1. Communication Disorders
Chapter 8
Communication Disorders
Developed by:
Blanche Jackson Glimps
Tennessee State University

2. Chapter Objectives
Identify and provide examples of four major functions of communication.
Describe the characteristics of each of the following communication disorders: speech sound errors, fluency disorders, voice disorders, and language disorders.
Explain why the number of children with speech and language impairments is much higher than the number of children who receive services under the speech or language impairment category.

3. Chapter Objectives
Describe and identify causes of primary types of speech and language impairments.
List the major components of a comprehensive evaluation used to detect the presence and extent of a communication disorder.
Identify the basic goals and common elements of effective interventions for speech-sound errors and language disorders.
Explain how the speech-language pathologist’s role changes as a function of the setting in which a child with communication disorders is served.

4. Definitions
Communication is the interactive exchange of information, ideas, feelings, needs, and desires
Communication involves
A message
A sender who expresses the message
A receiver who responds to the message
Functions of communication
Narrating
Explaining/Informing
Requesting
Expressing

5. Definitions
Language is a formalized code that a group of people use to communicate with one another
The five dimensions of language:
Phonology
Morphology
Syntax
Semantics
Pragmatics
Dialects are the learned patterns of speech and language appropriate to families and communities.

6. Definitions Speech is the oral production of language.
Speech sounds are the product of four related processes:
Respiration - Breathing that provides power
Phonation - Production of sound by muscle contraction
Resonation - Sound quality shaped as it passes through the throat, mouth, and sometimes the nasal cavities
Articulation - Formation of recognizable speech sounds

7. Typical Speech and Language Development
Most children follow a predictable sequence in the acquisition of speech and language skills.
Children between the ages of 11 and 36 months of age are exposed to a tremendous amount of spoken language.
Children who are learning to talk practice their new skill relentlessly.
Bridging the “30 million word gap” is a reference to the vast difference in the number of words that some children from poverty background hear by age 4 years compared with the experiences of more affluent children.

8. Communication Disorders Defined
ASHA definition
An impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal, and graphic symbols systems.
IDEA definition
A communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance.

9. Speech Impairments
Speech is impaired when it deviates so from the speech of other people that it
Calls attention to itself
Interferes with communication
Provokes distress in the speaker or listener
Three basic types of speech impairments are
Articulation disorders-errors in the production of sounds
Fluency disorders-difficulties with the flow or rhythm of speech
Voice disorders-problems with the quality or use of one’s voice

10. Language Disorders
Language disorder is impaired comprehension and/or use of spoken, written, and/or other symbol systems.
Language disorder may involve in any combination:
The form of language (phonology, morphology, and syntax)
The content of language (semantics), and/or
The function of language (pragmatics) in any combination.
Language disorders may involve receptive or expressive disorders

11. Characteristics: Speech Sound Errors
Distortions
Substitutions
Omissions
Additions
Articulation disorders
A child is not able to produce a given sound physically because that sound is not in his repertoire
Phonological disorders
A child has the ability to produce a given sound and does so correctly in some instances but not others

12. Characteristics
Fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm and repetition in sounds, syllables, words, and phrases.
Stuttering and cluttering are examples
Voice disorders
A phonation disorder causes the voice to sound breathy, hoarse, husky, or strained
Resonance disorders results in hypernasality or hyponasality

13. Characteristics: Language Disorders
Language disorders involve problems in one or more of the five dimensions of language:
Phonology
Morphology
Syntax
Semantics
Pragmatics
Language delay implies a child is slow to develop linguistic skills but acquires them in a typical sequence.
Language disorders suggests a disruption in the usual rate and/or sequence in which specific language skills emerge.

14. Prevalence
In the 2012 to 2013 school year, about 1,356,000 children ages 6 to 21 years received special education and related services under the IDEA category speech or language impaired.
It is the second largest disability category under IDEA.
Approximately two thirds of school-age children served by SLPs are boys.
About 50% of children who receive special education services because of a primary disability also have communication disorders.
The percentage of children with speech and language disorders decreases significantly from the earlier to the later school grades.

15. Causes: Speech Impairments
Cleft Palate
Paralysis of the Speech Muscles
Absence of Teeth
Craniofacial Abnormalities
Enlarged Adenoids
Traumatic Brain Injury
Dysarthria

16. Causes: Language Disorders
Developmental and Intellectual Disabilities
Autism
Traumatic Brain Injury
Child Abuse and Neglect
Hearing Loss
Structural Abnormalities of the Speech Mechanism
Aphasia
Genetics
Environmental Influences

17. Identification and Assessment
Screening and Teacher Observation
Evaluation components
Case history and physical examination
Articulation
Hearing
Phonological awareness and processing
Vocabulary and overall language development
Assessment of language function
Language samples
Observation in natural settings

18. Assessment of Children Who Are Culturally Diverse
Assess language proficiency in both the first and second languages when determining a culturally and linguistically different child’s communication competence.
Do not diagnose with a speech-language disorder if problems are observed only in English and not in their first language (or dialect).
Include assessment of basic interpersonal communication skills and cognitive academic language proficiency.
Assessment for the purpose of identifying children with disabilities are required, by IDEA, to be conducted in the child’s native language

19. Educational Approaches
Articulation and phonological errors:
Discrimination and production activities
Fluency disorders:
Behavioral principles and self-monitoring
Voice disorders:
Medical Examination and Direct vocal rehabilitation
Language disorders:
Vocabulary building, naturalistic interventions

20. Augmentative and Alternative Communication (ACC)
ACC refers to a diverse set of strategies and methods to assist individuals who cannot meet their communication needs through speech or writing.
ACC entails three aided or unaided components
A representational symbol set or vocabulary
A means for selecting the symbols
A means for transmitting the symbols
Symbol sets and symbol systems for ACC
Selecting the symbols
Transmitting the symbols

21. Placement Options
In 2011 to 2012, 87% of children with speech or language impairments were served in the general education classroom, 6% in resource rooms, and 4% in separate classrooms.
Some examples of service delivery models:
Monitoring
Pullout
Collaborative Consultation
Classroom or Curriculum Based
Separate Classroom
Community Based
Combination