Speech Disorder

Overview

In generally, Speech impairment mainly includes articulation, fluency and voice disorder problems.

Fluency is a part of proper speech. But in speech disorders there can be great disfluencies where there is repetition of words like in stuttering.

Either Stuttering or Stammering is the most common disfluency. Although it is common in young children, persistence of significant stammering even after 4 years of age is worrying.

Speech disorder can be because of articulation problems like denture misalignment, cleft palate, poor muscle coordination as either in cerebral palsy or in brain injury.

Speech is distorted here making it hard for listeners to understand in speech disorder.

Other speech Disorders

Voice disorders where there is obstruction in the airways like vocal cord tumors, enlarged adenoids etc.

Even things like voice overuse, screaming, singing, acid reflux moving up, nerve damage, vocal cord tumors etc can cause voice disorders.

Voice is hoarse, breaking, raspy, pitch and volume is altered, nasal tones etc are there in voice disorder.

Speech production also includes process like Phonation (a process, where voice produces as air in lung, moves up and vibrates the vocal cords) also Resonance (this air now passes through throat, nose and mouth).

Problems in Phonation and Resonance process leads to voice disorders. Furthermore, This includes altered voice quality, pitch, hyper or hypo nasal tone. [1]

Speech disorders are not same as language disorders.

Speech disorders prevent people from forming correct speech sounds, while language disorders affect a person’s ability to learn words or understand what others say to them.

However, both speech and language disorders can make it more difficult for a person to express their thoughts and feelings to others. [2]

Speech disorders can affect people of all ages.

Some types of speech disorder include stuttering, apraxia, and dysarthria & articulation problems.

1. Stuttering (Stammering):

Stuttering refers to a speech disorder that interrupts the flow of speech.

People who stutter can experience the following types of disruption i.e.:

• Repetitions occur when people involuntarily repeat sounds, vowels, or words.
• Blocks happen when people know what they want to say but have difficulty making the necessary speech sounds. Blocks may cause someone to feel as though their words are stuck.
• Prolongations refer to the stretching or drawing out of particular sounds or words.

The symptoms of stuttering can vary depending on the situation.

Stress, excitement, or frustration can cause stuttering to become more severe. Some people may also find that certain words or sounds can make a stutter more pronounced.

Stuttering can cause both behavioral and physical symptoms that occur at the same time.

These can include:

• Tension in the face and shoulders
• Rapid blinking
• Lip tremors
• Clenched fists
• Sudden head movements

There are two main types of stuttering:

• Developmental stuttering affects young children who are still learning speech and language skills. Genetic factors significantly increase a person’s likelihood of developing this type of stutter.
• Neurogenic stuttering occurs when damage to the brain prevents proper coordination between the different regions of the brain that play a role in speech.

2. Apraxia:

• The brain controls every single action that people make, including speaking. Most of the brain’s involvement in speech is unconscious and automatic.
• When someone decides to speak, the brain sends signals to the different structures of the body that work together to produce speech.
• The brain instructs these structures how and when to move to form the appropriate sounds.
• For example, these speech signals open or close the vocal cords, move the tongue and shape the lips, and control the movement of air through the throat and mouth.
• Apraxia is a general term referring to brain damage that impairs a person’s motor skills, and it can affect any part of the body.
• Apraxia of speech, or verbal apraxia, refers specifically to the impairment of motor skills that affect an individual’s ability to form the sounds of speech correctly, even when they know which words they want to say.

3. Dysarthria:

Dysarthria occurs when damage to the brain causes muscle weakness in a person’s face, lips, tongue, throat, or chest.

Muscle weakness in these parts of the body can make speaking very difficult.

People who have dysarthria may experience the following symptoms:

• Slurred speech
• Mumbling
• Speaking too slowly or too quickly
• Soft or quiet speech
• Difficulty moving the mouth or tongue

4. Sound speech disorders (articulation problems)

5. Speech disorder due to mutism

6. Voice disorders [2]

Depending on the cause of the speech disorder, several symptoms may be present. Common symptoms experienced by people with speech disorders are:

• Repeating sounds, which is most often seen in people who stutter
• Adding extra sounds and words
• Elongating words
• Making jerky movements while talking, usually involving the head
• Blinking several times while talking
• Visible frustration when trying to communicate
• Taking frequent pauses when talking
• Distorting sounds when talking
• Hoarseness, or speaking with a raspy or gravelly sounding voice
• Delayed language development
• Slow speech is one of the chief symptoms of speech disorders. [3]

Stuttering Symptoms:

• Difficulty in starting words (mmmmmm…….Mummy)
• Symptoms include repetition of words, sounds or letters (I..I..I…am…….Jooooohn)
• Sudden block of speech for few seconds when patient tries to say something (…..wwwwwww…..where are you?)
• Person may sound tense, out of breath while conversation since stammering takes lot of energy is main feature in symptoms of speech disorders.
• Completes word with much effort
• Head jerking while speaking, rapid blinking, tapping of foot, trembling lips, tightening facial & neck muscles
• Difficulty in completing the words, make them long (fooooood), repeats the words (I.. I.. want… want fooood), put extra sound (I umm. Umm. Want food), distorted sound, pauses while talking etc.
• There could be great frustration, embarrassment, low self confidence due to this. [1]

Exact causes of speech disorders are not known but some factors are linked with Speech Disorders:

Hearing loss:

Impaired hearing is a very common cause of Speech Disorders.

Heredity:

• Family heredity may be responsible for Speech Disorder.
• Heredity may also determine size of child’s mouth, jaw; teeth arrangement; strength of facial muscles which plays a role in proper speech.
• Also there could be a strong family inheritance in stuttering. This is one of the important causes of speech disorders.

Neurological Disorder:

• Progressive neurological disorder can cause speech disorders.
• Conditions like brain tumour, traumatic brain injury, muscular dystrophy, autism, cerebral palsy, Down syndrome, Parkinson’s disease and dementia etc may also cause speech disorder.

Orofacial myofunctional disorders:

This disorder causes speech disorder by exaggerated forward movement of tongue during speech or swallowing.

This is normal in infancy but improves as we grow up. But if it fails to improve it can lead to speech disorders. This is one of the chief causes of speech disorders.

Medical Condition:

• Enlarged adenoids or tonsils can also block the airways leading to forward protrusion of the tongue.
• Also damage to vocal cord, polyps, nodules, vocal cord paralysis, oral cancer, laryngeal carcinomas may cause Speech Disorders. These are leading causes of speech disorders.

Brain injury:

Stroke can result in apraxia of speech

Poor intellect:

It can also result in speech disorders.

Physical or structural impairment:

Structural impairments like cleft lips, cleft palate, tongue deformities, dental deformities can also cause speech disorders. [1]

A speech-language pathologist (SLP):

• It is a healthcare professional who specializes in speech and language disorders.
• An SLP will evaluate a person for groups of symptoms that indicate one type of speech disorder.
• To make an accurate diagnosis, SLPs need to rule out other speech and language disorders and medical conditions.
• An SLP will review a person’s medical and family history. They will also examine how a person moves their lips, jaw, and tongue and may inspect the muscles of the mouth and throat.

Denver articulation screening examination:

This test evaluates the clarity of a person’s pronunciation.

Prosody-voice screening profile:

SLPs use this test to examine multiple aspects of a person’s speech, including pitch, phrasing, speech patterns, and speaking volume.

Dynamic evaluation of motor speech skills (DEMSS) manual:

The DEMSS is a comprehensive guide for helping SLPs diagnose speech disorders. [2]

Special tests like EEG, MRI brain, PET scan of Brain may be required in some cases. [1]

Complication

Treatment

• Homeopathic medicines consider on total constitution of patient, acts on both mind and body.
• Homeopathy also helps in controlling anxiety, fear of public speaking, phobias, depression, etc along with speech disorders.
• Homeopathic treatment for speech disorders helps in building confidence in persons who stammers making speech easy for them.
• Moreover, it also helps in preventing the relapse of the condition.
• Homeopathic treatment for speech disorders provides complete holistic wellbeing to the patient by boosting the immune system and assisting recovery in the safest and most natural way.

Few of our amazing remedies include:

Nux Vomica:

Suited for Speech Disorder in adults as a result of overwork, abuse and overindulgence.

Stramonium:

Most frequently used medicine in Stammering. Difficulty in initiating speech along with bed wetting in violent nature kids also adults.

Stammering especially after episode of acute fear. Words come out with great effort.

Selenium:

Great remedy specifically for Stammering after acute and intense fear. Extreme fear of death. Bad effects of cold air. Additionally Fear of crowd.

Argentum Metallicum:

Useful remedy for stammering in nervous person who gets extremely anxious during public speaking. Great craving for sweets.

The remedy abbreviations with

• 4 marks- most effective,
• 3 marks- quite effective,
• 2 marks- less effective,
• 1 mark- least effective. [1]

Frequently Asked Questions

What is Speech Disorder?

Speech disorder is a group of conditions where there is problem in speech formation also creation which leads to difficulty in communication with others.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Speech Disorder?

• Nux Vomica
• Stramonium
• Selenium
• Argentum Metallicum

What are the most common Speech Disorder?

• Stuttering (Stammering)
• Apraxia
• Dysarthria
• Sound speech disorders
• Speech disorder due to mutism
• Voice disorders

What causes Speech Disorder?

• Hearing loss
• Heredity
• Neurological Disorder
• Medical Condition
• Brain injury
• Poor intellect
• Orofacial myofunctional disorders

Give the symptoms of Speech Disorder?

• Repeating sounds
• Adding extra sounds and words
• Elongating words
• Making jerky movements while talking
• Blinking several times while talking
• Visible frustration
• Taking frequent pauses
• Distorting sounds
• Delayed language development
• Slow speech