Subject: Clinical psychologyTopic: Explain any 5 Speech/Language disorders which have any associated psychological problem?

1. Stuttering: The stutterer, when he tries to speak must exert a higher effort to be able to articulate correctly. This effort supposes an increment of activation, and deterioration of performance may happen easily. As a consequence of failure, anxiety emerges which in turn further increases activation. 

The majority of psychological problems that stutterers have are associated with their stuttering. In other words, if the stutterers could speak fluently, they would not have any other problems.

In psychology, loss of control has been traditionally recognized as an important cause of depression, but more recently is also implicated in the appearance of anxiety disorders.       

       Depression and anxiety are not the only emotions that may cause psychological disorders affecting stutterers. The control of speech has great importance in social relationships. Continued failures in social relationships produce feelings of frustration, guilt, hostility and high levels of anger (Van Riper, 1973). 

Further, the incorrect management of feelings of guilt and frustration may disturb interpersonal relations causing additional social problems which may lead to many psychological disorders. The stutterer may have greater difficulty than non-stutterers in social interactions. Avoidances and flights may produce serious social problems that lead to psychological disorders.    

2. Specific Language Impairment :

Language impairments refer to a broad spectrum of difficulties including limited vocabulary, expressive deficits, phonological deficits, comprehension deficits, and pragmatic language deficits. All these problems have been reported in studies of children with behavioral disorders (Gallagher, 1999)

Children with SLI usually begin to talk at roughly the same age as normal children but are markedly slower in the progress they make. They seem to have particular problems with inflection and word forms (inflectional morphology), such as leaving off endings as in the past tense verb form.  A social communication disorder may be a distinct diagnosis or may occur within the context of SLI.             Social communication disorders include problems with social interaction (e.g., speech style and context, rules for linguistic politeness), social cognition (e.g., emotional competence, understanding emotions of self and others), and pragmatics (e.g., communicative intentions, body language, eye contact).    -The child with SLI becomes increasingly aware of his difficulties with language and may lose spontaneity and avoid conversation as he gets older.

3.         Aphasia :

The person with aphasia(either expressive or receptive) experiences a sudden and unexpected inability to function in the complete range of activities of everyday life; in cognitive, behavioral, leisure, occupational, social and family activities.

Patient  faces depression, communicative and social isolation, occupational  frustrations and reduced involvement  in everyday living and leisure activities that ultimately lead to psychological issues.Psychological support is important. 

Negative emotional reactions to this frequently manifest as depression both for individuals with aphasia as well as for those who are close to them. It is not surprising; therefore, that depression is the most reported and investigated mood state following brain damage.

Depression following a stroke, called post-stroke depression (PSD) is defined by the presence of clinically significant major or minor depression.Post-stroke depression (PSD) is considered the most frequent and important neuropsychiatric consequence of stroke. Approximately one-third of stroke survivors experience major depression. Moreover, this condition can have an adverse effect on cognitive function, functional recovery and survival.

4.       Learning Disability :

Learning disabilities, or learning disorders, are an umbrella term for a wide variety of learning problems. Learning disabilities look very different from one child to another. One child may struggle with reading and spelling, while another loves books but can’t understand math.

Three different situations regarding psychological problems in LD occur

The most prominent diagnosis fell under the spectrum of anxiety disorders and a minority were diagnosed with depression

Another area of interest is the relationship between learning disabilities and somatic complaints.

A third area where learning disabilities and behavioral problems coexist is with social behavior. Often children with learning disabilities have problems with familial and peer relationships. This may be the result of processing problems which make it difficult for LD children to pick up social cues. This in turn may result in avoidance behavior.

When learning disabilities and behavioral problems appear together, it is important to identify whether the behaviour is secondary to the learning disability or co-morbid. When the negative behaviour is caused by the learning disability, the solution to that behaviour often lies in dealing with the learning disability. When it is co-morbid, the interventions become more complicated, since the behaviour has to be treated separately from the learning disability.        

                5.       Intellectual Disability :

Many people who have an intellectual disability or an A.S.D., have difficulty in communication. They may find it hard to understand what is said to them and may have difficulty in expressing themselves. Their 

speech may be difficult to understand and some people may not develop speech. There are many associated psychological issues that has to b ruled out with multiple treatment approaches. These include psychosocial treatments, behavioral treatments, cognitive-behavioral treatments, and family-oriented strategies . 

Psychosocial treatments are intended primarily for children before and during the preschool years as this is the optimum time for intervention. This early intervention should include encouragement of exploration, mentoring in basic skills, celebration of developmental advances, guided rehearsal and extension of newly acquired skills, protection from harmful displays of disapproval, teasing, or punishment, and exposure to a rich and responsive language environment.

The role of the psychologist is to promote positive behavioural support. The aim of positive behavioural support is to improve the service user's overall quality of life by altering the environmental conditions which contribute to the challenging behaviours and through introducing a range of effective therapeutic strategies to reduce challenging behaviour and to increase more effective coping behaviours.