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The Different Speech Disorders Explained




Along with language disorders, speech disorders can be particularly debilitating for children. Speech disorders can lead to learning disabilities and impact them throughout adulthood. It can also affect things like self-esteem and lead to depression.


There are many types of speech disorders out there, but we will focus on some of the most common speech disorders in young children. With this information, we hope to serve as a guide stone to getting your child the treatment they need.


Let’s take a look at common speech disorders in children.


Stuttering


Stuttering, or stammering, is a fluency disorder. It refers to the repetition of sounds, syllables, or words; sound prolongations; and blocks in which speech is interrupted. Certain words or sounds can make the stutter even more pronounced. Stuttering is fairly common; it can affect 5-10% of all children at some point.


Symptoms


Stuttering typically starts between the ages of 2 and 6. Many times, this period will last less than 6 months. People who stutter can have varying symptoms. Additionally, things like stress, frustration, or excitement can cause the stuttering to increase. Here are the most common symptoms and some physical symptoms that can accompany a stutter:

  • Repeating words, syllables, or sounds

  • Completely halting speech production

  • Uneven speech rate

  • Face and shoulder tension

  • Quivering lips

  • Clenched fists

  • Jerky head movements

  • A rapid succession of blinks

If the stuttering lasts longer than 6 months, the child may need treatment. Boys are more likely to continue to stutter than girls, and those who start stuttering after the age of 3 ½ are more likely to continue.


Causes


There is no one cause of stuttering. But there are several possible causes. They are:

  • Family history of stuttering

  • Brain injury

  • Emotional distress

  • Emotional trauma

  • Abnormal brain function


Treatment Options


If your child suffers from a stuttering problem, it can help to have support from you, other family members, and your child’s teacher to make a difference. Treatment may not completely eliminate the stutter, but it can help with things like improving speech fluency, developing effective communication, and participation in activities.


Treatment options include:

  • Speech therapy: A speech-language pathologist (SLP) can help the child slow down their speech and notice when the stutter occurs.

  • Parent-child interaction: There are techniques you and your child can practice at home to help with stuttering. Talk with your child’s SLP to find the best approach that will work with your child’s issue.

  • Cognitive behavioral therapy (CBT): CBT is a good way to help resolve stress, anxiety, or self-esteem-related issues associated with stuttering.

  • Electronic fluency device: An electronic fluency device delays or alters the sound of someone’s voice which creates an echo. It can also mimic your speech as if you are talking in unison with another person. Both of these ways have proven to help those with stutters.

  • Support group: Joining a support group with other children with similar problems can help your child feel less alone.


Apraxia of Speech


Apraxia of speech, or verbal apraxia, refers to the speech sound disorder in which brain damage has impaired a person’s motor skills that affect one’s ability to make speech sounds. The person often knows the words they want to say, but are simply physically unable to.


Language problems like Aphasia can co-occur with speech disorders like apraxia of speech or dysarthria. These are all the results of brain damage. Aphasia is when the person is impaired in linguistic capabilities rather than motor skills used to speak.


Apraxia of speech can also occur in children upon birth, though this is uncommon. It is called childhood apraxia of speech (CAS), or developmental verbal dyspraxia.


Symptoms


These are some common symptoms of CAS:

  • Difficulty pronouncing vowels

  • Stressing the wrong part of the word

  • Difficulty transitioning from a sound, syllable, or word to another

  • Putting a pause between syllables

  • Inconsistency in pronunciations; making different errors on the same word

  • Difficulty pronouncing simple words


Causes


In most cases of CAS, the causes are not known. However, there are a few known causes of CAS:

  • Neurological impairment: This may be caused by infection, illness, or injury, during or after birth. Some genetic conditions can also cause neurological impairment associated with CAS.

  • Autism: Apraxia related to autism can be very difficult to diagnose. Take a few sessions with your SLP before a conclusion is drawn.

  • Genetic disorder: Many different complex disorders have CAS as a secondary characteristic. That being said, not all children with that particular genetic disorder will have CAS. One common genetic disorder associated with CAS is galactosemia.


Treatment Options


To help improve your child’s speech to be more clear, there are several treatment options to try. Treatment will involve learning how to plan the movements needed to say sounds and make the movements at the right time. Treatment options include:

  • Speech therapy: Working with an SLP 3-5 times a week, in the beginning, can make a difference with CAS and language skills. As your child's speech improves, the sessions can be less often. It can be helpful to do either individual or group therapy sessions. Speech therapy may include speech drills, sound and movement exercises, speaking practice, vowel practice, and paced learning.

  • Home practice: Your child’s SLP can give you some words or phrases for your child to practice at home. You can do a quick 5-minute session twice a day. They can also get some practice in real-life situations by creating situations where it is appropriate for your child to say the word or phrase.

  • Other communication alternatives: If your child has a severe case of CAS, it may be helpful to learn other communication methods, like sign language or natural gestures like pointing. However, as their speech gets better, these methods can be abandoned.


Dysarthria


Dysarthria is a speech sound disorder characterized by muscle weakness or difficulty controlling them. Muscle weakness or loss of control occurs in the parts that are needed for speech including the face, lips, tongue, throat, or chest. The speech is often slurred or slowed, making it difficult to understand.


Symptoms


Common symptoms of dysarthria speech problems include:

  • Slurred, gurgly, monotonous, nasally, or breathy speech

  • Mumbling

  • A voice that is strained or hoarse

  • Speaking too quickly or too slowly

  • Very soft or quiet speech

  • Difficulty moving tongue or mouth; may involve drooling

  • Unable to speak in a regular rhythm due to hesitative speech


Causes


The cause of dysarthria can be either developmental or acquired. Some common causes could be:

  • Brain or head injury

  • Brain tumor

  • Cerebral palsy

  • Lyme disease

  • Muscular dystrophy

  • Some medications including certain sedatives or seizure drugs


Treatment Options


When it comes to dysarthria, it is important to treat the underlying cause of the issue. If it was caused by prescription medications, change or discontinue the medications to relieve the issue. For those suffering from dysarthria that persists, it is a good idea to get treatment from an SLP.


Depending on your child’s level of impairment, he or she will work with your child to:

  • Slow down the rate of speech

  • Learn how to use more breath to raise voice volume

  • Practice mouth exercises to strengthen muscles

  • Practice lip and tongue exercises to strengthen muscles

  • Enunciate words and sentences more clearly

  • Introduce other communication methods including gestures, writing, or devices





Articulation Disorder


Articulation disorder is a functional speech sound disorder that occurs when the speaker has trouble with the motor functions that are needed to make certain sounds. Their lips, tongue, teeth, palate, and lungs are unable to coordinate. This causes the person to produce speech sounds that are distorted, or they will swap out sounds for ones that can make.

Symptoms


A child suffering from an articulation disorder may be hard to understand. Here are some articulation errors he or she is likely making:

  • Addition: This occurs when sounds or syllables are added that don’t belong. As an example, “puh-lay” instead of “play”.

  • Distortion: This occurs when a sound is changed. It can often sound like a lisp. For example, when the “s” sounds like a “th”.

  • Omission: Excluding certain sounds that he or she has difficulty with. For example, “leaving out the “sc” in “scratch”.

  • Substitution: This occurs when one sound is substituted for another. For example, not being able to form the “th” sound in “those” and replacing an “f” instead.

  • Behavioral issues: When a child is aware of their articulation issues, he or she might often be quiet or seem shy, get frustrated when speaking, or just stop saying some words completely. It is quite often the child will struggle with a lack of confidence and self-esteem.


Causes


In most children, there is no known cause for their articulation disorders. However, some articulation errors are known to be caused by things like:

  • Brain injury

  • Development or cognition issues

  • Deafness or hearing impairment

  • Physical disabilities that impact speech like cleft palate or cleft lip

  • Any nerve disorder that affects the nerves associated with speech


Treatment Options


To treat articulation disorder, it is very helpful for your child to undergo speech therapy. Having regular appointments with an SLP will make an improvement with articulation errors. This is what your SLP will focus on:

  • Figuring out the exact sounds your child has difficulty with

  • Correcting the way he or she creates sounds to produce the right sound

  • Teaching or re-learning ways to control the motor functions of speech. This can include how to shape the lips to express a particular sound.

  • Introducing exercises that strengthen the muscles involved in speech

  • Giving you exercises for your child to practice sound formation at home


Voice Disorders


Children are also susceptible to voice disorders. They are very common; about 5% of children may experience a chronic voice disorder. Voice disorder occurs when the speaker’s voice sounds noticeably different from others’ voices of the same age and sex. But thankfully, most voice disorders are harmless and often disappear on their own.


However, this may require some treatment to overcome. Typical voice disorders include laryngitis, muscle tension dysphonia, neurological voice disorders, polyps, nodules, or cysts on the vocal cords.


Symptoms

  • Harsh or hoarse voices

  • A voice that is too high or too low

  • A voice that is too loud or too nasally

  • Breathiness

  • Raspiness

  • Strained voice

  • Loss of voice


Causes

  • Excessive shouting

  • Excessively loud talking

  • Making too many harsh sound effects when playing

  • Infections like a cold or laryngitis which inflame the vocal cords

  • Paralyzed vocal cords

  • Growths on the vocal cords such as nodules, cysts, polyps

  • Recurrent Respiratory Papillomatosis (rare)

  • Tumors/cancers (extremely rare)


Treatment Options


Having a hoarse voice can be common in children. However, if it is a chronic issue, we recommend getting an assessment from an ENT and a speech pathologist from a voice clinic. It can also make a difference to pay more attention to taking care of your child’s voice. Be sure to make sure he or she is drinking plenty of liquids.


It is also a good idea to have quiet time where your child rests their voice or is encouraged to speak softer. Try to make sure your child does not spend a lot of time in smoky, dusty, or polluted environments. It also is essential that they are free from stress and anxiety so they can speak more calmly. In rare cases, surgery may be necessary.


Pay Attention to Milestones in Your Child’s Development


To detect any possible communication disorders in your child, it is important to pay attention to the normal milestones in childhood development. If you notice a language delay or any other developmental delays, you may want to reach out to your pediatric healthcare provider to get a more conclusive diagnosis. He or she will recommend an SLP, preferably certified by American-Speech-Language-Hearing Association (ASHA).


We are also here to help. Here at the RiteCare Childhood Language Centers of California, we’ve made a difference in childhood speech disorders for 60 years. Our certified SLPs perform free services to children in our community. And we will continue to make a difference in speech disorders like stuttering, CAS, dysarthria, articulation disorders, and voice disorders.



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