"More than 1 million U.S. children receive school-based treatment for speech and language impairments (American Speech-Language-Hearing Association [ASHA], n.d.)." As a result, the multi-disciplinary team members, when applicable, must be knowledgeable of speech and language disorders and related milestones, able to understand the role of the speech pathologist, and capable of providing support for students in the least restrictive environment.
Speech Disorders
Speech disorders prevent students from communicating with people in an effective way using sounds; specifically, students with a speech disorder struggle with making the correct sounds to properly pronounce a word (Eske, 2019)." Sometimes, students with speech disorders may omit or invent sounds for one or more of the syllables in a word or the entire word. They tend to do this because they can not make the correct sounds to properly pronounce the word. As a child, I struggled with making the correct sounds to properly pronounce words. I can remember stuttering when I tried to speak in sentences as an elementary school student. Although I never received professional services to improve my speech, I started to speak slower to give myself the time needed to properly pronounce words. Even today, on occasion, I will start to stutter when I talk.
Types of Speech Disorders
“There are many types of speech disorders.
Stuttering (Fluency Disorder, Dysfluency) - People who suffer from stuttering repeat syllables or words, extended utilization of a sound, and the discontinuation of speech.
Apraxia - People who suffer from Apraxia know what they want to communicate but they can not say the words.
Aphasia - People who suffer from Aphasia have lost their ability to speak, understand, or write languages.
Dysarthria - This condition is an organic speech sound disorder that involves difficulty expressing certain noises. This may involve slurring, or poor pronunciation, and rhythm differences related to nerve or brain disorders.
Lisping - The condition of lisping is the replacing of sounds in words, including “th” for “s.” Lisping is a functional speech impediment.
Hyponasality - This condition is a resonance disorder related to limited sound coming through the nose, causing a “stopped up” quality to speech.
Cul-de-sac resonance- This speech disorder is the result of blockage in the mouth, throat, or nose that results in quiet or muffled speech.
Orofacial myofunctional disorders - These conditions involve abnormal patterns of mouth and face movement. Conditions include tongue thrusting (fronting), where individuals push out their tongue while eating or talking.
Spasmodic Dysphonia - This condition is a voice disorder in which spasms in the vocal cords produce speech that is hoarse, strained, or jittery.
Other voice disorders - These conditions can include having a voice that sounds breathy, hoarse, or scratchy. Some disorders deal with vocal folds closing when they should open (paradoxical vocal fold movement) or the presence of polyps or nodules in the vocal folds (Speech Impediment Guide: Definition, Causes & Resources, 2021).”
Symptoms of Speech Disorders
People who have a speech disorder may exhibit the following symptoms.
blinking repeatedly when speaking
pause frequently when speaking
display twitchy movements when speaking
repeating sounds
adding extra sounds and words
extending words
alter sounds when speaking
appear frustrated when attempting to speak (Kahn, 2019).
Language Disorders
A language disorder is different from a speech disorder. Children with language disorders have trouble understanding and speaking language (Language Disorders in Children, n.d.). A student in my math resource room class has a communication disorder; moreover, he struggles with stating the steps for solving a problem even when the steps are explained verbally and written in sequential order. He also has trouble explaining his thinking when he solves a problem. He generally is able to learn new skills when I demonstrate my thinking out loud and provide him with a two-column graphic organizer; specifically, one column displays the steps of my work and the second column is where he shows his work.
Types of Language Disorders
There are three main types of language disorders.
Expressive Language Disorder
People who suffer from an Expressive Language Disorder struggle with conveying a message when they talk. They have challenges with creating sentences that are comprehensible. If a child does not meet the following milestones, they may suffer from an expressive language disorder. Between ages 0 to 3 months, the child should be able to use sounds to convey pain and pleasure. By 6 months, children should be making babbling sounds and able to use sounds and gestures to communicate that they want something. The number of consonants a child uses when babbling should increase by 12 months; moreover, their babbling should include vowel sounds. By two years old, a child should be asking short questions (2 words) and their words should be more clear. Family members should be able to understand what a child is trying to communicate by 3 years old, and the child should be able to use one word to describe objects. By 4 years old, a child should be speaking in 4-word sentences and other people should be able to understand them. A five-year-old child should be speaking fluently and able to tell stories (Bowen, n.d.).
Receptive Language Disorder
People who suffer from a Receptive Language Disorder struggle with understanding a message that is being conveyed to them. If a child does not meet the following milestones, they may suffer from a receptive language disorder. Between 0 to 3 months old a baby should turn towards a person who is speaking. They should appear to recognize a familiar voice. They show understanding of the word no and different tones. Children should respond when called by name, listen when spoken to, and respond to requests by 1 year old. By 2 years old, children should follow simple two directions. A three-year-old child should be able to follow simple two-step directions. By 4 years old, a child should understand simple questions. A five-year-old child can answer simple questions about a story after being read to (Bowen, n.d.).
Mixed Receptive-Expressive Language Disorder
People who suffer from a Mixed Receptive-Expressive Language Disorder struggle with both conveying a message when they talk and understand a message that is being conveyed to them.
The Role of the Speech Pathologist
Speech-language pathologists (SLPs) evaluate, diagnose, and treat communication conditions and disorders. When an SLP evaluates a client, ASHA “ indicates that [a] comprehensive speech-language pathology assessment includes these components:
Case history, including medical status, education, socioeconomic, cultural, and linguistic backgrounds and information from teachers and other related service providers
Patient/client/student and family interview
Review of auditory, visual, motor, and cognitive status
Standardized and/or non-standardized measures of specific aspects of speech, spoken and non-spoken language, cognitive-communication, and swallowing function, including observations and analysis of work samples
Identification of potential for effective intervention strategies and compensations
Selection of standardized measures for speech, language, cognitive-communication, and/or swallowing assessment with consideration for documented ecological validity and cultural sensitivity
Follow-up services to monitor communication and swallowing status and ensure appropriate intervention and support for individuals with identified speech, language, cognitive-communication, and/or swallowing disorders (American Speech-Language-Hearing Association, n.d.-a).”
After an SLP has evaluated a client, they compare the client’s skills to a database of skills for a client of the same age. Based on the analysis, the SLP diagnoses a client. Once a student has been diagnosed as having a speech or language disorder, the SLP develops and begins a treatment plan for the student that may take place in the home, school, or outpatient environments. Treatments may include speech therapy, behavior therapy, stimulant medications, and /or environmental modifications (Treatment of Communication Disorders and Recommended Reading, n.d.).
The Teacher and the Speech Pathologist Working Together
As a teacher, there are many ways that I can work with the SLP to bridge the learning gaps for students who may have Speech and/or Language disorders.
When a student is being evaluated for a Speech and/or Language disorder, I can share my classroom observations of the student with the SLP. I can be sure to complete the observation surveys and forms in a timely manner. Once a student has been diagnosed with a Speech and/or Language disorder, I can work with the SLP to understand the student’s treatment plan and discuss opportunities to support the student in the classroom. Also, I can provide general supports in class for the students as well, such as using a graphic organizer like a Frayer Model when introducing new vocabulary. I can also ensure that I am giving clear directions in class and using appropriate gestures. I can also frequently check for understanding and teach students to ask to help when needed.
Sources:
American Speech-Language-Hearing Association. (n.d.-a). Assessment and Evaluation of Speech-
Language Disorders in Schools. American Speech-Language-Hearing Association (ASHA).
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American Speech-Language-Hearing Association. (n.d.-b). School Services, Interrupted: What Parents of
Students Receiving Speech and Language Treatment in Schools Should Know During COVID-19
Closures. American Speech-Language-Hearing Association (ASHA). Retrieved November 27, 2021,
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