articulation disorders2

ARTICULATION DISORDERS

1.FUNCTIONAL 2.ORGANIC

Functional Articulation Disorders

When structure, hearing and all observable physical systems appear to be normal ,the articulatory problem is termed as FUNCTIONAL in nature,and its origin attributed to faulty learning. Most articulation disorders are considered to be of this type.

Organic Articulatory Disorders

If the cause of defective utterance is related to a structural deformity or physical defect ,the articulatory problem is classified as ORGANIC in nature.

Organic articulation disorders arise due to damage to the speech mechanism….damage may be

A..to the CNS B..to the peripheral nervous system C..to the structure of oral

mechanism

Some Organic Disorders 1.Apraxia of speech 2.Dysartheria 3.Cerebral palsy 4.Cleft palate 5.Degenerative Neurological

Disease

APRAXIA OF SPEECH

Definition; defined as, “A sensory motor speech disorder” OR “An articulatory programming

problem Problem at the level of articulatory

pla--nning.’

Etiology / Cause Some insult to brain like; 1. stroke 2. infections 3. tumors 4. traumaSite of lesion ;Broca’s area.

Speech Characteristics 1. Inability to coordinate

phonation,rate,& or stress. 2 .Articulatory struggle 3. Pt shows awareness of his

difficulty,some pts will get disgusted & give up with a gesture of “ forget it”.

4. Errors increases as the length of sentence increase.

5.The articulatory errors are inconsistent & vary among substitutions,repetitions,prolongations,additions.

6. Some times the errered word is articulated after the correct word (bottle---bobble)

7.Errors in articulation of consonants & changes in normal patterns of prosody

8.Innitial consonants are more difficult than final consonant.

9. Articulatory errors increases as the length & complexity of utterence increases.

10. Most difficulty is on the utterence of consonants.

11. Of single consonants fricative and affricate phonemes evoke the most errors.

12. At times perfect articulation present particularly when these are highly practiced utterences (Hi! How are you?, Fine.What’s going on? Where have you been?”

13. Patients articulate more easily when they can watch a highly visible word being pronounced by the clinician.

DEVELOPMENTAL APRAXIA OF SPEECH

Definition;

“Apraxia of speech in children is called DEVELOPMENTAL Apraxia of speech”.

SPEECH & OTHER CHARECTERISTICS

1.Apraxia of speech +high incidence of an accompanying oral apraxia

2.Efforts at immitation marked by struggle & groping responses from the articulators.

3. Unusual substitutions & distortions(two or more feature errors …m/s , t/f.

4.Other than speech features, Difficulty in fine motor skills Oral sensory deficits Language problems( expressive skills.

DYSARTHRIA Definition; “Disorder of phonation,

articulation,resonation & prosody which occur either single or in combination as a result of weakness,incoordination, & or abnormalities in the tone of the muscles of the speech mechanism & are due to impairmentof the central nervous system,peripheral nervous system or both”.

Speech charecteristics; Generally the speech

charecteristics of dysarthria fall into the areas of phonation, resonation,respiration,articulation & prosody.

Etiology /cause 1. cerebrovascular insult 2.head trauma 3.degenerative diseases 4.tumors 5.cerebral infections 6.toxic conditions

Types of Dysarthria & speech characteristics

1.Flaccid Dysarthria a. weakness & decreased muscle tone. b.hypernasality,imprecise consona- -nts,monopitch,nasal emission, breathiness & audible inspiration.

2.Spastic Dysarthria a.Weakness ,limited range of movem- -ent,spasticity,reduced diadochokin- -etic rate. b. Imprecise articulation,reduced rate, low pitch,harsh voice,strained & str- angulated phonation,affected pros- -ody.

3.Ataxic dysarthria a.Reduced muscle tone & tremors. Slow inaccurate ,irregular move- -ments b. Imprecise articulation,prosodic abnormality.(slow rate,excess & equal stress,monoloudness, monopitch & prolonged syllables.)

4.Hypokinetic Dysarthria a.Muscle function for speech & other motor movements slow & limited in range & mobility. b. Speech is monotone, monoloudn- -ess,reduced stress &imprecise ar- -ticulation,rapid short bursts of spe- -ch,inappropriate silences.

5.Hyperkinetic Dysarthria a.Quick Form; movements are qui- -ck,random & include involuntary movements. b.Speech pattern is imprecise cons- -onants,prolong intervals,voice stoppages,limited pitch variations, harshness,vowel distortion,hyper-

-nasality. a.Slow form;movements are slow & sus- -tained. b. Speech characteristics include harsh voice,strain-strangled voice,monopitch, monoloudness,unplanned variation in loudness.

6.Mixed dysarthria presents picture of all types of

dysarthria.

CEREBRAL PALSY Definition; “It is a developmental non

progressive disability characterized by

disorders of movements &/or posture,usually

accompanied by sensory,cognitive & behavior problems.”

Cerebral palsy is a spectrum of disabilities including abnormal

motor and sensory functions, perceptual dysfunctions, intellectual cognitive deficits & difficulties in

hearing,speech,language , adjustment ,learning & vision.

ETIOLOGY /CAUSE Prenatal:Infections,rh

factor,hemorrhage,anoxia. Perinatal:Anoxia, trauma. Postnatal:Trauma,infections.

a.Respiration.phonation,resonation are affected Impaired chewing,sucking & swal- -lowing b. Developmental dysarthria & Apraxia of speech present.

CLEFT PALATE DEFINITION; Cleft palate is a structural anomaly that can affect the

tissues,muscles and bony processes of lips,alveolar process,hard palate,soft palate and uvula.

variations of a type of clefting congenital deformity caused by abnormal facial development during gestation

Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined. The soft palate is in these cases cleft as well. In most cases, cleft lip is also present.

ETIOLOGY / CAUSE Trauma,malnutrition,drugs,viral

infections & genetic cause.

Speech characteristics; fall into the areas of Resonation,Pho- -nation & articulation. RESONATION Hypernasality esp of

plosives,affricates and fricatives.

ARTICULATION (decreased intraoral pressure)

Stops (p,b,t,d,k,g) Fricatives(s,z,sh,zh) Affricates (ch,j) Their production is weak or distort- -ed.

ARTICULATION (Dental occlusion abnormalities)

Bilabials(p,b,m) Labio dentals (f,v) Linguadental Lingua alveolar

PHONATION Decreased loudness,breathy &

weak voice.

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