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Types of Speech & Language Problems:

Speech & Language problems in Kids

Early Milestones

Delay in onset of Speech and Language:

A child who has not said his / her first meaningful word by the age of 18 months is delayed in speech and language acquisition. Some children may have said their first words by 18 months but subsequently the development may not have kept pace. Language delay is also associated with hearing impairment, mental retardation, cerebral palsy, autism etc. See FAQ for more information.

Some times a child who has shown normal speech / language development may regress. Such a situation also warrants immediate attention of a speech language pathologist.


Stuttering / Stammering:

Dysfluencies in speech are usually noticeable in most children after the second birthday. But, when word repetition (car, car, car gone) sound prolongation (ca…..r) syllable repetitions (ca..ca..ca….r) and pauses make the child unable to convey what he wants, or if the child / parent are worried about the disfluencies, then it is necessary to consult a speech language pathologist. Treatment is best initiated at the earliest. See FAQ for more information on stuttering.


Misarticulation:

Different speech sounds are acquired at different stages of a child's speech development. Sounds such as /pa/, /tha/ are acquired earlier and sounds such as /sa/, /ra/ and /sk/ (as in school), /tr/ (as in tree) are acquired later. In some children only one or two sounds may be mispronounced whereas in others so many sounds may be mispronounced that the child's speech may be unintelligible. Even at 4 years of age if your child's speech is not easily understood by a stranger then it is best to get professional help. See FAQ for more information on Misarticulation.


Developmental Dyspraxia:

These children have difficulty producing speech on command (i.e., requiring conscious effort), and find it easier to produce frequently used utterances (i.e., "hi", "hello", "bye"). Excessive effort is used to produce the simplest of sounds.


Speech Problems of children with repaired cleft lip and palate:

These children have nasal voice and misarticulation of speech sounds. Early intervention will help improve the quality of their speech.


Voice problems:

Voice problems include complete absence of voice (aphonia), hoarseness, harshness, breathiness, high/low pitched voice, etc. Children who scream and talk excessively are prone to voice problems. See FAQ for more information on Voice problems.


Speech and Language problems of children with L.D:

Children who lag behind in academics despite normal intelligence may be having learning disabilities. Some of them may have additional speech / language problems also. These children benefit from remedial programs.


Dysphagia

Dysphagia, also known as swallowing disorder can be caused by abnormal functioning of nerves and muscles of the mouth, pharynx and upper esophageal sphincter and is seen in adult and pediatric population. Dysphagia can be manifested as a difficulty in starting to swallow or as food being stuck in the neck or throat. Dysphagia may be due to mechanical obstruction of food material either in the oral cavity, pharyngeal / esophageal area or entering into laryngeal area. It can also be due to psychogenic or neurogenic in nature.
Dysphagia is commonly seen in surgical management of head & neck and oral cancer, stroke, dysarthria, esophageal motility etc. In pediatric population, swallowing or feeding difficulty is seen in conditions such as cerebral palsy, mental retardation, Autism Spectrum Disorders and Developmental delay. Speech language pathologist is an important team member involved in the assessment and management of adult/pediatric Dysphagia.

Speech & Language - Early Milestones Chart

0-3 Months
  • Cries immediately after birth.
  • Cries as a reflex reaction to his / her needs.
  • Differentiation of cries (different cries for hunger, discomfort etc.) in the latter half of this period.
3- 6 Months
  • Grunts, gurgles and makes cooing sounds when comfortable.
  • Produces some vowels and consonants.
6 - 9 Months
  • Produces strings of sounds such as 'Baba', 'Dada'.
  • Uses voice increasingly
  • Participates in routine plays such as 'Pat-a-cake'
9 -12 Months
  • Comprehends simple commands like "give it to daddy" and questions such as "Where is so and so" (referring to a sibling or a frequent visitor)
  • Points to some body parts.
1 - 2 Years
  • A child normally says his first word around one year of age.
  • Uses speech like pattern interspersed with true words.
  • Has a vocabulary of 50 -100 words.
  • Uses two word phrases in the later stages of this period.

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Speech & Language problems in Adults are

Stuttering / Stammering

Stuttering is a developmental disorder with onset in early childhood. An adult who has not overcome his stuttering may continue to stutter in adulthood.

Occasionally, stuttering may also occur in an adult consequent to psychological stress or neurological insult. See FAQs for more information on stuttering.


Voice Problems

Refer to voice problems in children. Adults may exhibit similar voice problems as those seen in children. However certain voice problems are exclusive to adults. These include Puberphonia and Laryngectomy.

High-pitched voice in men, especially in young adults, is called Puberphonia. This condition can be altered by voice therapy, usually with dramatic improvement. Other voice problems can also be treated successfully.

Laryngectomy is a surgical procedure where a patient's voice-box has been removed due to cancer and as a result, the patient is rendered avocal.

People who use their voice professionally (Singers, Teachers, Politicians) are prone to voice problems. With good vocal hygiene these problems can be prevented or minimized. See FAQ for more details.


Aphasia

Aphasia is a loss or impairment in language consequent to stroke, head injury or other neurological causes. See FAQ for more information.


Dysarthria

Dysarthria is impairment of speech due to neurological causes. One or more aspects of speech such as articulation, voice, resonance, prosody, may be affected. Dysarthria may be seen in the following conditions, Parkinson's disease, Multiple sclerosis, etc.


Dementia

Dementia is impairment of cognitive functions including language, found in some elderly individuals. This condition is associated with pathological changes in the brain. See FAQ for more information.


Dysphagia

Dysphagia, also known as swallowing disorder can be caused by abnormal functioning of nerves and muscles of the mouth, pharynx and upper esophageal sphincter and is seen in adult and pediatric population. Dysphagia can be manifested as a difficulty in starting to swallow or as food being stuck in the neck or throat. Dysphagia may be due to mechanical obstruction of food material either in the oral cavity, pharyngeal / esophageal area or entering into laryngeal area. It can also be due to psychogenic or neurogenic in nature.
Dysphagia is commonly seen in surgical management of head & neck and oral cancer, stroke, dysarthria, esophageal motility etc. In pediatric population, swallowing or feeding difficulty is seen in conditions such as cerebral palsy, mental retardation, Autism Spectrum Disorders and Developmental delay. Speech language pathologist is an important team member involved in the assessment and management of adult/pediatric Dysphagia.

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Speech Language Pathology - Diagnostic Services

Speech-Language pathologists diagnose different speech and language disorders based on detailed case history, client performance on various tests, and inputs from Audiologists, Psychologists, ENT surgeons and Neurologists

Clinical personnel at Dr.SRCISH

  • Qualified and experienced multi disciplinary team comprising of

State of art equipment for objective evaluation of various parameters of Voice and Speech

Department of Speech Language Pathology is well-equipped to assess the following, in both children and adults:
  • Voice

    • Detailed assessments done of an individual's pitch, loudness and quality of voice
    • Variety of sophisticated software programs/ assessment tools used [i.e., Dr. Speech, VAGHMI , Speech Science Lab (SSL), Computerized Speech Lab (CSL)].
    • Dr.SRCISH is the first Speech and Hearing Institute in the country to use Endo-Stroboscope for routine voice assessments.
    • Additional services provided
    • Institute provides specialized services for
      • professional voice care
      • forensic voice analysis
  • Articulation & Phonology:

    • Articulation and phonological disorders commonly manifest as unclear speech and pronunciation problems
    • Assessments are done using articulation tests available in English and various Indian languages
  • Fluency

    The Institute provides detailed assessment of fluency disorders, more commonly known as "stammering"/ "stuttering"
    Note: Apart from these, clinical services are also provided for speech disorders such as

    • Dysarthria
    • Developmental Apraxia
  • Language

    Assessment and intervention are provided for language impairments associated with the following disorders

    • Hearing impairment
    • Mental Retardation
    • Attention Deficit Hyperactivity Disorder
    • Autism and Pervasive Developmental Disorders
    • Cerebral Palsy
    • Stroke & Traumatic Brain Injury (TBI)
    • Neurological Disorders

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Speech & Language Problems

Speech & Language Therapy

Treatment in the context of speech - language disorders does not mean medical treatment. It refers to rehabilitation, teaching, counseling or behavior modification.

The Institute with its experienced speech language pathologists and trainee students, who work under supervision, offers treatment for a variety of speech & language disorders. Highlights of the treatment are:

  • Treatment on systematic and scientific lines
  • Customized treatment to suit patients' specific needs
  • Involvement of significant others in the treatment process
  • Use of state of art equipment. Regular monitoring to assess efficacy of treatment
  • Additional facilities such as intervention by clinical psychologists and social worker
  • Assistance with academic and vocational placement
Treatment services are available for:
  • Speech dysfluencies: Aims to modify rate of speech, regulate breathing and reduce muscle tension. Over the last few decades, the Institute has successfully treated a large number of Persons With Stuttering (PWS)
  • Articulation & Phonological Disorders: Aims at improving intelligibility of individuals' speech. Institute has software programs for providing therapy for these disorders
  • Voice: Aims to reach the patients' optimal pitch, loudness and quality Language therapy: Aims to rehabilitate individuals with language impairments (such as, Specific Language Impairment (SLI), Aphasia, Pervasive Developmental Disorder (PDD), etc.), by adopting a multi-modal stimulation approach (i.e., auditory, visual, tactile)
Additional Features of Immitance Audiometers at the Institute:
  • Quick screen facility - screens infant's middle ear status in < 3 seconds. Multi frequency probe tone
  • Different parameters of acoustic admittance can be tested (conductance, susceptance) help in accurate diagnosis
  • Acoustic reflex measures - latency, amplitude, and decay of the reflex tested, is useful in differential diagnosis.

Different types of Treatment available

  • Demonstration Therapy - Treatment of short duration provided for outstation clients. Caregivers are trained to carry out treatment procedures at home
  • Home training programs given after Demonstration therapy
  • Intensive treatment during vacation for students
  • Intensive group treatment program for persons with stuttering

Specilaity Clinics

  • Dysphagia clinic: aims at improving the patient's swallowing using food consistency modification, postural changes and oro-motor exercises along with direct swallowing therapy
  • Maxillo-facial (Cleft Lip & Palate) clinic: Provides assessment and remedial services for patients with cleft lip and palate
  • Post-stroke clinic: A team of SLP, psychologist, physiotherapist, occupational therapist will provide comprehensive remedial services for patients with aphasia.

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