Speech Therapy

The Role of Speech Therapy In Traumatic Brain Injury

2008-05-12T23:59:00.003-07:00

Traumatic brain injury can cause about a lot of speech and language disorders that would entail the need of speech therapy. That’s why the role of speech therapy in the rehabilitation process of a traumatic brain injury patient is very vital.

What Speech And Language Problems TBI Brings About

A person may have loss of consciousness after a traumatic brain injury. This loss of consciousness can vary from seconds, minutes, hours, days, months or even years. The longer you are out of consciousness, the more severe your injury is. After a traumatic brain injury, you may suffer secondary consequences, which are considered to be more lethal and dangerous than the primary injury.

Some of these secondary consequences include damage to your brain’s meninges, traumatic hematoma, increased intracranial pressure, herniation, hyperventilation, ischemic brain damage, and cerebral vasospasm. When these brain damages occur, they tend to affect parts of your brain that are responsible for speech and language processing and production, thus you get speech and language problems.

Traumatic brain injuries can cause you permanent or temporary memory loss, orientation problems, lesser cognitive performance or slower processing of thought, attention problems, deterioration of skills in basic counting, spelling and writing. You can also have Aphasia, where you have a loss of words.

Traumatic brain injury can also cause you difficulty in reading simple and complex information. Your naming skills, of everyday seen objects, familiar others can also be affected. It can also bring about dysarthria, or problems with movement, that can cause you to have shaky movements leading to difficulty speaking and writing.

Speech Therapy For Traumatic Brain Injury Patients

Treatment for traumatic brain injury patients can be classified into three categories. There are different treatments for early, middle and late stages of a traumatic brain injury. There are also compensatory strategies taught for a TBI patient.

Early Stage Treatment

Treatment during the early stage of a traumatic brain injury would focus more on medical stabilization. A speech therapist would also deal more on establishing a reliable means of communication between the patient and the therapist. The patient is also taught how to indicate yes or no, when asked.

Another goal is for the patient to be able to make simple requests through gestures, nods, and eye blinks. The behavioral and mental condition of the patient is also treated. During the early stage, sensorimotor stimulation is also done. Where in the therapist would heighten and stimulate the patient’s sense of sight, smell, hearing and touch.

Middle Stage Treatment

The main goal during the middle stage treatment is for the patient to develop an increased control of the environment and independence. The adequacy of patient’s interaction to the environment is also increased. The therapist should also stimulate the patient to have organized and purposeful thinking. The uses of environmental prompts are to be diminished during this phase.

A lot of activities focusing on cognitive skills like perception, attention, memory, abstract thinking, organization and planning, and judgment, are also given.

Late Stage Treatment

During the late stage of treatment, the speech therapists’ goal is for the patient to be able to develop complete independence and functionality. Environment control is eliminated and the patient is taught compensatory strategies to cope with problems that have become permanent.

Some of these compensatory strategies are the use of visual imagery, writing down main ideas, rehearsal of spoken/written material, and asking for clarifications or repetitions when in the state of confusion.

Therapy Procedures for Speech Disorders

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The terminal goal of speech therapy is for the client to spontaneously use the appropriate speech sounds of his or her linguistic culture in connected speech. In this context, therapy becomes a continuum of short-term goals designed to meet the terminal goal. And therapy procedures may either use the motor or traditional approach or the cognitive-linguistic approach.

Motor or Traditional Approach

This approach is structure-based and uses drills more. Drills are activities that have rapid rates of stimulus presentation and which puts much stress on accuracy of the patient’s response to the stimulus and the said response reaching various set criteria.

Under this approach is auditory training. Its proponent is Charles Van Riper. This procedure uses pictures and games as motivational events or events that serve as a way of presenting stimuli. Activities are mainly about speech sound discrimination. It highlights the awareness and detection of sound.

Another procedure is the exercise of the oral motor structures. It is used when an oral motor assessment shows muscle weakness or spasticity. For children, it should be made fun and functional. It also uses mirrors for visual feedback.

One other procedure under this approach is phonetic placement. Van Riper was also the proponent of this procedure. It provides clients with verbal descriptions or instructions regarding articulatory position and movements for target sound. It is usually used together with visual, auditory, tactile and kinesthetic cues.

Weiner’s contribution to this field is his modified sensory motor approach. It is where a word in which the target sound is correct in the final position is paired with a word in which the same sound is in error in the initial position. The words are produced without a pause to facilitate assimilation of the incorrectly produced sound.

In this line also is syllabication. It uses the syllable-by-syllable production of words. It is used in addressing weak syllable deletion or the deletion of the syllable in a word which is the least stressed.

One procedure that is closely related to syllabication is chaining. The client is first asked to say the whole word. If he says a syllable incorrectly, the therapist instructs the patient to look at his lips while he produces the word syllable by syllable with the patient following him after every syllable until he produces the word the same way that the therapist did.

Cognitive-Linguistic Approach

The first procedure under this approach is auditory bombardment, also known as cycles approach. There are treatment cycles which have their designated phonemes, taught in a span of 2-4 weeks. Auditory bombardment requires that the patient be bombarded with the phonemes that he needs to learn without him being aware of it.

Another procedure is auditory bombarding with PACT (Parents and Children Together). Here, production should not be over-emphasized. It may use funny, perceptually salient make-up words like ker-plunk, boing, shilly-shally or kaboom. All that matters is that the words contain the phonemes that are being targeted.

Modified cycles approach is also under this group. It requires the clinician to make purposeful and obvious lexical errors in words that contain target phonemes to make the patient correct the clinician, thus producing the target sound. Parental involvement is important for explanations of goals, procedures, and assignments.

Minimal contrast therapy, on the other hand, contrasts presence and absence of phonemes, establishing also the difference between phonemes. This procedure can be utilized in addressing perceptual or production difficulties when it comes to final sounds of words, establishing the difference between words like fee and feet.

Toys As Materials For Speech Therapy

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There are a variety of tools and materials, which are designed for speech therapy in the market right now, thus giving the therapist much more options when it comes to choosing the equipments that could best maximize his services. One variety of materials are toys. And there are various reasons for the rise in its use.

The Toys and Their Functions

Before the therapy starts, an evaluation of the patient’s oral motor structures is usually done. This is where the therapist inspects the various structures that are inside and around the patient’s mouth that are used for speech. Some of these are the lips, tongue, teeth, jaw and cheeks.

For the structures to be seen more accurately, a penlight is usually used. The only problem with it is that the child may not find it very pleasant to have a flashlight in his mouth. This is now why there already is the colorful and jelly-like oral light system, which gives the same amount of light minus the metallic appearance.

The examination of these muscles also usually requires gloves and tongue depressors; in which kids do not appreciate both of whose smell and taste. This is now the reason why colorful and fruit flavored gloves and tongue depressors are already available.

After the said oral motor examination has been performed, the therapist may find a weakening in one or some of the structures. Some seemingly ordinary materials and toys may aid the strengthening of these muscles. One of them is the straw, which can come in all colors and designs. It serves two purposes.

The first purpose is for the rounding of the lips. This activity is important for the articulation of vowels and the semi-vowel /w/. Another function is the act of sipping. In this activity, the velum, the muscle right above the throat is exercised. This muscle is used when producing vowels and back consonants like /k/ and /g/.

Another commonly used material is a toy, which has to be blown. An example would be the whistle. The whistle is considered a difficult blow toy. It means that among the toys that work when blown, it is one of those, which requires more effort for it to perform its function.

The whistle, like the straw, aids in the exercise of the muscles of the lips. Another structure, which it strengthens, is the cheeks. It maximizes the capacity of the cheeks to hold in air and to gradually blow it out.

Other materials that are more commonly used are picture cards and interactive books. They usually contain pictures of words, which represent all the speech sounds. When these cards are used, all the therapist has to do is to show the picture and have the child produce the word together with the speech sound within the word.

Why Play?

If the patient sees the materials they have for therapy are colorful and fun toys, he will come to think that the reason he is in the clinic is to play and have fun. And having the child thinking this, will allow the child to cooperate with the therapist.

Play is a universal activity that blends social, cognitive, linguistic, emotional, and motor components. It is an integration of the many aspects of a child. Play serves as a representation of the thoughts and abilities of a child. Through play, the therapist will be able to know how to approach the concerns of his patient.

Roles Of Speech Therapist In Laryngectomy Management

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There are three phases of management for laryngectomy: pre-operative, operative, and post-operative management. Each phase has its advantage and goals. A speech therapist plays vital roles in the first and last phase. Consulting a speech therapist during the first phase is equally important with seeing a therapist during the last phase, which is when voice rehabilitation really begins.

A speech therapist also has different roles in each phase, that’s why it is vital for a therapist to know the two phases he plays a role in.

Pre-operative Management

Pre-operative management includes informing the patient of the anatomical changes, and expectations regarding swallowing, voice, and the family as a part of the team. The therapist also informs the patient on the different speech options he has after the operation.

During this phase, the speech therapist should initiate ordering of the hardware or alternative means of communication. The therapist should also be open to questions that the patient may come up with. This is also the time for him to establish rapport with the patient.

The therapist can also offer re-assuring consultation with appropriate laryngectomee volunteers. This is also the time where he assesses the pre-laryngectomy speech and cognition of the patient. The laryngectomee is also informed with his prognosis, where the potential for recovery and long-term rehabilitation is discussed.

The advantages of this phase would be the evaluation of preoperative speaking skills such as speaking rate, articulation errors, accent patterns, oral opening degree when speaking, and vocal parameters. Cognition and hearing is also evaluated, along with oral-peripheral-mouth strength and sensation. The family can also get emotional support in this phase.

Assessment is done by the use of modified barium swallowing or Fiberoptic Endoscopic Evaluation of Swallowing. The patient’s communication needs are also assessed where living situation, occupation, social requirements and hobbies are looked at.

Postoperative Management

During this phase, the therapist is given an opportunity to help lessen the patient’s fears, and depression. He should also help the patient to accept the loss of voice and swallowing difficulties. The motivation of the patient should be increased, so that he can easily learn how to use alternative speech. Social implications are also addressed. Arrangements for voice rehabilitation are also done during the early parts of this phase.

Firs off, the therapist should confirm if the patient is already medically cleared for therapy. Then he should review the treatment procedure, re-evaluate the patient’s swallowing function then give diet recommendations, and create a treatment plan.

Problems Encountered During Postoperative Management

After the operation some problems may still occur. With regards to Tracheostomy, the patient and therapist should always be watchful of stoma hygiene, cannula hygiene, stoma covers, excessive mucus in the trachea, mucus encrustations in the stoma, and stoma safety and first aid.

There could also be problems related to taste, swallowing, smell and digestion. The patient may find it difficult to trap air within the lungs. This can lead to difficulties in creating internal subglottic pressure, elimination of body waste and childbirth.

Problems of social adjustment may also be present. The patient may find it hard or embarrassing to use alaryngeal speech in public. The altered physical appearance of the patient may also be an issue. Sometimes, the laryngectomee also has unrealistic expectations regarding acquisition of alaryngeal speech.

Play Levels Of Social Interaction In Speech And Language Therapy

2008-05-11T09:34:00.002-07:00

There are different levels of play used in the assessment of children’s speech and language. These levels are used to measure children’s play skills. However, there are also play levels of social interaction that can give a general overview of the child’s play skills.

In general, there are six play levels of social interaction that children go through respectively. Each level becomes more complex than the previous one, and requires more communication and language skills than the other.

Unoccupied Play

The first level of play is unoccupied play. In this kind of play, the child may seem like he is simply sitting quietly in one corner but actually is finding simple things that he sees around him to be rather amusing. A typical adult may not notice that what the child is doing is already considered to be play, unless they observe meticulously.

The child may just be standing and fidgeting at times, but this could already be unoccupied play at work.

Onlooker Play

The second level is onlooker play. In this level, the child watches other children play but doesn’t engage in play himself. This is when children learn to observe others. Such play level can show a child’s attention and awareness skills.

Solitary Play

The third level is solitary play where the child plays by himself and doesn’t intend to play with anyone else. This level shows an outright manifestation that the child do have play skills, only that it is still at a level that no interaction is required.

A child can be at this level when he is already able to play functionally with an object, can play by himself up to fifteen minutes, and is able to follow simple play routines.

Parallel Play

The fourth one is parallel play. This level characterizes children who play side by side but don’t communicate with each other. Neither do they share toys. It is said to serve as a transition from solitary play to group play and is at its peak around the age of four years.

A child is said to be in this stage when he is able to play alone, but the activity he is doing is similar with the play activity that other children beside him are engaging in. The child also doesn’t try to modify or influence the play of other children around him. Here, the child is playing ‘beside’ rather than ‘with’ the other kids in the area.

Associative Play

Next is the associative play. This is where the children still don’t play with each other but are already sharing the toys that they are playing with. This level shows the child’s awareness of other children, although there is no direct communication between them, other than the sharing of toys and the occasional asking of questions.

Their play session doesn’t involve role taking and has no organizational structure yet. The child still carries on the way he wants to play, regardless of what the other children around him are doing.

Cooperative Play

The last level is cooperative play. This is the final stage wherein the children are already playing together, sharing toys and communicating with each other.

This level usually happens at about the age of five or six, where children engage into group games and other highly structured play activities.

These levels can be utilized by the therapist as a guide when it comes to the interactions that he wishes to have with the child through play activities.

Importance Of Play In Speech Therapy

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Play has a very important role in speech therapy. It is actually one way that speech therapy can be conveyed, especially if the one undergoing therapy is a child.

What’s Play Got To Do With It?

Play isn’t just used during the therapy proper. In fact, play is already used during the initial phases of assessment. Kids can be very choosy with people that they interact with, so seeing a therapist for the first time doesn’t promise an instant click. Rapport has to be established first, and this is usually done through play.

Benefits Of Play

Other than using it as a tool to establish rapport, play also gives a lot of benefits. First off, it gives an over view of the child’s skills, whether it be their abilities or limitations.

Then, therapy wise, play can be used to make a child cooperate with whatever exercises a therapist has lined up for him/her. Since play doesn’t put much pressure on a child, he/she would likely cooperate to do the exercises and not know that what he/she is doing is already called therapy.

When the child is more relaxed, he can be at a more natural state. If a child is at his more natural state, then his skills could show more naturally. Thus, this would be a benefit on the therapist’s part, since the therapist could get a more comprehensive assessment of the child’s skills.

Play could also make therapy more fun and less scary. Since play is an activity to be enjoyed, the child would not get bored with monotonous therapy activities that seem like chores, rather than activities.

Play As A Skill

In fact, play is considered to be a skill itself, because it is a natural activity that children do. If a child doesn’t play, then there must be something wrong with him, most probably with his Inner Language skills. This is because; play is a representation of a child’s inner language. This is just one of the many reasons why play is important.

It actually has a domino effect, if you look at the bigger picture. Play is needed to have Inner language, which is in turn needed to have Receptive language that is a prerequisite of Expressive language. Thus, if a child has no play abilities, then his whole language system may be affected.

Play And Cognition

Play is also a basis of a child’s cognition skills. The more developed a child’s play skills are, the higher the probability that his cognition skills would be at a fair state. However, play and condition are not the same. Play is more likely a prerequisite or a co-requisite of cognition.

What Parents Have To Say

Unfortunately, most parents may have a negative impression when they see the therapist playing with their child. Initially, parents get surprised and shocked that they paid a very valuable amount for therapy, only to find out that their child would only be playing.

That’s why it is very important for therapists to explain the procedures that they are going to do with the child to the parents. To make the session more interesting, the therapist could also include the parent/s in the play session with the child.

In this way, the child would definitely think that it is a play session. Additionally, the parent can also do the play activity at home with the child. Doing this, could serve to be practice of the targeted skill of the play activity.

Early Learning To Listen Sounds And Speech Therapy

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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.

Delineating Speech And Language Therapy

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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.

Conditions For Speech Therapy: Laryngectomy

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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.

Conditions For Speech Therapy: Autism

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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’s Speech And Language Problems Targeted For Speech Therapy

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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.