Babies must first hear the sounds frequently and memorize them before learning to speak or learn their meaning. For children with hearing impairment, among the many activities that can facilitate listening to sounds are sound-object association activities also known as “learning to listen sounds”.
This type of activity involves associating a sound to a referent, an item such as transportation vehicle or animal with a routine meaningful action. Linking a sound to a referent is considered an important activity for auditory-based intervention because it encourages the child to attend to sounds, facilitate the recognition that sounds are different and help the child understand that different sounds have different meaning.
This activity also develops stored perceptual representation for specific sounds or language-based phonemes. It also develops auditory familiarity with the spoken language.
Considerations
There are some important things to consider when facilitating this kind of activity. One thing is to incorporate toys or personal action for very young child. This allows children to actively participate in the learning and listening process as this activity is meaningful and enjoyable for them.
Another thing is the variation of the supra-segmentals of these sounds. This restructures the auditory schema of a child for a particular sound each time he hears it in a different context. Also, toys used for learning to listen sounds should be simple representational items that are easily recognizable by young children.
Adults should also remember that “hearing comes first” for an effective auditory-verbal strategy. This means that the adult should first vocalize the sound before showing to the child the toy.
Magical Transportation Sounds
An example of learning to listen sound associated with transportation vehicle is aaaah(airplane) which is a good basic vowel and even the deafest kid typically comprehend and use it quickly. The clinician can vary the suprasegmentals of this sound as he shows to the child how he moves the airplane up and down.
Another sound is buhbuhbuh. It is one of the first consonants that the babies learn and besides from that, it is also an easy sound for the babies to imitate and produce on their own. The toy bus can be move around as the clinician vocalizes the sound. Ooooo is one sound that is good for stimulation of pitch variation with the same vowel.
The clinician can use a fire truck as he produces the sound with alternating high-low configuration. Other learning to listen sounds associated with transportation vehicles include brrrrrr(car), p-p-p-p-p(boat), and ch-ch-ch-ch(train). These sounds concentrate on stimulating the lip articulator and develop listening for some high frequency sounds.
Familiar Animal Sounds
Learning to listen sounds is also associated with animal sounds. A common sound that is use by clinicians is mooo(cow) which is a good vowel combined with the initial consonant /m/. This sound is produce with low voice and this change in voice is interesting for children.
The repeated tongue clicking for the hoarse is also a good sound because it is another prespeech skill. Most children are fascinated with the tongue clicking, thus, it is good for stimulation. This sound also exercises the movement of tongue. Meow has some nice vowel transition and clinician may use this to also produce inflectional variations within a two-syllable combination.
Other learning to listen sounds for animals include arfarfarf(dog), ssss(snake), quakquakquak(duck),hop-hop-hop(rabbit), oinkoink(pig), ba-a-a-a(sheep), and squeak(mouse).
There are also learning to listen sounds that can be associated with eating, sleeping, and clock. These sounds are mmmm, shhhhhhh, and t-t-t-t-t correspondingly.
Babies And Speech
Overview Of Language And Speech Therapy
The field of speech and language therapy is somewhat a vague body of knowledge that only a few people understand. What most people don’t know is that there is a difference between speech therapy as a whole and language therapy. Although the term ‘speech and language’ therapy is widely used, since speech and language problems coexist most of the time.
Differentiating Speech And Language Therapy
The truth of the matter is, that speech therapy and language therapy differ in some key areas. First off, they differ on the problems that they are targeting. The techniques and activities used during therapy are also different. Although there are times that these activities are done simultaneously, to target two problems at a time.
Speech Therapy
Speech therapy is done to treat speech problems. Such speech problems deal with how or the manner a person speaks. These speech problems are categorized into three general kinds. First, is voice or resonation disorders. Second, is articulation disorders. And, lastly, fluency disorders.
Voice disorders mainly deals on problems with the voice box or the larynx itself. These may be due to physiological malfunction, anatomical differences, fatigue, or neurological problems. Some voice disorders present problems in pitch, volume, and tone. The presence of breathy, raspy, nasal and weak voice is viable too.
Articulation disorders, on the other hand, deal with the manner a person speaks. The problem is rooted from the articulators themselves. Articulators are composed of the tongue, teeth, hard palate, soft palate, jaw, and cheeks. Articulation disorders may be due to weakness or physiological malfunction in any of the articulators, which results to distorted or incomprehensible speech.
Fluency disorders would deal on problems regarding the fluency of the person. It may be the case that he talks too fast or too slow. Stuttering and Cluttering are two of the major fluency problems that speech therapists deal with.
Speech therapy activities would likely include different exercises to practice speaking. Since most of the time, weak muscles are present; the therapy proper would usually include activities that can help strengthen these muscles. Different compensatory strategies are also taught, so that the patient can compensate for lost speaking skills.
Language Therapy
Language therapy mainly deals with problems regarding your inner language, receptive language and expressive language. Cognition skills can be the main cause of language problems. Unlike speech disorders, that manifest physical differences, most language disorders are due to problems the brain’s language processing.
Receptive language problems mainly deals on difficulties understanding received language, like what other people are telling you and comprehending written data. Expressive language problems on the other hand are difficulties on expressing oneself. You may have a hard time knowing which words to use verbally or even through writing.
Language based problems are usually treated through mental exercises. Workbooks are often used to practice and develop language skills. For very young children, play therapy is used to develop inner language, so that the therapist could later on target improving receptive and expressive language, respectively.
In some cases, speech and language problems are both present. This is especially true for individuals that had traumatic brain injuries or accidents that had an effect on the brain. They may manifest physiological problems due to damaged nerves that result to articulation or voice problems.
The can also have language problems like aphasia, especially if their brain was hit on its language areas.
Speech Therapy For Laryngectomy
A speech therapist has a vital role in the pre- and post op management of laryngeal cancer, because Laryngectomy patients have to undergo speech management. So here are some of the things to know about laryngectomy.
A Team Approach
Firs off, the management of laryngeal cancer requires a team approach. The patient gets to see a surgeon, radiologist, audiologist, speech-language pathologist, oncologist, physical therapist, maxillofacial prosthodontist, and a psychiatrist. All of these health care professionals work together to work on the management of the patient.
What Is Laryngectomy?
Laryngectomy is the total removal of the larynx. It is also the partition of the airway from the nose, mouth, and esophagus. A person that undergoes this kind of operation would have to breathe via an opening on the neck, called stoma.
Laryngectomy is done when a person has laryngeal cancer. It may be considered to be a traditional way of managing laryngeal cancer, since a lot of laryngeal cancer cases nowadays are treated with the use of chemotherapy, radiation, or other laser procedures. In severe cases that these don’t work, that is the only time laryngectomy is opted for.
Other than the larynx, other structures are also removed. These other structures includes Sternocleidomastoid, Omohyoid muscle, Internal Jugular vein, Spinal Accessory vein (CNXI), Submaxillary salivary gland. In most severe cases, the external carotid artery, strap muscles of the neck, Vagus nerve (CN X), Hypoglossal nerve (CN XII) and the lingual branch of the Trigeminal nerve (CN V) are also removed.
How Common Is Laryngectomy?
It is estimated by the American Cancer Society, in 2003, that around nine thousand five hundred people in the US were diagnosed of laryngeal cancer. This condition occurs about 4.4 times more predominantly with men than with women. Though, similar with lung cancer, laryngeal cancer is becoming increasingly frequent with women.
Tobacco smoking is so far the supreme risk factor in having laryngeal cancer. Other factors include radiation exposure, asbestos exposure, alcohol abuse, and genetic factors. In United Kingdom, laryngeal cancer is rather rare, since it only affects less than 3,000 people per year.
Possible Problems
After total Laryngectomy, possible problems may occur. These include having a scar tissue at the tongue base, narrowing of the esophagus, partial tongue base resection, dysphagia, Xerostomia, mouth sores and changes in smell, taste, appetite and weight.
Effects And Impacts Of Laryngectomy
Laryngectomy has two mechanistic effects. One, it separates respiration from speech. Two, it keeps the pharyngoesophageal region intact.
There are also impacts that Laryngectomy brings about. The main impact would be the loss of voice for communication. You may also lose the ability to express emotions such as laughing. You also get physical problems with regard to tasting and feeding.
Laryngectomy is frequently successful in treating early-staged cancers. Still, undergoing through the procedure would require major lifestyle change. There is also a risk of having severe psychological stress due to unsuccessful adaptations.
After The Procedure: Voice Replacement And Care
After the patient’s larynx is removed, voice prosthetics is used. This serves as a replacement for the lost larynx, so that the person will still be able to communicate and speak. In this case, Laryngectomees would have to learn new methods of speaking.
They should also be constantly concerned in taking care and cleaning their stoma. Severe problems can arise if foreign materials and water enter their lungs via their unprotected stoma.
Speech Therapy For Autism
Autism is one condition that requires speech therapy treatment. However, autism is often misunderstood and thought of to be something that can be left untreated. However, that should not be how things work. Autism presents a lot of problems, but the intensity of these problems could be decreased if given the correct treatment.
In Relation To Autism: Vocabulary
A lot of terms are commonly heard in relation to autism, such as: classic autism, infantile autism, Pervasive Developmental Disorder (PDD), Atypical PDD, Autistic like, PDD-NOS, Asperger’s Syndrome and high functioning Autistic.
What Is It Exactly?
Basically, Autism is a neurological disorder. It is classified to be a Pervasive Developmental Disorder. The main characteristic of Autism is that it affects three major areas in relation to speech and language. This triad is the impairment of the child’s: social interaction, communication and imaginative play.
Pervasive Developmental Disorder is actually an umbrella term for Autistic Spectrum Disorders. With the use of the term ‘pervasive’, it is emphasized that the disability’s range of deficits is beyond psychological development. On the other hand, the term ‘developmental’ puts emphasis that the occurrence of the condition is during the child’s development rather than later in life.
Autism is actually only one condition under this umbrella. Other conditions include Rett’s Disorder, which is a neurodevelopmental disorder that begins to show its symptoms during early childhood or infancy.
Another is Childhood Disintegrative Disorder; it somewhat resembles Autism but the difference is the first two to four years of the child’s life is rather normal, then the symptoms start to show.
Asperger’s syndrome is also in this umbrella. It is sometimes called high functioning autism. Lastly, PDD-NOS or Pervasive Developmental Disordere—Not Otherwise Specified is also related to Autism. These are children that present symptoms similar to but don’t quite match the other conditions.
What Causes Autism?
Even though a lot of research has been done, there is no identified single factor that causes Autism. Several factors are said to play a part in the occurrence of Autism. One of these is brain disorder. Recent studies show that there is a difference in the brains of people with Autism. Their cerebellum seems to be smaller than normal, and their limbic system is impaired.
Chemical imbalances are also said to play a part here. It was found that in some cases, symptoms came from food allergies, chemical deficiencies, hormonal imbalances or elevated brain chemical levels.
Heredity is also an important factor. A lot of genetic disorders have Autism as a symptom. An example would be the fragile-X syndrome. Other factors include pre-, peri-, post-natal trauma, brain damage complications and MMR immunization.
Whatever the cause may be, the child with Autism should be given the same structured training in able to stimulate his learning, language and social skills.
Diagnosis
For a child to be diagnosed of having Autism, he should first qualify for the Diagnostic Criteria for Autistic Disorders according to the DSM-IV.
Treatment: Therapy And Others
Due to the triad of Autism effects on the child, speech therapy becomes a vital part of Autism management. However, other members of the team are also needed such as pediatrician, pediatric neurologist, child psychiatrist, psychologist, occupational therapist, behavior therapist, and educators like schoolteachers or Special Education teachers.
Role Of Speech Therapist In Autism Rehabilitation
The Speech Therapist assesses hearing. He also evaluates whether the speech and language difficulties of the child is really due to Autism or another disorder. This can be taken from analyzing the child’s expressive language, receptive language, oral-motor functions, voice quality, articulation and fluency, auditory processing and pragmatic skills.
Aphasia Speech Problems
Aphasia can bring about a lot of speech and language problems that are to be treated for speech therapy. The kind of speech and language problems brought by Aphasia would highly depend on the kind of Aphasia that you may have.
Broca’s Aphasia
Broca's Aphasia is also known as motor aphasia. You can obtain this, if you damage your brain’s frontal lobe, particularly at the frontal part of the lobe at your language-dominant side.
If Broca’s Aphasia is your case, then you may have complete mutism or inability to speak. In some cases you may be able to utter single-word statements or a full sentence, but constructing such would entail you great effort.
You may also omit small words, like conjunctions (but, and, or) and articles (a, an, the). Due to these omissions, you may produce a "telegraph" quality of speech. Usually, your hearing comprehension is not affected, so you are able to comprehend conversation, other’s speech and follow commands.
Difficulty in writing is also evident, since you may experience weakness on your body’s right side. You also get an impaired reading ability along with difficulty in finding the right words when speaking. People with this type of aphasia may be depressed and frustrated, because of their awareness of their difficulties.
Wernicke’s Aphasia
When your brain’s language-dominant area’s temporal lobe is damaged, you get Wernicke's aphasia. If you have this kind of aphasia, you may speak in uninterrupted, long, sentences; the catch is, the words you use are usually unnecessary or at times made-up.
You can also have difficulty understanding other’s speech, to the extent of having the inability to comprehend spoken language in any way. You also have a diminished reading ability. Your writing ability may be retained, but what you write may seem to be abnormal.
In contrast with Broca’s Aphasia, Wernicke’s Aphasia doesn’t manifest physical symptoms like right-sided weakness. Also, with this kind of Aphasia, you are not aware of your language errors.
Global Aphasia
This kind of aphasia is obtained when you have widespread damage on language areas of your brain’s left hemisphere. Consequently, all your fundamental language functions are affected. However, some areas can be severely affected than other areas of your brain.
It may be the case that you have difficulty speaking but you are able to write well. You may also experience weakness and numbness on the right side of your body.
Conduction Aphasia
This kind is also known as Associative Aphasia. It is a somewhat uncommon kind, in which you have the inability to repeat sentences, phrases and words. Your speech fluency is reasonably unbroken. There are times that you may correct yourself and skip or repeat some words.
Even though you are capable of understanding spoken language, you can still have difficulty finding the right words to use to describe an object or a person. This condition’s effect on your reading and writing skills can also vary. Just like other types of aphasia, you can have sensory loss or right-sided weakness.
Nominal Or Anomic Aphasia
This kind of aphasia would primarily influence your ability to obtain the right name for an object or person. Consequently, rather than naming an object, you may resort to describing it. Your reading skills, writing ability, hearing comprehension, and repetition are not damaged, except by this inability to get the right name.
Your may have fluent speech, except for the moments that you pause to recall the correct name. Physical symptoms like sensory loss and one-sided body weakness, may or may not be present.
Transcortical Aphasia
This kind is caused by the damage of language areas on your left hemisphere just outside your primary language areas. There are three types of this aphasia: transcortical sensory, transcortical motor, and mixed transcortical. All of these types are differentiated from others by your ability to repeat phrases, words, or sentences.
Overview Of Speech Therapy
One of the not so noticed areas of rehabilitation medicine is Speech Therapy. In fact, a lot of people may not even know that something like this existed. It may be the case that this is your first time to encounter the field or you may have heard it somewhere, but don’t fully understand what the practice is all about.
The sad truth about Speech Therapy is that you may not encounter it unless the situation calls for it. However, getting to know what the practice is can be very beneficial information.
What Is Speech Therapy?
As the name suggests, speech therapy deals with speech problems that an individual may encounter. However, the field of Speech Pathology doesn’t only tackle speech, but also language and other communication problems that people may already have due to birth, or people acquired due to accidents or other misfortunes.
Speech therapy is basically a treatment that people of all ages can undergo through, to fix their speech. Although speech therapy alone would focus on fixing speech related problems like treating one’s vocal pitch, volume, tone, rhythm and articulation.
Goals Of Speech Therapy
Speech Therapy aims for an individual to develop or get back effective communication skills at its optimal level. Recovery mainly depends on the case and severity of your problem, especially if your speech problem is acquired, meaning you had normal speech skills before then you had an accident or abrupt incident that caused your current speech problem; thus, you may or may not get back your old level of speech function.
Speech Problems
Speech problems are mainly categorized into three namely: Articulation Disorders, Resonance or Voice Disorders and Fluency Disorders. Each disorder deals with a different pathology and uses different techniques for therapy.
Articulation Disorders
Articulation Disorders are basically problems with physical features used for articulation. These features include lips, tongue, teeth, hard and soft palate, jaws and inner cheeks. If you have an Articulation Disorder, then you may have a problem producing words or syllables correctly to the point that people you communicate to can’t understand what you are saying.
Resonance or Voice Disorders
Resonance, more popularly known as, Voice Disorders mainly deal with problems regarding phonation or the production of the raw sound itself. Most probably, you have a Voice Disorder when the sound that your larynx or voice box produces comes out to be muffled, nasal, intermittent, weak, too loud or any other characteristic not pertaining to normal.
Fluency Disorders
Fluency Disorders are speech problems with regard to the fluency of your speech. There are some cases that you talk too fast, in which people can’t understand you, thus, you have a Fluency Disorder of Cluttering. The most common Fluency Disorder however, is Stuttering, which is a disorder of fluency where your speech is constantly interrupted by blocks, fillers, stoppages, repetitions or sound prolongations.
Who Gives Speech Therapy?
A highly trained professional, called a SLP or a Speech and Language Pathologist, gives Speech Therapy. Speech and Language Pathologists are informally more popularly known as Speech Therapists. They are professionals who have education and training with human communication development and disorders.
Speech and Language pathologists assess, diagnose and treat people with speech, communication and language disorders. However, they are not doctors, but are considered to be specialists on the field of medical rehabilitation.