When you’re learning about something new, it’s easy to feel overwhelmed by the sheer amount of relevant information available. This informative article should help you focus on the central points.

Crouzon Syndrome is a condition that would require speech therapy. This is mainly because of the major features of the syndrome, which affect main physical components used for speech production, such as articulators.

Crouzon Syndrome

It is a result of premature closure of some cranial sutures and is also known as branchial arch syndrome as it specifically affects the first branchial arch where the maxilla and the mandible are developed. It is transmitted from generation to generation in an autosomal dominant manner.

How Often Does Crouzon Syndrome Occur?

As of year 2000, the demographics of Crouzon syndrome is that approximately one per twenty-five thousand live births have this condition. Crouzon syndrome also equally affects all kinds of ethnic groups.

Language Characteristics of Individuals with Crouzon Syndrome

The individual’s mental capacity dictates his/her ability to comprehend language. Unlike what some people think, not all individuals with Crouzon Syndrome have cognitive deficits. Usually, their mental capacity is in the normal range, which tells us that they are capable of acquiring language and using it as a means for communication.

These individuals have language skillswhich are at par with the skills of others of the same age. However, some still manifest significant mental developmental delay secondary to excessive intracranial pressure. In other cases, the presence of hearing problems contributes to the language acquisition difficulty.

Still in other cases, inappropriate breathing patterns make speaking difficult which in turn makes communication a tiring and an unpleasant experience.

Articulation Problems

Once you begin to move beyond basic background information, you begin to realize that there’s more to Speech Therapy than you may have first thought.

In some cases, an individual with Crouzon Syndrome may exhibit oral distortions of fricatives and affricatives especially sibilants and inconsistent distortions in productions of /r/ and /l/. Most of these errors are attributed to abnormal tongue placement as caused by the defective maxillomandibular relationship.

However, some individuals may display speech problems that are in no way related to their oral structures. Other speech manifestations are also characterized by denasalization of /m/, /n/. Problems in articulating bilabials and round vowels may also be present due to reduced skills in lip closure and lip rounding.

Voice Problems

Hypernasal speech is a common characteristic of individuals with Crouzon Syndrome. This is usually due to velopharyngeal insufficiency. Hyponasal speech may also present itself albeit less common. It is often due to nasal obstruction, which is surgically correctable.

These unusual resonance and speech patterns may either be a result of a small nose, high arched palate or the mandibular malocclusion. In terms of vocal quality, hoarseness may be present due to the development of vocal cord nodules in compensatory laryngeal activity.

Psychosocial-Emotional Problems

One psychosocial problem that individuals with Crouzon Syndrome face is the attractiveness vs. unattractiveness issue. Because of the prominent cranio-facial deformity these individual are often victims of bullying, teasing and social isolation.

The visual and hearing impairments often hinder the comfortable flow of communicative exchanges. They feel restricted and limited in their socializations, with a marked difficulty in socializing with the opposite sex. Some may even be treated as if they were less capable than their peers.

Most individuals with Crouzon Syndrome feel angry at society for demanding physical attractiveness. Although some of these issues may be generic, the people’s response varies. Some may become painfully shy and lose confidence.

And yet others may develop a rather strong character and work on proving to their community that they have worth and are just as good as everybody else.

Now might be a good time to write down the main points covered above. The act of putting it down on paper will help you remember what’s important about Speech Therapy.

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By Anders Eriksson, feel free to visit my latest venture: GVO to claim your $1 trial membership!

When most people think of Speech Therapy, what comes to mind is usually basic information that’s not particularly interesting or beneficial. But there’s a lot more to Speech Therapy than just the basics.

Autism is one condition that requires speech therapy treatment. However, autism is often misunderstood and thought of to be something that can be left untreated. However, that should not be how things work. Autism presents a lot of problems, but the intensity of these problems could be decreased if given the correct treatment.

In Relation To Autism: Vocabulary

A lot of terms are commonly heard in relation to autism, such as: classic autism, infantile autism, Pervasive Developmental Disorder (PDD), Atypical PDD, Autistic like, PDD-NOS, Asperger’s Syndrome and high functioning Autistic.

What Is It Exactly?

Basically, Autism is a neurological disorder. It is classified to be a Pervasive Developmental Disorder. The main characteristic of Autism is that it affects three major areas in relation to speech and language. This triad is the impairment of the child’s: social interaction, communication and imaginative play.

Pervasive Developmental Disorder is actually an umbrella term for Autistic Spectrum Disorders. With the use of the term ?pervasive’, it is emphasized that the disability’s range of deficits is beyond psychological development. On the other hand, the term ?developmental’ puts emphasis that the occurrence of the condition is during the child’s development rather than later in life.

Autism is actually only one condition under this umbrella. Other conditions include Rett’s Disorder, which is a neurodevelopmental disorder that begins to show its symptoms during early childhood or infancy.

Another is Childhood Disintegrative Disorder; it somewhat resembles Autism but the difference is the first two to four years of the child’s life is rather normal, then the symptoms start to show.

Asperger’s syndrome is also in this umbrella. It is sometimes called high functioning autism. Lastly, PDD-NOS or Pervasive Developmental Disordere?Not Otherwise Specified is also related to Autism. These are children that present symptoms similar to but don’t quite match the other conditions.

What Causes Autism?

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Even though a lot of research has been done, there is no identified single factor that causes Autism. Several factors are said to play a part in the occurrence of Autism. One of these is brain disorder. Recent studies show that there is a difference in the brains of people with Autism. Their cerebellum seems to be smaller than normal, and their limbic system is impaired.

Chemical imbalances are also said to play a part here. It was found that in some cases, symptoms came from food allergies, chemical deficiencies, hormonal imbalances or elevated brain chemical levels.

Heredity is also an important factor. A lot of genetic disorders have Autism as a symptom. An example would be the fragile-X syndrome. Other factors include pre-, peri-, post-natal trauma, brain damage complications and MMR immunization.

Whatever the cause may be, the child with Autism should be given the same structured training in able to stimulate his learning, language and social skills.

Diagnosis

For a child to be diagnosed of having Autism, he should first qualify for the Diagnostic Criteria for Autistic Disorders according to the DSM-IV.

Treatment: Therapy And Others

Due to the triad of Autism effects on the child, speech therapy becomes a vital part of Autism management. However, other members of the team are also needed such as pediatrician, pediatric neurologist, child psychiatrist, psychologist, occupational therapist, behavior therapist, and educators like schoolteachers or Special Education teachers.

Role Of Speech Therapist In Autism Rehabilitation

The Speech Therapist assesses hearing. He also evaluates whether the speech and language difficulties of the child is really due to Autism or another disorder. This can be taken from analyzing the child’s expressive language, receptive language, oral-motor functions, voice quality, articulation and fluency, auditory processing and pragmatic skills.

There’s no doubt that the topic of Speech Therapy can be fascinating. If you still have unanswered questions about Speech Therapy, you may find what you’re looking for in the next article.

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By Anders Eriksson, feel free to visit my latest venture: GVO to claim your $1 trial membership!

Before a child could undergo speech therapy with the diagnosis of Autism, he should pass a criteria of characteristics first that is given by the DSM-IV. So here are the criteria for a child to be diagnosed with such conditions.

Autistic Disorder Criteria: Social Interaction

First off, a child should have impairment in social interaction. This could be manifested by at least two of the following behaviors. First is a marked impairment with the use of different non-verbal behaviors like facial expression, eye-to-eye gaze, and body posture.

Second is the child’s failure to develop peer relationship that is appropriate for his developmental level. In this case the child may seem to have difficulty gaining friends, or even just relating to other children within his age.

The child may also have the lack of spontaneity to share his emotions and thoughts. He may not share enjoyment, achievements, or interests to other people. In this case, the child doesn’t usually bring or point to objects that interest him.

The lack of emotional reciprocity is also possible. No matter how hard you try to connect or show your emotions and feelings to the child, he wouldn’t care less.

Autistic Disorder Criteria: Communication

The child also has communication impairment. Having at least one of the following conditions manifests this.

First is having a delay, or even total lack of spoken language development or expressive language. In this case, the child doesn’t even try to use of compensatory strategies to communicate or other means of communication like gestures.

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For children that have adequate speech, the communication impairment is manifested by not being able to initiate or sustain a conversation with other people.

The child can also have stereotyped and repetitive use of language. This phenomenon is actually called idiosyncratic language, where what the child keeps on saying seems to me meaningless. He may keep on saying the word ?blue? for countless of times, even for the whole duration of the day.

He can also lack the ability to have varied, spontaneous make-believe play or social imitative play that is appropriate for his developmental level. Play is one of the notable things that differentiate a child with Autism with normal children. For an Autistic child, play does not exist. The main concern is that play is an important factor for language development since it is a prerequisite or co-requisite of inner language.

Autistic Disorder Criteria: Repetitive And Stereotype Behavior Patterns

An Autistic child also manifests repetitive behavior. This criteria is judged by having at least one of the following conditions.

The child may have an encompassing preoccupation with one or more restricted and stereotyped patterns of interests that may seem abnormal in respect to focus and intensity. For example the child can sit and look at the ceiling fan for the whole day, and doesn’t care what is happening in his environment, all that matters is the fan.

The child also has fetish with routines and rituals. If he passes by a certain way to school, it has to be the same way. If you use the main stairs going to his classroom, then taking a different route like the elevator would definitely agitate him, make him angry and have tantrums.

The child may also have repetitive behaviors or mannerisms. Hand flapping, finger twisting, and complex body movements are examples of these.

Lastly, he can also be preoccupied with object parts like buttons, screws and other small details.

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The field of speech and language therapy is somewhat a vague body of knowledge that only a few people understand. What most people don’t know is that there is a difference between speech therapy as a whole and language therapy. Although the term ?speech and language’ therapy is widely used, since speech and language problems coexist most of the time.

Differentiating Speech And Language Therapy

The truth of the matter is, that speech therapy and language therapy differ in some key areas. First off, they differ on the problems that they are targeting. The techniques and activities used during therapy are also different. Although there are times that these activities are done simultaneously, to target two problems at a time.

Speech Therapy

Speech therapy is done to treat speech problems. Such speech problems deal with how or the manner a person speaks. These speech problems are categorized into three general kinds. First, is voice or resonation disorders. Second, is articulation disorders. And, lastly, fluency disorders.

Voice disorders mainly deals on problems with the voice box or the larynx itself. These may be due to physiological malfunction, anatomical differences, fatigue, or neurological problems. Some voice disorders present problems in pitch, volume, and tone. The presence of breathy, raspy, nasal and weak voice is viable too.

Articulation disorders, on the other hand, deal with the manner a person speaks. The problem is rooted from the articulators themselves. Articulators are composed of the tongue, teeth, hard palate, soft palate, jaw, and cheeks. Articulation disorders may be due to weakness or physiological malfunction in any of the articulators, which results to distorted or incomprehensible speech.

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Fluency disorders would deal on problems regarding the fluency of the person. It may be the case that he talks too fast or too slow. Stuttering and Cluttering are two of the major fluency problems that speech therapists deal with.

Speech therapy activities would likely include different exercises to practice speaking. Since most of the time, weak muscles are present; the therapy proper would usually include activities that can help strengthen these muscles. Different compensatory strategies are also taught, so that the patient can compensate for lost speaking skills.

Language Therapy

Language therapy mainly deals with problems regarding your inner language, receptive language and expressive language. Cognition skills can be the main cause of language problems. Unlike speech disorders, that manifest physical differences, most language disorders are due to problems the brain’s language processing.

Receptive language problems mainly deals on difficulties understanding received language, like what other people are telling you and comprehending written data. Expressive language problems on the other hand are difficulties on expressing oneself. You may have a hard time knowing which words to use verbally or even through writing.

Language based problems are usually treated through mental exercises. Workbooks are often used to practice and develop language skills. For very young children, play therapy is used to develop inner language, so that the therapist could later on target improving receptive and expressive language, respectively.

In some cases, speech and language problems are both present. This is especially true for individuals that had traumatic brain injuries or accidents that had an effect on the brain. They may manifest physiological problems due to damaged nerves that result to articulation or voice problems.

The can also have language problems like aphasia, especially if their brain was hit on its language areas.

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If you’re seriously interested in knowing about Speech Therapy, you need to think beyond the basics. This informative article takes a closer look at things you need to know about Speech Therapy.

PROLAM-GM is an acronym for the various intervention and transfer strategies used in the management of stuttering. PROLAM, which stands for physiological adjustments, rate manipulation, operant controls, length and complexity of utterance, attitude changes, and monitoring, are the intervention strategies. GM, which stands for generalization and maintenance, are the transfer strategies.

Physiological Adjustments

Physiological adjustment strategies include tactics that manipulate bodily components known or thought to be involved in the production of stuttered speech. An example of this would be the attempt to use gentle contact between the articulators when talking.

The rationale behind this approach is that the physiological components necessary for the production of normal fluent speech are in some way used inappropriately when stuttering occurs. Therefore, the therapy tactics used will result in a ?readjustment? of the disordered component, or in use of compensatory behaviors and strategies.

Rate of Speech Manipulations

Use of a reduced speech rate to modify stuttering operates in the belief that: (a) reduction of rate results in simplification of the physiological speech processes, thus allowing easier synchronization or; (b) reduction in the rate of speech prevents the stutterer from anticipating feared stimuli that result in the production of the stuttering response.

The rate of the stutterer’s speech may be reduced by: prolongation, combining prolongation with continuous phonation, and using an instructional rate control method.

Operant Controls

Use of operant controls in the management of stuttering believes that if stuttering is an operant behavior (behaviors whose frequency or probability of occurrence are influenced by the consequences they generate), then its frequency will increase if it is reinforced, and its frequency of occurrence will decrease if it is punished.

Two of the most frequently used operant procedures for treating stuttering are positive reinforcement of fluency and punishment of stuttering.

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Length and Complexity of Utterance

Controlling the length and complexity of the stutterer’s utterance reduces stuttering and increases fluency. This technique is often used to increase fluent speech. Most of the approaches utilizing this technique combine manipulation of length and complexity of the client’s language with operant controls (punishment of stuttering and reinforcement of fluency).

Attitude

There are two components of stuttering namely: the feelings accompanying it and the speaking behaviors that are resulted from it. It is believed by some that to have a successful therapy, a balance of treating both factors should be done. That’s why attitude manipulation is done in some approaches while in other approaches it can be optional depending on the case of the client.

Monitoring

In the science of Speech Pathology, especially in the field of stuttering, there are a lot of meanings for the term ?monitoring’. Some say it’s a process in which the PWS becomes aware of what he is doing at the time he is doing it. Some say it is a specific form of consciousness where the act of speaking is raised from an automatic level to a purposeful level. Basically, it has three key components: self-awareness, deliberate control and self-feedback.

Generalization

The technical term for generalization is ?the occurrence of a relevant behavior under different nontraining conditions.? The term generalization is usually interchanged with ?transfer’ or ?carryover’.

Maintenance

Sometimes, when clients are able to achieve fluency, they think the fight is over. They forget to maintain their skills and in result they have a relapse with their stuttering. Maintenance refers to different after-treatment activities to help clients keep the skills they learned from therapy intact.

Some activities to help maintain skills are daily self-monitoring activities, regular clinic contacts, refresher programs and having self-help groups.

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There are different levels of play used in the assessment of children’s speech and language. These levels are used to measure children’s play skills. However, there are also play levels of social interaction that can give a general overview of the child’s play skills.

In general, there are six play levels of social interaction that children go through respectively. Each level becomes more complex than the previous one, and requires more communication and language skills than the other.

Unoccupied Play

The first level of play is unoccupied play. In this kind of play, the child may seem like he is simply sitting quietly in one corner but actually is finding simple things that he sees around him to be rather amusing. A typical adult may not notice that what the child is doing is already considered to be play, unless they observe meticulously.

The child may just be standing and fidgeting at times, but this could already be unoccupied play at work.

Onlooker Play

The second level is onlooker play. In this level, the child watches other children play but doesn’t engage in play himself. This is when children learn to observe others. Such play level can show a child’s attention and awareness skills.

Solitary Play

The third level is solitary play where the child plays by himself and doesn’t intend to play with anyone else. This level shows an outright manifestation that the child do have play skills, only that it is still at a level that no interaction is required.

A child can be at this level when he is already able to play functionally with an object, can play by himself up to fifteen minutes, and is able to follow simple play routines.

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Parallel Play

The fourth one is parallel play. This level characterizes children who play side by side but don’t communicate with each other. Neither do they share toys. It is said to serve as a transition from solitary play to group play and is at its peak around the age of four years.

A child is said to be in this stage when he is able to play alone, but the activity he is doing is similar with the play activity that other children beside him are engaging in. The child also doesn’t try to modify or influence the play of other children around him. Here, the child is playing ?beside’ rather than ?with’ the other kids in the area.

Associative Play

Next is the associative play. This is where the children still don’t play with each other but are already sharing the toys that they are playing with. This level shows the child’s awareness of other children, although there is no direct communication between them, other than the sharing of toys and the occasional asking of questions.

Their play session doesn’t involve role taking and has no organizational structure yet. The child still carries on the way he wants to play, regardless of what the other children around him are doing.

Cooperative Play

The last level is cooperative play. This is the final stage wherein the children are already playing together, sharing toys and communicating with each other.

This level usually happens at about the age of five or six, where children engage into group games and other highly structured play activities.

These levels can be utilized by the therapist as a guide when it comes to the interactions that he wishes to have with the child through play activities.

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By Anders Eriksson, feel free to visit my latest acquisition: Free Google Traffic System and make sure to visit my bonus site!

Current info about Speech Therapy is not always the easiest thing to locate. Fortunately, this report includes the latest Speech Therapy info available.

During the assessment of an individual with suspected fluency disorder, there are some things to remember to make the assessment more comprehensive and useful. Here are some of those critical points to take note of during assessment.

Benefits Of Obtaining Both Reading and Conversation Sample

It is more beneficial to obtain both reading and conversation sample from school children and adults because this would give more reliability and credibility to the samples taken.

Since stuttering varies in different situations, a reading and conversation sample would allow the clinician to see the behaviors of the person in two different tasks. A conversational speech sample is likely to have more variability, while a reading passage would likely have less variability.

Information To Assess Motivation

Through interview, a therapist can learn a lot from his client. In fact, insight about the client’s motivation could be seen by asking the following questions like ?What do you believe caused you to stutter??, ?Has you stuttering changed or caused you more problems recently?, ?Why did you come in for help at the present time??, ? Are there times or situations when you stutter more? Less? What are they??.

Benefits Of Continuing Evaluation

No individual could be understood in an hour or two; that’s why continuing of evaluation is recommended. The clinician might overlook an important element at times and some times a vital clue will not be present in the samples of behavior taken from the limited time of the evaluation period.

Note The Difference When Assessing Feelings and Attitudes

You can see that there’s practical value in learning more about Speech Therapy. Can you think of ways to apply what’s been covered so far?

Assessing a school-age child’s feelings and attitudes would require the clinician to establish rapport and to get to know the child much better after some time, because the clinician’s judgment is also a fair measurement in the case of school-age children.

Talking to the child and observing his behaviors would be necessary. When the clinician has known the child much better, he could administer the A-19 Scale to the child. Other methods could also be used such as ?Worry Ladder? and ?Hands Down? that could be found in the workbook, The School-Age Child Who Stutters: Working Effectively with Attitudes and Emotions.

For adults and adolescents assessment of feelings and attitudes are usually done by administering tools such as, the Modified Erickson Scale of Communication Attitudes, the Stutterer’s Self-Rating of Reactions to Speech Situations, the Perceptions of Stuttering Inventory and the Locus of Control of Behavior Scale.

Remember The Role Of The IEP Team

An Individualized Education Program (IEP) team is appointed to a child to be the ones to consider reports by the clinician and other information. They decide if the child meets the state’s eligibility standards and if the child’s stuttering has a negative effect on his education.

If a child is eligible for services measurable, the IEP team sets goals and short-term objectives for the child. They also provide services needed by the child for improvement in the educational setting.

Goals Of Trial Therapy

Trial therapy for a school-age child is done to understand what approach might work and what might be difficult for him. This could increase the child’s motivation and positive outlook for the treatment. In the case of adults and adolescents, trial therapy is done for 3 main reasons.

First, is to get an idea of how a client would respond to different therapy approaches. Second, is to make a differential diagnosis between developmental, neurological or psychological stuttering. Third, it gives a preview to the client of what to expect during therapy sessions, in effect it would give them motivation to go on their treatment.

About the Author
By Anders Eriksson, feel free to visit my latest venture: GVO and make sure to claim your $1 trial membership!

Imagine the next time you join a discussion about Speech Therapy. When you start sharing the fascinating Speech Therapy facts below, your friends will be absolutely amazed.

One of the main categories of speech problems in need for speech therapy are fluency disorders. However, there are different types of fluency disorders, even though they may all seem the same. Each type has its own cause, and defining characteristics that make them stand out from one another.

There are basically six main types of fluency disorders, while some are considered to be other conditions that are related to fluency disorders.

Normal Developmental Disfluency

Normal developmental disfluency, is a fluency disorder that is a lot of times mistaken to be stuttering. This condition occurs with children from ages 1:6- 6 years old, although the peak of the condition is considered to be 2-4 years of age.

A lot of parents may be concerned of the way their child speaks, but in reality, this is a normal condition that every child goes through. Normal developmental disfluency is a normal part of a child’s development. So there is really no need to worry at all.

A child would normally get over this stage as his speech skills develop. However, a proper environment, and interaction is needed for that to happen. If a child is pressured by his parents or people around him about his speech, the higher the probability that his disfluency would become a problem in the future and could develop to stuttering.

Stuttering

Stuttering is a disorder of childhood (developmental) that is characterized by an abnormally high frequency or duration of stoppages in the forward flow of speech. Although normal developmental disfluency has its own share of stoppages, stuttering on the other hand has some extra characteristics that normal developmental disfluency doesn’t have.

What makes stuttering different, from normal developmental disfluency, is that stuttering has escape behaviors, avoidance behaviors, and other secondary behaviors. These so called behaviors are also called physical concomitants. Some examples are eye blinks, head nods, jaw tremors and total body gyrations.

Neurogenic Disfluency

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This kind of disfluency is a result of an identifiable neuropathology in a person that has no history of fluency problems prior to occurrence of the pathology. People who have accidents that caused brain problems, which induced their disfluency, fall into this category.

Neurogenic disfluency has similar characteristics as stuttering, including the physical behaviors like eye blinks and tremors. The thing is that, the main problem in conditions like these is not fluency at all, but the lesser control of muscles needed in speech production.

Psychogenic Disfluency

A disfluency with no found evidence of neurological dysfunction and no history of developmental stuttering. It is of sudden onset and attributed to an identifiable emotional crisis. Can be grouped into three categories namely: emotionally based, manipulative, and malingering disfluencies

An example of this kind of disfluency is when a person starts to stutter when a specific other is around. For instance, a student who is afraid of her teacher, starts to stutter every time her teacher is around but speaks fluently when around her friends and family.

Language Bases Disfluency

This is a disfluency that is attributed to the development of linguistic sophistication. The main root of the problem here would be language problems, which would require language based therapy rather than fluency-based therapy.

Mixed Fluency Failures

These are fluency failures that are characterized by overlapping causative factors. Speech pattern observed is the result of a blend of two or more factors/disfluency.

Cluttering

This is a condition that is related to fluency disorders. It is considered to be the extreme of stuttering. It is a disorder of timing and rhythm of speech where the person speaks too fast that his speech can’t be comprehended. The thing is, a clutterer isn’t aware that he is cluttering, while a stutterer is very much aware that he stutters.

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There are a variety of tools and materials, which are designed for speech therapy in the market right now, thus giving the therapist much more options when it comes to choosing the equipments that could best maximize his services. One variety of materials are toys. And there are various reasons for the rise in its use.

The Toys and Their Functions

Before the therapy starts, an evaluation of the patient’s oral motor structures is usually done. This is where the therapist inspects the various structures that are inside and around the patient’s mouth that are used for speech. Some of these are the lips, tongue, teeth, jaw and cheeks.

For the structures to be seen more accurately, a penlight is usually used. The only problem with it is that the child may not find it very pleasant to have a flashlight in his mouth. This is now why there already is the colorful and jelly-like oral light system, which gives the same amount of light minus the metallic appearance.

The examination of these muscles also usually requires gloves and tongue depressors; in which kids do not appreciate both of whose smell and taste. This is now the reason why colorful and fruit flavored gloves and tongue depressors are already available.

After the said oral motor examination has been performed, the therapist may find a weakening in one or some of the structures. Some seemingly ordinary materials and toys may aid the strengthening of these muscles. One of them is the straw, which can come in all colors and designs. It serves two purposes.

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The first purpose is for the rounding of the lips. This activity is important for the articulation of vowels and the semi-vowel /w/. Another function is the act of sipping. In this activity, the velum, the muscle right above the throat is exercised. This muscle is used when producing vowels and back consonants like /k/ and /g/.

Another commonly used material is a toy, which has to be blown. An example would be the whistle. The whistle is considered a difficult blow toy. It means that among the toys that work when blown, it is one of those, which requires more effort for it to perform its function.

The whistle, like the straw, aids in the exercise of the muscles of the lips. Another structure, which it strengthens, is the cheeks. It maximizes the capacity of the cheeks to hold in air and to gradually blow it out.

Other materials that are more commonly used are picture cards and interactive books. They usually contain pictures of words, which represent all the speech sounds. When these cards are used, all the therapist has to do is to show the picture and have the child produce the word together with the speech sound within the word.

Why Play?

If the patient sees the materials they have for therapy are colorful and fun toys, he will come to think that the reason he is in the clinic is to play and have fun. And having the child thinking this, will allow the child to cooperate with the therapist.

Play is a universal activity that blends social, cognitive, linguistic, emotional, and motor components. It is an integration of the many aspects of a child. Play serves as a representation of the thoughts and abilities of a child. Through play, the therapist will be able to know how to approach the concerns of his patient.

Now might be a good time to write down the main points covered above. The act of putting it down on paper will help you remember what’s important about Speech Therapy.

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Voice training is done to find an appropriate source of sound production that can be articulated for communication purposes. Criteria for selecting sound source include: degree of tissue loss, esophageal stenosis, physical limitations of the patient; noise level of the patient’s environment; motivation level; and patient’s preference of sound source.

Types Of Sound Source

There are mainly three types of sound source a patient can choose from. These are: external man-made prosthesis or artificial larynx; sphincter like junction of the pharynx and esophagus or esophageal speech; and lastly, surgically implanted device or transesophageal puncture and silicon prosthesis.

Artificial Larynx

The principle of artificial larynx is to have an external mechanical sound source that is substituted for the larynx. Anatomic structures for articulation and resonance are most of the time unaltered.

There are two general types of electrolarynges that are available: neck type and intra oral type. The neck type is placed flush to the skin on the side of the neck, under the chin, or on the cheek. Sound is conducted via the oropharynx and is articulated normally.

The intraoral type is used for patients that can’t conduct sound through skin adequately. A small tube is placed toward the posterior oral cavity, and the produced sound is then articulated. The tube has little effect on articulatory accuracy if the patient is taught properly and learns to use it well.

The advantage of artificial larynx is that voice is restored after surgery immediately and the maintenance of the hardware is minimal. The disadvantage however, is that the quality of sound may seem mechanical.

Esophageal Speech

Most of this information comes straight from the Speech Therapy pros. Careful reading to the end virtually guarantees that you’ll know what they know.

The principle behind esophageal speech is that air is of greater pressure in one chamber (oral cavity) will flow to a chamber containing less pressure (esophagus), if these chambers are connected.

Goals of esophageal speech include: to be able to phonate upon demand, use a rapid method of air intake, short latency between air intake and phonation, produce four to nine syllables per air charge, achieve a speaking rate of 85-129 words per minute, and attain good speech intelligibility.

There are mainly three methods of esophageal speech. Injection is a method where air in the mouth/nose is compressed by lingual or labial movement and is injected into the esophagus. Swallowing method uses air that enters during oral opening when swallowing. The air is used to produce voice.

Inhalation method maintains a patent airway between the nose, lips and esophagus. The stoma is used for inhalation. Air enters the esophagus when the pharyngo-esophageal muscle is relaxed during inhalation.

The advantage of this kind of speech includes: no external devices, natural sounding speech, and the possibility of pitch and loudness control. Disadvantages on the other hand are: there is reduced length of utterance, is hard to learn and requires good articulation.

Transesophageal Speech

This is another approach to voice restoration. It requires a surgical/prosthesis procedure that makes use of a man-made device inserted into a surgically created midline transesophageal fistula.

Air is conducted from the trachea to the esophagus through the prosthesis to excite the pharyngo-esophageal segment for voice production.

Advantages include: rapid restoration, natural sound, normal utterance length, hands-free, minimal maintenance and intelligible tonal language. Disadvantages are: the need for surgery, puncture stenosis, candida growth, aspiration of foreign objects, and troubleshooting.

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