DEFINITIONS
Articulation: the process by which sounds, syllables, and words are formed when the jaw, teeth, tongue, lips, and palate alter the airstream coming through the vocal folds. It is the production of speech sounds. Intelligibility is a measure of how well speech can be understood. Someone with an ‘articulation disorder’ can be hard to understand because they say sounds incorrectly. Most errors fall into one of three categories: omissions, substitutions, or distortions. An omission might be 'at’ for ‘hat’ while a substitution may be ‘wabbit’ for ‘rabbit’ or ‘thun’ for ‘sun’. When the sound is said inaccurately, but sounds something like the intended sound, it is called a distortion.
Phonology: the science of speech sounds and sound patterns. We have language rules about how sounds can be combined. If a child does not use conventional rules for language but develops their own, they may have a ‘phonological disorder.’ In this case, classes of sounds, rather than single sounds, are affected. For example, they may have their own rule for sounds produced at the back of the mouth-they make them all in the front of the mouth. So instead of saying ‘cup’ they say ‘tup’ or ‘doe’ for ‘go’. Sounds can be classified in three ways: where they are produced, how they are produced, and whether the voice is used. A ‘phonological process’ is an unusual rule that is being used and changes one of these factors. Some phonological processes are: fronting, backing, gliding, cluster reduction, devoicing, and stopping.
Voice Disorders: divided into 2 categories, organic and functional. Organic disorders stem from disease or pathology whereas functional voice disorders result from abuse or misuse of the voice. Organic disorders require medical intervention whereas functional voice disorders can often be managed by voice therapy. A normal voice is pleasant sounding and has age and sex appropriate pitch and loudness. When a voice is not pleasant sounding, is too loud or too soft or is too high or low for one’s gender, a voice problem may be present.
Stuttering: refers to a break in fluent or smooth, forward-moving speech. Everyone has disfluencies from time to time. “Stuttering” is speech that has more disfluencies than is considered average. There are many kinds of disfluencies. Those heard in the speech of normal speakers include fillers (um, ah), hesitations, whole word and phrases repetitions, and revisions. Disfluencies more characteristic of stuttering include sound or syllable repetition, prolongations (unnatural stretching out of sounds), and blocks (sound gets stuck and cannot come out). Type, frequency, and duration of disfluency can differentiate stuttering from normal disfluencies. The average speaker has up to 7-10% of their speech disfluent. (Counting the number of disfluent words in a 100-word sample). Stuttering occurs at frequencies greater than 10% and can last from a half second up to 30 seconds, and is accompanied by tension. Many children go through a period of normal nonfluency between the ages of 2 and 5 years (see further explanation in the stuttering section of this site). There are many theories and misconceptions about the cause of stuttering. There are many myths also. Here are some facts:
Apraxia: a motor disorder in which voluntary movement
is impaired without muscle weakness. Rather, the ability to select and sequence movements is impaired.
Oral Apraxia affects one’s ability to move the muscles of the mouth for non-speech purposes, such as coughing,
swallowing, wiggling their tongue or blowing a kiss. Verbal Apraxia, or Apraxia of Speech, is impairment
in the sequencing of speech sounds.
Apraxia that happens as a result of an incident causing brain damage is said to be ‘acquired’. Developmental
Apraxia of Speech (DAS) is not well understood. It occurs in children and is present from birth.
Diane Paul-Brown and Roseanne Clausen, ASHA 11/99 state, “A child with developmental apraxia of speech has trouble
correctly producing and sequencing sounds, syllables, and words. Generally, there is nothing wrong with the
muscles of the face, tongue, lips, and jaw. The problem is thought to arise from difficulty accessing the
‘motor plan’ from the brain for saying a sound or word.”
“Signs that can indicate Developmental Apraxia of Speech…in very young children: does not coo or babble as an infant,
produces some first words after some delay but words are missing sounds or have difficult sounds replaced with
easier ones; produces relatively few different consonant sounds; is unsuccessful at combining sounds; simplifies
words by replacing or deleting difficult sounds; may have feeding problems. In older children, they may make
inconsistent sound errors that are not the result of immaturity; can understand language better than they can produce
it; difficulty imitating speech; may appear to be searching for something when trying to produce sounds or coordinate
the articulators; has greater difficulty saying longer phrases; ability to speak appears to be affected by anxiety;
listener has difficulty understanding the child.”
Language: When we speak of ‘language’ we are not speaking of another ‘language’, such as French or Spanish. Language in our discipline refers to a wide variety of concepts, including but not limited to vocabulary, syntax, and pragmatics. Some folks also include auditory processing/phonological skills under language as well. Vocabulary or semantics refers to the acquisition of words and their meaning. Our language can either be ‘receptive’ (what you understand) or ‘expressive: (what you are able to use to let others know your thoughts/wants/needs). Syntax or morphology refers to using correct word order and grammar, such as verb forms, possessives, pronouns, plurals, Wh-questions, or sentence construction. Actually using our language to communicate has been termed ‘pragmatics’. It includes listening, problem solving, conversational skills, taking turns, and exchanging information.
Auditory Processing: our ability to make sense of what we are hearing through our auditory channel, our ears. Frank Musiek, audiologist and researcher, described it as “How well the ear talks to the brain, and how well the brain understands what the ear tells it.” A central auditory processing disorder can only be diagnosed by an audiologist with current training in this area and then only in children 8 years or older. The speech/language pathologist can evaluate the child’s perception of speech and the receptive/expressive language abilities. These professionals work together to determine the scope of the problem and the most effective treatment strategies and techniques.
Alternative/Augmentative Communication: methods that help individuals with communication difficulties to communicate more easily and effectively. These methods can be used by those with difficulty speaking, writing, understanding others or reading. AAC methods may be used to replace difficulties or support them. Some of the AAC methods most commonly used include the use of objects, pictures, graphic symbols or manual signs. Many times technical aids are used with voice output, visual displays or monitors. Individuals who use AAC can have cerebral palsy, hearing and visual impairments, intellectual disabilities, autism, head and spinal cord injuries, motor speech difficulties, progressive diseases, and strokes. AAC is beneficial to all ages in many communication settings. It truly provides increased independence and quality of life.
