Speech Therapy

Language is critical in shaping and reflecting our thoughts, beliefs, feelings  and concepts.”
Speech Therapy and Testings for all disorders mentioned below across all age group is given…

Evaluation & Therapy for individuals with –

Language Disorders :

• Hearing Impairment: Hearing loss, also known as hard of hearing, anacusis, or hearing impairment, is a partial or total inability to hear. It may occur in one or both ears. In children hearing problems can affect the ability to learn language. After fitting hearing aids or cochlear implant these children needs Auditory training and  speech & language therapy.
• Mental Retardation: Intellectual disability (ID), once called mental retardation, is characterized by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. People with intellectual disabilities can and do learn new skills, but they learn them more slowly. they do have delayed language development hence required speech and language therapy.
• Autism Spectrum Disorders: These disorders are characterized by social deficits and communication difficulties, stereotyped or repetitive behaviors and interests, sensory issues, and in some cases, cognitive delays. Early speech or behavioral interventions can help children with autism gain self-care, social, and communication skills
• Cerebral Palsy: Cerebral palsy is the name given to a number of motor problems which usually result from damage done to the brain during early childhood. It is called cerebral palsy because the area of the brain that is damaged is the cerebrum. It can not be cured.It is treated with therapies. The person affected often has trouble standing or walking. Those affected may also be partly paralyzed.
• Childhood Aphasia: Loss of receptive & Expressive language in children ~ age 3-10.Different than regressive autism, landau-kleffner syndrome has a continuous epileptic pattern on eeg in slow-wave sleep. 80% have clinical seizures, also behavior problems & inattention.Assessed by ped. Neurologists, ped. Neuropsychologists, & speech/language pathologists. Cause unknown. Treatment: anti-epileptic meds and speech and language therapy.
• Learning Disability: Language-based learning disabilities or LBLD are “heterogeneous” disorders associated with young children that affect their academic skills such as listening, reasoning, speaking, reading, writing, and maths calculations. It is also associated with movement, coordination, and direct attention. LBLD is not usually identified until the child reaches school age. Most of the children with this disorder find it hard to communicate, to express ideas efficiently and whatever they say can be ambiguous and hard to understand, It is caused by brain damage or a structural development of brain usually at birth. It is often hereditary, and is frequently associated to specific language problems. There are two types of learning disabilities: non-verbal, which includes disabilities from psychomotor difficulties to dyscalculia, and verbal, language based.Treatment: speech and language therapy.
• Specific Language Disability: Specific language impairment (SLI) is diagnosed when a child’s language does not develop normally and the difficulties cannot be accounted for by generally slow development, physical abnormality of the speech apparatus, autism spectrum disorder, acquired brain damage or hearing loss.Intervention is usually carried out by speech and language therapists.
• Adult Aphasia: Aphasia is the name given to a collection of language disorders caused by damage to the brain.Aphasia is most commonly caused by stroke.It can also be caused by other brain diseases, including cancer (brain tumor), epilepsy, and Alzheimer’s disease, or by a head injury. In rare cases, aphasia may also result from herpesviral encephalitis. The herpes simplex virus affects the frontal and temporal lobes, subcortical structures, and the hippocampal tissue, which can trigger aphasia. In acute disorders, such as head injury or stroke, aphasia usually develops quickly. While when from brain tumor, infection, or dementia it develops more slowly.
• Brain Injury: Speech Therapy for those who survive severe brain injury is far more than relearning how to speak. Within the context of a severe brain injury, Speech Therapy starts with the fundamental physical structures from which speech sounds are made.  The field goes onward from there to encompass all of the motor, memory and higher thinking processes involved in normal communication. Brain injury rehabilitation involves two essential processes, restoration of functions that can be restored and learning how to do things differently when functions cannot be restored to pre-injury level.

 

Articulation Disorders :

• Misarticulation (Tutlana): speech disorders in which some speech sounds (called phonemes) in a child’s (or, sometimes, an adult’s) native language are either not produced, not produced correctly, or are not used correctly.
• Cleft Lip & palate: Cleft lip and cleft palate, also known as orofacial cleft and cleft lip and palate, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP).A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections.
• Phonological Disorders: Occurs when a child does not develop the ability to produce some or all sounds necessary for speech that are normally used at his or her age. Phonological disorder is sometimes referred to as articulation disorder, developmental articulation disorder, or speech sound production disorder.
• Apraxia: Apraxia is a motor disorder caused by damage to the brain (specifically the posterior parietal cortex), in which someone has difficulty with the motor planning to perform tasks or movements when asked, provided that the request or command is understood and he/she is willing to perform the task.it involves the loss of previously acquired speech levels. It occurs in both children and adults who have (prior to the onset of apraxia) acquired some level of speaking ability. AOS affects an individual’s volitional speech and is typically the result of a stroke, tumor, or other known neurological illness or injury. Apraxia may be accompanied by a language disorder called aphasia.
• Dysarthria: it is the reduced ability to motor plan volitional movements needed for speech production as the result of weakness/paresis and/or paralysis of the musculature of the oral mechanism needed for respiration, phonation, resonance, articulation, and/or prosody.
• Post surgical management of oral carcinoma: Mouth cancer refers to cancer that develops in any of the parts that make up the mouth. Mouth cancer can occur on the:Lips
  Gums
  Tongue
  Inside lining of the cheeks
  Roof of the mouth
  Floor of the mouth
  Cancer that occurs on the inside of the mouth is sometimes called oral cancer or oral cavity cancer.Mouth cancer is one of several types of cancer grouped in a category called head and neck cancers. Mouth cancer and other head and neck cancers are often treated similarly. after the removal of oral cancer patients have problem in speaking normally which can be corrected by speech therapy

 

Voice Disorders :

• Puberphonia and Androphonia: puberphonia(male having female voice), androphonia(female having male voice). The persistence of adolescent voice even after puberty in the absence of organic cause is known as Puberphonia. This condition is commonly seen in males. The patient has an unusually high pitched voice persisting beyond puberty. This is uncommon in females because laryngeal growth spurt occurs commonly only in males.This condition is best treated by voice therapy (vocal exercises) by speech-language pathologists (SLPs) /speech therapists.
• Laryngectomy: Laryngectomy is the removal of the larynx and separation of the airway from the mouth, nose and esophagus. In a total laryngectomy the entire larynx is removed and in a partial laryngectomy only a portion is taken out. The laryngectomee breathes through an opening in the neck known as a stoma. This procedure is usually performed in cases of laryngeal cancer.
  • Voice functions are generally replaced with a voice prosthesis placed in the tracheo esophageal puncture created by the surgeon. The voice prosthesis is a one-way air valve that allows air to pass from the lungs/trachea to the esophagus when the patient covers the stoma. The redirected air vibrates the esophageal tissue producing a hoarse voice in lieu of the larynx.
  • A second method is the use of an electrolarynx. An electrolarynx is an external device that is placed against the neck and creates vibration that the speaker then articulates. The sound has been characterized as mechanical and robotic.
  • A third method is called esophageal speech. The speaker pushes air into the esophagus and then pushes it back up, articulating speech sounds to speak. This method is time-consuming and difficult to learn and is seldom used by laryngectomees.

• Vocal Abuse & misuse: Vocal abuse involves the incorrect use of the vocal tract, that eventually causes harm to the vocal folds. Vocal abuse often occurs when the inappropriate pitch and loudness levels are used, leading to vocal misuse. Vocal misuse and abuse can be characterized by use of excessive force that can result in the thickening of the vocal folds, polyps, or development of vocal nodules. This actually causes structural changes in the vocal folds that can lead to phonation problems (problems activating and sustaining one’s voice). These phonation problems are most often characterized by breathiness, harshness, and hoarseness
• Vocal Cord Palsy: Vocal cord paralysis occurs when the nerve impulses to your voice box (larynx) are disrupted. This results in paralysis of the vocal cord muscles.Vocal cord paralysis can affect your ability to speak and even breathe. That’s because your vocal cords, sometimes called vocal folds, do more than just produce sound. They also protect your airway by preventing food, drink and even your saliva from entering your windpipe (trachea) and causing you to choke.There are a number of causes of vocal cord paralysis including nerve damage during surgery, viral infections and certain cancers. Treatment for vocal cord paralysis usually involves surgery. Voice therapy can sometimes be an option.
• Spasmodic Dysphonia: Spasmodic dysphonia (or laryngeal dystonia) is a voice disorder characterized by involuntary movements or spasms of one or more muscles of the larynx (vocal folds or voice box) during speech.There are a number of potential treatments for spasmodic dysphonia, including botox, surgery and voice therapy.
• Vocal nodule, cysts, polyps, laryngeal web
• Voice disorders due to neurological lesion Parkinsonism, Huntington’s Chores, Multiple Sclerosis etc.

Fluency Disorders :

• Stuttering / Stammering (Haklana): it is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases as well as involuntary silent pauses or blocks in which the person who stutters is unable to produce sounds. The term stuttering is most commonly associated with involuntary sound repetition, but it also encompasses the abnormal hesitation or pausing before speech, referred to by people who stutter as blocks, and the prolongation of certain sounds, usually vowels or semivowels.
• Cluttering: Cluttering (also called tachyphemia or tachyphrasia) is a speech and communication disorder characterized by a rapid rate making speech difficult to understand, erratic rhythm, poor syntax or grammar, and words or groups of words unrelated to the sentence.

Swallowing Disorders: 

Difficulty swallowing (dysphagia) means it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain. In some cases, swallowing may be impossible.

Occasional difficulty swallowing, which may occur when you eat too fast or don’t chew your food well enough, usually isn’t cause for concern. But persistent dysphagia may indicate a serious medical condition requiring treatment.

Dysphagia can occur at any age, but it’s more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause.

Dementia: 

Dementia isn’t a specific disease. Instead, dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning.

Dementia indicates problems with at least two brain functions, such as memory loss and impaired judgment or language, and the inability to perform some daily activities such as paying bills or becoming lost while driving.

Though memory loss generally occurs in dementia, memory loss alone doesn’t mean you have dementia. There is a certain extent of memory loss that is a normal part of aging.

Many causes of dementia symptoms exist. Alzheimer’s disease is the most common cause of a progressive dementia. Some causes of dementia may be reversible.