Speech Therapy

Communication

Communication is of outmost importance to fulfilling needs and desires in our lives. It is a means of sharing our thought, ideas, feelings and knowledge and understands the same of people who are important to us. Communication can be broadly classified into verbal and non-verbal.

Verbal communication

involves use of speech (sounds) and language (words/sentences) to understand or express our needs, thoughts, ideas and knowledge.

Nonverbal communication

involves use of means other than verbal mode to understand or express our needs, feelings, thoughts, ideas and knowledge. It may include any of the following body language, variations in tone and pitch of voice, eye contact, gestures, symbols, sign language and Augmentative Alternative communication (AAC) devices.

Speech

Normal speech production requires coordination between the respiratory, laryngeal, articulatory and resonatory mechanism. Disorders of speech fall into three main categories:

1- Articulation/phonological disorders –
Young children often produce speech sound errors like saying ‘lelo’ for yellow, ‘wat’ for ‘rat’, it is a part of developmental process , however when this pattern of speech production continues beyond the expected age, it warrants for a visit to the Speech Language Pathologist’s (SLP) office.
2- Fluency disorders – Fluent speech has a continuous and rhythmic flow. Fluency disorders arise when this flow is interrupted to the extent where it impairs the individual’s ability to communicate. The SLP can evaluate if it is a disorder or normal disfluency.
3- Voice disorders – Voice is produced by the vibration of the vocal folds caused by the air flowing out of the respiratory mechanism. Voice disorders arise when the phonatory ability of the vocal folds is affected, features of voice get affected and resonance is varied by conditions of the vocal tract. An experienced SLP can evaluate the extent and nature of the disorder and its management.

Speech Language Pathologists are trained professionals who can assess and plan the direction of treatment of the above mentioned disorders present in pediatric and geriatric clients.

Language

Language is a complex and dynamic system of conventional symbols that is used in various modes for thought and communication (ASHA). Language is intrinsically related to cognition and hence cognitive abilities influence all aspects of language. Language is made up of five components; Semantics, Syntax, Morphology, Pragmatics and Phonology.

Language disorders may be broadly understood as:

1- Spoken language disorders – Spoken language disorders involve difficulty with listening, comprehension and/or expression in one or more components of language (Semantics, Syntax, Morphology, Pragmatics and Phonology).They are mostly developmental in nature.
2- Written language disorders – Writing is the most complex form of language, and children with oral language difficulties are often at risk for reading and written language deficits.
3- Languages disorders following neurological impairment – This group of disorders includes aphasia, dementia, traumatic brain injury and right hemisphere damage and are seen in adults.

Based on the nature of language impairment a Speech Language Pathologist evaluates and plans intervention along with input from family members and caregivers. In most of the disorders SLP is a member of a team working with the client.

Augmentative Alternative Communication (AAC)

AAC is a system of communication that augments the communication in individuals with severe expressive communication difficulties. It includes use of signs/symbols, sign language, PECS and speech generating devices.

SLP evaluates the clients communicative needs, sensory and motor abilities, language and cognitive abilities before deciding on the most suitable AAC system for the client.

Assessments

Peabody Picture Vocabulary Test, Fourth edition (PPVT-4 scale)

Vocabulary assessment is important in assessing the effects of injury or disease and is related to reading comprehension and general verbal ability.

The PPVT-4, measures the receptive (hearing) vocabulary of children and adults. It is a norm-referenced instrument that is untimed and individually administered.

Applications:

1- Provides information about English language development which is useful in diagnosing reading difficulties.
2- Screening preschool children
3- Useful in assessing receptive language of children with autism or cerebral palsy or other disabilities, as it does not require oral responses.

Time taken: 10-15 minutes
Age range: 2:6 – 90+ years

Expressive Vocabulary Test, Second Edition (EVT-2)

EVT-2 is a quick measure of expressive vocabulary knowledge and word retrieval.

Applications:

1- Screening for expressive language problems
2- Screening preschool children
3- Measuring word retrieval
4- Understanding reading difficulties
5- Evaluating the acquisition of English words

Time taken: 10-20 minutes
Age range: 2:6-90+ years

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