C ommunication Disorders

1. Communication Disorders

2. “Communication is a universal process by which human being exchange ideas, impact, feelings and express needs” (Adkins, 1991) • Communication occurs in a variety of ways, • Drama, literature, music and arts. It is verbal or nonverbal, and there are both sending and receiving components. • Stroke, or cerebrovascular accident is the most common cause of impaired communication.

3. Stroke • Most common occurrence in older adult men and in the African American population • Perceptual deficits such as neglect and denial as well as spatial disturbances may also affect persons ability to communicate • The most residual deficits of a stroke is a problem with language • Language involves not only speaking but also conveying and comprehending thoughts and ideas

4. Aphasia • A communication problem either with speaking, writing, or understanding • It may be defined as a multiple-modality loss of language ability • Usually caused by damage to the dominant hemisphere • It is necessary to determine which type of aphasia-expressive or receptive-is present

6. Expressive Aphasia • the function of language primarily resides in the left hemisphere of the brain • Most often when an injury affects the dominant cerebral hemisphere the result is EA. • It occurs when an injury damages the inferior frontal gyrus, just anterior to the facial and lingual areas of the motor cortex

7. Teaching strategies • Working with EA, you might try having the person recall word images, first by naming commonly used objects and those objects in the immediate environment • Let the person repeat words spoken by the nurse • Keep the sessions short

8. Receptive Aphasia • Wernicke’s area of the brain is located in the temporal bone and is needed for auditory and reading comprehension • When this area affected, persons are left with Receptive Aphasia • Their hearing is unimpaired, they are nevertheless unable to understand the significance of the spoken word. • Speech therapy should be one of the earliest intervention

9. Teaching Strategies • Working with RA you need to establish a means for nonverbal communication • Speak more slowly and slightly louder to the person • Keep your teaching session filled with praise and always acknowledge the client’s frustration • Speak slowly • Don’t use baby talk • Speak in normal tones • Speak in slow, short, and simple sentence • Allow the person time to answer • Be patient

10. Dysarthria • Is a problem with voluntary muscle control of speech • It occurs as a consequence of damage to the central or peripheral nervous system and affect the same muscles used in eating and speaking.

11. Teaching Strategy • Be sure the environment is quiet • Ask the speaker to repeat unclear parts of the message • Do not simplify your message • Ask question that need only short answer • Encourage person to use more oral movement to produce each syllable and to speak more loudly • Ask the patient who is unintelligible to gesture, write or point to messages on a communication board

12. Laryngectomy • Cancer in the larynx is five times more common in men than in women • Esophageal speech was the primary method in speaking after a laryngectomy • ES involves taking air into the upper part of the esophagus and adopting its normal sphincters to vibrate like vocal chords • Tracheosophageal speech is more rapid restoration of speech. The person must rely on prosthesis and the tracheosophageal fistula may undergo stenosis

14. Teaching Strategies • Watch the speakers lips • Do not alter your message • If you don’t understand the speaker. Repeat what you think the person said, and ask for more information • Seek a quiet environment

15. Articulation Disorders- impairment of the ability to articulate speech sounds. • Fluency Disorders- interruption in the flow speaking characterized by atypical rate, rhythm and repetition of sounds, syllables, words and phrases. This may be accompanied by excessive tension, struggle behavior and secondary characteristics. • Voice Disorders- abnormal production of vocal quality, pitch, loudness and resonance compared to an individual’s age or sex.

16. Phonological Disorders- abnormal development of sound system of the language and the rules that govern sound combinations. This results in difficulty producing age expected speech sounds. • Language Disorders- impaired comprehension and/or use of spoken and written language. This disorder may include difficulty with • Semitics- meaning of language • Syntax- grammatical construction of language • Pragmatics- social use of language, includes conversational skills • Phonological awareness- knowledge of the sound structure of language, reading, spelling, and writing

17. Cleft Palate- birth defect in which there is an opening through the soft palate and the bony roof of the mouth. A cleft is surgically repaired in infancy. It may result in hypernasality and various articulation disorders.