Topic: Speech and Language Disorders
Researched and written by: Tamara Zeff
                                                I attest that the following report is a product of my own original work.

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Overview               Communicating with others (friends, family, teachers, etc.) is a natural part of most people’s daily lives.  It is so natural that most of us do not even think about it when we are communicating.  However, some people are not as fortunate as others are.  The reason for this is that many people are categorized as having a speech or language disorder.  Although speech and language can be two separate entities, they go together hand-in-hand.             A speech disorder is not as straightforward as it sounds.  There are many different aspects that are part of speech disorders.  A speech disorder is not just a difficulty in producing sound, but also a disorder involving the quality of a person’s voice, or their fluency of speech (Turnbull, Turnbull, Shank, & Smith, 2004).  Speech disorders also may be related to other disorders.             A language disorder also involves many different things.  A person with a language disorder has problems receiving, understanding and formulating what they read, what other people say, or even things they want to say (Turnbull, et al., 2004).  This difficulty can affect the way a person lives their life from day to day, whether it be at home, work, or school.  Language disorders are also related to other disorders.              Speech and language disorders can be related to other disorders, or can stand-alone.  Some of the other disorders it is related to are cleft palate or lip, hearing loss, auditory processing disorder, autism, and cerebral palsy.  With a cleft palate or lip, the person has a split in the upper part of the oral cavity or upper lip, which results in the difficulty of speech (Turnbull, et al., 2004).  A person with a hearing impairment can have a total loss of hearing (deafness) or a partial loss of hearing.  The disability affects the way a person speaks and communicated with others.  An auditory processing disorder is where a person can hear information, but has trouble understanding, remembering, or recognizing the information (Ciocci, 2002).  This can affect a person negatively when it comes to speech and language if they have to sit in on a meeting or a lecture.  Those with autism have two main language impairments, delayed language and echolalia.  Delayed language indicates that the person can only focus on one thing at a time, and has limited communication abilities.  Echolalia is where the person repeats everything they hear (like a child learning to talk) because they do not know how to respond properly (Turnbull, et al., 2004).  People who suffer from cerebral palsy have a hard time expressing themselves and have articulation problems because they can not organize the muscles around their mouth and throat.  (Turnbull, et al., 2004).              Many authors have shown that an early language delay can be related to later speech difficulties.  There are many factors that can cause a speech and language disorder.  Hearing, health and medical problems can also cause the disorder to occur.  Medical problems are associated with a woman’s pregnancy and birth.  However, oromotor and feeding history have the most effect on speech disorders (Broomfield & Dodd, 2004).             There have been many studies done in regards to speech and language disorders.  These studies have helped in determining gender-based statistics, as well as finding out the characteristics of the disorder.  The impact of speech and language disorders in the classroom and treatment as it relates to the classroom has also been studied.  This paper is designed to inform readers of the statistics, characteristics, classroom impact, and treatment of speech and language disorders in children. Statistics             Roughly five percent of all youth, aged from birth to twenty-one years old, has speech or language impairments (Turnbull, et al., 2004).  Out of this group, 19.2 percent are receiving some form of special education.  By the time children enter the first grade, five percent are diagnosed with speech disorders (National Institute on Deafness and other Communication Disorders, 2004).  There are more than 160 cases of Landau-Kieffner Syndrome (LKS), a childhood disorder that involves a loss in the ability to understand and use language (National Institute on Deafness and other Communication Disorders, 2004).  Between six and eight million Americans have some kind of language impairment.  Boys are more apt to have a speech or language impairment than girls.  For speech disorders the ratio is 1.5 : 2.4, male : female, and for language disorders the ratio is varied on a scale from .98 : 1 to 2.30 : 1, males : females (National Institute on Deafness and other Communication Disorders, 2004).  Communication disorders affect one out of every ten people in the Unites States and more than one million students had a speech or language impairment for the 2000-2001 school year (National Dissemination Center for Children with Disabilities, 2004). Characteristics             There are many characteristics that are associated with speech and language disorders.  These characteristics range from subtypes of the disorder to behavior related issues.  There are four subtypes to speech disorders and four subtypes associated with language disorders.  The four characteristics associated with speech disorders are articulation disorder, apraxia of speech, voice disorder, fluency disorder (Turnbull, et al., 2004).  The four characteristics of language disorders are phonological delay, consistent deviant phonological disorder, inconsistent deviant phonological disorder, and articulation disorder (Broomfield & Dodd, 2004).              Articulation disorder in regards to speech disorders is where a child has trouble producing sounds and sound combinations of speech correctly (Turnbull, et al., 2004).  This can take many forms.  A child may replace, take out, add, or change sounds or sound combinations.  This type of speech disorder can be mild or moderate and is one of the most frequent disorders in pre-school and school-aged children.             Apraxia of speech is a motor speech disorder, which affects the production of speech.  Apraxia of speech can be developmental or it can be caused by outside factors.  Some of these factors include a stroke, tumor, or head injury.  Students with apraxia have problems with the movement of speech.  They have trouble using long words or sentences when they are under pressure.  They also have errors in the production of vowels, inconsistent speech errors, voicing errors, along with others (Turnbull, et al., 2004).              Voice disorders occur when pitch, duration, intensity, resonance, and vocal quality of a person are not normal.  Pitch is the rate of vibration of the vocal fold.  Duration is how long a speech is required.  Intensity is the loudness or softness of a person’s voice.  Resonance is the expected quality of a person’s voice, and vocal quality is affected by problems of breath support and resonance (Turnbull, et al., 2004).              A fluency disorder deals with the flow of speaking.  For example, does a person talk smoothly and naturally?  When this flow is interrupted a person can be diagnosed with a fluency disorder.  Interruptions in the flow of speaking include, but are not limited to, hesitations, repeating words, using umm to frequently, or stuttering when speaking (Turnbull, et al., 2004).              A phonological delay is where a person uses incorrect pronunciation as well as the inability to distinguish sound differences in their use of meaning changes.  Different letter combinations make different sounds and someone with a phonological delay cannot distinguish between the different sounds (Turnbull, et al., 2004).    This delay is more typical in younger children (Broomfield & Dodd, 2004).  Consistent and inconsistent deviant phonological disorders are also part of the phonological delay.  A person with a consistent deviant phonological disorder uses some developmental rules, which may be correct for their age group (Broomfield & Dodd, 2004).  A person with an inconsistent deviant phonological disorder can produce some words differently some of the time, but not all (Broomfield & Dodd, 2004).             Speech and language disorders can also cause problem behaviors in some children. According to Huaqing Qi and Kaiser (2004), this can be due to the fact that children with speech and language disorders may have trouble communicating with their peers while playing or solving problem.  These problem behaviors include physical aggression, lying, running away, hyperactivity, impulsive behavior along with others (Lochman & Szczepanski, as cited in Huaqing Qi & Kaiser, 2004).  Children with language disorders interact with their peers less than children without language disorders.  However, their interaction with adults is the same as children without language disorders.  Children with speech and language disorders may exhibit more problem behavior and interact socially with peers less often then children without speech and language problems because of their frustration at not being able to communicate with others as freely (Huaqing Qi & Kaiser, 2004). Classroom Issues             Children with speech and language disorders have a harder time in the classroom than children without speech and language disorders.  Reading, reading comprehension, spelling, writing, and mathematics were studied by Goulandris, Nathan, Snowling, and Stackhouse (2004) to see how these subjects affected those with speech and language disorders.  There were five levels (level 3, level 2c, level 2b, level 2a, level 1) a child could score in, with level one being the lowest and level three being the highest.  Children were expected to receive a level two or above on the tests.             The reading comprehension test tested a child’s ability to read something by themselves and then answer questions based on what they had just read by writing down their answers (Goulandris, Nathan, Snowling, & Stackhouse, 2004).  73.8 percent of the children tested received a score at a level two or above and 26.2 percent of the children scored at a level one or below.  The reading test was designed to assess a child’s ability to read out loud without faults and talk about what they read to show they understood it.  78.6 percent of the children tested received a score at a level two or above and 21.4 percent scored at a level one or below (Goulandris, Nathan, Snowling, & Stackhouse, 2004).  A teacher administers the writing test.  It is designed to test the child’s ability to communicate what they mean into words, and to also use correct punctuation and spelling.  The child’s handwriting must also be legible.  83.3 percent of the children tested received a score at a level two or above and 16.7 percent scored at a level one or below (Goulandris, Nathan, Snowling, & Stackhouse, 2004).  The spelling test checked the child’s ability to spell words that they don’t normally use.  These words could have one or more syllables and also may have more than one spelling (i.e. their, there, they’re).  57.1 percent of the children received a score at a level two or above and 42.9 percent scored at a level one or below (Goulandris, Nathan, Snowling, & Stackhouse, 2004).  The mathematics test required the children to read a problem and then write down their answers (Goulandris, Nathan, Snowling, & Stackhouse, 2004).  95.2 percent of the children tested received a score at a level two or above and 4.8 percent scored at a level one or below.              The scores varied from test to test with children scoring high on some and low on others.  The low scores for reading and spelling follow the consistent pattern that children with speech and language disorders have problems with literacy.  The reading comprehension test may not have been very accurate because the children could have been able to know what was going on in the book based on the pictures that they saw.  Punctuation and spelling in the writing test was not a problem to children with speech and language disorders (Goulandris, et al., 2004).             Dockell and Lindsay (2001) studied how teachers felt about having students with speech and language disorders in their classrooms.  Some teachers may find themselves in the middle when it comes to educating children with speech and language disorders.  While it is their job to teach, many teachers may feel that they do not have the qualifications or training to teach a child with this disorder.  Some teachers also may find it stressful having a child with a disability in their class.              When teachers were asked to define what a speech and language disorder was, many teachers did not know.  About 40 percent did not think they could give any information on what the disorder was (Dockell & Lindsay, 2001).  While many teachers can report the strengths of a child, they could not report them in any one area.  Some teachers felt there wasn’t enough involvement from the speech and language therapist.  They felt the speech and language therapist only came to the classroom when asked (Dockell & Lindsay, 2001).  Based on this study, the main things teachers need are appropriate training to work with children with speech and language disorders, and more involvement from the speech and language therapist.             Since most times the children are taken out of the classroom for speech and language therapy, it is very important to know their views.  It is also important to know their views on how they feel about having their disability.  Their peers obviously know where they are going.  Many young people preferred one-on-one therapy as opposed to group therapy (Hayett, Owen, & Roulstone, 2004).  Most children talked about the games and activities they did in therapy, and overall seemed to enjoy it.  These children were also okay with being taken out of the class for their therapy.  They did not feel scrutinized.  Many children said they have trouble in school with their peers both physically and verbally as a result of their speech and language disorder.  Overall, most students are concerned with having friends and getting on at school (Hayett, et al., 2004).  Treatment             There are a variety of treatment programs at school that can be offered to help a child.  One method for helping children with speech and language disorders is to have teachers adopt the International Phonetic Alphabet.  This alphabet provides symbols to indicate all speech sounds in the world.  This helps children who have difficulty with the sounds of letters and letter combinations.  By using this alphabet teachers can more easily figure out when a child is having an error in sounds (Rahilly, 2002).  Another method for helping children is the traditional model of service provision.  It is clinic based and has one speech and language therapist for one child (Law, Lindsay, Peacey, Gascoigne, Soloff, Radford, & Band, 2002).    Consultation is another method for helping children with speech and language disorders.  Instead of having direct work with children, the speech and language therapist works closely with the classroom teacher, parent, or other professionals involved with the student.  Consultation cannot work if there is not enough time for discussion of what needs to be done.  This model helps a child learn by going beyond what is said and done in the classroom (Law, et al., 2002).    A fourth method for helping children is the collaborative approach.  A team is made up of the speech and language therapist, teacher, parent, key-worker, and child do develop a program that will be effective to help the child (Hirst & Britton, 1998).  According to this model, a child will get a more effective support network if others are involved in the child’s learning process, not just the speech and language therapist (Hirst & Britton, 1998).  Greenspan (2004) provided some suggestions for teachers in helping children with speech and language disorders.  Some of these suggestions are to have opportunities for classmates to have discussions with each other.  This will help them to talk more and be more confident when they talk.  Call on the child during group time so they get comfortable talking in front of others.  Work with the parent, child, and speech therapist in helping the child learn different sounds.  Playing little games can be a great resource. Summary             This paper has examined what a speech and language disorder is and the counterparts related to the disorder.  The overview stated the definitions of a speech and language disorder and also gave insight as to what other disorders are related to it.  The statistics showed that speech and language disorders are not uncommon and that it affects mostly the male gender.  It was noted that there are four subtypes to speech disorders and also four subtypes to language disorders.  Children with speech and language disorders also exhibit some behavioral problems due to their lack of communication.  It was shown that children with this disability have a harder time in the classroom when five comprehensive tests were given.  It was also found that teachers do not know how to describe what the disorder is and they have some reservations about these children being in their classroom.  Children expressed how they felt about having a speech or language disorder and also gave their views on what it is like having to go to speech and language therapy.  Different methods and suggestions were given to parents and teachers to help children with speech and language disorders.

References

(2004, January). Speech and language impairments. National Dissemination Center for Children with Disabilities. Retrieved November 9, 2004, from http://www.nichcy.org/pubs/factshe/fs11txt.htm

(2004, June). Statistics in voice, speech, and language. National Institute on Deafness and Other Communication Disorders, Retrieved November 9, 2004, from http://www.nidcd.nih.gov/health/statistics/vsl.asp

Broomfield, J., & Dodd, B. (2004, June). The nature of referred subtypes of primary speech disability. Child Language Teaching and Therapy, 20(2), 135-151.

Ciocci, S. R. (2002). Central auditory processing disorders. Office of Educational Research and Improvement.

Dockrell, J. E., & Lindsay, G. (2001, September). Children with specific speech and language difficulties-the teachers’ perspective. Oxford Review of Education, 27(3), 369-394.

Greenspan, S. (2004, January/February). Working with the child who has delayed speech. Early Childhood Today, 18(4), 22.

Hirst, E., & Britton, L. (1998). Specialized service to children with specific language impairment in mainstream schools. International Journal of Language and Communication Disorders, 33(Suppl), 593-598.

Huaqing Qi, C., & Kaiser, A. P. (2004, June). Problem behaviors of low-income children with language delays: an observation study. Journal of Speech, Language, & Hearing Research, 47(3), 595-609.

Law, J., Lindsay, G., Peacey, N., Gascoigne, M., Soloff, N., Radford, J., & Band, S. (2002, June). Consultation as a model for providing speech and language therapy in schools: a panacea or one step too far?. Child Language Teaching and Therapy, 18(2), 145-163.

Nathan, L., Stackhouse, J., Goulandris, N., & Snowling, M. J. (2004, June). Educational consequences of developmental speech disorders: key stage 1 national curriculum assessment results in english and mathematics. British Journal of Educational Psychology, 74(2), 173-186.

Owen, R., Hayett, L., & Roulstone, S. (2004, June). Children’s views of speech and language therapy in school: consulting children with communication difficulties. Child Language Teaching and Therapy, 20(1), 55-73.

Rahilly, J. (2003, April-May). The contribution of clinical phonetics to the investigation of oracy problems in the classroom. Clinical Linguistics and Phonetics, 17(3), 241-253.