Speech Problems in Adult
Medical conditions such as stroke, head injury and Parkinson’s Diseases can result in speech disorders in adults which often affect their ability to communicate with others.
There are two main types of speech disorders: Dysarthria and Apraxia of speech.
Dysarthria
Dysarthria are speech problems in which the patients are unable to produce the clear speech sounds due to weakness in the speech muscles such as the lips and the tongue.
In order to articulate clearly and correctly, we have to be able to move our speech muscles at an adequate speed, range and rate. Our muscles also have to be strong enough so that they can contract well and move to the full range or come together for example in closing the mouth.
Patients with dysarthria have difficulty in producing speech sounds because of the weakness in the muscles. The presentations of their problems can differ across individuals. Some patients may produce a very soft voice and may be unable to raise the volume of their speech. Some may sound very hoarse or strained, while others can have a normal voice but with poor articulation of specific speech sounds.
Speech Therapy in such instances involves intensive graded exercises to guide patients produce the correct speech sounds: from word to sentence and then to conversational level. In some patients, speech may be facilitated by communication aids.
Apraxia of Speech
Apraxia of Speech is a speech disorder in which a patient has difficulty with producing the correct speech sounds consistently. The patient will have intact speech muscles and he / she can produce the words correctly some times but wrongly during other times.
Apraxia of speech is a disorder which causes much frustration to the individual because of the inconsistent error patterns in their speech attempts. It can also cause embarrassment because the patient is not able to control his speech sounds and sometimes the word produced has a totally different meaning as intended.
Speech Therapy for Apraxia of Speech involves the use of different techniques to help the patient gain control of their speech. Some patients would benefit from visual and tactile promptings, while other may benefit from auditory cueing. The recovery of the patients depends on various factors including the intensity of therapy, family support, and motivation of the patient.
A word on Developmental Dyspraxia
Developmental Dyspraxia is a neurologically based developmental disability which is present from birth. Like Apraxia of speech, it is a disorder related to the motor planning. The muscles can be intact and children with dyspraxia have the ability producing the correct speech sounds. However, they cannot get their body to do it at will. The presentations of dyspraxia can be different and the severity of the impairment varies.
For some children, they may have poor speech intelligibility and may seem to struggle to produce a certain sounds. They may, however, have no difficulty in moving around their tongue or lips when asked to or during functional non-speech tasks. On the other hand, some children may have both difficulties with speech and non-speech tasks. They may have difficulty performing oral motor tasks which are not related to speech. For example, they may have difficulty in blowing, sucking or moving their tongue tips.
Signs of Dyspraxia
- Highly unintelligible speech
- Have increasing difficulty with longer words, e.g. say “mato” for “tomato”
- Prefer to use gestures rather than speech
- Have difficulty imitating the movement of the tongue and lips
- Have difficulty with speech – maintaining clarity with fast speech rate
If you suspect your child has dyspraxia, please contact ISSW for more information.
