Speech disorders include speech motor disorders and fluency disorders (stuttering and poluttering).
Speech motor disorders can also be subdivided into
- Dysarthria
- dyslalia
- Dysglossia
Dysarthria
Dysarthria is a collective term for acquired motor speech disorders. This disorder is caused by damage to the cranial nerves or the central nervous system. This damage means that those affected have difficulty making the movements they need to make when speaking.
Depending on the type of neurological damage, the following forms of dysarthria can be described:
- Hypo- and hypertonic dysarthria: Result from too low or too high muscle tension. In hypotonic dysarthria, those affected speak indistinctly and tire quickly when speaking. Spasmodic sounds are uttered indistinctly and with a rough, pressed voice.
- Hypokinetic dysarthria: Affected persons speak indistinctly and monotonously. The facial muscles appear immobile and the volume fluctuates significantly. In some cases, there are involuntary muscle movements or noises (grimacing, clicking sounds).
- Ataxic dysarthria: Speech is characterized by a strongly fluctuating volume and pitch. Articulation is uncoordinated and changes frequently during speech.
- Mixed dysarthria: Exhibit characteristics of several forms of dysarthria.
- Anarthria: Is the most severe form, in which those affected are unable to speak extensively or completely.
The dyslalia
Dyslalia (articulation disorder), on the other hand, refers to an impairment of pronunciation in which those affected are unable to form certain sounds. Organic changes are usually responsible for this.
The causes are varied and include
- Congenital malformations (cleft lip and palate)
- Damage to central or peripheral nerves
- Hearing impairment
- Tooth loss
- Lack of perception in the oral cavity
- Psychological factors
Dysglossia
Dysglossia involves pronunciation disorders associated with the lips, tongue, jaw, palate, teeth and vocal folds.
The fluency disorder
With fluency disorders, there is no problem with articulation. Instead, those affected have difficulty speaking fluently. Fluency disorders are particularly annoying for conversation partners.
It is characterized by:
- Frequent pauses in speech and repetitions
- Stuttering, stammering (speaking too quickly)
- Logophobia (fear of speaking)
- Bradylalia (delayed speech with pauses and drawn-out syllables)
- Mutism (silence without an organic cause, psychological).
Children with speech disorders have problems with their speech motor skills @ YURII MASLAK /AdobeStock
In addition to congenital factors or injuries to the lip, tongue, etc., speech disorders are usually caused by neurological conditions:
- Certain brain diseases of unknown cause
- Consequences of trauma
- stroke
- Inflammation of the brain or meninges (encephalitis, meningitis).
- Brain tumor
- Huntington's disease
- Parkinson's disease
- Multiple sclerosis
- Amyotrophic lateral sclerosis
- To determine the cause of a speech disorder, the doctor first conducts a detailed medical history interview.
- This is followed by a neurological examination.
- If appropriate, additional neuropsychological test procedures are used: if brain damage is suspected, imaging procedures such as EEG (electroencephalography), CT (computer tomography) or MRI (magnetic resonance imaging) provide additional information.
- If there is a suspicion of inflammation of the brain or the meninges, cerebrospinal fluid diagnostics may be considered. This involves the doctor taking fluid from the spinal cord, which experts then examine in the laboratory.
People with speech disorders are often under psychological strain, as the speech disorder has a negative impact on work and everyday life.
It is difficult for those affected to make social contacts. Everyday activities such as visits to the doctor or telephone calls are a challenge. They are reluctant to seek professional help out of shame or fear of negative reactions.
However, the earlier therapy is started, the better the chances of successful treatment.
Medication, surgery and speech therapy are available for the treatment of speech disorders. In most cases, they lead to a significant improvement in the ability to speak.
Treatment depends on the type of disorder, the damage and the individual needs of the patient:
- In the case of a specific cause, the doctor focuses on eliminating the cause and treating the underlying disease. Both medical and surgical procedures are used.
- However, most patients benefit from speech therapy (speech therapy). This teaches them the perception of body tension, breathing, voice formation and articulation. Speech and voice exercises as well as training of the laryngeal muscles round off the therapeutic program.
- If psychological factors are the cause of speech disorders, these can be treated with a combination of psychotherapy and speech therapy.
In order to improve communication skills, those affected can make use of certain aids. These include mechanical or electronic communication aids that enable correct pronunciation or better intelligibility. Examples of aids include soft palate prostheses, electronic amplifiers or portable electronic typewriters.
The first point of contact for people with speech disorders is a neurology specialist.
The course and prognosis for people with speech disorders depend on several factors:
- Mild speech disorders that doctors treat early on can often be completely remedied.
- In the case of underlying illnesses and nerve damage, the focus is on maintaining the ability to communicate. If necessary, with technical support.
A speech disorder is either a speech motor disorder or a speech flow disorder. Early diagnosis is helpful in order to find a suitable therapy. Contact persons are specialists in neurology.
