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After reading this article you will learn about the speech and language disabilities.
Aphasia:
The term ‘aphasia’ is a general term used to describe different kinds of language disabilities resulting from damage to the brain. Such a damage can result from internal sources like a tumor or hemorrhage or on the other hand from external injuries through accidents or a fall, or infections. ‘Aphasic’ patients show a variety of symptoms and there are considerable amount of individual variations in disabilities and the forms in which they occur.
In some cases, the symptoms relate to expression like, a difficulty in pronouncing words or retarded fluency or inaccuracy in expression. In such instances very often it has been found that there is no evidence to show that the movement and control systems have been affected, and only damage to the brain is evident. Some aphasics on the other hand show the opposite symptoms of over fluency.
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They are not able to control the speed of speech and make necessary pauses. Then, there are patients, who while being fluent normally find it difficult to utter a particular word or speech structure. This of course, is sometimes experienced by many of us… the word is at the ‘tip of the tongue’. But in normal cases, it is not a symptom of ‘aphasia’.
There are still others, who use a substitute word to the regular word. For example ‘rod’ for ‘stick’. In addition to the expressive symptoms, one also comes across patients with receptive problems. They are not able to understand or repeat certain words spoken to them.
However, they use the same word fluently on other occasions. There are variations in the pattern of the symptoms. Some patients show in general, expressive symptoms, occasionally also receptive symptoms, the latter being occasional and mild.
While it is generally agreed that aphasia is essentially related to brain injury or damage, still there is a controversy as to whether specific symptoms can exactly be correlated with specific localised damage. While, there is some evidence to show that there is specific localised damage related to a specific speech disability, equally so, one has enough evidence to question the validity of the claim of such localised relationships.
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Thus, Broca, a pioneer in the study of speech disorder claimed that damage to the particular area of the brain named after him, results in disabilities of expression. Wernicke another leading investigator concluded that damage to another area of the brain named after him, results in receptive disabilities. But there are other investigators who do not agree with this view.
Aphasic patients have also been classified into different categories. Thus, receptive aphasics have been classified into, name deafness, sentence deafness, etc. Claims have been made that these specific forms of receptive disabilities can be correlated with specifically localised brain damages. But some authorities argue that in all forms of aphasia, irrespective of the symptoms, there is a central language difficulty, which manifests itself in the forms of difficulty to formulate propositions.
In other words, according to them what underlies these disabilities is essentially a communication deficiency. They go to the extent of suggesting that aphasia is a kind of thought disorder, an inability to encode and decode thought from and into language symbols.
The brain damages underlying aphasia are generally irreparable. Aphasic symptoms in the initial phases are unstable. They keep on varying. The symptoms during the initial stages keep changing and become less severe and perhaps there is even an apparent recovery. But, beyond this point the symptoms stabilize and remedy is possible, but not very often.
One factor, which appears to make a difference, to the possibility of recovery of the patients seems to be the age of the onset of the disease. Lenneberg observed that if the damage occurs when the individual is less than four years old, there can be recovery without any permanent damage.
If the onset sets in between the age of seven and puberty, then the damage becomes permanent, but partial recovery may be possible. But, if the disability occurs later than puberty, there appears to be very little probability of recovery.
This explanation is based on the view that in the early years both the hemispheres of the brain have the capacity to develop language functions. But, as the individual grows, lateralization grows, the left hemisphere specialises in the language functions leaving the right hemisphere out of this. In view of this, in cases of adult aphasia the possibility of recovery is very little.
Some of the common forms of language impairment resulting from brain damage or brain injury under the category of aphasia are:
Audible aphasia: inability to understand spoken words,
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Expressive aphasia: inability to utter words,
Nominal aphasia: inability to recall names,
Formulating aphasia: inability to pronounce sentences,
Par-aphasia: inability to use correct words resulting in confused speech and
Alexia: loss of ability to read.
Hearing Disabilities and Speech Disabilities:
Acquisition of speech skills certainly depends on our hearing ability. The child in its early years depends on ‘heard language’ for acquiring language skills. It is a pity that while visual difficulties and motor difficulties are noticed early, hearing difficulties are not noticed that early.
We normally take hearing for granted. From the point of view of evolution, it has been shown that hearing is a more basic function than seeing and at the level of animals, hearing plays a more crucial role than seeing. But, at the human level, when a little child looks at a parent and smiles, we are excited, but a similar importance is not attached to hearing.
Hearing difficulties are often ignored and not noticed until one notices them manifested in speech difficulty or disability. Hearing difficulties can be grouped under two categories. One category arises from a sensory motor organ defect where the person is unable to receive the speech sound stimulus known as receptive.
The other category is called, conductive loss, where even if the sound stimuli are received, they are not properly conducted from stage report to the interpretation. It is unfortunate that not much attention has been paid to understand the role of hearing defects in the development of language behaviour.
Some Common Forms of Language Difficulties:
Some of the common forms of difficulties are listed below:
1. Stuttering,
2. Lisping,
3. Slurring and
4. Psychological Factors
Hitherto an attempt has been made to examine the role of injuries to the brain and defects in the hearing apparatus in the origin of speech and language difficulties. But, there are certain common forms of speech difficulties which are not associated with any defect or injury to the brain or hearing apparatus and no other organic or bodily defect is evident.
Some of these are:
1. Stuttering:
It is a speech disorder which involves a blocking or repetition of words, sometimes struggling with speech sounds. The term stuttering is synonymous with the older terms stammering, which is gradually going out of use.
The speaking behaviour of the stuttered may vary from mild difficulty with initial syllables of certain words an in “C-c-c come here’ or D-d-d-don’t do that’, to violent contortions or a momentary inability to utter any sound at all. Most stutterers can speak fluently, but under stressful conditions blocking occurs.
History points that some of the well-known figures, were stutters – Moses, Aristotle, Demosthenes, and Charles Lamb are a few from the list. Occasionally stuttering results from brain damage and physical impairment in the hearing mechanism. But, currently many investigators opine that stuttering arises from faulty learning.
Parents and teachers constantly correct the speech when the child is speaking or block the free flow of speech. This is likely to evoke anxiety about the ability to speak fluently and the child is likely to stutter more. Various forms of aversive conditioning techniques, desensitization, rhythm exercises, voice making and other behaviour modification techniques are employed in treating such disorders.
2. Lisping:
This consists of letter sound substitution, the most common form is the substitution of the ‘the for ‘s’ or ‘z’ as in “Thive Thankar” for “Shiv Shankar”. Other common forms are ‘la’ for “R”, like ‘Lamu’ for ‘Ramu’, ‘U’ for ‘R’ etc. Lisping is usually found among preschool children. Under normal circumstances they learn to’ overcome this by the time they reach the school going age. However, it is the physical deformity of jaw, teeth or lips, which leads to lisping.
3. Slurring:
Slurring or indistinctness of speech occurs due to inactivity of the lips, tongue or jaw. This may happen when we are frightened or become self-conscious due to the presence of others. This occurs in children, especially when they are excited or are in a haste to say everything that they want to say, and rush through words without pronouncing each of them clearly. Paralysis of the vocal organs or lack of development of the tongue sometimes causes it.
4. Psychological Factors:
While major language difficulties arise as a result of damage or injury to the brain or hearing apparatus or any other part of the body associated with speech, more recently it has been noticed that speech difficulties and problems can be caused by psychological factors like defective learning, anxiety, perceptual abnormality, etc. Thus, stuttering has often been found to be associated with a high degree of anxiety and psychological methods of treatment like counseling and behaviour modification have been employed successfully.
Schizophrenia:
Schizophrenia is regarded as the most complex of psychological disorders. Among the symptoms, a major symptom in schizophrenia is the disturbance of language. Schizophrenics show a number of features like retarded fluency, confusion, etc.
The schizophrenic speech often goes down to the level of child language like single word sentences. Words are combined and a number of ideas are telescoped into few words… ‘food give eat’; words also are coined like ‘eat go’ (I will go and eat or I will eat and go). The utterances are not clear.
Speech regresses to a childhood stage very often. Similarities between schizophrenic speech and primitive tribal languages are seen. Thus, we can see that even though there is no brain damage or any other physical injury, speech difficulties arise as part of general psychological disturbances.
In fact, some writers like Bateson et. al. have suggested that actually schizophrenia is a communication disorder. But this is a very restricted view of schizophrenia.