speech disorder

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the utterance of vocal sounds conveying ideas; the faculty of conveying thoughts and ideas by vocal sounds. The process is controlled through motor speech areas located in the frontal lobe of the brain.

The Mechanics of Speech. The voice originates in the larynx, which is in the upper end of the air passage to the lungs and is behind the thyroid cartilage. The larynx, in cooperation with the mouth, throat, trachea, and lungs, works on the same principle as musical instruments such as organs and oboes, in which air is forced over a thin reed to produce sound. The vocal cords, two reedlike bands, are attached at one end to the wall of the larynx behind the laryngeal prominence or “Adam's apple”; the other ends are attached to movable cartilages. When the voice is not being used, muscles move these cartilages outward and hold the vocal cords against the sides of the larynx so that breathing is not obstructed. When a person starts to speak, sing, grunt, or shout, the ends of the vocal cords connected to the cartilages are brought across the larynx, so that they partly obstruct it. As air is forced through, the cords vibrate, producing sound waves, which are what is known as the voice.

In speaking, the size and shape of the mouth and pharynx are varied as the sound goes through, by means of muscles of the mouth, throat, and tongue. Vowel sounds are initiated in the throat and are given their distinctive “shapes” by movements of the mouth and tongue. Consonants are formed by controlled interruptions of exhaled air.
Volume, Pitch, and Timbre. The voice itself has three characteristics: volume, pitch, and timbre (or quality). Volume depends on the effort made in forcing air through the vocal cords. The pitch of the voice depends on the amount of tension placed on the vocal cords, and on the length and thickness of the cords. Children's and women's vocal cords are short, giving them higher-pitched voices. A man's are longer and thicker and his voice is deeper. Timbre is affected by the size and shape of the individual's various resonating chambers (mouth, pharynx, chest, and others) and the way they are used. Bones in the head and chest also contribute to the quality of a voice. By long training in the use of the voice, singers are able to alter and control the mouth, throat, and chest cavities to produce a wide range of harmonics or overtones.
Speech Defects. Over 100 muscles are involved in the utterance of a simple word, and the construction of a simple sentence is a feat so complicated that it is beyond the capacity of any animal except the human being. The process of learning to talk is obviously a difficult task for children, and it is not surprising that 5 to 7 per cent of children reach adulthood with a serious speech disorder.

The baby learns to make specific sounds with the voice by babbling and cooing. Gradually he or she becomes able, more or less unconsciously, to put these sounds together to form intelligible speech in imitation of parents and other speakers in the environment. This complicated process is sometimes disturbed if the child has congenital physical defects, illness, or psychologic difficulties. As a result, speech disorders may occur.
Congenital Causes. Prominent among the congenital defects that may cause speech problems are cleft lip and cleft palate. These abnormalities are evident at birth and should be corrected by surgery at an early age. Another congenital defect is ankyloglossia (tongue-tie), abnormal shortness of the frenulum of the tongue. This condition, which if uncorrected may cause lisping and other awkwardness, is easily corrected by surgical cutting of the frenulum as soon as the difficulty becomes evident. Congenital deafness will prevent a child from learning to speak in the usual way and may result in mutism. However, if the speech mechanisms are normal, the child can be taught to speak by a speech therapist. Malformations of the nasal passages, larynx, or other parts of the voice-producing tract may cause oddities in the sound of the voice. Such defects also can be corrected in many cases by minor surgery.
Other Causes. By the age of 5 or 6 years most children have mastered the basic art of talking. Serious difficulties that persist or appear for the first time after this age, and that are not due to congenital defects, are likely to arise from illness, injury, or a psychologic disturbance. Damage to speech centers of the brain by multiple sclerosis, syphilis, or parkinson's disease, for example, may cause speech to be singsong, explosive, mechanical, or slurred. In such instances improvement of speech follows treatment of the basic disorder. Poor alignment of the front teeth also may interfere with proper speech. Speech defects of psychologic rather than physiologic origin include stammering and stuttering.
speech disorder defective ability to speak; it may be either psychogenic or neurogenic. See also aphasia, aphonia, dysphasia, and dysphonia. Called also lalopathy and logopathy.
esophageal speech speech produced by expelling swallowed air across one or more constrictions in the pharyngoesophageal segment; used after laryngectomy.
explosive speech loud, sudden enunciation, occurring in certain brain diseases.
speech and language in the omaha system, a client problem in the physiologic domain, defined as articulated vocal sounds, symbols, signs, or gestures used for communication.
mirror speech speech in which the order of syllables is reversed.
pressured speech logorrhea.
scanning speech speech in which syllables are separated by pauses.
telegraphic speech speech consisting of only certain prominent words, without others such as modifiers; it is typical of children around age two but in older persons it is a form of agrammatism.

speech disorder

Articulation deficiency, dysfluency, speech disturbance, voice disorder Audiology Any of a group of defects in speech involving abnormal pitch, loudness, or quality of sound produced by the larynx Neurology A disorder of impaired or ineffective verbal communication not attributed to faulty innervation of speech muscles or organs of articulation–eg, language and learning disabilities Etiology Neural damage, paralysis, structural defects, hysteria, mental retardation, hearing impairment, ADD, learning disabilities, autism, schizophrenia, cerebral palsy, cleft palate, vocal cord injury, disorders of palate, cri-du-chat syndrome, Tourette syndrome See Amimia, Dyslexia. Cf Agraphia, Aphasia, Apraxia.

speech disorder

Any abnormality that prevents a person from communicating through spoken words. The disorder may develop from brain injury, stroke, muscular paralysis of the organs of speech, structural defects of the mouth, teeth, or tongue, somatization disorders, or cognitive deficits.

Patient discussion about speech disorder


A. How old are you now?
What are your interests?
Are you sure the problem getting a job is your speech and not the way to dress or present yourself?
What other jobs have you held in the past and what happened to them?
I can think of a few places I have run into people with speech problems, such as the cable man or a waitress at a local restaurant. Consider asking a speech therapist what kinds of jobs other people with your particular problem hold.

More discussions about speech disorder
References in periodicals archive ?
I love to celebrate the eucharist; however, with speech impairment I find it a challenge to say the whole eucharistic prayer on my own.
Shaun, 29, of Meltham, raised pounds 150 for Afasic, a charity which helps children with speech impairment.
Among subjects who developed stroke, significantly fewer of those on ramipril showed cognitive, motor, or speech impairment, compared with those on placebo.
R DB (Nov 2001) has a 14-year-old daughter who has cerebral palsy, developmental delay and speech impairment.
I'm not sure I want to think about that,'' said Tompkins, who is blind and suffers a speech impairment.
In terms of achievement, groups with all general education students had relatively higher average objective scores and groups with a student with a speech impairment were relatively high on the average objective score and the average open-ended score.
Now he is paralysed down one side, has a speech impairment and suffers severe short- term memory loss.
Mother has had a series of brain strokes, infarctions, which have caused speech impairment and loss of some mental abilities," Barbara explains.
He has a hearing and speech impairment and requires medication that I could not afford.
Like 1 in 4 people left with a speech impairment after a stroke, Qualicare Home health aides made sure that patients are never without pencil and paper so the patients can communicate.
Wasnik informed that to address the needs of persons with hearing and speech impairment, the Ministry of Social Justice and Empowerment has started the process of establishing an Indian Sign Language Research and Training Centre.
DC Corbett, 40, was left with memory loss and a speech impairment, the court heard.

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