Disorders
Below you will find a brief list of the disorders we treat, as well as critical information about each. To learn more about these disorders and the therapy used to treat them, contact us today!
Apraxia
Apraxia of speech (AOS) is an acquired oral motor speech disorder affecting an individual's ability to translate conscious speech plans into motor plans, which results in limited and difficult speech ability. Apraxia can affect volitional (willful or purposeful) movement patterns, however it usually also affects automatic speech.Individuals with AOS have difficulty connecting speech messages from the brain to the mouth. AOS is a loss of prior speech ability resulting from a brain injury such as a stroke or progressive illness.
Developmental verbal dyspraxia (DVD), also known as childhood apraxia of speech (CAS) and developmental apraxia of speech (DAS); is an inability to utilize motor planning to perform movements necessary for speech during a child's language learning process. Although the causes differ between AOS and DVD, the main characteristics and treatments are similar.
Articulation
Articluation Disorders can cause children to do one or more of the following problems:
- delete sounds
- substitute sounds
- add sounds
- distort sounds
Individual sounds are typically developed by a certain age. If a sound isn't developed by the expected age, the child could have an articulation disorder.
Speech Development Chart
| By Age: | Children should be able to say the following sounds: | ||||||
| 3 yrs | h | w | m | n | b | p | f |
| 4 yrs | d | t | k | g | y | ng | |
| 6 yrs | l | v | sh | ch | j | ||
| At this age a child may still have errors on the r, s , z and th sounds, but they should be developing. | |||||||
| 8-9 yrs | A child should be able to say ALL sounds correctly including: | ||||||
| r | s | z | th (thin) | TH (that) | |||
Adapted from:
¹Pena-Brooks, Adriana, & Hegde, M.N. (2000). Assessment and treatment of articulation and
phonological disorders in children. Austin, TX, U.S.A.: PRO-ED, Inc.
Cleft Palate
Cleft palate is a condition in which the two plates of the skull that form the hard palate on the 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. Palate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate). When cleft palate occurs, the uvula is usually split. The hole in the roof of the mouth caused by a cleft connects the mouth directly to the nasal cavity.
The following images show the roof of the mouth. The top shows the nose, the lips are colored pink. For clarity the images depict a toothless infant.
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Incomplete cleft palate
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Unilateral complete lip and palate
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Bilateral complete lip and palate
A result of an open connection between the oral cavity and nasal cavity is called velopharyngeal inadequacy (VPI). Because of the gap, air leaks into the nasal cavity resulting in a hypernasal voice resonance and nasal emissions while talking. Secondary effects of VPI include speech articulation errors and compensatory misarticulations and mispronunciations.
Language Disorders
Language disorders or language impairments are disorders that involve the processing of linguistic information. Problems that may be experienced can involve grammar, meanings, or other aspects of language. These problems may be receptive (involving impaired language comprehension), expressive (involving language production), or a combination of both. Language disorders can affect both spoken and written language, and can also affect sign language.
Phonological Processes
Phonological disorders occur when a child uses incorrect speech patterns by making errors on sound patterns or sound blends. This chart shows the typical devolopment of phonological processes.
TYPICAL PHONOLOGICAL PROCESS DEVELOPMENT CHART
| Substitution Processes - when one class of sounds is replaced for another class of sounds. | |||
| Phonological Process |
What is Happening? | Examples | Gone by Age |
| Stopping (Stop) |
When a child substitutes a stop (b, p, d, t, g, k) for a fricative (s, z, f, v, th's, h, sh,and zh as in measure) |
/pat/ for fat | 3 yrs. |
| /pine/ for vine | 3 1/2 yrs. | ||
| /tear/ for chair | 4 1/2 yrs. | ||
| /dob/ for job | 4 1/2 yrs. | ||
| /take/ for shake | 4 1/2 yrs. | ||
| /tope/ for soap | 3 yrs. | ||
| /pum/ for thumb | 5 yrs. | ||
| Deaffrication | When a child replaces an affricate (ch, dz as in judge) with a stop (b, p, d, t, g, k) or a fricative (s, z, f, v,th's, h, sh, and zh as in measure) |
/tear/ for chair | Not Available |
| /sop/ for chop | |||
| /karm/ for charm | |||
| /dob/ for job | |||
| /dim/ for gym | |||
| /zan/ for Jan | |||
| Velar Fronting (VF) |
When a child replaces a velar sound (k, g, ng) with a sound that is made toward the front of the mouth. Fronting usually happens more often in the beginning of words compared to the end |
/top/ for cop | 3 1/2 yrs. |
| /reen/ for ring | 3 1/2 yrs. | ||
| /tup/ for cup | 3 1/2 yrs. | ||
| /doh/ for go | 3 1/2 yrs. | ||
| /tum/ for gum | 3 1/2 yrs. | ||
| Depalatalization (Dep) |
When a child substitutes an alveolar fricative (s, z) for a palatal fricative (sh, and zh as in measure) |
/tek/ for check | Not Available |
| /matsiz/ for matches | |||
| /dudz/ for judge | |||
| /dane/ for Jane | |||
| Backing *This occurs in children with severe phonological disorders. |
When a child substitutes a front sound (t, d) with a back sound (k, g) |
/kop/ for top | Not Available |
| /hope/ for soap | |||
| /gime/ for dime | |||
| /bike/ for bite | |||
| Liquid Gliding (LG) | When a child substitutes a glide sound (w, y) for a liquid sound (r, l) |
/wabbit/ for rabbit | 5 yrs. |
| /wook/ for look | |||
| /wing/ for ring | 5 yrs. | ||
| /yeef/ for leaf | |||
| This can also occur in consonant clusters |
/bwed/ for bread | 5 yrs. | |
| /gween/ for green | 5 yrs. | ||
| /bwack/ for black | |||
| /gwas/ for glass | |||
| Vocalization (Voc) |
This is also known as vowelization and happens when a child substitutes a vowel for a syllabic liquid | /simpo/ for simple | Not Available |
| /abuh/ for able | |||
| /tabo/ for table | |||
| /papo/ for paper | |||
| Syllable Structure Processes - sound changes that modify the syllabic structure of words. | |||
| Phonological Process |
What is Happening? | Examples | Gone by Age |
| Unstressed Syllable Deletion (USD) | When a child doesn't say the syllable with the least amount of stress | /medo/ for tomato | 4 yrs. |
| /tefon/ for telephone | 4 yrs. | ||
| /efant/ for elephant | 4 yrs. | ||
| /nana/ for banana | 4 yrs. | ||
| /side/ for outside | 4 yrs. | ||
| Reduplication (Redup) | When a child repeats a syllable of a target word which creates a multi-syllabic word form. Reduplication can be Total or Partial |
Total | |
| /baba/ for bottle | 2 1/2 yrs. | ||
| /dada/ for dog | 2 1/2 yrs. | ||
| /tata/ for television | 2 1/2 yrs. | ||
| Partial | |||
| /bada/ for bottle | 2 1/2 yrs. | ||
| /dadi/ for dog | 2 1/2 yrs. | ||
| /tatu/ for television | 2 1/2 yrs. | ||
| Dimunization (Dim) |
When a child adds an "-ee" and sometimes a consonant + "-ee" to a target word. | /cup-ee/ for cup | Not Available |
| /book-ee/ for book | |||
| /doll-ee/ for doll | |||
| Epenthesis | When a child says an unstressed vowel usually "uh" between two consonants. | /suh-poon/ for spoon | Not Available |
| /cup-uh/ for cup | |||
| /puh-late/ for plate | |||
| Final-Consonant Deletion (FCD) | When a child leaves a single consonant or consonant cluster off of the end of a word. This can happen on words that end with a vowel (open-syllable word) or on words that end in consonants (closed-syllable word) |
Open | |
| /ma/ for mom | 3 yrs. 3 mos. | ||
| /da/ for dog | 3 yrs. 3 mos. | ||
| /wag-ih/ for wagon | 3 yrs. 3 mos. | ||
| Closed | |||
| /boo/ for books | 3 yrs. 3 mos. | ||
| /ha/ for hand | 3 yrs. 3 mos. | ||
| Initial Consonant Deletion (ICD) *This is more uncommon but can occur in children with severe phonological disorders. |
When a child does not say the first single consonant or consonant cluster at the beginning of a word. |
/own/ for phone | Not Available |
| /ah-zit/ for closet | |||
| /oo/ for shoe | |||
| /indo/ for window | |||
| /op/ for stop | |||
| Cluster Reduction/ Deletion (CR) or Cluster Substitution |
When a child deletes or substitutes some or all parts of a cluster. Cluster deletion can be Total or Partial |
Total | All Cluster Reduction and Substitution should be gone by 3 1/2 yrs. |
| /op/ for stop | |||
| /eight/ for straight | |||
| /da/ for dark | |||
| Partial | |||
| Cluster Substitution | /top/ for stop | ||
| /bwed/ for bread | /tate/ for straight | ||
| /pwace/ for place | /dak/ for dark | ||
| Assimilation Processes - one sound changes to become more like another sound, usually its neighboring sound. | |||
| Phonological Process |
What is Happening? | Examples | Gone by Age |
| Labial Assimilation | When a sound is changed to a labial sound (b, p, m, w) because of another labial sound in a word. Labial Assimilation can be Total or Partial |
/wap/ for wax | Not Available |
| /peb/ for pen | |||
| /mob/ for moss | |||
| Total | |||
| /bub/ for bug | |||
| Partial | |||
| /bup/ for bug | |||
| Velar Assimilation | When a non-velar sound is changed to a velar (k, g, ng) sound. Velar Assimilation can be Total or Partial |
/kug/ for cup | Not Available |
| /keek/ for keep | |||
| /goag/ for goat | |||
| Total | |||
| /kuck/ for cup | |||
| Partial | |||
| /kug/ for cup | |||
| Nasal Assimilation | When a non-nasal sound is changed to a nasal (m, n, ng) because of the influence of another nasal sound in
the word. Nasal Assimilation can be Total or Partial |
/mom/ for mop | Not Available |
| /nong/ for long | |||
| /non/ for nose | |||
| Total | |||
| /mom/ for mop | |||
| Partial | |||
| /mon/ for mop | |||
| Alveolar Assimilation | When a non-alveolar sound is changed to an alveolar sound (t, d, n, l, s, z) | /tot/ for toss | Not Available |
| /suit/ for soup | |||
| /dod/ for door | |||
| Total | |||
| /tot/ for top | |||
| Partial | |||
| /tod/ for top | |||
| Prevocalic Voicing | When a voiceless sound that comes before a vowel is changed to a voiced sound. | /den/ for ten | Not Available |
| /zuit/ for suit | |||
| /vight/ for fight | |||
| /bie/ for pie | |||
| Postvocalic Devoicing | When a voiced stop, fricative, or affricate, that follows a vowel is changed to a voiceless sound (devoiced) | /pick/ for pig | Not Available |
| /tuck/ for tug | |||
| /sat/ for sad | |||
| /bis/ for bees | |||
Adapted from:
Pena-Brooks, Adriana, & Hegde, M.N. (2000). Assessment and treatment of articulation
Dyslexia
Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities.
For more information about dyslexia, visit the International Dyslexia Association at www.interdys.org
Stuttering
Stuttering is a type of disorder in which the speech flow is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases. It can also involve silent pauses or blocks in which the person is unable to produce certain sounds. The term stuttering is most commonly associated with involuntary sound repetition, but it also involves hesitation or pausing before speech. "Stuttering" covers a wide range of severity, from barely perceptible impediments to severe symptoms that can prevent communication.
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