1. Speech or language impairment: difficulties with speech or language; trouble
pronouncing words or making sounds with the voice; hard to understand words or
express themselves.
a. Speech Disorders: impairment of the articulation of speech sounds, fluency,
and/or voice
i. Apraxia: motor skills, hard say sounds and words due to a disconnect in
brain communication. “Verbal dyspraxia” or “developmental apraxia” but
children do not outgrow it.
 Don’t say words the same every time
 Stress on wrong syllable
 Distorts/changes sound
 Difficulty with fine motor skills
 Delayed language development
 Problems reading/writing
 Classroom challenges: understanding written directions, difficulty
asking/answering questions and communicating
 Accommodations,
a. supports, and interventions to support the student’s
academic, social, and/or behavioral success in the
classroom.
b. Make movements with sounds, practice
c. Transition supports - transitioning into or out of high
school.
ii. Dysarthria: face and mouth muscle weakness.
● Slur or mumble
● Slow or fast speech
● Speech too soft, robotic, or choppy
● Not moving tongue, lips, or jaw well
● Changes in voice sound
● Causes: stroke, Brian injury, tumors, muscle diseases
● Tips for listeners
○ Quiet area, pay attention, watch gestures, ask to repeat
● Classroom challenges
● Accommodations
○ SLP: Slowing speech, using more breath to make louder,
strengthen muscles
● Transitions:
iii. Orofacial Myofunction Disorders (OMD): abnormal movement pattern
of face and mouth
 Interferes with normal face and mouth growth and development
 Problems eating, talking, breathing
 Tongue thrusting
 Breathless, difficulty breathing, breath with nose
 Limited tongue movement
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Messy eating
Over/under bit
Tongue pushing past teeth
Difficulty says “s” and “j” sounds
Drooling
Difficulty closing lips to swallow
Treatments
a. Dentist, orthodontist, oral surgeon
b. Change how chow or swallow
c. Paying close attention to mouth movements
 Classroom challenges
 Accommodations:
 Transitions:
iv. Speech sound disorders: trouble saying sounds clearly, “articulating
disorder” or “phonological disorder”
 Not learn all sounds by age 4 (z, v, th)
 Starts as children, in adults after brain injury
 May sub one sound for another (w for r, w wabbit)
 Leave out or add or change sound (nana, banana)
 Causes
a. Brain message delay (apraxia)
b. Muscle weakness (dysarthria)
c. Developmental disorder or genetic disorders
d. Brain damage or healing loss
v. Stuttering: getting stuck on certain sounds or words
 Disfluencies (adding sounds like uh, um)
a. May have more or different disfluencies
 Repetitions-repeat word, phrase
 Prolongations-stretching a sound
 Blocks-not finishing a thought, pauses, stops in speech
 Changing a word
 Tension or negative feeling about talking, hide stuttering, availed
words or situations
 Can change daily with stress or excitement
 Behaviors: head nodding, eye blinking, frustration
vi. Voice disorders (short or long term)
 Chronic cough
 Paradoxical vocal fold movement (PVFM): hard to breath and talk
 Spasmodic dysphonia: long term vocal folds (inside larynx/voice
box) harder time vibrating, vocal folds spasm or tighten
a. Sounds jerky, shake your, hoarse
 Vocal fold nodules & polyps: growths in vocal folds that make
vibration sound different
a. Force voice wrong way the fold swell, swollen spots
become hard a callus
b. Scratchy, hoarse voice
 Vocal fold paralysis: one or both folds are not able to move
a. Breathing or swallowing issues
b. Language disorders: impaired comprehension and/or use of spoken, written,
symbol systems
i. Preschool language disorders: occur in age 3-5, problems following
direction or understanding questions, learning new words or saying
sentences
 Receptive language: understanding gestures, following directions,
answering questions, pointing
 Expressive language: have trouble asking questions, naming
objects, using gestures, put words together into sentences,
learning songs and pronouns, covering, talking differently to
different people
 Trouble reading and writing
 Holding a book right, turning pages
 Telling a story
 Naming letters and numbers, learning alphabet
 Cause:
a. Family
b. Born early or underweight
c. Hearing
d. Autism
e. Developmental and genetic disorders
f. Fetal alcohol syndrome
g. Stroke or brain injury
h. Nutrition
 Tips:
a. Talk to, read to, point, listen and answer, get in ask
questions, give time to answer, limit screen time
ii. Learning disabilities: problems reading, writing, spelling
 Early speech and language issues can lead to LD
 Brain disorder
 Same signs as PLD
 Trouble remembering details
 Telling left from right
 Order of numbers and letters
 Memorizing
 Telling time and doing math
iii. Selective mutism: more than just shy or not talking around new people
until comfortable. Will NOT talk at certain times, no matter what
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Speaking at home but not school
Last longer than 1 month
Can speak the language but wont
Does not have a speech or language problem that would cause it
Causes: anxiety, fear, shy, want to be alone
Treatment
a. Stimulus fading: slowing adding a new person while talking
to
b. Shaping: praise and reward
c. Self-modeling technique: watching videos of themselves
talking in a comfortable situation, gain confidence
2. Medical and developmental conditions
Medical and Developmental Conditions
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3.
Attention Deficit/Hyperactivity Disorder
Autism (Autism Spectrum Disorders)
Cleft Lip and Palate
Right Hemisphere Brain Injury
Traumatic Brain Injury