Communication disorders

Communication disorders affecting speech and language can afflict children and adults. They can be the result of damage to the brain's language areas, such as when a person suffers a stroke, and affect the way words are spoken andthe way they are understood.

Babies begin to understand language when they are just a few months old. By the age of 6 months, some babies understand such simple things as "no" and "bye-bye." Between the age of a year and a year-and-a-half, children can say their first words (usually "Mama" and "Dada"), follow simple instructions (suchas "Come here), and even use two-word phrases such as "all gone." Although all children develop language skills at different rates (boys tend to develop them slightly later than girls do), a child who is showing no progress in language may be suffering from a communication disorder. Or, the child may have difficulty hearing. In either case, the child should be examined by a pediatrician. There may be a physical cause to the difficulty, or there may be a psychological or emotional cause.

Some children suffer from articulation problems, that is, pronouncing words clearly. For example, some children hear the difference between the sound of an "r" and the sound of a "w," but cannot produce the R sound, so the word "rock" may be pronounced "wock." Other children cannot hear the differences in speech sounds, which can make learning to read especially difficult because they cannot associate spoke sounds with the symbols on the page. Unless problems such as these (and as lisping) are corrected, the child may find him or herself sorely disadvantaged in social situations when older.

Stuttering is another common form of communication problem. The stutterer cannot get words to come out in a smooth flow, although he or she knows what heor she wants to say. Some stutterers will grow out of stuttering as they become more expert with spoken language. Others will never shake the problem, andit can get worse when the person is nervous or in an unfamiliar situation. Stuttering affects about 1% of children.

Some speech problems have a physical cause, such as a cleft lip or palate (which can be corrected with surgery), or cerebral palsy, a disease which affects muscle control, including the muscles used for speech.

Speech development can be delayed in some children by hearing loss or deafness (because the child cannot hear, he lacks the model to work with in learningto speak), by mental retardation, or by learning disabilities that can effect the child's ability to understand or order language.

If the language center of the brain suffers an injury (such as a stroke or head injury), communication problems can result, a condition called aphasia. Not always will a person's entire communication ability be knocked out. Some patients may lose the ability to name objects, although they know what the objects are (called anomia). Others may not be able to articulate words properly(dysarthia), which can result if the nerves to the voice box or mouth have been damaged. Some people cannot comprehend written words (ataxia). Persons suffering from Broca's aphasia (or expressive aphasia), are similar to stutterers in that they know what they want to say but have trouble getting the wordsout. People with Wernicke's aphasia, meanwhile, speak fluently but the wordscome out garbled and confused (a "word salad") because they cannot make senseof what is being said or tell exactly what they themselves are saying. The most damaging language disruption is global aphasia, in which a person can comprehend only a very few words and may be completely unable to speak.

Fortunately, many of these conditions can be helped through speech therapy. Children are often taught language through play, such as with a doll's house.For example, through using a doll's house, the therapist can teach the childthe names of objects and then, by asking the child to do certain actions withthe objects, about action verbs. Practice is key, and parents must be sure to work with the child in between sessions with the speech therapist.

Speech therapists can also help adults who have suffered brain damage, although the extent of a patient's recovery depends on the extent of the damage. Exercises for the tongue and mouth can help a dysarthria patient, and other patients can be helped through the use of picture boards to communicate. Patients can recover part or all of their speech spontaneously six months to two years after the damage occurs.

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