Speech and language disorders affect millions of people around the world and at their most fundamental level impede our ability to speak, understand, read and write. Disorders may vary from imperceptible sound errors in speech to an inability to communicate effectively with others.
Speech and language disorders are disparate in their symptoms. A speech disorder will affect the flow of speech, ranging from hesitation while speaking to repetition of certain words, epitomized by stuttering. An estimated three million Americans are affected by stuttering. In addition, speech disorders may be in the form of a lisp or problems with vocal chords that result in a hoarse tone of voice.
Language disorders refer to various conditions, such as when a person can’t understand either spoken or written words. People with language disorders may also struggle in comprehending symbols of speech like sign language or simple gestures.
Language disorders in children are often genetic or caused by conditions affecting brain development, such as autism. In adults, they are normally the result of acquired brain development disorders, caused by trauma to the brain, such as a stroke or head injury.
Language specific disorders can involve the actual language form, known as phonology (sounds), morphology (how words are formed) or syntax (the order of words in sentences). Other areas affected are an ability to understand the actual meaning of the words (semantics) and function of the language in communicating with others (semantics and pragmatics).
At present, it is estimated that in America alone between six to eight million people suffer with a language disorder.
Types of language disorders may include what is referred to as “impaired language development” which manifests itself in slow development of linguistic skills. In other cases, specific disorders are diagnosed.
Aphasia is the inability to either use or comprehend language, normally occurring after a brain injury or stroke. Around one million Americans suffer from aphasia, which is acquired by an estimated 80,000 people each year following trauma to the brain.
Auditory Processing Disorder
Auditory Processing Disorder (APD) affects around 5% of all children of school age, preventing them from processing the information that they hear. In cases of APD, the brain’s ability to recognize and interpret sounds is affected, specifically in the area relating to composing speech. Children with APD cannot differentiate between subtle differences in the sounds in individual words. As a result, their language development is impaired.
Apraxia of Speech
Apraxia of speech (AOS) comes in two forms, acquired or childhood. Sufferers are unable to express themselves through speech correctly or consistently. Acquired AOS normally occurs in adults as a result of damage to the parts of the brain responsible for speech, typically following a stroke, tumor or head injury. Acquired AOS is often the result of aphasia or muscle weakness which affects the actual production of speech. Childhood apraxia of speech (CAS) exists at birth, and while its cause is not completely known, it often occurs in families with a history of learning disabilities or language disorders. The severity of apraxia ranges from mild to severe.
Landau-Kleffner Syndrome (LKS)
Landau-Kleffner Syndrome (LKS) is a rare neurological disorder that occurs during childhood involving the total loss of the ability to either understand or use spoken language. Children affected by LKS initially develop normally before losing their ability to speak for no apparent reason. Some suffers are affected by epilepsy which normally disappears during adulthood. Due to its symptoms, LKS is often misdiagnosed as autism, learning disabilities or even emotional or behavioral problems. While some people remain permanently affected, others can recover their language abilities over time.
Expressive Language Disorder
Again, expressive language disorder occurs during childhood and is either developmental or acquired. The developmental strain normally disappears during the period that a child learns to talk, while acquired expressive language disorder is the result of brain damage and can occur at any age. It is characterized by difficulty expressing oneself through speech, a limited vocabulary and an inability to formulate sentences in a way which makes sense. It does not, however, affect intelligence but simply the ability to form complex sentences.
Receptive/Expressive Language Disorder
People with receptive language disorder experience difficulty understanding language while those with expressive disorder have difficulty producing language. People may sometimes be afflicted with both. Consequently, they are unable to communicate substantially. In addition to experiencing difficulty with processing language and making connections between words and what they represent, they may also be unable to enunciate effectively. Receptive language disorders are often the result of brain injuries or strokes, or they can be inherited conditions.
Common Forms of Treatment
In all cases of language disorders, symptoms can be ameliorated by working with speech language therapists.
Typical strategies adopted during language therapy include developing connections between words, letters and their sounds. Development of vocabulary and practicing the use of language is also useful. Depending on the type of disorder and its severity, therapists may also integrate multisensory techniques within their program.
There is no one-size-fits-all approach to language therapy. Treatment varies according to the type and severity of the disorder and the age of the person. The subject’s awareness of his or her problem will also affect the success of therapy. Therapists will work with each person to help him or her to learn how to articulate actual sounds of speech.
In the cases of children with language disorders, attention will be paid to grammar, conversation, vocabulary and also storytelling. In specific cases, such as aphasia, patients will be advised on how to improve their ability to speak, read and write.
Another essential element of the therapist’s role is to involve close family and friends to enable people to communicate as effectively as possible in educational and social environments. In extreme cases, speech generating devices may be used; such devices allow the patient to press relevant letters or pictures to produce speech.
Most language disorders can be improved with time and patience, although not all will disappear completely. Sufferers of acquired apraxia may experience spontaneous recovery whereas some cases of LKS may affect people throughout their lives. In all cases, early diagnosis and involvement of speech and language therapists will greatly influence the possibility of long-term recovery.