviant development of comprehension and/or us of the signs and symbols used to express or receive ideas in a spoken, written, or other symbol system. A language disorder appears or exists without other disabilities
There are three aspects of language: form, content, and use and language impairment might exist in these aspects.
Speech Impairments. In general, the known causes of speech impairments are varied and include, brain damage, malfunction of the respiratory or speech mechanisms, or malformation of the articulators. For example, many individuals with severely misaligned teeth cannot articulate well, a cleft lip or palate affects the ability to produce oral speech. Most cleft lips can be repaired through plastic surgery and do not have a long-term effect on articulation. A cleft palate, however, can present continual problems because the opening of the palate and the roof of the mouth allows excessive air and sound waves to flow through the nasal cavities. The result is a very nasal-sounding voice and difficulties in producing some speech sounds, such as s and z. A cleft palate is one physical cause of a speech impairment that requires the intensive work of many specialists (plastic surgeons, orthodontists, and Speech and Language Pathologists) to help the individual overcome the resulting speech disability.
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Voice problems are not as common in schoolchildren, although they can be symptomatic of a medical problem. For example, conditions that interfere with muscular activity, such as juvenile arthritis, can result in a vocal disturbance.
Voice problems also can be caused by the way the voice is used: Undue abuse of the voice by screaming, shouting, and straining can cause damage to the vocal folds and result in a voice disorder. Rock singers frequently strain their voices so much that they develop nodules (calluses) on the vocal folds, become chronically hoarse, and must stop singing or have the nodules removed surgically.
f) Stuttering, a lack of fluency in speaking may be characterized by severe hesitations or the repetition of sounds and words. Although professionals can describe stuttering, they seem unable to agree on or explain a single cause (Silverman, 1996). They can, however, describe conditions when nonfluency is more likely to occur in stutterers. For example, stuttering is more likely to occur when the conversational situation is very complex or unpredictable (Weiss, 1995). It appears that stress makes its likelihood more probable. stuttering has been seen to run in families. About 71% of stuttering is related to genetics.
Language Impairments, Many problems that fall into the area of language impairments have multiple causes. As with aphasia, they can result from brain injury or disease that damages the central nervous system. They can result from the inability to hear well at the time language should be developing. For example, children with chronic otitis media, or ear infections, often have associated difficulties with language development, possibly because of the interruptions in hearing language during the typical developmental periods or because of related health problems. Some researchers have found a family connection with language impairments (Lahey & Edwards, 1995). However, most often, poor language development is caused by various environmental factors, including the lack of stimulation and proper experiences for mental development and learning language. Environmental factors also affect children's abilities to acquire language and become proficient in its use. Some children do not develop language because they have no appropriate role models. Some are left alone too often; others are not spoken to frequently. Some are punished for speaking or are ignored when they try to communicate. Many of these children have no reason to speak; they have nothing to talk about and few experiences to share.
Language delay, Children with delayed language generally acquire language in the same sequence as their peers but do so more slowly. Many of these children do not have a disability and catch up with their peers. Some children acquire language in the correct sequence, do so very slowly, and never complete the acquisition of complex language structures. For example, most children with mental retardation have language delays. Their language development will remain below that of their peers who have normal intelligence and are developing at expected rates. Some, like Leonard, maintain that these youngsters' language is not impaired, but rather merely delayed. These children profit from intensive language instruction that can be delivered by classroom teachers with the help of Speech and Language Pathologists.
Today, almost every school in the United States has access to an SLP. In some cases, the SLP is a permanent faculty member. In other cases, the SLP works part time at several schools or is an itinerant teacher, travelling from one school to another. In all cases, the SLP is available to receive referrals, provide therapy, and consult with teachers concerned about a student's communicative abilities. As we noted earlier, the role of the SLP has changed over the last decade. Today these professionals collaborate more with teachers, provide less direct services to children (particularly those with more mild disabilities), and guide teachers in the implementation of language development and remediation programs. General education teachers play a crucial role in children's language development. Teachers must create rich learning environments by providing a stimulating instructional setting that encourages oral language and provides the framework necessary for literacy (see the Tips for Teachers box for some ideas on how to accomplish these goals). For instance, teachers might include activity centers in their classrooms. One center could have electrical components to create circuits so that children can discover cause-and-effect relationships; another center could have magnets and containers of different types of materials. Some part of the day could be set aside for children to talk about their exploration of the materials in the activity centres. Teachers could also use this discussion time to talk about other topics of interest to the children, such as current affairs, environmental issues, or sports. In the following sections, we discuss ways in which all teachers can foster speech and language improvement in their students.