Common Speech and Language Disorders in Children and Adults

Posted on Feb 1, 2025 in Medicine & Health

Late Talkers

A late talker is a child between 18 and 30 months old who isn’t speaking much or at all but is otherwise developing normally. Comprehension skills, gestures, challenges with literacy skills, loss of sounds or words previously learned, as well as a decrease in social skills and feeding difficulties, are potential risks as late talkers age.

Speech delay normally originates in the brain but can sometimes be caused by physical impairment, social adjustment problems, or learning difficulties.

Furthermore, some of the factors that can influence the development of language are biological ones, a family history of language disorders, and chronic ear infections.

In conclusion, there are some recommendations that can probably help the child’s development. What speech pathologists mostly recommend is to try to expand the child’s vocabulary by talking, asking questions, and using gestures to complete the language. However, one of the most important things that your child should do is go to speech therapy because this will increase the probability of increasing the child’s vocabulary.

Stuttering

Stuttering is a disorder characterized by interruptions in the production of speech sounds, also called disfluencies.

It’s a speech disorder characterized by involuntary repetitions and may be accompanied by various facial movements and respiratory disorders. It begins during childhood and, in some cases, lasts throughout life.

Stuttering can affect more than just a person’s observable speech. As a result, diagnosing stuttering requires the skills of a certified speech-language pathologist. A qualified professional can note the number and types of speech disfluencies a person produces in various situations, assess how the person reacts and deals with a lack of fluency, and collect information about “taunts” that can make the problem worse.

The exact cause of stuttering is unknown, but some of the causes that produce stuttering may be genetic.

On the other hand, most treatment programs for people who stutter are “behavioral” but, generally speaking, saying the words in a slightly slower and less physically tense way and controlling your breathing would be some of the strategies to improve stuttering, although they do not lead to one hundred percent improvement.

Voice Disorders

Voice disorders are a group of conditions that affect the sound and the quality of the voice. It is characterized by an abnormality of pitch, volume, resonance, and quality. We call that a dysphonia. But when there is a complete absence of voice, it is an aphonia.

It can be caused by two factors: on the one hand, by congenital abnormalities like reflux, cleft palate, and velopharyngeal insufficiency. On the other hand, by environmental conditions as allergies, vocal abuse, cigarette smoke, chronic throat clearing, dryness, etc.

All these causes can affect the parts of the structures that make us phonate and can develop laryngitis, vocal nodules and polyps, vocal cord paralysis, paradoxical vocal fold movement, and spasmodic dysphonia.

Depending on the problem, the treatment will be different: medical, surgical (removing the part affected or the nodule or polyp), and behavioral (with voice therapy that includes vocal hygiene, breath support, etc).

In conclusion, we must be careful about different factors that can damage the structures we need to produce phonation.

Aphasia

Aphasia is a speech pathology that affects how you communicate. It is basically caused by a lesion to the language centers of the brain, and it is usually more centered on the left side of the brain. The left side of the brain controls understanding, speaking, and using signed language.

People with aphasia have a delay in understanding, communicating, reading, and writing, which makes it very difficult for them to properly communicate and have a conversation.

Furthermore, aphasia is normally caused by a stroke or some sort of TBI (traumatic brain injury). Some other causes for aphasia can be brain infections, brain tumors, brain disorders, etc.

In conclusion, aphasia can’t be treated medically, so the patients must visit their local SLP. In speech therapy, aphasic patients are mainly given these strategies to try and improve their communication skills: using hand gestures, writing, painting, pointing to letters/pictures. This is a type of treatment called AAC (Augmentative and Alternative Communication), which helps people with aphasia and other speech pathologies to communicate, even if it is non-verbally.

Key Terms and Definitions

Aphonia: Loss of voice due to organic or functional diseases of the vocal organs.
Dysphonia: Characterized by altered vocal quality, pitch, loudness, tremorous voice, or vocal effort.
Otolaryngologist: A doctor specialized in diagnosing and treating diseases of the ear, nose, and throat.
Stroboscope: An instrument for studying periodic motion or determining speeds of rotation.
GERD (Gastroesophageal Reflux Disease): A medical condition in which acid from the stomach frequently goes back up into the esophagus.
Tracheotomy: A medical operation in which the trachea is cut, usually to help them to breathe.
Thyroplasty: A procedure performed to change the position of the vocal cord.
Endoscopy: A tube with a camera to look inside your body.
Comorbidity: The condition of having two or more diseases at the same time.
Prognosis: A doctor’s judgment of the likely or expected development of a disease.
Stroke: A blockage or breaking of a blood vessel that leads to the brain.
Hemisphere: One of the two halves of the brain.
Impairment: Deterioration in the functioning of a body part, organ, or system that can be temporary or permanent and can result from injury or disease.
SLP: A professional trained to evaluate and treat people who have voice, speech, language, swallowing, or hearing disorders, those that affect their ability to communicate or consume food.
Screening: A test or examination to discover if there is anything wrong with someone.
Follow-up: To discover more about something or to take further action connected with it.

Service Delivery for Childhood Disfluency Disorders

Service delivery for childhood disfluency disorders encompasses, among other factors, treatment format, provider(s), dosage, timing, and setting. Fluency treatment is a dynamic process; service delivery may change over time as the client’s needs change.

Format: Refers to the manner in which a client receives treatment: one-on-one or as a member of a group of people receiving services at the same time. In most settings, fluency treatment typically takes place one-on-one to allow focused teaching of new skills and ensure privacy for the discussion of personal issues.
Provider: Refers to the person providing treatment. The primary provider of fluency treatment is the SLP. Approximately 67% of SLPs working in schools reported serving students with fluency disorders. SLPs providing pediatric services in various health care settings reported spending 3% of their time serving children with fluency disorders.
Dosage: Refers to the frequency, intensity, and duration of treatment. Dosage depends largely on the nature of the treatment (direct or indirect) and the task level. Scheduling concerns, cost, and insurance reimbursement also are likely to be factors affecting dosage. Given these potential issues, determining dosage often comes down to the professional opinion of the SLP and the needs of the child and family.
Timing: Refers to the initiation of treatment relative to the diagnosis. Fluency treatment can occur at any point after the diagnosis. In general, the earlier preschool stuttering is addressed (relative to its onset), the easier it is to manage. For older children, initiation of treatment depends in large part on the child’s motivation which, in turn, is dependent on such factors as the speaker’s perceived needs, degree of adverse impact experienced, and previous treatment experiences.
Setting: Refers to the location of treatment. Children with disfluencies are seen in all of the typical speech-language pathology service settings, including private practices, university clinics, hospitals, and schools. Telepractice is possible as well.

Additional Key Terms

Smoothness: The quality of being smooth or even without interruptions or irregularities.
Rate: The speed or frequency at which something occurs or is measured.
Avoid (Avoidance): To stay away from or prevent something from happening.
Onset: The beginning or start of something, especially a medical condition or symptom.
Hesitation: The act of pausing or delaying before doing something, often due to uncertainty or doubt.
Incidence: The number of new cases of a disease or medical condition that occur within a specific time period.
Dosage: The amount of medication or treatment prescribed or administered, often measured in a specific unit of measurement.
Timing: The specific time or sequence in which something occurs or is scheduled to occur.
Setting: The environment or context in which something occurs, often used in the context of healthcare or medical treatment.
Ossicles: Three small bones in the middle ear (malleus, incus, and stapes) that transmit sound vibrations from the eardrum to the inner ear.
Cochlea: A spiral-shaped, fluid-filled organ in the inner ear that is responsible for converting sound waves into neural signals that are sent to the brain for processing.
Otitis: An inflammation or infection of the ear, typically caused by a bacterial or viral infection.
Eardrum: A thin, delicate membrane that separates the outer ear from the middle ear and vibrates in response to sound waves.
Genetic: Relating to genes or heredity, referring to traits or conditions that are inherited from one’s parents.
Delay: A period of time during which something is postponed or held back, often referring to developmental delays in children’s speech, language, or other skills.
Language Onset: The age at which a child begins to use language or speak their first words.
LLE: Late Language Emergence refers to children who have a delayed start in speaking and have a smaller vocabulary than other children of the same age.
Incidence: The number of new cases of a particular condition that occur in a population during a specific time period.
Prevalence: The proportion of individuals in a population who have a particular condition at a given time.
Toddlers: Children between the ages of one and three years old.
Peers: Children of the same age or developmental stage.
SLI: Specific Language Impairment, a language disorder that affects a child’s ability to understand or use language despite having normal hearing and intelligence.

Spanish Medical Terms

Encefalocele: A disorder that originates specifically in the anterior neuropore, due to the fact that the neural tube on the side of the skull has not closed correctly, causing a bulb or protrusions in the area of the brain.
Gastrulation: A process that begins at the end of the 3rd week of gestation, in which the embryo begins to collect specific characteristics, forming embryonic layers that will result in the nervous system and specific organs.
Myelomere: A nerve that has been divided due to segmentation in the rhombencephalon or posterior cerebellum, from its primary ventricles, causing it to connect with the spinal nerves.
Myeloschisis: Failure caused by defects of the posterior neuropore.
Neuropore: The opening that will be found in the anterior and posterior area of the embryo during the formation of the neural tube. This neural tube will originate in the nervous system.
Neurulation: The process by which the neural tube of the embryo is formed. The precursor structure of the CNS, that is, the brain and spinal cord.
Teratogenic Substance: A chemical substance that, when acting on the embryo or fetus, can seriously alter the growth and intrauterine development of the baby.
Dysraphic Disorder: Malformations that are generated due to neurulation defects.
Depolarization: This is the part of the process that causes an electrical signal to be released, which will cause the transmission of information through the nervous system (excitation). This causes an increase in the electrical charge inside the neuronal membrane.
Anastomosis: Surgical union of an anatomical element with another similar to the same structure.
Arteriosclerosis: It is an involutive disease of the arterial system, which involves the production of an atheroma plaque, necrosis and calcification of the media, and sclerotic inflammation of the internal tunic. Its cause can be hereditary or nutritional.
Atherosclerosis: It is the accumulation of fats, cholesterol, and other substances inside the arteries and on their walls; This accumulation is called plaque and can cause narrowing of the arteries and blockage of blood flow.
Stroke: Episodes of sudden, acute, or subacute insaturation in which a permanent or transitory neurological deficit occurs in relation to the affected brain area.
Cerebral Infarction: It is an ischemic stroke, during which a part of the brain mass dies due to a lasting lack of blood supply. The cause is the occlusion of the cerebral arterial system due to thrombosis or embolism.
Ischemia: Transitory or permanent decrease in the blood supply of a part of the body, produced by a normal or pathological alteration of the artery or arteries afferent to it.