Module 10 Speech and Language Disorders    

Children who struggle with speech and language disorders are at a disadvantage in the classroom because they have problems receiving and interpreting language, replicating language, or articulating language. Such communication disorders can be primary conditions or secondary to other disorders such as cerebral palsy or mental retardation.

An example of a primary speech condition is articulation which refers to the management of the tongue and lip movements in association with the teeth. Management of articulation is related to the patterns of sound, also called phonology. Children who have articulation problems may have difficulty learning to read using a phonics approach which requires children to sound out the word. They can not reproduce the individual phonemes on demand and therefore they fail to blend the sounds into recognizable words which are part of their normal oral vocabulary. They are also more likely to hesitate to pronounce words out loud because they are self conscious about their speech difficulty or distortions.

Other types of speech difficulties may include:

Fluency – speech rate and rhythm.

Voice – speech pitch, volume and quality.

Syntactic structure – organization of phrases and clauses.

Morphology – use of prefixes and suffices to build words.

Semantic content – concepts and vocabulary.

Pragmatics – the application of semantics, syntactics, and morphology to varied listeners and settings. I.e. knowing how to start a conversation, change topics, and take turns talking.

A common example of a fluency problem is stuttering. Young children typically hesitate or repeat themselves when learning to speak normally. Generally stuttering is not a concern unless the repetitions contain a minimum of three or more attempts per unit or if the dysfluency lasts for 2 seconds or longer. More advanced stuttering may also include facial mannerisms and efforts to hide vocal blocking. If stuttering is severe, students may avoid attempting conversations. This puts them at a disadvantage because it puts them out of the loop for learning about interacting with other people. It also can lead to difficulty in organizing written communications as they do not practice normal oral interactions.

Voice disorders are any abnormality in pitch, loudness or quality arising from the vibration of the vocal cords as modified by the mouth cavity. Voice problems may be caused by medical or psychological conditions. Medical conditions could be significant things like a cleft palate or a neurological disorder affecting the vocal cords to something as simple as hoarseness secondary to chronic sinus infections.   Non-medical causes can be attributed to vocal abuse such as constant yelling or being conditioned to keeping voice tone at a whisper level because of fear and anxiety.

Syntax involves word order and how sentences are normally constructed. Most children learn to speak English fluently by about 6 years of age.  For example, the normal flow of most sentences is that a verb will follow a noun. The misuse of nouns, pronouns, verbs and adjectives in oral language can lead to learning problems because communications can become mixed up. The child may not be able to follow conversations or may not be able to ask for assistance. Morphology disorders are closely related to syntax errors as they are smaller units of meaning related to language. A child with a morphology disorder may not be able to apply past tense or irregular verb forms. Usually with morphology errors meaning can still be determined but children can be teased by their peers or adults for non-standard use of words.  For example, “I buyed a new shirt.”

Semantics is understanding the meaning of words and organizing them into sentences which communicate ideas about daily life. It is different than syntax or morphology because it addresses broader meanings about the world rather than the technical mechanics of sentence structure. Initially children learn semantics by building vocabularies about tangible objects such as “book” or “apple”. Later children learn about abstract words which help link objects to actions or relationships. These “function” words would be verbs, adverbs or adjectives. For example, “before” and “after” are abstract words with entirely different meanings. Acquisition of skill in semantics is a foundation tool in learning reading comprehension.   

Finally, pragmatics is applying language in appropriate settings with appropriate awareness of the audience in a social sense of interaction. It can include physical awareness of eye contact and physical distance between speakers. It also includes understanding of meanings of abstract information, maintaining a conversation, taking turns speaking, and generally understanding the needs and intent of the other person.

Unfortunately, difficulties in speech are often interpreted as lack of intelligence by casual bystanders, peers, and significant others. I can relate to this as I have personally known people during my own academic years that had normal or above intelligence but were perceived as less than normal because of speech impediments. My own brother, Owen, who died last year from an unrelated heart ailment caused by childhood rheumatic fever, also had an early crib accident which severed his tongue down the middle. The family story is that Mother was tending to the newborn infant (me!) while Owen was bouncing in his crib for attention. Just one year older than me, Owen caught his chin on the rail of the crib. This played a pivotal role in Owen’s life as the tongue did not heal correctly. This was during the 1950s and surgery was not available to do a repair. Owen’s speech was very difficult. He underwent years of speech therapy after he entered kindergarten. (Note that during those days, there were no early intervention programs.) Of course, I was jealous of Owen getting to play with the nice lady who brought puppets to our house, but that is another story. The speech therapy was successful and eventually Owen did learn to speak correctly. As a teenager you would have noticed only a slight impairment. The path to normal speech was not easy for Owen. He did not progress through elementary school at a normal rate and was held back in second grade. We went through school in the same grade after that. What I remember is that the teachers and other students were often not patient with him to let him get the words out. He would try so hard but it was easier to rush and dismiss his efforts. Other children would laugh and make fun of him. Eventually, he gave up trying so hard. He became a mediocre student and got routed into general classes rather than college bound curricula. He never learned to enjoy reading and became known for working with his hands.