Stuttering

Stuttering is defined as disruptions of speech sounds or “disfluencies” that affects the fluency of conversational speech. This typically begins in childhood but can last for a lifetime depending on familial history, age of onset, and severity.

There is no, one cause of stuttering; rather, a combination of four factors are considered the cause. These factors include genetics (according to the National Stuttering Foundation website, approximately 60% of people who stutter [PWS] also have a family member that does so), child development (developmental delays or sound production disorders), neurophysiology (recent studies have demonstrated that PWS process language differently than those who are typically fluent), and environmental factors (family dynamics).

According to the American Speech and Hearing Association, stuttering includes repetitions of whole words, part words, and speech sounds that occur more in persons who stutter (PWS) than others. Other behaviors include speech being stopped or “blocked” with an open mouth posture with little to no speech coming out as well as sounds in words being prolonged. Some examples include:

·         Sound Repetition o   “t-t-t-t-t-t-to the store”
·         Part-Word Repetition o   “ma-ma-ma-ma-make it go”
·         Whole-Word Repetition o   “my-my-my-my dog is big”
·         Block o   “____________THE cookie is mine”
·         Prolongation o   “sssssssss-it next to me”
·         Interjection o   “I, um-um-um like um-um ponies”

 

Typical disfluencies include whole-word repetitions (“the the ball is red”) or part-word repetitions that occur once or twice (“li-li-like my dress?”); typical disfluencies can also include interjections and filler words. These disfluencies typically occur between 1.5 and 5 years and have a tendency to ebb and flow in a child’s speech. This is thought to be due to large language gains that occur sporadically throughout a child’s development w hich cause difficulty with organization of vocabulary and associated categories or attributes, as well as word-finding difficulties.

Children who are thought to exhibit a mild stutter will repeat sounds more than twice and will have tension or “struggles” that are visible in their face and body. Additionally, some children exhibit a pitch rise during stuttered moments as well as “prolongations” (“mmmmmmmmmmmmm-y mommy makes sandwichessssssssss”) and “blocks” (“____________THE puppy is big”.

Severe stuttering is characterized by the examples provided above in addition to physical characteristics. These include obvious tension in the face and mouth (facial contortions), shoulders and neck as well as physical movements (head bobbing, hand movements, leg movements, table tapping, etc.). Additionally, prolongations and blocks noted in PWS’s speech are noted to be longer and increasingly severe in nature.

Treatment is dependent on a child’s age, awareness of the disfluencies, as well as additional concomitant diagnoses. Most treatment centers on changing the patient’s behaviors to improve communication; for example, making sentences shorter and less complex as well as slowing the rate of speech by using a reduced speed or pausing/chunking their words between slow and easy breaths. Additionally, strategies and techniques can be taught to older children to improve their speech during and prior to a stuttering moment.

Source: (Stuttering. (n.d.). Retrieved October 20, 2015, from http://www.asha.org/public/speech/disorders/stuttering.htm), (If You Think Your Child Is Stuttering… (n.d.). Retrieved October 20, 2015, from http://www.stutteringhelp.org/if-you-think-your-child-stuttering)

 

North Hills ENT and Anderson Audiology have several convenient locations for Speech Therapy!

North Hills ENT – 817-595-3700
4351 Booth Calloway Road, Ste. 308
North Richland Hills, TX  76180

North Hills ENT– 817-595-3700
647 S. Great Southwest Pkwy., Ste. 103
Grand Prairie, TX  75051

www.NorthHillsENT.com

Anderson Audiology – 817-282-8402
1550 Norwood Drive, Suite 100
Hurst, TX  76054

www.AndersonAudiologyDFW.com

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Speech Sound Disorders

Does your child continue to say words or sounds incorrectly? Are they not “growing out of it?” It may be a good idea to have them evaluated by a professional.

Speech sound disorders are mistakes that children make in their articulation or pronunciation of words past a certain developmental age. There are two types of disorders: Articulation disorders – making sounds and Phonological processes – sound patterns. Speech sound disorders can be a result of developmental disorders (autism), genetic syndromes (Down syndrome), hearing loss, illness, or neurological disorders (cerebral palsy).

Articulation disorders include errors with sound substitutions (“b” for a “v”- “tibi”/“TV”), sound deletion (“-ouse”/”house”), or sound addition (“blooduh”/”blood”). Sounds in our language are developed at different ages and some sound errors are considered appropriate at different times; this is why it is important to seek out evaluation from our certified pediatric speech-language pathologist to understand typical development and to know where your child falls with their intelligibility.

Phonological processes are patterns of sound errors or sound rules that are learned inappropriately rather than learning the proper rules during development. Patterns include substituting the “k” and “g” for the “t” and “d” (“tup”/”cup”, “do”/”go”), or a reduction of two consonants in a word (“tar”/”star”, “lock”/”clock”). These processes decrease by certain ages as well.

These disorders are diagnosed through a formal evaluation with standardized tests performed by a certified speech and language pathologist. Articulation and Phonological disorders are treated with a child-centered speech therapy program individualized to the patient’s needs in order to “improve articulation of individual sounds and reduce errors in production of sound patterns.” Parents are encouraged to be an active participant in their child’s therapy session as well as in their home-practice activities.

Make an appointment to see our pediatric speech-language pathologist today if you have any concerns about your child’s pronunciation or ability to be understood by family and friends!

Source: (American Speech-Language-Hearing Association (n.d.) Speech Sound Disorders: Articulation and Phonology. (Practice Portal). Retrieved October, 15, 2015, from www.asha.org/Practice-Portal/Clinical-Topics/Articulation-and-Phonology.)

 

North Hills ENT and Anderson Audiology have several convenient locations for Speech Therapy!

North Hills ENT – 817-595-3700
4351 Booth Calloway Road, Ste. 308
North Richland Hills, TX  76180

North Hills ENT– 817-595-3700
647 S. Great Southwest Pkwy., Ste. 103
Grand Prairie, TX  75051

www.NorthHillsENT.com

Anderson Audiology – 817-282-8402
1550 Norwood Drive, Suite 100
Hurst, TX  76054

www.AndersonAudiologyDFW.com

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Late Talkers or Late Language Emergence

Late language emergence, or “late talkers,” is a delay in the development and onset of language skills where there are no additional disabilities, motor deficiencies, or cognitive delays diagnosed. These children typically present with either a “mixed receptive and expressive language delay” or just an “expressive language delay.” An expressive language delay is usually characterized by a limited vocabulary and slowed articulation or sentence structure development while a “mixed” language delay typically presents with difficulty comprehending and producing language. If these diagnoses go untreated by a certified speech-language pathologist in speech therapy, it can result in development of language and literacy delays as the child ages and progresses through school. Additionally, it can be a sign of underlying disorders including but not limited to: specific language impairment, social communication disorder, autism spectrum disorder, learning disability, attention deficit hyperactivity disorder, intellectual disability, etc.

Some signs and symptoms of a “late talker” include but are not limited to:

·         Child uses little to no words/word combinations  by age of 18 mos. to 2 years o   Points and grunts instead of labeling, commenting or requesting

o   Exhibits little to no 2-word sentences by 2 years old

·         Child demonstrates a limited vocabulary o   Children should exhibit a vocabulary between 5-20 words by 18 months, 150-300 words by 2 years, and 900-1000 words by 3 years
·         Child exhibits frustration/behavior difficulties when attempts at communication fail

 

o   Tantrums occur when he/she is not understood

o   Little to no attention to tasks and acting out from difficulty communicating

·         Not pointing to objects or pictures

 

o   Will not identify pictures of animals or objects when given a verbal prompt by 12 months
·         Not answering questions appropriately/repeating a question as the answer

 

o   “Do you want juice?”… “want juice?”

o   “What did you have for breakfast?”… “I eat”

o   “Where do you sleep?” … “Blanket”

·         Difficulty with following multi-step directions o   “Get the toy, and give it to me”

o   “Take off your shoes, put them away, then wash your hands”

·         Difficulty with understanding/using pronouns o   “I”, “me”, “you”, “my”, “mine”, “he”, “she”, “they”, “his”, “hers”, “him”, “her”
·         Difficulty with understanding/using simple prepositions o   “on”, “off”, “over”, “under”, “front”, “back”, “next to”
·         Difficulty with understanding/using verbs or action words o   “run”, “eat”, “jump”, “play”, “drink”, “sleep”, “wash”, etc.

 

If your child exhibits any of these “red flags”, please don’t hesitate to contact our Pediatric Speech Therapy Center to schedule a language evaluation today!

 

North Hills ENT and Anderson Audiology have several convenient locations for Speech Therapy!

North Hills ENT – 817-595-3700
4351 Booth Calloway Road, Ste. 308
North Richland Hills, TX  76180

North Hills ENT– 817-595-3700
647 S. Great Southwest Pkwy., Ste. 103
Grand Prairie, TX  75051

www.NorthHillsENT.com

Anderson Audiology – 817-282-8402
1550 Norwood Drive, Suite 100
Hurst, TX  76054

www.AndersonAudiologyDFW.com

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