Speech-Language Disorders and the Speech-Language Pathologist

What are speech and language disorders?

Speech and language disorders affect one's ability to talk, understand, read, and write. Such disorders have different causes, and may range from a few speech sound errors or repetitions of sounds or words to a total loss of the ability to use speech to communicate effectively.

How many persons have speech and language disorders?

• The prevalence of speech sound disorders in young children is 8-9%. By the first grade, roughly 5% of children have noticeable speech disorders; the majority of these speech disorders have no known cause.
• Between 6 and 8 million people in the United States have some form of language impairment.
• About one million persons in the United States have aphasia (partial or complete impairment of language comprehension and expression caused by brain damage, most often from stroke).
• It is estimated that more than 3 million Americans stutter.
• Approximately 7.5 million people in the United States have a voice disorder.

Source: National Institute on Deafness and Other Communication Disorders (NIDCD)

What is a speech disorder?

A speech disorder is a problem with fluency, voice, and/or how a person says speech sounds.

• Fluency disorder - an interruption in the flow or rhythm of speech characterized by hesitations, repetitions, or prolongations of sounds, syllables, words, or phrases.
• Articulation disorder - difficulties with the way sounds are formed and strung together, usually characterized by substituting one sound for another (wabbit for rabbit), omitting a sound (han for hand), and distorting a sound (ship for sip).
• Voice disorder - characterized by inappropriate pitch (too high, too low, never changing, or interrupted by breaks); quality (harsh, hoarse, breathy, or nasal); loudness, resonance, and duration.

What is a language disorder?

A language disorder is a problem with understanding and/or using spoken, written, and/or other symbol systems (e.g., gestures, sign language). The disorder may involve 1) the form of language (phonology, morphology, syntax), 2) the content of the language (semantics), and/or the function of language in communication (pragmatics) in any combination.

1. Form of Language

• Phonology is the sound system of a language and the rules about how sounds are combined.
• Morphology is the structure of words and how word forms are constructed.
• Syntax is the order and combination of words to form sentences.

2. Content of Language

• Semantics is related to the meanings of words and sentences.

3. Function of Language

• Pragmatics is the combination of language components (phonology, morphology, syntax, and semantics) in functional and socially appropriate ways.

Language disorders may include:

• Impaired language development - characterized by a marked slowness or gaps in the development of language skills.
• Aphasia - the loss of acquired language abilities, generally resulting from stroke or brain injury.

How can a speech-language pathologist help individuals with speech and language disorders?

Treatment will vary depending on the nature and severity of the problem, the age of the individual, and the individual's awareness of the problem. Speech-language pathologists select intervention approaches based on the highest quality of scientific evidence available in order to:

• Help individuals with articulation disorders to learn how to say speech sounds correctly
• Assist individuals with voice disorders to develop proper control of the vocal and respiratory systems for correct voice production
• Assist individuals who stutter to increase their fluency
• Help children with language disorders to improve language comprehension and production (e.g., grammar, vocabulary, and conversation, and story-telling skills)
• Assist individuals with aphasia to improve comprehension of speech and reading and production of spoken and written language
• Assist individuals with severe communication disorders with the use of augmentative and alternative communication (AAC) systems, including speech-generating devices (SGDs)
• Help individuals with speech and language disorders and their communication partners understand the disorders to achieve more effective communication in educational, social, and vocational settings
• Advise individuals and the community on how to prevent speech and language disorders

In which settings do speech-language pathologists work?

Speech-language pathologists provide professional services in:

• public and private schools
• hospitals
• rehabilitation centers
• short-term and long-term nursing care facilities
• community clinics
• colleges and universities
• private practice
• state and local health departments
• state and federal government agencies
• home care
• adult day care centers
• centers for persons with developmental disabilities
• research laboratories
• institutes and private agencies

What else do speech-language pathologists do?

In addition to working with children and adults with speech and language disorders, speech-language pathologists also assess and treat:

• Swallowing disorders - the inability to swallow correctly.
• Cognitive-communication disorders - the impairment of cognitive processes including attention, memory, abstract reasoning, awareness, and executive functions (e.g., self-monitoring, planning and problem solving).
• Auditory processing disorders - the inability to understand spoken language in the absence of a hearing problem.
• Accent modification for individuals without communication disorders.