Speech and Language Impairments


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Acronyms, Abbreviations, Definitions

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Activities for Speech

  • Resources and support library - A list of resources and support tools related to speech and language disorders.
  • Speech Paths - Speech Paths is a speech pathology community resource providing resources and information to speech language pathologists and related medical specialties including audiology, occupational therapy, physical therapy, respiratory therapy and dysphagia clinicians.
  • Speech Therapy Activities - This site has a variety of printable activities and ideas for different ages, all FREE! Help yourself and share with your colleagues. Parents are also encouraged to enjoy the activities.

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American sign Language

  • American sign language browser - 1. Click on desired letter below to open an index of words that begin with that letter to the right. 2. Then click on a word to the right to obtain its sign.
  • American Sign Language - American Sign Language (ASL) is a complete, complex language that employs signs made with the hands and other movements, including facial expressions and postures of the body. It is the first language of many deaf North Americans, and one of several communication options available to deaf people. ASL is said to be the fourth most commonly used language in the United States.

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Anatomy

  • Anatomy & Physiology of the Larynx - Voice production is a complex action, and involves practically all systems of the body.  Voice production begins with respiration (breathing).  Air is inhaled as the diaphragm (the large, horizontal muscle below the lungs) lowers.  The volume of the lungs expands and air rushes in to fill this space.

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Aphasia

  • Aphasia-Overview - Aphasia is a disorder that results from damage to language centers of the brain. For almost all right-handers and for about 1/2 of left-handers, damage to the left side of the brain causes aphasia. As a result, individuals who were previously able to communicate through speaking, listening, reading and writing become more limited in their ability to do so.
  • Aphasia Therapy in the New Millennium - This article highlights national and international developments in aphasia therapy research over the past two years. We will focus on three areas: 1 ) the emergence of nontraditional treatments for aphasia, 2) the need to place aphasia treatment within the context of the complex brain mechanisms involved in the recovery process as well as the need for clinicians to apply theoretical frameworks in deciding the course of patient treatment, and 3) developments in the frontiers of neuroscience.
  • Understanding Primary Progressive Aphasia - Primary progressive aphasia is a rare neurological syndrome in which language capabilities become slowly and progressively impaired. This information sheet was prepared by the NAA to help explain the condition of Primary Progressive Aphasia to the general public.
  • Diagnosing Primary Progressive Aphasia - Aphasia usually results from damage to the left side of the brain; it is unusual for aphasia to result from right-sided brain damage. The severity of aphasia and prognosis for recovery depend on the volume of tissue damage and its exact location(s), the type of injury, and whether other parts of the brain are also damaged. The onset of aphasia is usually sudden as the cause is most often stroke or traumatic brain injury. Infection can also cause the rapid onset of aphasia.
  • Effective Tools for Family Education - There is no doubt that the education of family members about the nature of an acquired communication disorder and effective communication strategies has a significant positive effect on social relationships. It also may positively affect perceived quality of life and ultimate functional abilities.
  • Booklets, Books, and Newsletters on Aphasia - A list of books, booklets, and newsletters related to aphasia.  Appropriate for individuals with aphasia, their families, and professionals.

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Apraxia

  • Apraxia - Apraxia (also referred to as apraxia of speech, verbal apraxia, or dyspraxia) is a motor speech disorder caused by damage to the parts of the nervous system related to speaking. It is characterized by problems sequencing the sounds in syllables and words and varies in severity depending on the nature of the nervous system damage.
  • Apraxia in Adults - People with apraxia know what words they want to say, but their brains have difficulty coordinating the muscle movements necessary to say those words and they may say something completely different, even nonsensical. For example, a person may try to say "kitchen", but it may come out "bipem". The person will recognize the error and try again, sometimes getting it right, but sometimes saying something else entirely. This can become quite frustrating for the person.
  • Apraxia of Speech-signs and symptoms - Apraxia of speech is a motor-speech programming disorder resulting in difficulty executing and/or coordinating (sequencing) the oral-motor movements necessary to produce and combine speech sounds (phonemes) to form syllables, words, phrases and sentences on voluntary (rather than only reflexive) control.  Many children are able to hear words, and are able to understand what they mean, but they can’t change what they hear into the fine-motor skill of combining consonants and vowels to form words.
  • Apraxia, Hypernasality and Velopharyngeal Incompetence (VPI) - A list of online resources to learn about hyponasality, hypernasality, and Velopharnygeal Insufficiency (VPI).
  • Characteristics of Children with Apraxia of Speech - This list was compiled from professional literature which is referenced at the end. Professionals and researchers do not all agree on the characteristics that define apraxia and some of those listed below may also be present in children with other severe speech sound disorders.
  • Childhood Apraxia of Speech - Childhood apraxia of speech is a disorder of the nervous system that affects the ability to sequence and say sounds, syllables, and words. It is not due to muscular weakness or paralysis. The problem is in the brain's planning to move the body parts needed for speech (e.g., lips, jaw, tongue).

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Articulation Disorder

  • Articulation Disorders- signs and symptoms - Articulation disorders are speech sound errors that do not change in different word contexts. These errors occur during the production of isolated speech sounds (phonemes) and are thus misarticulated at the syllable and word levels as well. Articulation errors on individual consonants or vowels do not necessarily change due to context. 

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Assessment

  • The Uses and Misuses of Processing Tests - If you have ever been involved in an educational evaluation for learning disabilities---whether as a parent, teacher, or in some other role---you have probably heard about "processing tests" and "processing disorders." Many aspects of these evaluations can be problematic, but perhaps none more so than those entailing the use (and potential misuse) of processing measures. Yet the right measures, carefully interpreted, can be enormously helpful in education.

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Auditory Processing Disorder

  • Auditory Processing Disorder (APD) — An Overview - Auditory Processing Disorder (APD) is a complex problem. The term is used by many people, in very different ways. There is research underway to help understand this disorder. There also is research to investigate therapies that will help individuals who may have an auditory processing disorder.
  • Auditory Processing Disorder in Children - Human communication relies on taking in complicated perceptual information from the outside world through the senses, such as hearing, and interpreting that information in a meaningful way. Human communication also requires certain mental abilities, such as attention and memory. Scientists still do not understand exactly how all of these processes work and interact or how they malfunction in cases of communication disorders. Even though your child seems to "hear normally," he or she may have difficulty using those sounds for speech and language.
  • Basic Principles of Auditory Processing Disorder - Management of APD should incorporate three primary principles: (I) environmental modifications, (2) remediation (direct therapy) techniques, and (3) compensatory strategies. All three of these components are necessary for APD intervention to be effective.

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Central Auditory Processing Disorder

  • Central Auditory Processing (CAP) - A number of children with learning disabilities demonstrate Central Auditory Processing (CAP) problems. These children usually have normal hearing and normal intelligence. They are unable to effectively utilize auditory information, especially when competing sounds are present. They are described as inattentive, easily distracted by background noise, and exhibit difficulty following verbal directions.
  • Central Auditory Processing Disorder — An Overview - Auditory Processing Disorder (APD) is a complex problem. The term is used by many people, in very different ways. There is research underway to help understand this disorder. There also is research to investigate therapies that will help individuals who may have an auditory processing disorder.
  • Central auditory processing disorder-about CAPD - Life is complicated these days, for children as much as adults. There's a lot to remember and a lot to do. But sometimes a child may seem to be more than simply distracted by a complex life. Although their hearing may be normal, kids with central auditory processing disorder (CAPD) can't process the information they hear in the same way as others because their ears and brain don't fully coordinate.
  • Central Auditory Processing Disorders (CAPD's) - Not all the hearing is done in the ear. In fact, simply stated, the ear merely brings in all the environmental sounds human beings can hear and delivers them unseparated to the bottom of the brain in the brain stem (just above the spinal cord). As the hearing nerves criss-cross up these several inches the "sorting out" or processing begins.
  • Central Auditory Processing Disorders-signs and symptoms - A CAPD is a receptive language disorder. It refers to difficulties in the decoding and storing of auditory information (typically incoming verbal messages). This type of receptive language disorder is a result of genetic factors and/or early otitis media though causal factors may not be able to be found.
  • Treatment For Central Auditory Processing Problems - One approach focuses on training certain auditory and listening skills such as auditory discrimination (e.g. telling the difference between peas and bees), localization of sound, sequencing sounds, or identifying a target sound in a noisy background. Training these skills in isolation, however, may not help a child to understand complex language, such as a teacher's instructions. Therefore, another approach concentrates on teaching more functional language skills (e.g., vocabulary, grammar, conversational skills) and uses strategies (e.g., visual aids and repeating directions) to facilitate the processing of languages.

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Cleft Lip and Palate

  • Cleft Lip and Palate Resource - One child in 700 is born with a cleft. It is the fourth most common birth defect, and the first most common facial birth defect. And yet so many parents feel so alone. WIDE SMILES was formed to ensure that parents of cleft-affected children do not have to feel alone. We offer support, inspiration, information and networking for families everywhere who may be dealing with the challenges associated with clefting.

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Developmental Milestones

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Developmental Delays in Speech and Language

  • Delayed speech and language development - It's important to discuss early speech and language development, as well as other developmental concerns, with your child's doctor at every routine well-child visit.
  • Developmental Speech and Language Disorders - Developmental expressive language disorder is a disorder in which a child has lower-than-normal proficiency in vocabulary, the production of complex sentences, and recall of words.
  • Developmental Speech Apraxia Resources - Cincinnati Children's recommends the following Web resources for more information about Developmental Speech Apraxia.
  • Late Blooming or Language Problem? - Parents are smart. They listen to their child talk and know how he or she communicates. They also listen to his or her playmates who are about the same age and may even remember what older brothers and sisters did at the same age. Then the parents mentally compare their child's performance with the performance of these other children. What results is an impression of whether or not their child is developing speech and language at a normal rate.
  • Speech delay - This website was created to help parents, caregivers, teachers, friends, therapists, and relatives of language/speech delayed children.  We cover a variety of topics, with "talking tips" for adults; a speech forum to communicate with a speech-language and/or hearing expert, or peers; links to many other helpful sites, a sign language section with multiple common signs, and a "books/products" section if you choose to obtain further information/helpful products.

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Dysphagia

  • Dysphagia - People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.
  • Feeding and Swallowing Disorders in Children - Swallowing disorders, also called dysphagia (dis FAY juh), can occur at different stages in the swallowing process.
  • New Visions (Feeding and Swallowing Resource) - New Visions provides continuing education and therapy services to professionals and parents working with infants and children with feeding, swallowing, oral-motor, and pre-speech problems.

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Expressive Language Disorder

  • Expressive language disorder – developmental - Approximately 3 to 10% of all school-age children have expressive language disorder. The causes of this disorder may vary, or may be unknown. Cerebral damage and malnutrition may cause some cases -- perhaps in combination with genetic factors.
  • Mixed receptive-expressive language disorder - Mixed receptive-expressive language disorder is a language disability which causes impairment of both the understanding and the expression of language.

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Frequently Asked Questions

  • Frequently Asked Questions from Parents of Children Recently Diagnosed with Apraxia of Speech - What is apraxia of speech and how does it differ from a developmental delay of speech? What is the usual prognosis for children with apraxia of speech? What is the usual method of treatment for apraxia? What causes apraxia? Will my child ever be able to speak "normally"?  What are other associated features of apraxia? How do you know if you have a "good" therapist? Will my insurance company pay for therapy?

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General Information

  • How Do We Learn Language? - How do children learn so much about language in so little time? Adult-like knowledge of language requires many complex skills, and it's not at all obvious how we acquire them. We possess phonological skills: the ability to perceive and analyze sounds in real time, and to produce sounds by coordinating our larynx, pharynx, tongue, palate, jaw, and lips. We possess a lexicon: thousands of vocabulary words. And we possess syntactic skills: the grammar rules of our native language, which govern how words and morphemes can be combined to produce correct sentences.
  • How to Help Your Child Get the Most Out of Speech Therapy - Parents are an extremely important part of their child’s therapy program. Parents help determine whether or not their child’s experience in speech/language therapy is a success. I have seen over and over again during my years as a speech/language specialist, that the children who complete the program most quickly and with the most lasting results are those whose parents have been involved.
  • How to Think About a Speech/Language Evaluation - The following are tips for parents who suspect apraxia of speech may be an issue in their child and are seeking a speech/language evaluation. The tips were put together by an experienced mom involved with the Apraxia-KIDS (SM) Network.
  • Language Disorders and Attention Deficit Hyperactivity Disorder - The child or adolescent with ADHD and learning problems will often present to the Speech Language Pathologist with a range of clinical problems in language that are contributing to the learning disorder.
  • Low Cost Speech Therapy - Often universities that offer a masters degree in Communication Disorders and Sciences or Speech-Language Pathology have speech and language clinics where their students gain valuable experience under the direction of clinical faculty...
  • Signs and symptoms of speech and language disorders - See the menu on the left to view an overview of the signs and symptoms of a multitude of speech and language disorders.
  • Taking Care of Your Voice - We rely on our voices to inform, persuade, and connect with other people. Your voice is as unique as your fingerprint. Many people you know use their voices all day long, day in and day out. Singers, teachers, doctors, lawyers, nurses, sales people, and public speakers are among those who make great demands on their voices. Unfortunately, these individuals are most prone to experiencing voice problems. It is believed that 7.5 million people have diseases or disorders of voice. Some of these disorders can be avoided by taking care of your voice.
  • Students Who May Have Word Finding Difficulties - Six different groups  of students who may have word finding difficulties are identified and described.  References about students who are affected by word finding difficulties are also presented.
  • What is a language disorder? - Children whose language development lags significantly from the timetable may be considered developmentally delayed in language acquisition. A child with a language disorder may not use the language commensurate with her peers. She may be delayed in acquiring the vocabulary, syntax, grammar and pragmatics of her age mates.
  • What is a speech disorder? - Although some children are precocious in the acquisition of speech and may be able to produce understandable speech by the time they are 30 months of age, in some children, it is not uncommon for one or two speech sounds to remain "unlearned" until 72 months of age. By the time a child is 48 months old, however, she should be speaking well enough to be understood all of the time.
  • What is a Speech/Language Specialist? - This article will address the question, "What is a Speech/Language Specialist?"  It will discuss the various names we are known by and the various roles you might find us in.  I will also discuss the training one needs to pursue this as a career choice.
  • What Is Voice? What Is Speech? What Is Language? - The functions, skills, and abilities of voice, speech, and language are related. Some dictionaries and textbooks use the terms almost interchangeably. But for scientists and medical professionals, it is important to distinguish among them.

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Glossary

  • A general reference - A reference of frequently used medical terms related to speech and language impairments.

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Hypernasality

  • Hypernasality: a voice or resonance disorder? - Hypernasality is often mislabeled as a voice disorder. In fact, it is a resonance disorder! Voice disorders are caused by dysfunction of the larynx. Hypernasality is caused by a dysfunction of the velopharyngeal mechanism.

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Landau-Kleffner Syndrome

  • Information on Landau-Kleffner syndrome - Landau-Kleffner syndrome (LKS) is a childhood disorder. A major feature of LKS is the gradual or sudden loss of the ability to understand and use spoken language. All children with LKS have abnormal electrical brain waves that can be documented by an electroencephalogram (EEG), a recording of the electric activity of the brain. Approximately 80 percent of the children with LKS have one or more epileptic seizures that usually occur at night.

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Laryngeal Papillomatosis

  • Information on Laryngeal Papillomatosis - Laryngeal papillomatosis is a disease consisting of tumors that grow inside the larynx (voice box), vocal cords, or the air passages leading from the nose into the lungs (respiratory tract). It is a rare disease caused by the human papilloma virus (HPV).

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Lisping

  • Information on lisping - A lisp is a Functional Speech Disorder (FSD). A functional speech disorder is a difficulty learning to make a specific speech sound, or a few specific speech sounds.

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Literacy

  • Speech & language, literacy and inclusion - Narratives are important because they engage students in learning activities that support oral and written language development concurrently and interrelatedly; they provide a bridge between oral communication - regulating social interaction, and writing - providing information. With narratives, Speech Pathologists support development of specific language skills, provide repeated exposure to concepts and teach literate styles of language use.

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Organizations

  • American Academy of Audiology - The American Academy of Audiology promotes quality hearing and balance care by advancing the profession of audiology through leadership, advocacy, education, public awareness and support of research.
  • American Speech-Language-Hearing Association - ASHA is the professional, scientific, and credentialing association for more than 123,000 members and affiliates who are speech-language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally.
  • Canadian Association of Speech and Language Pathologists - CASLPA is the single national body that supports the needs, interests and development of speech-language pathologists, audiologists and supportive personnel across Canada.
  • National Aphasia Association - The NAA's mission is to educate the public to know that the word aphasia describes an impairment of the ability to communicate, not an impairment of intellect. The NAA makes people with aphasia, their families, support systems, and health care professionals aware of resources to recover lost skills to the extent possible, to compensate for skills that will not be recovered and to minimize the psychosocial impact of the language impairment.
  • National Center for Voice and Speech (NCVS) - The NCVS was organized on the premise that a consortium of institutions is better able to acquire and maintain resources to fulfill the global mission of the sponsors than a single organization. NCVS members, although geographically separate, were linked by a common desire to fully understand the characteristics, limitations and enhancement of human voice and speech.
  • National Student Speech Language and Hearing Association (NSSLHA) - The National Student Speech Language Hearing Association (NSSLHA) is a pre-professional membership association for students interested in the study of communication sciences and disorders.
  • National Stuttering Association - If you are a person who stutters, a parent of a child or teen who stutters, a speech-language pathologist, a teacher, an employee, a doctor or other professional who works with people who stutter…you will want to take advantage of the helpful opportunities and benefits from a NSA membership!
  • The National Coalition on Auditory Processing Disorders - The mission of the National Coalition on Auditory Processing Disorders, Inc. is to assist families and individuals affected by auditory processing disorders through education, support, and public awareness as well as promoting auditory access of information for those affected by auditory processing disorders.

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Orofacial Myofunctional Disorders

  • Information on orofacial myofunctional disorders - With an orofacial myofunctional disorder (OMD), the tongue moves forward in an exaggerated way during speech and/or swallowing. The tongue may also lie too far forward during rest, or may protrude inappropriately between the upper and lower teeth during speech, swallowing, and at rest.

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Phonological Disorders

  • Phonological Principles - The terms phonological therapy and phonological remediation permeate the current speech-language pathology literature. They are often used ambiguously, and it is not always clear whether they refer to intervention for developmental phonological disorders, or intervention that is, by nature, somehow 'phonological'.

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Receptive Language Disorder

  • Receptive language disorders-signs and symptoms - Receptive Language Disorders include: Central Auditory Processing Disorders (CAPD), Aphasia, Comprehension Deficit, "delayed language," "delayed speech." Also receptive language disorders refer to difficulties in the ability to attend to, process, comprehend, retain, or integrate spoken language.
  • Overview of Receptive Language Disorder:  Receptive Language Disorder is a type of learning disability affecting the ability to understand spoken, and sometimes written, language. They often have difficulty with speech and organizing their thoughts, which creates problems in communicating with others and in organizing their thoughts on paper.
  • From the National Library of Medicine:  Mixed receptive-expressive language disorder is a language disability which causes impairment of both the understanding and the expression of language.
  • From ASHA: Late Blooming or Language Problem?
  • Also, many students with Receptive Language Problems are actually diagnosed with Central Auditory Processing Disorder, which can be found through NASET-CLICK HERE

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Resources to Use in the Classroom

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Semantic and Pragmatic Difficulties

  • Information on semantic and pragmatic difficulties - Semantics is the aspect of language function that relates to understanding the meanings of words, phrases and sentences, and using words appropriately when we speak. Children with semantic difficulties have a very hard time understanding the meaning of words and sentences.

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Sensory Integration and Motor Disorders

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Spasmodic Dysphonia

  • Spasmodic Dysphonia-Overview - We have all experienced problems with our voices, times when the voice is hoarse or when sound will not come out at all! Colds, allergies, bronchitis, exposure to irritants such as ammonia, or cheering for your favorite sports team can result in a loss of voice. But, people with spasmodic dysphonia, a chronic voice disorder, face the persistent question: "What's wrong with your voice?"
  • Spasmodic Dysphonia-About - Spasmodic dysphonia (or laryngeal dystonia) is a voice disorder caused by involuntary movements of one or more muscles of the larynx or voice box. Individuals who have spasmodic dysphonia may have occasional difficulty saying a word or two or they may experience sufficient difficulty to interfere with communication. Spasmodic dysphonia causes the voice to break or to have a tight, strained or strangled quality. There are three different types of spasmodic dysphonia.

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Stuttering

  • Early childhood stuttering - This site is dedicated to providing information about the nature of early childhood stuttering and ways to prevent its development. You will find numerous articles about early childhood stuttering, including warning signs, ways to reduce communication demands for children, and intervention programs for preventing and treating early childhood stuttering.
  • Stuttering - Stuttering is a communication disorder that affects the fluency of speech. It begins during childhood and, in some cases, persists throughout the life span. The disorder is characterized by disruptions in the production of speech sounds. Speech-language pathologists refer to these disruptions as "disfluencies."
  • Stuttering-Overview Stuttering-About - Stuttering is a disorder of speech that affects the fluent production of sounds, words, phrases, and sentences. Repetitions, hesitations, or prolongation of speech sounds at the beginning of words or within words are frequently heard, as are repetitions, single or multiple, of entire words or phrases.
  • The Stuttering Homepage - The Stuttering Home Page, created by Judith Maginnis Kuster and maintained at Minnesota State University, Mankato, is dedicated to providing information about stuttering for both consumers and professionals who work with people who stutter.
  • Research and Comment from the Researchers at East Carolina University on stuttering - Instead of being the core stuttering ‘problem’, syllabic repetitions may be a biological mechanism, or ‘solution’, to the central involuntary stuttering block. Simply put, stuttering is an endogenous transitory state of ‘shadowed speech’, a choral speech derivative that allows for a neural release of the central block.

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Velocardiofacial Syndrome

  • Information on velocardiofacial syndrome - Velocardiofacial syndrome (VCFS) is a disorder that has been associated with over thirty different features. (A disease or disorder that has more than one identifying feature or symptom is a syndrome.) The name velocardiofacial syndrome comes from the Latin words "velum" meaning palate, "cardia" meaning heart and "facies" having to do with the face.

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Voice Disorders

  • Vocal Abuse and Misuse - When you abuse or misuse your voice, you can damage your vocal folds, causing temporary or permanent voice changes.
  • Vocal Cord Paralysis - Vocal cord paralysis is a voice disorder that occurs when one or both of the vocal cords (or vocal folds) do not open or close properly. Vocal cord paralysis is a common disorder, and symptoms can range from mild to life threatening.
  • Voice problems in children - Pediatric voice problems involve pathologic laryngeal conditions, including inflammation of the vocal folds, chronic laryngitis, vocal nodules, vocal polyps and contact ulcers, all of which can be identified by the child’s Ear, Nose and Throat doctor. These conditions, usually caused by vocal abuse, are normally reversible with the elimination of laryngeal overuse and tension, along with a program of vocal hygiene.

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Traumatic Brain Injury: Cognitive and Communication Disorders

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