Diagnosis of language, speech, voice and DEGLUTITION disorders and deficiencies and correcting these disorders with appropriate therapy methods is called Voice and speech therapy. This process is carried out by Voice and speech therapists who have at least four years of undergraduate education. The Voice and speech therapist is an important member of the rehabilitation team.
What disorders does the speech and Voice therapist treat?
- Childhood and adult period Voice disorders
- Articulation (Pronunciation disorders)
- Motor speech disorders
- Voice disorders
- DEGLUTITION disorders
- Postoperative speech disorders
- Lip - Palate Cleft tongue and speech disorders.
LANGUAGE ACQUISITION AND LANGUAGE DISORDERS
Many children learn their mother tongue spontaneously without special effort. However, this does not mean that this situation is very easy. Some studies even say that children start learning language in the womb. It starts to communicate from the time it was born. Babies, for example, cry out all their needs; when babies are hungry, wet their diapers, alone, they express it by crying. When the babies grow a little, they attract the attention of those around them with their little sound games. such like "ba-ba-ba-ba-ba, de-de-de-de-d, ma-ma-ma". Then the first words begin to appear: Like ‘Mother’, ‘father’, ‘food’, ‘water’, ‘pee’. After a while, the child learns the suffixes and other features of the language and makes sentences.
Language disorders occur due to the absence or delay of the speaking process. The first 3 years and the short term thereafter are very critical. Families should consult a language and speech therapist as soon as they feel a difference in their children at this age. The sooner the language and speech disorders are recognized and the sooner they intervene, the higher the efficiency.
- Language and speech disorders can be seen not only in childhood but also in adults for various reasons.
- Childhood language disorders
- Delayed Language-Speech
- Specific Language Disorder
- Secondary language disorders. Autism, hearing loss, mental disability, Down syndrome, cerebral palsy (CP) are disorders such as language disorders.
- Adulthood language disorders
- Aphasia. Acquired language disorder.
- At what age does speech therapy begin?
- Speech therapy started in children 3 years and older.
CHILDHOOD LANGUAGE DISORDERS
Childhood language disorders can sometimes occur without any cause due to reasons such like; hearing loss, mental retardation, autism, cerebral palsy (CP).
Delayed Language-Speech: It is called language-speech, which means that a child's speech and / or understanding up to the age of 4, regardless of a cause, is behind his peers. Some of them recover without treatment. Since it cannot be predicted in which child the speech delay will be self-addressed, the subject should not be neglected and a speech therapist should be consulted.
Specific Language Disorder: A specific language disorder definition is used for children over the age of 4 who have no language impairment disability and whose speech or understanding is behind their peers.
A language cannot be spoken just by knowing the words. In order to speak that language, it is necessary to use appropriate words, to use suffixes, to form sentences by putting words together.
Late speech of the child may be a precursor of specific language disorder. Language and speech delay should not be neglected with the thoughts such as "his father spoke late, so It recovers" and‘ his uncle also spoke late, so It recovers by the time".
Early diagnosis and early intervention are important in language disorders. Professional support from the language and speech therapist is required. Because the language and speech therapist tries to reach the target by identifying the cause of the problem, developing and implementing the appropriate therapy program through evaluation and tests.
Secondary Language Disorders: Children with diagnosis such as hearing loss, mental disability, autism, Down syndrome, cerebral palsy (CP) may develop more slowly than their peers. This leaves the child's speech or understanding behind their peers.
As with other language disorders, early intervention is important in secondary language disorders. Therapy in secondary language disorders requires serious discipline, knowledge and labor. The task of the language and speech therapist is to bring the speech and understanding of children with secondary language disorders to the level closest to their peers. The therapist determines and applies the child's remaining language areas and appropriate treatment program.
This is a neurogenic acquired language disorder. Damage to various areas of the brain may occur as a result of blockage or bleeding in the vessels supplying the brain. If the damage is in the language areas of the brain, a person's language loss, aphasia, occurs. In the first months there is a spontaneous recovery. However, the following period is critical; if a person evaluates this period well and starts treatment immediately, a more efficient recovery is obtained.
Aphasia is generally divided into two main groups: Anarthria and fluent aphasia.
Anarthria Aphasia: Usually a combination of language disorder and paralysis occurs. Although there is often information about the language and its sub-parts, one has trouble communicating it as a language output. Awareness of the person and his / her environment is often high. In these patients, very few words are produced, error in the sounds of words, damage in repetition; understanding is better than speaking. They usually speak in short terms and make a lot of effort to be able to speak. Instead of ‘children playing ball in the garden' they can say‘ ball… garden ’.
Fluent Aphasia: Although fluent aphasia often has language outcomes, there is a major shortage of speech content. One hears but cannot understand it. They can usually write, but the content of their writing may be meaningless.
Fluent aphasia should not be confused with hearing loss. The person hears, but has trouble processing it as a language input. In fluent aphasia, the problem is usually in letters, that is, in speech sounds. Since he/she cannot process speech, the person is not aware of his speech. He/she can produce meaningless words (neology) as if you were speaking another language. For example, when the patient is asked what he/she is doing in the day, he she can answer meaningless sentences such like: ‘a second day… a day we can do something… the next day... more than one day…'
Global Aphasia: Language disorder and paralysis are determined together. One has problems in both producing and understanding speech. Each area of the language, such as reading, writing, repetition and naming, is affected.
Treatment of aphasia
The earlier aphasia is intervened, the more improvements are observed. In the treatment of aphasia, information is obtained from the person's previous life and attempts are made to create associations with appropriate materials. With these associations, the person's lost language abilities are tried to be reconstructed.
Neuroplasticity is effectively used by the speech and speech therapist in this process. During the therapy process, language and speech therapists associate with information about the person's life before the illness. Thus, therapists stimulate the patient's brain and try to regain the lost language ability.
ARTICULATION (PRONUNCIATION) DISORDERS
Articulation (Pronunciation) Disorders.
Articulation is the production of speech sounds (letters) with the help of speech organs (tongue, lips, teeth, palate, etc.).
The organs of speech shape the air in the mouth. Articulation disorder is seen when the speech organs are in an abnormal position.
If the child cannot make a sound, says it differently than normal (lisper or nasal) or replaces one sound with another sound (such as bear instead of bee), this is an articulation disorder.
Phonology is a language component that includes rules related to the ordering and fusing of speech sounds.
The phonological development of the child is the acquisition of sounds and the proper use of these sounds in the word. Phonological development may vary. Each sound has a certain learning age.
Delays in learning lead phonological disorders.
The child may be making mistakes in sorting and merging speech sounds, such as displacement, drop, and substitution. For example, the child would say; "pook ”instead of“ book ”. “te: fund”, Instead of “phone“, instead of ", instead of "Lamp" says "kamp'. The important point here is that the child cannot place the letters in the word even though he/she says all the letters in the word.
In articulation and phonological disorders, professional support from language and speech therapists is required. Because the therapist tries to reach the target in a short time by identifying the problem with the evaluation and tests and arranging the appropriate therapy program.
MOTOR SPEECH DISORDERS
Speech requires quick coordination of many muscles in the face and neck. Tension, laxity, coordination disorder and paralysis occur in the muscles that control the speech pattern due to central and / or peripheral nervous system damage. These disorders affect respiration, vocalization, resonance, vocalization and prosody, making speech difficult to understand.
The most prominent feature of speech apraxia is that the child has difficulty in ordering the sounds and syllables correctly. It is much more difficult for these children to produce long and complex words than short and simple words. They may also say a word that they say is right, or they may not repeat it.
Children with speech apraxia learn language more slowly than their peers. Individuals with speech apraxia need an intensive therapy process. In addition, the contribution of the family in speech apraxia is important in terms of the effectiveness of the treatment.
Fluency disorders can be examined in two sub-headings: roughly stuttering and fast impaired speech.
Stuttering is a form of speech with impaired natural fluency and speed. Stuttering behavior often occurs with blocks, sounds and syllable repetitions. Blocks are such like (sudden burst of sound after the speaker stops for a while), sound repetitions (k-k-k-k-k-k-door), syllable repetition (be-be-be-mine).
Although many theories have been proposed, the exact cause of stuttering is not known. It is thought to be genetic. However, there is not enough data to support this. Fear and other psychological factors are not the cause of stuttering but can be triggers. Stuttering by imitation does not pass to another.
First of all, it should be known that stuttering is not a disease, nor is it a disorder that can be terminated in one or two weeks. Stuttering can only be controlled by regular and planned therapy by language and speech therapists.
Cluttering (Fast missing talk)
Another form of speech in which fluency is impaired is cluttering. They speak very quickly and irregularly. They sometimes add a letter to the word and make speeches that are irrelevant to the subject. Stuttering and cluttering can be seen together. Like stuttering, cluttering is tried to be controlled with treatment.
The sound needs to be heard comfortably, to please the audience, to be able to express emotions and to reflect one's age and gender.
We produce sound by vibrating the air from the lungs with vocal cords. However, some pathologies and misuse of sound may cause problems in the sound production mechanism. Sound differs perceptually. Bifurcation, thickening and thinning, hoarseness, ups and downs occur in the sound. If these problems are neglected, the disorder gradually increases. Even singers, announcers, actors, teachers, imams such as the loss of one's job can even lead.
Language disorders are often due to carelessness and misuse of sound hygiene. If the disorder is left untreated, it may progress and cause medical problems such as nodules and polyps.
Language therapy is a unique treatment. However, it can be applied in addition to medical and surgical treatments in advanced cases.
Ingestion occurs in three phases. (a) Oral phase: The process of chewing food / drink into the bolus through the mouth and delivering it to the pharynx. (b) Pharyngeal phase: The process of sending the bolus to the esophagus. (c) Esophageal phase: The process of delivery of the bolus to the stomach.
Normally, the oral phase is voluntary, while the pharyngeal and esophageal stage occurs spontaneously. In one of these stages, the problem that occurs for any reason is called Dysphagia, Deglutition disorder.
Deglutition disorder is manifested by symptoms such as coughing, chewing and swallowing during or after eating, drinking or escaping or accumulating in the mouth, chest tightness and weight loss.
- In the rehabilitation of deglutition disorders, compensatory and therapeutic methods are used. The aim of swallowing therapy is to make the patient swallow more easily and safely by bringing the nutrients needed to the proper consistency. Thus, to determine the body posture that the patient can swallow more easily with various maneuvers, to increase sensory awareness, to stimulate the swallowing reflex, to reduce delays between the phases and to ensure that the muscle groups working during swallowing work appropriately by using various techniques. Speech and language therapists can make recommendations and intervene on these issues within their professional boundaries.