How to Tell if a Speech Problem Is Serious


The best way to determine the true nature of your child’s speech delay is with the help of a speech language pathologist. They can run a number of tests to determine if your child has a basic speech delay that can be resolved easily or something more serious.


Diane Bahr, a speech language pathologist and author of Nobody Ever Told Me (or My Mother) That: Everything from Bottles and Breathing to Healthy Speech Development, says a common articulation test known as a phonological analysis will yield a lot of clues as to the true nature of the speech delay.


“If speech is mostly slurred and distorted-sounding, it may be a muscle function problem called childhood dysarthria,” she says. “I use a list of behavioral characteristics based on the speech language pathology literature to determine childhood apraxia of speech, known as a motor programming problem. Many children with serious speech problems have a combination of muscle function and motor programming difficulties.”


 

Resolving the More Serious Speech Delays


If your child has Down Syndrome or autism, there’s a good chance that he might be at risk for having a more serious speech problem as well. “Children with Down syndrome and other congenital disorders (affecting muscle tone in the body) will likely have childhood dysarthria and childhood apraxia of speech,” says Bahr. “Children with autism also tend to have childhood apraxia of speech.”


 

Pulling Away from Others


One reason speech loss is so upsetting is that it cuts you off from other people. Whether the loss is sudden or gradual, “friends tend to drift away,” says Dr. Simmons-Mackie. “You’re not able to do the things you used to do together, because you don’t have the communication to support it.” If your mobility is also impaired, that just adds to the challenge.


At the same time, you may have lost some of the roles that once gave your life meaning and purpose. Perhaps you’ve quit your job, given up a hobby, or turned over household chores to someone else because you can’t communicate well enough to do these things anymore. Such life changes can be stressful. They make a difficult situation even harder to handle.


 

When you do go out, you may be upset by the reactions you get. “People make all kinds of assumptions when you can’t talk,” Dr. Simmons-Mackie says. “They may think you have dementia or a mental illness.” Some people may treat you as if you’re a child or talk to others as if you aren’t there. Most of the time, this type of behavior is motivated by ignorance rather than meanness. But it still hurts—and it may make you feel even more like withdrawing into a shell.


 

The Latest Options in Speech Generating Devices


More than 2 million Americans are speech-impaired because of a severe communication disorder. Today, a growing number of these individuals have found their voice through speech generating devices (SGDs)—electronic devices that talk for them. Several recent advances in SGD technology have made the devices even more powerful and accessible. Here’s a quick look at some of the innovative new features that are available.


 

One Look Can Say It All


With SGDs, the machine may be doing the talking. But it’s the user who chooses what is said. Typically, this is done by typing on a keyboard, touching a screen, rolling a trackball, or tilting a joystick. But for users with very limited mobility, there are other options as well.


Eye tracking uses a sophisticated camera system to track the glint in a user’s eye. This allows the system to see where the person is looking on a screen. Then it directs a cursor to that location. After the user’s gaze has stayed on the same location for a set time—typically, somewhere between one-quarter-second and one second—the cursor clicks on that spot. In some systems, a blink can also activate a click. In this way, the user can select letters, words, or symbols to create a message.


Head tracking is similar. But rather than following the gaze of the eyes, a specialized camera tracks the movement of a small, disposable reflective dot that sticks to the user’s forehead or glasses. The user is then able to point and click a cursor with head movements. In essence, the “head dot” works like a wireless mouse.


The newest twist, which is called brain-computer interface (BCI), is still experimental and sounds like something straight out of a sci-fi novel. The user wears a cap with electrodes on it. These electrodes are attached to an EEG machine, which tracks electrical activity inside the brain. “The person looks at a screen that’s flashing letters very quickly. When the desired letter flashes, the person’s EEG changes,” says Melanie Fried-Oken, Ph.D., professor and director of the Assistive Technology Program at Oregon Health and Science University. This triggers the SGD to select that letter. Dr. Fried-Oken is one of the researchers studying this new technology. She says it shows great promise for helping those who can’t voluntarily move any part of the body, sometimes even the eyes.


 

Gadgets and Gizmos


“The newest wave in the area of SGDs is iPad apps,” says Dr. Beukelman. With speech generating applications for the popular tablet computer, the user touches letters, words, or symbols on the screen to select what to say. Such apps don’t offer all the whiz-bang features found on the most advanced traditional SGDs. But they may be an option for people with simpler communication needs and good finger dexterity.


A handy variation on the SGD theme is the ability to synch with other devices, such as a phone or intercom. Some SGDs can be outfitted with a wireless adapter that allows them to control a computer from several feet away.


In short, there are a growing number of innovative options to fit the varied needs of SGD users. Dr. Beukelman says, “For people who can’t meet their communication needs with their own speech, SGDs can open up a whole new world.”


Certain speech-language pathologists (SLPs) are trained to evaluate and recommend SGDs within the field of augmentative and alternative communication. If you think an SGD might be right for you, an SLP can help you sift through the options and find the best match for your needs.



 

8 Tips for Coping with a Loved One’s Loss of Speech

When a loved one loses the ability to speak, it’s a big loss for you as well. You may miss the heart-to-heart talks or the family discussions. Maybe you’ve quit work or given up a hobby to become a full-time caregiver. Regardless, it's stressful. Here are 8 tips for fostering better communication at home ›


Partners in Communication


Such feelings aren’t selfish; they’re normal and common. But that doesn’t mean you have to simply accept feeling this way. There are steps you can take to achieve better two-way communication. And that will help both you and your loved one feel less frustrated and stressed.


Your loved one’s speech-language pathologist may have specific suggestions for fostering better communication at home. In addition, these tips may help:

1.

Reduce distractions. Pick a quiet spot for your conversation. Minimize background noise by turning off music and the TV.

2.

Simplify the message. Use short, simple sentences, and emphasize key words. But don’t talk down to the person. Keep it adult.

3.

Speak slowly and clearly. Just don’t make the common mistake of speaking louder and louder, which won’t help at all.

4.

Listen patiently. Give the other person ample time to respond. When you’re out in public, resist the urge to jump in and speak for your loved one. If you must do so, show respect by asking permission first.

5.

Praise a good effort. Encourage any attempts at speech by the other person. Offer positive feedback, and avoid frequent corrections. In this situation, a solid effort counts far more than perfect execution.

6.

Paraphrase often. This gives you a chance to model correct speech without nagging or criticizing. For instance, if the person says, “He isn’t live there,” you might say, “That’s right. He doesn’t live there.”

7.

Be open-minded. Speech isn’t the only valid way of communicating. Accept other forms of communication, such as writing, drawing, gesturing, pictures—whatever helps the other person get a message across.

8.

Create a new normal. If your family enjoyed lively dinner conversations in the past, for example, keep that up. Don’t leave out the person with a communication problem. Instead, make an extra effort to involve him or her. For a better transition, share these tips with other family members.

Problem/Issue


A loved one can’t tell you that he or she is hungry


You and your loved one substitute another skill that he or she already knows for speaking, such as writing in a spiral notebook.



Your loved one has severe speech limitations


Your family learns to communicate using aids, such as:

• A communication board with words or pictures for “bathroom” or “water”

• A simple electronic device with recorded voice messages, such as a talking photo album

• A high-tech speech generating device or computer software to talk with family members

• Simple hand gestures



Your loved one wants to stay involved in social groups


Your loved one stays engaged, but moves from being a leader to being a participant. Your family starts making scrapbooks or remnant books to use in social groups so you have common topics and language in front of you.



Family members get frustrated during communication


Speech pathologists teach relatives to accept all communication attempts and support new methods of communication.

Experts estimate that as many as 25% of all children with autism may never develop verbal language skills.


.. 



 

 

Why Compensating for Lost Speech Isn’t “Giving Up”

 

If your loved one has a speech impairment, your family may struggle with this question: If we “allow” him or her to communicate using gestures, books, or devices, does that mean there’s no hope that he or she will speak normally?


It’s a tough question that challenges families every day. After a loved one’s stroke, for example, family members may be wary of these methods—often called compensatory strategies—and hope that their loved one will improve with therapy alone. And that’s normal—we want to focus on our loved one’s recovery. For many of us, recovery means helping loved ones regain or improve their natural speech. But there are other strategies that shouldn’t be ignored, including some that can help your loved one “compensate” for impaired speech.


Compensatory strategies focus on ways to work around temporary or permanent speech limitations. Perhaps most important, they allow people with impaired speech to remain socially connected with their loved ones. For example, communicating through writing, gesturing, or a speech generating device might help them feel less frustrated and more involved in their care.


In addition, using alternative strategies like picture books or boards helps people with speech problems practice communicating, which may motivate them during their recovery. For example, many people with traumatic brain injuries (TBIs) eventually regain some of their speech, but it can be a slow process. Using a compensatory method, such as a speech generating device, during their recovery can enhance the development of speech and language.


.

How Compensatory and Restorative Strategies Work Together


The goal of traditional restorative strategies is to correct the impairment. Such approaches might include organized retraining exercises that target specific aspects of speech, for example, learning to regain control of vocal and breathing systems that affect speech. Or they might focus on regaining swallowing control, if that is affected. The goal of these exercises is to restore or “cure” the speech problem.


However, recovering lost speech can take a long time. For some people, a solution that blends therapy to recover lost speech skills with compensatory strategies works best. For example, combining speech recovery and compensatory methods can help people with the brain disorder aphasia have more meaningful conversations with others. Often the compensatory strategy is one that we all use for communication already, but now must be relied on more often and in different situations. For example, two friends in class might pass notes to one another so they don’t disturb the teacher. Passing pre-written notes is a great compensatory strategy for someone with aphasia to use while he or she regains natural speech.


Support Your Loved One


Learning new ways to communicate can be stressful for you and your loved one. If your family member is adjusting to a compensatory strategy, here’s how to show your support:

•

Keep up an eager and confident attitude toward his or her recovery.

•

If your loved one is starting to use a communication board, tell the therapist about your loved one’s hobbies and preferences. That way, the board might include pictures or symbols he or she can “point to” to request favorite shows or foods.

•

Make time for your whole family to learn how to use the compensatory method.



 

jamie, Thank you for following and posting on the forum..Teresa