Welcome to this blog! All posts are made by the students of the University of South Carolina taking an Introduction to Speech-Language Pathology class. Our aim is to provide information and/or share personal experience in dealing with speech, language, hearing and swallowing disorders. We hope you find the information helpful!
Laryngeal cancer
(by K.)
The American Speech-Language-Hearing Association has labeled these following risk factors that may increase your risk of laryngeal cancer: heavy smoking and drinking, poor eating habits – not enough vitamins from fruits and vegetables, weakened immune system, exposure to chemicals and certain substances such as wood dust, paint fumes, or soot, and acid reflux.
Symptoms
The signs for detecting laryngeal cancer are ambiguous to the general public. The ASHA has provided a list of signs (listed below) to consider so that laryngeal cancer does not get overlooked by those at risk. Therefore, if any of these signs persist, that individual should seek help from a licensed physician in order to accurately diagnose the condition and get it properly treated.
• hoarseness or change in his or her voice
• difficulty swallowing
• a lump in the throat
• bad cough or chest infection
• shortness of breath
• bad breath (halitosis)
• weight loss
• prolonged earache
Laryngectomy
As a result of laryngeal cancer, the removal of the larynx is sometimes necessary in treating a patient. The patient will no longer be able to produce voice once the larynx has been removed. The Speech-Language Pathologist will work with the patient before and after the procedure to assess the patient’s condition in order to properly rehabilitate him/her. To communicate after the larynx has been removed, the patient can use a pen and paper for written language, alternative and/or augmentative communication devices to express themselves, or a combination of these.
Fortunately, the patient is not hindered from ever producing sounds or speech again once the voice box has been removed. This alternative form of communication is known as alaryngeal speech. SLPs primarily focus on teaching the patient how to produce alternative speech sounds through various means after the procedure. Three options for learning how to communicate following a laryngectomy include esophageal speech, artificial larynx, or tracheoesophageal puncture (TEP).
Quality of life in dysphagia
(by Jillian Tyler)
Dysphagia is defined as problems with swallowing or difficulty with swallowing. It is considered unsafe swallowing because it involves increased risk of penetration (food entering larynx) or aspiration (food entering the lungs).
Some patients with dysphagia report a lowered quality of life because their eating is affected. Eating is a social interaction that some of these patients can no longer enjoy. A 2013 study by Shim, “Factors associated with compliance with viscosity-modified diet among dysphagic patients” discusses the issue of compliance with diet and what factors are involved. They found that compliance with the special diet of food thickeners was correlated with in-patient and out-patient status. The in-patient participants were more likely to comply than their out-patient counterparts. The main reason for discontinued use of thickeners was complaints with texture, taste, greater difficulty in swallowing, and inconvenience of preparing meals. It is easy to tell that a modified diet is not preferred by most patients with dysphagia. Eating can have a huge impact on quality of life and there should be more research conducted in order to find a way to increase quality of life through a different type of modified diet.
References
Shim, J.S., Oh. B.M., & Han, T.R. (2013). Factors associated with compliance with viscosity-modified diet among dysphagic patients. Ann Rehabil Med, 37(5): 628-32.
Resources for individuals with non-fluent aphasia
(by C.)
A helpful site for general information, symptoms, causes, assessments, and treatment
Aphasia Alliance is a coalition of key organisations from all over the UK that work in the field of aphasia containing many helpful tips for caregivers and patients
A support group site offering chances to donate to research, share experiences, and discuss common issues
National Aphasia Association. Site for news and events, programs, advocacy, and shopping
Traumatic brain injury
(by Casey Hamilton)
Traumatic Brain Injury is neurological damage to the brain resulting from the impact of external forces. Some examples of external forces that could cause this type of disorder are car accidents, sports, falls, or violence. Typically, sports like football and hockey are well-known to be associated with this disorder.
Statistics and risk factors
The prevalence of TBI is larger than most people would think. As the leading cause of death and disability among children and young adults in the US, TBI is a serious and preventable disorder. Each year, 1.5 million people are diagnosed with TBI in the US and it is responsible for 50,000 deaths. Proper use of seat belts and sports equipment are just a couple ways to diminish the risk of TBI in individuals. Furthermore, there are some risk factors that people should be aware of. These include the fact that men are more likely to suffer from TBI than women as well as people of low socioeconomic status are likely to suffer from TBI more than those of higher status. Age and occupation are other risk factors that are associated with TBI. Infants, adolescents, and the elderly are of the highest risk to develop TBI. Those with dangerous occupations such as marines who are exposed to bombs blasting and other possible dangers are also at a higher risk than the normal person who works at a desk. These are all factors to keep in mind when referring to TBI.
Symptoms
The symptoms associated with this disorder are ranging from mild to more severe. In cases of mild TBI (often referred to as concussions), symptoms of dizziness, not being able to think clearly, or having trouble thinking and remembering can occur. Multiple cases of mild TBI may have long-term impacts on an individual’s health. In cases of more severe TBI, there are both non-language and language symptoms. Examples of some non-language symptoms would be problems with consciousness, strength, balance and cognitive deficits like problems with memory, attention, motivation, and emotions. The language symptoms of TBI include aphasia, which is an acquired language disorder that involves the rules of language rather than the articulation of speech, deficits in the form and content of language, expressive deficits such as excessive speech, short utterances, impaired pragmatics, reduced cohesion and coherence, and difficulty initiating and maintaining flow of conversation. In addition, the receptive deficits associated with the language symptoms of TBI include difficulty understanding others’ intentions and implied meanings, difficulty understanding humor or sarcasm, and difficulty understanding abstract language. All of these symptoms may appear with the presence of traumatic brain injury.
References
Barwood, C. S., & Murdoch, B. E. (2013). Unravelling the influence of mild traumatic brain injury (MTBI) on cognitive-linguistic processing: A comparative group analysis. Brain Injury, 27(6), 671-676. doi:10.3109/02699052.2013.775500
Apraxia of Speech video review
(by Ashlie B. Ouzts)
This Youtube video is about a family who is affected by apraxia of speech from one of its family members. The start of the video involves a speech pathologist who gives some statistics and information of the disorder. Later in the video, we find out that Noah, who is a young child, has been diagnosed with Apraxia of Speech. His parents talk about their journey of having a child who has a speech disorder and the steps that took as a family to determine their child’s speech disorder.
Here is the link: http://youtu.be/raGf1WsR8x4 (Youtube: Apraxia: One Family’s Journey-www.OAFCCD.com)
Diagnosing Language Disorders in Speakers of African American English
(by F.)
A language disorder can range from total absence of speech to a minor variance in syntax; meaningful language may be produced, but with limited content, that is, reduced vocabulary, restricted verbal formulations, omissions of articles, prepositions, tense and plural markers, or a paucity of modifiers (Stewart, 2005). Because of this, many clinicians that are unfamiliar with features of African American English Dialect (AAE) are more likely to diagnose its speakers with disorders because of misinterpreting the differences from SAE for deficits. In addition to lack of awareness on the part of the cilinician, most tests are designed to use Standard American English and are tested with middle class, mostly white children who are speakers of Standard English (Bryen, 1976).
Studies show that children perform better on tests that take their dialect into account. Currently African American Dialect Speakers are disproportionately diagnosed with disorders and many are because of the lack of proper testing. If a child is to be properly diagnosed, he or she should be tested with a standard that is “free of linguistic barriers”.
Below you can find some examples of syntactic features, taken from (Horton, 2004), that are unique to AAE and can be confusing sometimes for non-speakers of AAE who might mistake them for a sign of language impairment:
Completive done
Marks a completed action or event, intensification
• I done forgot what you said already (AAE)
• I’ve already forgotten what you have said (SAE)
Invariant/habitual be
Signifies an event taking place over time
• She be at church on Tuesday evenings. (AAE)
• She always is at church on Tuesday evenings. (SAE)
Been
Event took place in the distant past
• I been known her. (AAE)
• I know her and have known her for a very long time. (SAE)
Zero copula/auxilary
Forms of is/are (including contractibles) do not appear in certain contexts
• She a nice teacher. (AAE)
• She is a nice teacher (SAE)
Third person singular
-s/-z forms used as an inflection on present tense verbs help to mark habitual action in SAE are not included in AAE verb phrases
He cook everyday. (AAE)
He cooks everyday. (SAE)
Etc.
According to American Speech-Language-Hearing Association, “a test that can be used with children who speak AAE, the Diagnostic Evaluation for Language Variation (DELV)” (Stewart 2005). It is the first test of its kind. The DELV scientifically based assessment of “complex aspects of children’s syntactic, semantic, phonologic, and pragmatic development. It is designed for children between the ages of 4 and 9 and is non-discriminatory to non-SAE users” (Stewart 2005).
References
Stewart, L. B. (2005, May 5). The ASHA Leader. Difference or Deficit in Speakers of African American English?. Retrieved April 22, 2014, from http://www.asha.org/Publications/leader/20
Horton-Ikard, R., & Miller, J. F. (2004). It is not just the poor kids: the use of AAE forms by African-American school-aged children from middle SES communities. Journal Of Communication Disorders, 37(6), 467-487.doi:10.1016/j.jcomdis.2004.02.001
Sensorineural hearing loss
(by B.)
Causes
Sensorineural hearing loss, also known as nerve-‐related hearing loss is caused by damage to or abnormality of the inner ear or auditory nerve. Damages and abnormalities can be caused by a variety of factors, such as head trauma, viral infection or genetic conditions (Hearing Loss Association of America). The inner ear consists of a fluid-‐filled cavity, including the vestibule, the semicircular canals and the cochlea, which contains hair cells that detect hearing signals and transmit input to the brain for processing through the auditory nerve. Damage to any of these structures disturbs the typical process of sound detection, causing hearing loss. Hearing loss is often typically incurred with aging.
Symptoms
According to the National Institute of Health, symptoms of sensorineural hearing loss, or general hearing loss, include:
• Overall decrease in sound intensity
• Decrease in acuity (clarity of hearing)
• Perceived sporadic increase in intensity, including resulting pain, also known as loudness recruitment
• Difficulty hearing in high-‐noise settings
• Tinnitus (ringing of the ears)
Sensorineural hearing loss may also be accompanied by secondary symptoms related to damage or abnormality of the vestibular system contained within the inner ear, which controls balance and spatial awareness. These symptoms include loss of balance, dizziness or vertigo.
Cochlear Implants
Cochlear implants are devices used to compensate for sensorineural hearing loss by directly stimulating the auditory nerve (American Speech-‐Language-‐Hearing Association). Cochlear implants consist of an external part, including a microphone, speech processor and transmitter used to collect and convey auditory signals, and an internal part, surgically inserted into the inner ear, including a receiver and electrodes which stimulate the auditory nerve. Cochlear implants are often recommended in healthy patients that suffer from severe hearing loss willing to work through rehabilitation and hearing therapy, and may not benefit from hearing aids. Studies indicate that cochlear implants are a more successful option when treatment begins early, particularly in prelingually deaf children, or those whom have not yet acquired language skills (Gomes Bittencourt, Giantomassi Della Torre, Ferreira Bento, Tsuji, de Brito, 2012). However, cochlear implants are not effective in all patients with sensorineural hearing loss.
References
American Speech -‐Language-‐Hearing Association. (2014). Cochlear implants. Retrieved from http://www.asha.org/public/hearing/Cochlear-‐Implant/
Gomes Bittencourt, A., Giantomassi Della Torre, A. A., Ferreira Bento, R., Tsuji, R. K., and de Brito, R. (2012). Prelingual deafness: Benefits from cochlear implant versus conventional hearing aids. DOI: 10.7162/S1809-‐ 97772012000300014
Hearing Loss Association of America (2014). Types, causes and treatment. Retrieved from http://www.hearingloss.org/content/types-‐causes-‐and-‐treatment
National Institute of Health (2014). Sensorineural deafness. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/003291.htm
University of California San Francisco (2014). Hearing loss diagnosis. Retrieved from http://www.ucsfhealth.org/conditions
Prognostic factors in aphasia
(by Brittany Freeman)
Prognostic factors of aphasia recovery may determine how well someone may overcome this disorder. Because aphasia occurs because of some type of brain injury, many of these factors are based off of the type of injury that caused the aphasia. These factors include where in the brain there is damage, the type and severity of the brain damage. One’s age may influence how well their language and speech improves after the injury, as well as how motivated they are to improve their communication skills. Motivation to get better as well as a more positive outlook highly increases the chances that they will be able to improve the fluent aphasia. Someone’s level of education may influence how well they overcome aphasia. Someone that is highly educated will improve more than someone who is not so educated. As with almost every treatable disorder, overall health and wellness of the individual before the aphasia occurred has a huge impact on their prognosis. A healthier person will be more likely to overcome aphasia than a person in poor health.
Types of aphasia
(by Michelle Velez-Martinez)
There are several types of aphasia which can be classified under two categories: fluent and non-fluent aphasia.
When an individual has fluent aphasia, he or she has difficulty understanding others. Their own speech is fluent, but what they are saying is not meaningful, or the content of what they are saying does not make sense. Fluent aphasia generally results from damage in the posterior brain of the language- dominant hemisphere.
When an individual has non-fluent aphasia, his or hers understanding is relatively spared, but they have difficulty producing fluent speech. Non-fluent aphasia generally results from damage in the anterior brain of the language- dominant hemisphere.
Types of Fluent Aphasia
1) Wernicke’s Aphasia
Wernicke’s aphasia arises from damage to the temporal lobe of the brain—more specifically near or around Wernicke’s area. Symptoms include:
- Difficulty understanding what others are saying
- Logorrhea, or talking excessively
- Neologisms, or using non- existing words
- Jargon, or putting together words that will end up with a sentence without meaning
- Paraphasias, or substituting words
2)Transcortical Sensory Aphasia
Transcortical Sensory aphasia arises from damage to the temporal/ parietal/ occipital lobes junction (or the area where these three brain lobes meet. Symptoms of this type of aphasia are very similar to that of Wernicke’s aphasia, but individuals with Transcortical Sensory aphasia tend to have relatively good repetition skills
3) Conduction Aphasia
Conduction aphasia arises from damage to the pathway between the speech production area and the speech perception area of the brain. Symptoms of this type of aphasia include a very noticeable difficulty with repetition and reading out loud.
4) Anomic Aphasia
Anomic aphasia is not specifically associated with damage to a certain brain area, but still arises from some type of damage to the brain. Symptoms of this aphasia include a noticeable difficulty with anomia, the inability to retrieve words or use the words one is thinking of.
Types of Non- Fluent Aphasia
1) Broca’s Aphasia
Broca’s aphasia arises from damage to the frontal lobe of the brain– more specifically near or around Broca’s Area. Symptoms include:
- Slow, hesitant, or labored speech
- Agrammatism or poor use of grammar / violating the rules of grammar.
- Wrong Word Order
2) Transcortical Motor Aphasia
Transcortical Motor aphasia arises from damage from the frontal lobe of the brain. Symptoms of this type of aphasia are very similar to symptoms of Broca’s aphasia, but individuals with Transcortical Motor aphasia tend to have relatively good repetition skills.
Individuals may also be diagnosed with Global Aphasia—this is when an individual exhibits deficits across all language attributes (speech fluency, grammar, etc.) The symptoms may be both expressive (such as those individuals with nonfluent aphasia) and receptive (like individuals with fluent aphasia). But most patients are non- verbal, meaning they do not physically talk).
Individuals may also be diagnosed with Primary Progressive aphasia. This is a relatively newly described disorder. In this type of aphasia, there is a progressive loss of language due to gradual degeneration of the front lobe or temporal lobe in the brain—meaning that the brain slowly deteriorates and the skills learned slowly go away with time. Symptoms for this type of aphasia are diverse. This disorder will typically arise with individuals around the age of 65 or older and there is poor prognosis for it. Treatment is provided to compensate for deficits by using alternative methods of communications.
Dyslexia and low self-esteem
(by M.)
Low self-esteem is also a common side effect of dyslexia, as mentioned above these children are often wrongly labelled as dumb and are not give the same opportunities as children without reading disabilities. A 2005 British study showed that children diagnosed with dyslexia have a quality known as “learned helplessness.” This term refers to lower motivation, passivity, decreased performance, and lack of engagement (Burden & Burdett, 2005). This indicates that in addition to any help the student receives from a reading specialist or speech-language pathologist, it is also important for them to receive encouragement and positive reinforcement from parties such as their parents, teachers, and peers.
Is a child with dyslexia doomed to a life of bad grades? Certainly not, with the right teaching approaches and outside help, a child with dyslexia can academically achieve anything. The International Dyslexia Association is a great resource for those with dyslexia or parents of children with dyslexia. The IDA website (http://www.interdys.org/) gives basic information on dyslexia, where help can be found, and some tips and tricks for improving reading skills.
References and Resources
Burdett, J., & Burden, R. (2005). Factors associated with successful learning in pupils with dyslexia: a motivational analysis. British Journal of Special Education, 32(2), 100-104.
The International Dyslexia Association: Promoting literacy through research, education and advocacy. http://www.interdys.org/
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