INTERVENTION STRATEGIES FOR SPEECH

DISORDERPrepared by:

Edna Mag Eiry

Ainul Hafidza Rusli

Aniza Seli

Syazwan Zain

INTRODUCTION The speech problems that will be

discuss in this presentation : - Articulation Disorder - Stammering - Aphasia - Dyspraxia - Expressive Language Problem

ARTICULATION DISORDER

WHAT IS ARTICULATION? Articulation is the process by which

sounds, syllables, and words are formed when your tongue, jaw, teeth, lips, and palate alter the air stream coming from the vocal folds.

WHAT IS AN ARTICULATION DISORDER? A person has an articulation

problem/disorder when he or she produces sounds, syllables. or words incorrectly so that listeners do not understand what is being said or pay more attention to the way the words sound than to what they mean.

Many articulation errors are developmental in nature; that is some sounds are later developing, and many children will produce these sounds incorrectly until they mature.

One example is the [th] sound, as in “thumb”. This is one of the latest sounds to develop (between the ages of 6 an 8). Therefore, if a 7-year-old can not yet say this sound, it is not reason to be concerned.

TYPES OF SOUND ERRORS. Most errors fall into one of three

categories- 1. Omissions 2. Substitutions 3. Distortions

OMISSION . An example of an omission is "at" for

"hat" or "oo" for "shoe."

SUBSTITUTION An example of a substitution is the use

of "w" for "r." which makes "rabbit" sound like "wabbit," or the substitution of "th" for "s" so that "sun" is pronounced "thun."

DISTORTION When the sound is said inaccurately, but

sounds something like the intended sound, it is called a distortion.

WHAT CAUSES AN ARTICULATION PROBLEM? Articulation problems may result from

physical handicaps, such as cerebral palsy, cleft palate. or hearing loss, or may be related to other problems in the mouth, such as dental problems.

However, most articulation problems occur in the absence of any obvious physical disability. The cause of these so-called functional articulation problems may be faulty learning of speech sounds.

WHO CAN HELP?

1. PARENTS OR TEACHERS

By setting a good example. Don't interrupt or constantly correct the

child. Don't let anyone tease or mock (including fiends or relatives). Instead, present a good model. Use the misarticulated word correctly with emphasis.

If the child says, "That's a big wabbit," you say "Yes, that is a big rabbit. A big white rabbit. Would you like to have a rabbit?"

2. SPEECH-LANGUAGE PATHOLOGIST

Contact a speech-language pathologist if you are concerned about speech.

A speech-language pathologist is a professional trained at the master's or doctoral level to evaluate and help the child or adult with an articulation problem as well as other speech and/or language disorders.

The speech-language pathologist should be certified or licensed by the state.

The speech-language pathologist can advise whether professional help is indicated and how to arrange for assistance.

The speech-language pathologist can also give you guidance or provide services to help prevent or eliminate a problem.

Early help is especially important for more severe problems.

ARTICULATION THERAPY Articulation therapy consists of drill

exercises and various cues to help the child correct his/her sound productions.

These cues may be verbal (e.g. tell the child where to place his /her tongue) or visual (having the child look at the therapist’s mouth or in the mirror) or tactile (i.e. touch; having the child slide her finger down her arm when making the [s] sound.

The PROMPT tactile-kinesthetic cueing system may also be used to promote correct sound production. Frequent practice is essential for articulation therapy to be successful.

STAMMERING

WHAT IS ‘STAMMERING’? Stammering is a speech problem and it results in low self esteem and low confidence levels in the child.

Children should be made to overcome stammering by figuring out the reasons. Here are some tips to overcome stammer.

First, realised that you or your child doesn't have to be fluent all the time. Some form of stammering affects almost everyone in varying degrees. Even who you perceive as fluent speakers may say words like 'ah' or 'er' every now and again. Others repeat the same word a few times before carrying on, while others stammer or fumble over certain words.

If you or your child stammers, you should aim on trying to reduce the amount of stammering, not on completely getting rid of it.

Slow down. People who stammer usually do get nervous when speaking to others, and this causes them to speak faster than normal. When their fast speech is coupled with stammering, their words get more even incoherent, and they may have to repeat themselves to make themselves understood. This naturally affects their confidence still further, worsening the stammering. So if your child stammers, he should consciously try to slow down his speech.

If your child stammers while speaking to you, never interrupt him or finish off the sentence for him. Don't show impatience. Listen to him calmly and let him complete what he is saying, by himself.

Maintain eye contact with your child when he is speaking. Looking away will give the impression that you are not listening to what he is saying.

Don't make him repeat certain words if he stumbles over them. He may repeat them fine this time, but it's not going to help him for the next time.

Don't tell your child to take a deep breath before starting or to think about what he is going to say before saying it. These things don't help.

Make your child read out a paragraph from a book aloud everyday. Reading out something is easier from speaking impromptu because you don't have to form the thoughts before saying something out aloud.

Encourage your child to speak as often as possible. Invite your friends over and let your child speak to them for a while before going to his room.

Don't get frustrated with your stammering. If you are in a situation which makes you nervous, instead of shutting up completely ask questions of the other person.

Don't try and distract the person from your stammering by making exaggerated body movements. You can move your hands around a little - it may help you get your point across - but don't try and hide your stammer.

APHASIA

WHAT IS ‘APHASIA’? Aphasia is a disorder that results from damage to the parts of the brain that contain language. Aphasia causes problems with any or all of the following: speaking, listening, reading, and writing.

Damage to the left side of the brain causes aphasia for most right-handers and about half of left-handers. Individuals who experience damage to the right side of the brain may have additional difficulties beyond speech and language.

Individuals with aphasia may also have other problems, such as dysarthria, apraxia or swallowing problems.

In some cases, a person will completely recover from aphasia without treatment.

But for most cases, language recovery is not as quick or as complete. In these instances, speech-language therapy is often helpful. Recovery usually continues over a two-year period.

Many health professionals believe that the most effective treatment begins early in the recovery process. Some of the factors that influence the amount of improvement include the cause of the brain damage, the area of the brain that was damaged, the extent of the brain injury, and the age and health of the individual.

Aphasia therapy aims to improve a person’s ability to communicate by helping him or her to use remaining language abilities, restore language abilities as much as possible, compensate for language problems, and learn other methods of communicating.

Individual therapy focuses on the specific needs of the person, while group therapy offers the opportunity to use new communication skills in a small-group setting.

Stroke clubs, regional support groups formed by people who have had a stroke, are available in most major cities. These clubs also offer the opportunity for people with aphasia to try new communication skills.

Family involvement is often a crucial component of aphasia treatment so that family members can learn the best way to communicate with their loved one. Family members are encouraged to:

i. Simplify language by using short, uncomplicated sentences.

ii. Repeat the content words or write down key words to clarify meaning as needed.

iii. Maintain a natural conversational manner appropriate for an adult.

iv. Minimize distractions, such as a loud radio or TV, whenever possible.

v. Include the person with aphasia in conversations. vi. Ask for and value the opinion of the person with aphasia,

especially regarding family matters.vii. Encourage any type of communication, whether it is

speech, gesture, pointing, or drawing. viii. Avoid correcting the person’s speech.ix. Allow the person plenty of time to talk.x. Help the person become involved outside the home. Seek

out support groups such as stroke clubs.

Computers can also provide an alternative system of communication for people with difficulty expressing language.

Lastly, computers can help people who have problems perceiving the difference between phonemes (the sounds from which words are formed) by providing auditory discrimination exercises.

EXSPRESSIVE

LANGUAGE

DISORDER

DEFINITION Expressive language disorder is a condition

in which a person has difficulty expressing themselves with language, both in speech and writing.

Usually, people with expressive language disorder have normal or near normal intelligence, and understand the words they hear or read, but they have difficulty in using those words to express themselves to others

They are usually also below the average level for their age in:

-Putting words and sentences together to formulate thoughts

-Recalling words -Using language appropriately in a

variety of settings with different people (for example, at home, in school, with parents and teachers)

SYMPTOM The signs and symptoms vary drastically

from child to child. The child does not have problems with the pronunciation of words, as occurs in phonological disorder .

The child does have problems putting sentences together , using proper grammar, recalling the appropriate word to use, or other similar problems.

A child with expressive language disorder is not able to communicate thoughts, needs, or wants at the same level or with the same complexity as his or her peers.

The child often has a smaller vocabulary than his or her peers.

in some cases, an expressive language problem has an immediately obvious cause, such as a stroke or brain damage that has affected the language processing center of the brain.

DIAGNOSIS Speech pathologists perform specific assessments in

order to find out which areas of language appear to be difficult for your child. The way such assessments are conducted is not stressful for the child, and parents are usually present during these consultation times.

Other assessments that speech pathologists may recommend for further testing include:

-Complete hearing and auditory processing tests -Tests for learning difficulties -Assessments of cognitive function (thinking and

intelligence).

TREATMENT Treatment options depend on the degree of

severity of the disorder. Treatment may include: -Group sessions with a speech pathologist -Individual therapy sessions with a speech

pathologist -School-based language intervention programs -Assistance from special education teachers -Teacher’s aide support for children with

severe language disorders -Speech pathology sessions combined with

home programs that parents can use with their child.

THINGS TO REMEMBER Expressive language disorder means a

child has difficulty with verbal and written expression.

The cause of expressive language disorder is often unknown.

Treatment depends on the severity but it includes therapy with a speech pathologist.

DYSPRAXIA

WHAT IS DYSPRAXIA Dyspraxia is an impairment or

immaturity of the organization of movement.

In many individuals, there may be associated problems with language, perception and thought

TEENAGER & ADULTS

Trouble with speech control — volume, pitch, articulation

Difficulty writing Extreme sensitivity to light, touch,

space, taste, smells Difficulty with personal grooming Difficulty driving Very clumsy

SCHOOL AGE CHILDREN

Trouble with activities that require fine motor skills, like holding a pencil, buttoning, cutting with scissors

Poor coordination — trouble with sports activities

Slow or difficult-to-understand speech Speech difficulties can cause severe

social awkwardness and unwillingness to attempt social interactions

The following intervention are designed to:

enable the child to attain desired sensory thresholds;

achieve an optimal level of arousal and attention;

support effective social and environmental engagement.

INTERVENTIONS Give the child as much encouragement

as possible and make sure they are not made to feel a failure

Be aware of their difficulties and give strategies to reduce the frustration they experience particularly when required to complete written work

Break down activities and tasks into smaller components

INTERVENTIONS Work with parents as they know their

child better than anyone else Ensure that where required assistance is

given to the pupil to find their way around as they may forget where they are supposed to be

Encourage a close relationship with another child who can act as a mentor

Ensure that instructions are always clear and precise