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Description : Check out this medical presentation on Pediatrics, which is titled "Speech & Language Problems in Children", to know about speech and language problems in children.

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Published on : Aug 03, 2021 | Views : 1827 | Downloads : 7

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SPEECH & LANGUAGE PROBLEMS IN CHILDREN Anna L. Eifert, MS, CCC-SLP Speech, Language & Learning Texas Children’s Hospital
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TOPICS Terminology Characteristics Etiology Evaluation Management
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TERMINOLOGY: COMMUNICATION Receiving, sending, processing and comprehending concepts, or verbal, nonverbal and graphic symbol systems Verbal - Spoken Nonverbal - Gesture/Sign Graphic - Written
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TERMINOLOGY: SPEECH Articulation - production of speech sounds (phonemes); e.g., /p/, /f/, /s/, /k/ Voice - production of vocal quality, pitch, loudness, resonance and duration Fluency - flow or smoothness of speech production
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TERMINOLOGY: LANGUAGE Receptive and Expressive Language Content Semantic - word meanings/vocabulary Form Syntactic - grammar, word order Morphological - structure of word forms Phonological - sounds Use Pragmatic - function or use in context
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CHARACTERISTICS OF AN ARTICULATION OR SPEECH SOUND DISORDER Difficulty pronouncing speech sounds Reduced intelligibility Patterns use of one or more consonants for most others (e.g., “tat” for “cat”) omission of consonants at ends of words (e.g., “ca-” for “cat”) difficulty with consonant clusters (e.g., “tick” for “stick”)
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CHARACTERISTICS OF DYSFLUENCY/STUTTERING Usual onset between 2 and 5 years of age Highest risk of onset occurs before age of 3.5 Onset prior to age 3: majority of children recover fluency Part-word repetitions, sound prolongations, blocks Struggle and tension Rising pitch Fear and avoidance Associated behaviors
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CHARACTERISTICS OF A VOICE DISORDER Quality: hoarse, harsh, breathy Resonance: hypernasal/hyponasal Pitch: too high or too low Loudness: too soft or too loud
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CHARACTERISTICS OF A LANGUAGE DISORDER Language form: “the girl hat” “her go her house” “did you remembered” Language content: “a frog up and down” Language use: “Catch Home Improvement tonight at 10:30 on Channel 7”
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Characteristics of autism Communication Not speaking or very limited speech Loss of words the child was previously able to say Difficulty expressing basic wants and needs Poor vocabulary development Problems following directions or finding objects named Repeating what is said (echolalia) Problems answering questions Speech that sounds different (e.g., "robotic" speech or speech that is high-pitched) http://www.asha.org/public/speech/disorders/Autism/
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CHARACTERISTICS OF AUTISM Social skills Poor eye contact with people or objects Poor play skills (pretend or social play) Being overly focused on a topic or objects that interest them Problems making friends Crying, becoming angry, giggling or laughing for no known reason or at the wrong time Dislike being touched or held http://www.asha.org/public/speech/disorders/Autism/
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CHARACTERISTICS OF AUTISM Reacting to the world around them Rocking, hand flapping or other movements Not attending to things the child sees or hears Problems dealing with changes in routine Using objects in unusual ways Unusual attachments to objects No fear of real dangers Being either very sensitive or not sensitive enough to touch, light or sounds Feeding difficulties (refusing certain food textures) Sleep problems http://www.asha.org/public/speech/disorders/Autism/
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REQUIREMENTS FOR NORMAL DEVELOPMENT Intact Mechanism Hearing Sensitivity Perception Intelligence Structural integrity Motor skill Emotional stability Favorable Environment Stimulation Reinforcement Realistic Expectations
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ETIOLOGY: ARTICULATION Hearing loss Neuromotor (Apraxia & Dysarthria) Structural defects Rule-based Developmental
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ETIOLOGY: STUTTERING Child factors that contribute to onset of stuttering Age of rapid development High internal demand for complex language Impulsive/compulsive need for talking Temperament characteristics Progress of normal development: speech, language, motor, social, emotional and cognitive
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RISK FACTORS FOR PERSISTENT STUTTERING Gender Genetics and family history Age of onset Length of time since onset Speech sound errors
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ETIOLOGY: VOICE Misuse vs. Organic Changes Vocal nodules Resonance Hypernasal Velopharyngeal Insufficiency (VPI) Cleft Palate Hyponasal
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ETIOLOGY: LANGUAGE Specific Language Impairment (SLI) discrepancy between verbal and nonverbal ability strong familial incidence
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ETIOLOGY: LANGUAGE Mental Retardation Learning Disabilities ADHD CAPD Degenerative disorders Autism/PDD Hearing loss Traumatic Brain Injury Abuse/Neglect Otitis Media
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EVALUATION Causative Vs. Descriptive Standardized/Objective Testing Observational/Subjective Testing Instrumented Observation
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EVALUATION Language Form/Content/Use Receptive Expressive Articulation Voice Fluency
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EVALUATION Phonological awareness Auditory/Visual processing Memory Reasoning Reading Written Language Math
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REFERRAL CRITERIA Persistent concern by caregiver Development slows or plateaus No consistent words by 18 months No word combinations by 24 months Speech is difficult for parents to understand at 24 months Disfluencies more than tension-free, whole word repetitions
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REFERRAL CRITERIA Speech is difficult for others to understand at 36 months Difficulty following instructions Difficulty using language appropriately Child is frustrated or teased Child avoids speaking situations Academic difficulty
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MANAGEMENT Parent education Role in stimulating language development Promote an optimal listening environment Increase saliency of speech signal (seating, gaining attention first, speaking clearly) Reducing background noise Enhance responsiveness of language environment Responding to communicative attempts Elaborating on topics Rhyming games, songs, stories Regular book reading
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MANAGEMENT Speech and Language Intervention Target specific areas of concern High structure (stimulus-response-reinforcement) Low structure (client-led, play-based) Generalization of learned skills Functional Outcomes Pull-out versus Inclusion
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MANAGEMENT Technology Passy Muir speaking valve Augmentative communication Computer applications
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MANAGEMENT: LATE TALKERS PREDICTORS OF A POSITIVE OUTCOME good language comprehension good sound repertoire verbal/gestural imitation gestures play skills social skills RISK FACTORS otitis media family incidence of language & learning problems parental needs
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SUMMARY Parent/teacher/physician concerns Physician referral Evaluation and Recommendations Management
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REFERENCE LIST http://www.asha.org/ http://jshd.pubs.asha.org/ http://lshss.pubs.asha.org/ http://www.stutteringhelp.org/ http://www.apraxia-kids.org/