The chapter describes the possibilities of involving a speech-language therapist in the assessment of the pragmatic level of communication in autism spectrum disorders (ASD), where one of the most frequently impaired areas is communication pragmatics. These difficulties lead to a disruption of social interaction, which might be one of the obstacles to speech-language intervention in these children. The text is based on an originally developed testing material aimed at selected pragmatic-oriented communication situations relating to everyday activities and real life. Based on a comparison of domestic and international resources in this area, as well as mediated and own empirical experience, our assessment approach is based on the conclusion that pragmatics can be understood in different contexts and perspectives. The text presents the results of a partial survey comparing the performance of children with ASD and children with typical development. The assessment focused on the children's election of the correct picture of a pair of pictures that represent usual communication and social situations. The results of the research suggest fewer incorrect responses in children with ASD and in different areas compared with children with typical development. However, the results of a qualitative analysis indicate a necessity to expand the assessment of communication pragmatics by adding an individually specific qualitative analysis of children's performance.
Comprehensive studies on aspects related to the assessment of different biomedical parameters (acoustic and laryngeal signs and oral airflow amplitude), as well as parameters for speech disorders, articulation rate, speech inconsistency, and speech stimulability, are essential for better professional practice and to understand misarticulations in children with speech sound disorders (SSDs). Different equipments that enable noninvasive collection and analysis of data have become more common in speech-language pathology practice. Studies recently conducted by our research group have emphasized the evaluation of auditory-perceptual processing by means of assessments of central auditory processing, electrophysiology of hearing—considering that pure-tone, speech audiometry, and tympanometry are routinely used with children during the diagnostic phase and motor speech production performed by acoustic analysis of speech, electroglottography, aerodynamic measures, and ultrasound tongue imaging. This chapter presents the recent advances observed in studies with Brazilian-Portuguese speakers aiming to improve the assessment of speech sound disorders and to understand better the relationship between the different processing mechanisms involved in speech.
The question about the possibility of identifying the best therapeutic approach for children with autism spectrum disorder (ASD) has also been discussed in the literature. The intervention should be individualized, in order to involve the current level of development of the child and to identify the profile of the facilities and difficulties of each child. The families are constantly involved in complex and changeable context and are aware of the importance of access and participation to the treatment chosen, since that service delays can directly affect efficacy. In general, studies on language acquisition and development in autism focus on the child’s communication, and some analyze the mother seeking to understand how the role of parents and caregivers influences the communication of the children with autism. Observing the importance of the active inclusion of parents in the speech and language therapy of children with ASD, a Distance Speech Therapy Intervention project, was developed that would allow language stimulation of a greater number of children and adolescents with autism.
This chapter reviews the main aspects of dysphagia in children: epidemiology, etiology, physiopathology, bedside assessment, and instrumental assessment in the perspective of planning treatment. More details will be given on the endoscopic assessment in children of different ages in consideration of the information useful in planning treatment. This chapter offers a review of the literature on the topic and a simple diagram of the main aspects of the management of dysphagia in children. This chapter aims to offer a simple and useful guide for students and professionals working in the field and suggestions for the implementation of clinical steps in daily practice when and where managing children with swallowing disorders is a reality.
Aphasia is a condition that may appear when parts of the brain (Broca's or Wernicke's area) responsible for language production and processing are damaged. In most cases, patients have the left side of their brain affected. Thus, formulaic language remains intact in most cases. During speech therapy, this can be a solid base to build on. Formulaic language consists of formulas that are fixed phrases, stereotypes that behave as a single-unit lexical item. They have a significant role in language acquisition and fluent discourse production. These ready-made parts of speech are stored in the long-term memory. Studies suggest that the processing of formulaic language engages right hemisphere areas of the brain. Due to their language impairment, people with aphasia often have a lower quality of life, consequently social and professional integration for them being problematic. The investigation of preserved patterns, such as formulaic language and impairments related to different aspects of discourse, may provide insights both for clinical practice and for cognitive science, therefore, facilitating a more efficient approach to treatment.
In Russia, there are many decades of experience in the scientific study of the problem of impaired language development in children. Today, the term "Systemic speech-and-language underdevelopment (SLU)" has firmly established in Russian science and practice, implying a complex developmental disorder of speech and language in children with a primary normal hearing and a conserved intellect, in which the main components of the language system are violated: vocabulary, grammar, phonetics, and, as a consequence, dialogic and monologic speech. Traditionally, a differentiated level-by-level analysis of the speech and language abilities of children is used. The variability of the manifestations and severity of speech-and-language disorders were initially systematized and characterized in four levels of underdevelopment: from the complete absence of phrase speech to the availability of simple and complex sentences with lexico-grammatical errors. Effective algorithms of speech therapist work with SLU are introduced. The effectiveness of the application of these models and algorithms on the material of various language groups is proved.
Autism Spectrum Disorders (ASDs) constitute a group of disorders characterized by changes present at early ages and manifesting in the areas of development of communication, behavior, and interpersonal relationship. Because ASD significantly affects communication and the social skills, all multicultural context needs to be better investigated. There is an urgent need to understand the impact of migratory process, bilingual environment exposure on the language development of children with ASD. The present study aims to present the results of 657 foreign residents in Brazil that answered an online questionnaire to know the consolidated information about ASD. Participants from 23 countries responded to the survey. Bolivia and Argentina were the countries with the highest number of participants. The present study found that 100% of the participants have heard of autism. About 80.6% of the sample had a family member with autism. The sociodemographic diversity identified in this study reflects the sociocultural diversity present in Brazil, besides reinforcing the importance of considering this population when thinking about strategies and behaviors directed at individuals with ASD.
Subarachnoid hemorrhages (SAHs) are grave medical emergencies, whereas 30–50% of all SAHs may ultimately result in death. Subarachnoid hemorrhages share many resemblances with other neurological traumas such as a cerebral vascular accident, meningitis, and/or traumatic brain injury. Autoimmune encephalopathies (AE) occur when human antibodies assault the body's cell surfaces and/or synaptic proteins. Consequently, widespread nervous system and diffuse brain involvement may occur. With subarachnoid hemorrhages and autoimmune encephalopathies, multiple areas of cognition and language can be impaired. Case studies in communication sciences and disorders are underutilized, yet are important in evidenced‐based practice. Speech‐language pathologists in medical settings have worked with patients and families with similar types of disorders. Therefore, speech‐language pathologists should be well equipped to provide therapy with these types of injuries. This chapter presents two case studies and cognitive language rehabilitation strategies following diffuse brain injuries.
Phonological development in some children does not follow the typical trajectory. This may affect their communication processes. The primary aim of this chapter is to characterize the phonological development of Spanish‐speaking children with phonological problems. The characterization is based on the Theory of Natural Phonology, which poses that children with phonological problems produce phonologically simplified words resulting from the application of strategies known as phonological simplification processes. Phonological development implies the progressive elimination of these strategies. It has been observed that children with phonological problems produce phonologically simplified words until advanced age. This chapter focuses on studies involving Chilean children with phonological problems, in an attempt to characterize their phonological performance. Overall, the point can be made that Chilean children with phonological problems have a trajectory of phonological development of their own, with phonological simplification processes equally affecting syllable structure and word structure. Also, these processes tend to consistently decrease with age at a steady rate. Once 5 years of age, however, processes tend to become more persistent and decrease becomes slower. They are also prone to have problems both with the phonological representation of words and lexical comprehension. Finally, they seem to be challenged by phonological awareness and grammar.
Risk factors are understood to encompass "aspects of individual behavior or lifestyle, environmental exposure, hereditary or congenital characteristics that are associated with a health related condition". These are conditions that increase the chances of the child presenting speech-language disorders and that can be avoided, controlled, or treated. Risk is defined as the chance of a child exposed to certain factors (environmental or biological) to acquire or develop speech-language disorders. The objectives of the present study were: to identify the risk factors for speech-language disorders in children up to five years of age and to verify the relationship between risk factors and speech-language diagnostic hypotheses. The aspects of being male gender, prematurity, shyness, being an only child or youngest child, presenting deleterious oral habits, having a family history of speech-language disorders, and use of licit or illicit drugs during pregnancy seem to be the factors that should draw the attention of the health professionals in child development. Therefore, the monitoring of children who have these risk factors should be performed in order to promote the necessary stimulation and the construction of healthy environments.
The present study aimed at exploring the responses of listeners in conversational speech between parents and toddlers. Children’s responses toward parents and parents’ responses toward children were the focus of this study. Participants included five dyads each of typically developing two‐year‐old toddlers and their parents from Japanese‐ and English‐speaking families. Responses of a mother/father toward a child or a child toward a mother/father were classified into three categories: non‐lexical backchannels (e.g., hoo, nn, hai), phrasal backchannels (e.g., hontoo “really,” soo desu ka “is that right?”), and repetition. The results showed that the average ratio of overall backchannels and repetitions produced by parents was quite similar in both languages and was much greater than that produced by children in both languages. Among Japanese‐speaking parents, non‐lexical backchannels and repetitions were preferred to phrasal backchannels, while among English‐speaking parents non‐lexical backchannels were most frequently used. With Japanese‐speaking parents, almost half of the repetitions were exact repetitions. They frequently repeated what a child had said and added the sentence‐final particle “ne” or content words. These findings are expected to be useful in understanding response behaviors in spoken communication between parents and their children.
Subtypes of speech sound disorders (SSDs) with a sensorimotor origin are known as motor speech disorders (MSDs). The symptoms can be diverse, and the causes of the disorders in children are in many cases unknown. Examples of MSD are childhood apraxia of speech and dysarthria. MSD is often seen in neurodevelopmental disorders such as cerebral palsy, developmental coordination disorder (DCD) or autism spectrum disorders (ASD), or it is seen with no obvious diagnosis but usually with comorbid problems. Within all existing comorbidity dysfunctions, the motor and sensory systems are of interest for identifying possible underlying mechanisms of MSD. Namely, soft neurological signs such as hypotonia, decreased speed and low accuracy of motor skills and delayed motor development are given consideration by many researchers for better understanding of underlying motor mechanisms of MSD. Results from comorbidity studies highlight the relationship of MSD with complex sensorimotor tasks and sequential motor tasks. In this chapter, our aim is to frame findings from studies about comorbidity of sensory and motor dysfunctions in MSD in order to theorise affected mechanisms and propose an underlying global motor deficit. We will conclude with implications for therapy models.
Discourse is essential for interaction and for the expression of ideas, feelings and opinions. Telling personal stories, such as talking about your day or recounting what happened in the playground, is essential for communication and establishing rela- tionships. However, due to their language impairments, people with aphasia (PWA) and children with developmental language disorder (DLD) often have problems with everyday discourse which impact on their lives more widely. While improvement in language skills is supported by speech-language pathology (therapy), it tends to focus on smaller linguistic components, such as single words and sentences. This chapter outlines how speakers construct discourse in everyday situations and focuses on the meanings that people use discourse to convey, as well as the lexical and grammatical resources they use to convey these meanings. Current methods for discourse analysis will be outlined and key developments in narrative discourse production therapy will be reviewed. is some consensus beginning to arise from the evidence base on essential targets for intervention and effective methods for improving discourse, and overall discourse is a promising area for speech-language pathology and therapy.
This chapter describes a creative method for treating children with selective mutism. It is a case study of a 5 year, 8 month old child who has been silent since the first day of school for 2.5 years. No one, for 2.5 years, has ever heard him speak. He used to stare at his classmates as they played but did not participate. His mother described his language as normal and behavior as quiet. When the researcher first saw him he was wearing a “Superman” costume. The researcher used the child’s ambition to be superman as a platform to think creatively to treat his deficiency. He spoke in 1 hour and 30 minutes. The single session treatment successfully treated the child and he was observed afterwards for 2 months, no relapses, and he continued speaking. To maintain the success, the teacher and the student-teacher were advised to use the “descriptive language approach.” He was observed regularly.
Speech-language pathologists have been actively involved with the assessment and intervention processes of language disorders, especially concerning the child population. Regarding their professional role toward reading disorders, other professionals have been equally involved with the learning process such as educational psychologists, educators, for instance. It is therefore less clear of the involvement and possible role of speech-language pathologists, focused on adolescent and young adults with reading difficulties that may interfere with the learning processes. The aim of this chapter is to discuss the competences of speech-language pathologists and their essential role in the clinical settings with reading disorders, not only with children but also at later stages in the schooling process. Additionally, it will be discussed of the role of these professionals as a part of the school team in order to advice best practices of language-related learning processes, as well as to work with students who need special education adaptations, in all ages.
27 pre-school (26 native Czech-speaking and 1 native Russian-speaking) children (age 4; 6–7; 9 and gender 18 m; 9 f); 17 children with speech and language disorders from speech and language kindergarten (SLK) and 10 children with typical language development (TLD) from a kindergarten of common type, received two tests of language comprehension, the Token Test (TT) and the subtest from the Heidelberg Language Development Test (H-S-E-T) called The Sentence Comprehension Test (SCT). The results of the TT (success rate of children with TLD was 77%; children from SLK scored 70%) surpassed the results of the SCT (children with TLD 59%; children from SLK 44%) in both groups. The most severe deficiencies have been observed in children with SLI and a boy with severe bilateral sensorineural hearing loss. The observed differences between the means in both groups (TLD, N = 10; SLD, N = 17) were not statistically significant, using Student's t-test (TT, p = 0.28; SCT, p = 0.11). There were not statistically significant differences between the means in children from three compared groups (TLD, N = 10; SLI, N = 8; articulation disorders, N = 6), using the ANOVA (TT, p = 0.60; SCT, p = 0.23).
Several methods have been proposed for the perceptual evaluation of voice quality, but the GRBAS and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scales are the most widely used and recommended as part of standardised voice evaluation protocols. In this study, cross-cultural adaptation and translation of the GRBAS (the first translation from the original Japanese version) and CAPE-V scales to European Portuguese were carried out following international guidelines. Results from a study of the intra- and inter-rater reliability of the perceptual evaluation of voices with the GRBAS and CAPE-V scales, before and after a training programme, designed according to the most recent American Speech-Language-Hearing Association and Japan Society of Logopedics and Phoniatrics guidelines, are also reported.
The acquisition and development of language are primary in a child's life, especially because language is one of the main means of social interaction. Therefore, it is of great importance that good language development has been assured to children and, when necessary, good intervention at their difficulties. Currently, in the field of children's language in Brazil, different therapeutic approaches are arguable, but the necessity of development of structured therapeutic programs is verified, elaborated with technical and scientific quality so that they may stimulate the different abilities of language, aiming at considering the specificities of each child in order to minimize the difficulties. Such intervention programs would guide speech-language pathologists to plan their therapies and provide more effects in the intervention process. The aim of this study is to elaborate a stimulation program for verbal language for children with language delay. For this reason, the stimulation program was judged by peers (experts) after it was designed. The experts verified if the strategies were coherent about (a) the stimulation target and (b) the complexity level. In conclusion, the program reached the goal, since it could give direction and enhance to speech-language pathologists in cases of difficulties in verbal language.
Introduction Parkinson’s disease (PD) can influence the function of respiration, pho‐ nation and articulation, quality of speech, swallowing, salivation, and graphomotor skills. Aim and methodology: This chapter is based on research of the degree of impairments of speech, phonation, salivation, swallowing, and handwriting in 64 patients with PD. The results of maximal phonation time (MPT) were compared with two control groups of healthy young (N = 35) and healthy elderly (N = 35) subjects. The degree of impairment of these functions was measured by the Unified Parkinson Disease Rating Scale (UPDRS) subtests. Results and discussion: In the group with PD, speech impairments of various degrees were present in 82.81% of patients. The problem of salivation control of different degrees was present in 68.75% of the sample. Swallowing difficulty of different degrees was present in 53.15% of the sample. Difficulty writing of various degrees had 84.38% of the sample. The average MPT in group with PD was 11.61 s, 21.39 s in the group of healthy young, and 20.52 in the group of healthy elderly subjects. Conclusion: Patients with PD on subtests UPDRS had various degrees of damages to the functions. Patients with PD had significantly shorter MPT than the control group.
Research about speech sound disorders (SSD) in children with Down syndrome (DS) and children with specific language impairment (SLI) suggests similar linguistic profiles with weakness in phonology skills. The question is if these similarities are superficial or share deficits in levels and underlying skills to its speech disorders: phonological memory (PM), coordination motor skills, and articulatory muscular system. Our research involved 24 children divided into four groups: SLI, DS, and two groups of typical development. SLI group presented a mild‐moderate speech disorder and DS group moderate‐severe. Following skills were evaluated: nonverbal intelligence, PM, and oral motor coordination (oral‐DDK). The Iowa Oral Performance Instrument (IOPI) was used for the measurement of physiological variables (strength and endurance of tongue and lips). Percentage of consonants correct (PCC) was found. Phonological memory, motor coordination, and physiological variables are factors associated with SSD in teenagers with DS. However, SSD in children with SLI only are associated to phonological memory. Motor coordination and physiological variables are not involved in their SSD of mild and moderate‐severe levels. We have objectively measured the strength and endurance of tongue and lips. This may have clinical implications. It is necessary to assess objectively all the variables affecting articulatory accuracy to design intervention programs in SSD.
