Speech is the verbal means of communicating and involves the coordination of the muscles and movements necessary to produce speech.

Speech includes:

• Articulation and Phonology

  • Articulation refers to the correct movement of the speech sound mechanisms (tongue, larynx, teeth, jaw, etc.) to produce intelligible speech.

    • An articulation disorder occurs when any of those mechanisms are weak, damaged, malformed, out of sync with the others, or not working properly.

    • A student with an articulation disorder may substitute one sound for another, omit sounds, or distort sounds in words.

  • Phonology refers to the rules, or patterns, of the sound system of language.

    • If these rules are broken, “phonological processes” can result.

    • While many younger children exhibit these phonological processes, they usually disappear as speech develops.

    • When one or more of the processes persist, a phonological disorder develops.

    • A phonological disorder involves patterns of sound errors—for example, deleting final consonants off of words, or replacing all sounds produced in the back of the mouth (e.g., ‘k’ or ‘g’) with sounds produced in the front of the mouth (e.g., ‘t’, ‘d’).

• Voice

  • The use of the vocal folds and breathing to produce sound.

    • A voice disorder may be characterized by hoarseness; loss of voice; inappropriate pitch, loudness, or resonance; and vocal fatigue.

    • Many voice disorders are caused by straining the voice (e.g., by frequent yelling, shouting, speaking too much, talking loudly above background noise, etc.).

    • Children with prolonged or consistent vocal hoarseness may receive therapy to learn to how to use their voices without abusing them.

• Fluency

  • Fluency refers to the rhythm of speech.

    • A fluency disorder (also called dysfluency or stuttering) is an interruption in the flow of speaking.

    • These disorders are be characterized by repetition of sounds, syllables, words, or phrases; prolongations of sounds; and/or blockage of sound production.

    • Dysfluencies may be accompanied by excessive tension and struggle behaviors.

If a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she may have a speech disorder.

Language

Language is the socially shared rule system that governs communication. Receptive language is the ability to understand what is heard or read. Expressive language is the ability to express thoughts coherently and clearly to others (verbally or in writing).

The components of language are:

• Form—the elements that connect sounds and symbols in order, including:

  • Phonology—rules governing the sequencing of speech-sound patterns

  • Morphology—rules governing change in meaning within words (e.g., by using plural markers, tense markers, etc.)

  • Syntax—rules of sentence structure; grammar

• Content

  • Semantics—rules governing the meaning of words

• Use

  • Pragmatics—rules for social language (verbal and nonverbal)

If a person has difficulty understanding others’ verbal or written messages, he or she may have a receptive language disorder.

If a person has difficulty expressing a message to others verbally or in writing, he or she may have an expressive language disorder.

If a person understands language adequately and uses language correctly but has difficulty using language appropriately in different social contexts, then he or she may have a pragmatic language disorder.

SLPs can provide augmentative and alternative communication (AAC) systems for individuals with severe language disorders, such as those sometimes seen in individuals with Autism Spectrum Disorders.

Along with the aforementioned speech and language disorders, SLPs may also assess, diagnose, and/or provide therapy for:

• Oral-motor disorders

  • Weak speech muscles, which can decrease speech intelligibility

  • Difficulty sequencing sounds and words to produce intelligible speech (known as ‘apraxia of speech.’)

• Hearing impairment and deafness

  • Therapy provided is called ‘aural rehabilitation’ and can include training in auditory perception, using visual cues, improving speech, developing language, and managing communication.

  • SLPs can also check hearing aids and assistive listening devices as well as work with classroom teachers to develop ways to maximize the child's academic success.

• Auditory processing

  • Difficulty processing what the ear hears

  • This occurs in the ABSENCE of a hearing impairment; the brain can hear sound but how the brain translates that sound is disrupted

  • May result in difficulty with sound discrimination, auditory memory tasks, following auditory directions, phonics/learning to read, paying attention (especially in the presence of background noise), and auditory distractibility

• Orofacial Myofunctional Disorders

  • The tongue moves forward in an exaggerated way (called a tongue thrust) during eating and speaking

  • May speech cause a lisp and other sound distortions as well as swallowing difficulties

• Swallowing disorders (called ‘dysphagia’)

  • Trouble chewing and/or swallowing safely and efficiently

In addition to providing therapy, speech-language pathologists in schools evaluate newly referred students to determine the presence or absence of a communication disorder, develop and help implement Individualized Education Plans (IEPs), and work with classroom teachers and other members of the Child Study Team to review student progress and maintain appropriate speech, language, and academic goals.

Resources:
1) American Speech-Language-Hearing Association (ASHA)
2) National Stuttering Foundation
3) Autism Society
4) NJ Speech-Language-Hearing Association (NJSHA): Child Language Disorders
5) NJ Speech-Language-Hearing Association (NJSHA): Parent Resources