San Diego / La Jolla Speech Therapy

La Jolla, CA 92037

SPEECH PROBLEMS

SPEECH ISSUES FOR INFANTS, CHILDREN, ADULTS & SENIORS

Adult and Pediatric Incidence

One in ten Americans has a communication disorder because of stroke, an undetected hearing loss, a stuttering problem, a head injury, a language disorder, or some other disorder or problem that interferes with speech, language, or hearing.

An estimated six million children under the age of 18 have a speech or language disorder. Boys make up two-thirds of the population. Over one million children received services for speech or language disorders under the Individuals with Disabilities Education Act (IDEA) in the 1997-1998 school year. This number represents a 10.5% increase from a decade earlier.

Approximately 7.5 million people in the United States have trouble using their voices.
Disorders of the voice involve problems with pitch, loudness, and quality. Pitch is the highness or lowness of a sound based on the frequency of the sound waves. Loudness is the perceived volume (or amplitude) of the sound, while quality refers to the character or distinctive attributes of a sound. Many people who have normal speaking skills have great difficulty communicating when their vocal apparatus fails.

The prevalence of speech sound disorder in young children is 8 to 9 percent.
By the first grade, roughly 5 percent of children have noticeable speech disorders; the majority of these speech disorders have no known cause. Children with specific speech sound disorders, which has also been termed articulation disorder or phonological disorder, have clinically significant difficulties producing the speech sounds of their language expected for their age. The extent of these patterns of errors will affect the intelligibility of their speech to some degree and in some cases rendering the speech unitelligible to those unfamiliar with the child.

Two recent publications provide summaries of prevalence estimates of this condition (Law et al. 2000; Shriberg, Tomblin, and McSweeny 1999).
All these estimates have focused on children in the early school years and the prevelance estimates range from 2 percent among the oldest children who were 8 years old, to 24.6 percent among the youngest who were 5 years old. Much of this variability can be attributed to different diagnostic standards. The median prevalence estimate across these studies falls in the range of 8 to 9 percent. These studies all showed a greater rate of im0pairment in boys than girls with male to female ratios ranging from 1.5 to 2.4. Speech sound disorders have been shown to occur with SLI, particularly among children referred for clinical services. Risk factors for speech sound disorders consist of family histories of speech sound disorder (Lewis, Ekelman, and Aram 1989) and chronic otitis media (Shriberg LD et al. 2000).

Usually by 6 months of age an infant babbles or produces repetitive syllables such as "ba, ba, ba" or "da, da, da."
Babbling soon turns into a type of nonsense speech called jargon that often has the tone and cadence of human speech but does not contain real words. By the end of their first year, most children have mastered the ability to say a few simple words. By 18 months of age most children can say 8 to 10 words and, by age 2, are putting words together in crude sentences such as "more milk." At ages 3, 4, and 5 a child's vocabulary rapidly increases, and he or she begins to master the rules of language. Research suggests that the first 6 months are the most crucial to a child's development of language skills. For a person to become fully competent in any language, exposure must begin as early as possible, preferably before school age.

It is estimated that more than 3 million Americans stutter.

Autism is one of the most common developmental disabilities, affecting individuals of all races and ethnic and socioeconomic backgrounds. Current estimates suggest that approximately 400,000 individuals in the United States have autism. Autism is 3 to 4 times more likely to affect boys than girls and occurs in individuals of all levels of intelligence. And in the case of autism, imagine trying to navigate the mysterious rules and social norms not to mention language of a culture with no prior exposure and no ability to predict what needs to happen t "fit in". (theory of mind).

A language disorder is impaired comprehension and/or use of spoken, written and/or other symbol systems.

The disorder may involve

the form of language

the content of language

the function of language

Form of Language

Phonology is the sound system of a language and the rules that govern the sound combinations.

Morphology is the system that governs the structure of words and the construction of word forms.

Syntax is the system governing the order and combination of words to form sentences, and the relationships among the elements within a sentence.

Content of Language Semantics is the system that governs the meanings of words and sentences.

Function of Language

Pragmatics is the system that combines the above language components in functional and socially appropriate communication.

Between 6 and 8 million people in the United States have some form of language impairment.
About 1 million persons in the United States currently have aphasia (acquired language deficits due to neurological injury) Disorders of language affect children and adults differently. For children who do not use language normally from birth, or who acquire an impairment during childhood, language may not be fully developed or acquired. Many children who are deaf in the United States use a sign language. Many adults acquire disorders of language because of stroke, head injury, dementia, or brain tumors. Language disorders also are found in adults who have failed to develop normal language skills because of mental retardation, autism, hearing impairment, or other congenital or acquired disorders of brain development.

Primary or Specific Language Impairments (SLI) are diagnosed in children who have clinically significant impairments in their development of spoken language in the absence of sensory or neurodevelopmental disorders. The typical range of prevalence estimates was between 2% and 8% with an overall median prevalence of 5.95%. Most studies reported a greater prevalence of SLI in boys than girls. Reading impairments have been widely shown to be strongly associated with SLI (Catts et al. 2001; Catts 1993)

Communication difference/dialect is a variation of a symbol system used by a group of individuals that reflects and is determined by shared regional, social, or cultural/ethnic factors. A regional, social, or cultural/ethnic variation of a symbol system should not be considered a disorder of speech or language.

Augmentative/alternative communication systems attempt to compensate and facilitate, temporarily or permanently, for the impairment and disability patterns of individuals with severe expressive and/ or language comprehension disorders. Augmentative/alternative communication may be required for individuals demonstrating impairments in gestural, spoken, and/or written modalities.

American Speech-Language-Hearing Association. (1993). Definitions of Communication Disorders and Variations. Available from www.asha.org/policy.

Swallowing Disorders

Dysphagia (dis-FA´je-ah), or difficulty in swallowing, affects as many as 15 million Americans and approximately one million new cases are diagnosed each year. 75% of children and adults who have had a stroke and 90% of children or adults with a neurological diagnosis (brain tumor, head injury, progressive disease) are affected. Symptoms can include coughing before, during or after swallowing, frightening choking episodes, the sensation of food getting stuck in the throat, pain during swallowing, recurrent pneumonias or respiratory symptoms are especially serious including "wetness" or phlegm in your voice, shortness of breath or changes in breathing sounds while eating or drinking.

If not properly managed, dysphagia can lead to aspiration pneumonia, which is caused by foreign substances (such as food or saliva containing microorganisms) going down the trachea (or wind pipe) and into the lungs. Aspiration pneumonia is a very serious condition and one of the leading causes of death among the elderly. Dysphagia can also cause complications such as choking and bronchospasm as well as chronic malnutrition and dehydration, which can lead to significant weight loss, muscle wasting and physical debilitation.

Excellent oral hygiene is essential in the prevention of aspiration pneumonia. Be sure to see your dentist regularly and to use recommended oral hygiene products frequently throughout the day as you recover from your difficulty swallowing.

FEEDING AND Swallowing: A comprehensive look at your LOVED ONE'S medical needs, social/behavioral concerns and skills for successful and stress-free feeding.

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San Diego and La Jolla speech therapy, stroke recovery, surgery recovery -- CALL (619) 840-7872 -- for children and kids speech therapy, accent reduction, language and speaking training help for stutterers and stuttering, brain surgery therapy, TBI, swallowing for kids,adults, strokes -- speech therapist located in La Jolla.

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