Epidemiology and Prognosis of Speech and Language Disorders

The relationship of speech to language and communication is so transparent in everyday human life – that the significant ability of a man to produce speech and influence understanding can be easily overlooked – even though not every man is capable of displaying this basic skill.

Speech and language skills are needed when communicating and exchanging information. Speech is a system that relates meaning with sounds. It consists of articulation (i.e., the physical production of sounds), voice (i.e., the quality, loudness and resonance of sounds), and fluency (i.e., the smooth and rhythmic flow of sounds and words). Meanwhile, language is a socially shared code for representing concepts through the use of arbitrary symbols and rule-governed combinations of those symbols.

Now that you have a sharp insight on the concepts of speech and language and how pivotal they are to human existence, there are circumstances in which individuals find it utmost difficult to socially get along with fellow men in the society because of their inability to exhibit oral communication skills due to impediments – speech sound and language disorders.

A speech and language disorder refers to an impairment in a person’s articulation of speech sounds, fluency, voice, comprehension and use of spoken, written or other symbol systems. According to the Individuals with Disabilities Education Act, “speech-language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance” (Individuals with Disabilities Education Act, 2004).

In the same vein, speech and language disorders can be divided into three major categories; Articulation disorders, impairment of speech fluency (stuttering or stammering) and language impairment. Articulation disorders involve the production of defective speech sounds and sound combinations that may be distorted, omitted, substituted, or added as accessory sounds. Sometimes articulatory disorders are the result of neurogenic disorders and dysarthria.

Meanwhile, the impairment of speech fluency – also known as stuttering or stammering is characterized by repetition of sounds, syllables, words, or phrases; sound prolongations; irregular pauses (hesitations) and word substitution.

The third category – language impairment is a linguistic disability, or faulty symbolization, which refers to disorders in both expression of thought through verbal language and its comprehension. This category includes various disorders, ranging from delayed/deviant language development to neurogenic disorders known as aphasia.

The Pattern of Development

Infants start learning in uterus. The fetuses can hear external sounds before birth. Their brain and sensory systems begin to prepare for the speech and language system in their environment. Newborns can make fine discriminations among the speech sounds they hear and prefer the sounds of the language they have been exposed to. Children soon acquire the phonemic (i.e., sound), phonological, morphological, semantic, syntactic, and pragmatic components of their native language.

Furthermore, cognitive, biological and social changes during infancy impact communication development. Children experience several milestones as they develop speech and language skills. At two months of age, children begin cooing and have intentional communication. At six months, their tongue and pharynx elongate resulting in production of consonant-vowel combinations (e.g., /da/). At twelve months, there is more dissociation of gross motor movements, greater dissociation of oral and pharyngeal structures resulting in more varieties of sound productions.

Children universally have their first words at approximately twelve months of age. Also at twelve months. At eighteen months, children are able to jargon, produce most vowels, and produce many consonants. They are able to use 5 to 10 single words and comprehend about 50 words. By twenty four months, fast-mapping occurs and vocabulary expands to 50 words with the production of two-word combinations. This speech and language development continues throughout childhood.

However, children with speech and language delays and disorders have difficulties understanding what is said to them and have difficulties expressing their thoughts. According to the American Speech-Language-Hearing Association, signs of speech and language impairment include: Problems understanding what others say, difficulties following directions and recalling information, problems saying words and expressing thoughts, difficulties producing sounds that are clear and intelligible, troubles playing and interacting and problems reading and writing.

The Mainsprings of Speech & Language Disorders

A range of environmental, biological, genetic, and perinatal conditions may be associated with adverse developmental outcomes that result in speech and language impairments. Advances in medical technology make it possible for high risk children to survive. Some risk causes of speech and language disorders in children include; Low Apgar score, low birth weight, premature birth, chronic otitis media, family history of speech and language disorders, exposure to environmental toxins, stroke, brain injuries, cancer (e.g., laryngeal, oral) and limited language exposure. These mainspring causes may result in children with delayed cognitive skills, limited attention, hearing loss, neurological disorders, intellectual disabilities, and physical impairments such as cleft palate, that negatively impact speech and language development.

The Headway

Speech-language pathologists make evidence-based approaches for intervention, counselling, collaboration with family members and other professionals, and identification of individuals at risk for or presenting with speech-language disorders. Speech-language pathologists are trained to follow specific diagnostic procedures needed for differential diagnosis that consider the impact of cultural, ethnic, regional, linguistic, dialectical differences and socioeconomic factors that may impact speech and language learning and use.

Hence, parents should seek the services of speech-language pathologist when they are concerned about their child’s communication abilities. Even if it is grossly admitted that there is a national shortage of speech-language pathologists in a country like Nigeria, yet it is a thing of joy to know that a professional setup like hEarMax Centre is readily available to provide solutions to your speech-language concerns. This, is the only headway!

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