While speaking to several parents over the years, I have realized that early on in the evaluation process, the majority of parents do not understand that there is a difference between "speech" and "language". "Speech" is an omnipresent term that is used to describe therapy services. Most people refer to services as "speech therapy" "speech services" or seeing a "speech therapist", however our technical term in the United States is a Speech-Language Pathologist due to the fact that speech and language are two distinct areas. At times, a child may need to work on both speech and language, however a lot of the time it's one or the other that is being targeted.
What is Speech?
Speech refers to a neuromuscular process by which we turn language into a sound signal that is transmitted through air. It is the physical aspect of talking and how we say sounds and words. It incorporates using muscles including the tongue, lips, cheeks, jaw and vocal tract to produce intelligible words.
What is Language?
Language refers to a system of conventional spoken or written symbols (including written, spoken or expressed through gestures and body language) used by people in a shared culture to communicate with one another. It is the words we use and how we use them to share ideas and get what we want. Language consists of:
What is Communication?
Communication is the process of conveying a message and sharing information among two or more people. It must have a sender and a receiver as well as involve formulation, transmission, reception and comprehension of a message.
Which disorders fall under the category of "speech"?
Articulation Disorder – This is a label given to children who demonstrate sound production errors that do not affect meaning. These speech sound errors may consist of omissions, substitutions, distortions or additions. (e.g. children who say "wion" for "lion" or children who have a lisp). At a young age, it is common for children to have difficulty producing various speech sounds. There are several charts online to look at to see which errors are age appropriate.
Phonological Disorder – This is a language based disorder that presents itself in the area of speech. If a child is diagnosed as having a phonological disorder, it means the child is having difficulty understanding the sound system and using speech sound patterns correctly in a language. They often do not use some or all of the speech sounds to form words as expected for a child their age. It is a speech simplification process that results in a collapse of phonemic contrasts which affect meaning. (e.g. a child is consistently dropping the "s" in s blend words (pin for spin OR nap for snap), yet they can correctly produce the "s" sound in other contexts such as "sock").
Stuttering- Fluency is the overall rate of speech. Stuttering is classified as an abnormally high frequency and/or duration of stoppages in the forward flow of speech.
Childhood Apraxia of Speech (CAS) – This label is given to children who have the inability to plan and execute volitional motor movements in spite of intact muscle strength and coordination. With CAS, the brain has difficulty with developing the motor plan for speech movements as well as a disconnect when sending the message from the brain to the muscles of the mouth. This may impact speech production and prosody.
Dysarthria - Dysarthria is characterized by impaired muscular control over the speech mechanism. With Dysarthria, the motor plan for speech correctly gets sent to the mouth, however an individual has difficulty executing the speech movements due to muscle weakness.
Voice Disorder - This refers to the overall quality of one’s speech. A voice disorder includes abnormalities in the production of sound by the larynx involving pitch (high/low), volume (loudness/softness) and other qualities of your voice. Examples of various vocal qualities include: strain/strangle, breathy, hoarseness, harsh, nasal, gurgly and tremor.
Orofacial Myofunctional Disorder - The Oral Peripheral Mechanism (OPM) refers to the oral structures including lips, teeth, tongue, jaw and palates involved in verbal production. Orofacial Myofunctional Disorders refer to disorders of the muscles and functions of the face and mouth. It involves abnormal movement patterns of the lips, jaw or tongue during rest, swallowing or speech.
Which disorders fall under the category of "language"?
Expressive Language Disorder - Expressive language is the output of language consisting of speaking and writing. These skills are a child's ability to organize and use spoken language to express their wants, needs, thoughts and feelings. It also includes their ability to use age appropriate vocabulary and follow the rules of grammar, which dictate how words are combined into phrases and sentences. If a child is struggling in this area, it is referred to as an Expressive Language Disorder. Common issues being: a child is not using words to communicate, not combining words into phrase/sentences, not using beginning/endings of words, not using appropriate sentence structure.
Receptive Language Disorder - Receptive language refers to the understanding of language or the input of information consisting of listening and reading. These skills include a child's ability to understand spoken language by processing sounds, words and sentences, retrieving words and information, and understanding vocabulary, grammar and sentence structure. If a child is struggling in this area, it is referred to as a Receptive Language Disorder. Common issues being: not following directions, not answering questions when asked, appearing confused when told something.
Social (Pragmatic) Communication Disorder - Pragmatics refers to the rules that govern and describe the use of language in communicative interactions, including the social aspects of language. These includes social skills, such as, when it is an appropriate time to say something, what words to use, or how to say something in a given context. Pragmatics also incorporates using appropriate body language and non-verbal communication as well as interpreting other's body language and responding to social cues.
You can have speech without language - Think about a toddler using jargon. The toddler is physically speaking, however we do not understand what they are saying.
You can have language without speech - Think about American Sign Language (ASL). ASL is a true language shared by a certain culture that is governed by particular rules, however involves no speaking.
You can communicate without speech or a shared language - Think when you are in a foreign country and you do not speak the same language. You communicate through nonverbal communication such as pointing, body language, facial expressions, drawing pictures, etc.
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