Articulation disorders are the most common types of speech errors in children. Articulation errors may take the form of substitutions, omissions, or distortions of sounds. An example of a substitution would be the substitu tion of the w sound for the r sound, as in "wabbit" for "rabbit." Substitutions are the most common form of articulation errors. An example of an omission would be if the d sound was left out of the word "bed," as in "be_." Finally, sounds can also be distorted, as in "shleep" for "sleep."
Stuttering is defined as an interruption in the flow or rhythm of speech. Stuttering can be characterized by hesitations, interjections, repetitions, or prolongations of a sound, syllable, word, or phrase. "I wa-wa-want that" is an example of a part-word repetition, while "I, I, I want that" is an example of a whole-word repetition. When a word or group of words such as "uh," "you know," "well," or "oh" is inserted into an utterance, it is termed an interjection. "I want uh, uh, you know, uh, that" is an example of a sentence containing interjections. There may also be secondary behaviors associated with
DSM-IV-TR Criteria for Speech Disorders
Phonological Disorder (DSM code 315.39)
Failure to use developmentally expected speech sounds appropriate for age and dialect
Examples include errors in sound production, use, representation, or organization (substitutions of one sound for another, omissions of sounds such as final consonants)
Speech sound production difficulties interfere with academic or occupational achievement or with social communication
If mental retardation, speech-motor or sensory deficit, or environmental deprivation is present, speech difficulties exceed those usually associated with these problems
Stuttering (DSM code 307.0)
Disturbance in the normal fluency and time patterning of speech inappropriate for age
Characterized by frequent occurrences of one or more of the following:
• sound and syllable repetitions
• sound prolongations
• broken words (such as pauses within a word)
• audible or silent blocking (filled or unfilled pauses in speech)
• circumlocutions (word substitutions to avoid problematic words)
• words produced with an excess of physical tension
• monosyllabic whole-word repetitions
Fluency disturbance interferes with academic or occupational achievement or with social communication
If speech-motor or sensory deficit is present, speech difficulties exceed those usually associated with these problems stuttering. In order for an individual to extricate himself or herself from a stuttering incident, secondary behaviors may be used. A stutterer may blink the eyes, turn the head, tap his or her leg, look away, or perform some other interruptive behavior to stop the stuttering. In therapy, secondary behaviors are very difficult to extinguish.
While articulation disorders and stuttering are often seen in children, voice disorders are common among adults. Voice disorders are categorized into disorders of pitch, intensity, nasality, and quality. A person with a voice disorder of pitch may have a vocal pitch which is too high. A person may speak too softly and thus exhibit a voice disorder of intensity. Still others may sound as though they talk through their nose (hypernasality) or always have a cold (hyponasality). The most common voice disorder is a disorder of quality. Examples of disorders of vocal quality include a voice that sounds hoarse, breathy, harsh, or rough. This type of voice disorder may be caused by vocal abuse, or an overusage of the voice, and might be found among singers, actors, or other individuals who abuse or overuse their voices. If the vocal abuse continues, vocal nodules (like calluses) may appear on the vocal folds. Vocal nodules may be surgically removed, and a person may be put on an extended period of vocal rest.
Speech disorders may be caused by a variety of factors. They may result from physical problems, health problems, or other problems. Physical problems such as cleft lip and palate, misaligned teeth, difficulty in controlling movements of the tongue, injury to the head, neck, or spinal cord, poor hearing, mental retardation, and cerebral palsy can contribute to poor articulation. The exact causes of stuttering are not known; however, a variety of factors are thought to be involved, including learning problems, emotional difficulties, biological defects, and neurological problems. Problems with voice quality can be caused by too much strain on the vocal folds (for example, yelling too much or clearing the throat too often), hearing loss, inflammation or growths on the vocal folds (vocal nodules), or emotional problems.
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This book discusses the futility of curing stammering by common means. It traces various attempts at curing stammering in the past and how wasteful these attempt were, until he discovered a simple program to cure it. The book presents the life of Benjamin Nathaniel Bogue and his struggles with the handicap. Bogue devotes a great deal of text to explain the handicap of stammering, its effects on the body and psychology of the sufferer, and its cure.