Speech Sound Disorders in Children Symptoms and Treatment
Speech Sound Disorders in Children Symptoms and Treatment
Speech itself, the act of making sounds precisely enough to be understood by others, is an athletic feat.
Like any other physical skill, speech demands a good physique and good muscle coordination. Some children are handicapped by weak muscles or poorly formed structures in the mouth or vocal tract.
Others cannot command their muscles to perform the rapid, fast-changing adjustments which the pronunciation of words requires. Because these children cannot speak easily and because they quickly become frustrated by their continual failure, they may appear to be deaf, mentally retarded, or emotionally disturbed.
Thus any examiner confronted with a child who has trouble learning to talk will be certain to check the physical structures involved in producing speech and the child’s ability to maneuver them.
Christopher is an example of a child who has difficulty making speech sounds.
He had passed his second birthday when his mother brought ,him to a clinic for a speech, language and hearing evaluation. He could say only one word which his parents could understand: “more.” He jabbered all the time at home, but his speech consisted mainly of vowel sounds, and occasionally an M, N, R or L.
Although his muscle coordination was normal he didn’t use his tongue for making sounds if he could avoid it.
Chris was born with a cleft lip and palate, a split in his upper lip which continued hack through the roof of his mouth, so that he had an opening between his mouth and nasal cavities. Surgeons had repaired his lip when he was six-weeks-old and had closed the cleft palate when he was one-and-a-half.
But Chris still had physical deformities which caused him trouble: too short a soft palate to permit him to block off his nose from his mouth; misaligned teeth which left a gap or open bite on the left side of his mouth, and in addition, a habit of protruding his tongue.
His doctors plan to straighten his teeth and lengthen his soft palate through dentistry and surgery when Chris is older. Meanwhile, he needs help in learning how to make speech sounds despite his handicap. Following the advice of speech consultants, his parents have enrolled Chris in a year-round nursery, school program for speech-handicapped children which is supplemented with individual therapy sessions.
At first Chris could not even blow a feather across a table top, a sign that he has trouble controlling his breathing and developing sufficient air pressure for speaking. After Chris succeeded in this task he had to learn how to tell whether he was blowing through his mouth or his nose.
He had to learn that for some sounds he must use his mouth and for others he must send ,!he air through his nose. first Chris could not make his tongue move up or down or side-to-side more than a fraction of an inch. This meant that T, F, TH, S and many other consonant sounds were impossible for him to imitate correctly.
Chris wants very much to speak, a strong plus in his favor. He has not yet become so frustrated over his failure to make himself understood that has given up altogether. To encourage him and give him confidence, his teacher has helped him learn 15 words beginning with M and N, the consonant sounds he can make, words like “moon”, “money” and “many.” This child is well on his way to joining the speaking world, but like other cleft palate children or children with deformed and poorly functioning structures, he will need years of help and his parents’ understanding that he is not ruined for life.
What causes such structural deformities? No one knows yet. What happens is that in the process of laying down the tissues which form the hard and soft palate, the throat cavity and the base of the skull, something goes awry. Sometimes there is too much tissue and sometimes too little. The result is often some opening, slight or severe, in the palate which separates the top of the mouth from the nasal cavity, and air leaks through.
Usually the doctor spots – be problem at birth and surgeons go to work to repair the deformity. Often this requires a series of operations at different stages in the child’s development.
Sometimes the surgeon will have to fashion an artificial device like a plate to cover the cleft, or a valve the patient can wear in his throat and operate to close his mouth off from his nose.
A cleft is not always visible. Sometimes it lies concealed beneath the mucous membrane lining of the roof of the mouth and only the child’s difficulty as he tries to speak suggests that something is wrong. Then X-rays and examinations by specialists will reveal the extent of the problem.
Poor muscle coordination prevents other children from making themselves understood. Their speech making equipment is perfectly intact. The problem is that they cannot manipulate it. Suppose you took a three-year-old to a puppet show where the skilled handling of 30 separate strings could make a small puppet dance, run and throw a ball. Now you give the same puppet to the child. The object becomes a lifeless doll in his baby hands and gone is all the magic.
Speaking 1: far more complex than manipulating a puppet, yet far easier a task for most of us because the brain and spinal cord plan and direct the sequence of necessary movements. Any impairment in this unconscious, effortless signal system can make learning to talk as difficult as working a dozen puppets.
Cerebral palsy can affect a child this way. C.P. is not a specific disease, but rather a name for a pattern of behavior caused by different kinds of injury to the brain and spinal cord. C.P. children cannot control their muscles easily. The simple act of reaching for a toy may be accompanied by flailing and waving arm movements and their heads may bob and roll.
Naturally, speech with its requirement for smooth, delicate muscle adjustments is supremely difficult for them.
For other children the damage may be slight and coordination problems on a smaller scale. Awkward in hopping, jumping and dancing to music, they are awkward in their speech movements too. Therdiiy often calls for exercises to reduce their overall clumsiness. With smoother movements their speech improves as well.
Exercise and practice is the treatment for all these children. They need skill in listening so that they can identify individual sounds which call for individual muscle movements. They need skill in making the muscles involved in speech more flexible and controllable.
They need confidence and encouragement as well.
Of course their prospects for improvement depend upon the severity of the damage involved. Many will not learn to speak on their own beyond a certain level, but good teaching can show them what to aim for and how to achieve better command of their muscles.
Their speech may never be as smooth and effortless-seeming as it is for other people, but they can often be helped to make themselves understood, certainly a triumph, and their doorway to the speaking world.
What causes poor muscle control? There are many sources of damage. Malformations in development due to oxygen deprivation or infections in the womb, premature birth or birth injuries, virus diseases during infancy which cause nerve damage, tumors, blood clots in the vessels supplying the nerves and muscles, concussions and other accidents are some of the major factors responsible.
What is important is that the child be helped as early as possible. He will need years of extra practice before he can be understood easily by others and the more time he has the better. He almost always has some potential for improvement. There are persons who have overcome partial paralysis, deformed tongues, and the loss of all their teeth and whose speech is clearly intelligible.
Speech Sound Disorders in Children Symptoms and Treatment article source : Learning to talk by National Inst. of Health Bethesda ,Md, document