Self Help for Adults
Speech and language disorders usually result from stroke,cancer, tumors, aneurysm, brain injury or neurological disease. Difficulties may occur with speaking, listening/comprehending, reading or writing, which can be referred to as aphasia.
Some characteristics of aphasia are: difficulty following directions, "wrong" or inappropriate responses to questions, trouble with understanding speakers, difficulty understanding written words, and trouble reading and writing. The patient may use words that don't make sense or substitute words or sounds. He or she may have trouble repeating words or phrases and have difficulty naming pictures and objects.
Strategies for Working with Aphasia Patients
- Use your normal voice and mannerisms.
- Decrease or eliminate distractions.
- Demonstrate or gesture what you want the person to do.
- Use alternative communication such as pointing, body language and facial expression.
- Continue daily activities that may stimulate meaningful speech.
- Be patient.
Problems with positioning lips, tongue or vocal cords to produce speech may be apraxia. This does not result from oral motor weakness. Instead, the speech signal from the brain is interrupted on its way to the mouth, so the person may know what he or she wants to say, but cannot produce the sound correctly. He or she may demonstrate effort when talking or repeat common or familiar words frequently. The person may speak slowly or repeat sounds/words similar to stuttering.
Cognition relates to the thinking skills that allow us to function independently. Strokes, head injury, dementia, neurological diseases and emotional problems can cause cognitive difficulties, including trouble with attending to task, distraction and remaining on topic in conversation. The person may have memory problems; disorientation to person, place, time or situation; and/or difficulty learning new information. He or she may have language difficulties (see aphasia) and/or difficulty with solving problems. The person may exhibit unsafe behaviors, difficulty with planning/organization or with concrete or literal thinking skills. Visual-spatial-constructional problems may occur, which can lead to trouble with reading and writing.
Strategies for Working with Cognitive Patients
- Decrease distractions.
- Remind the person to stay on task/topic.
- Use simple, one-step directions.
- Use a simple journal to help with memory.
- Follow a daily routine.
- Remove unsafe objects and clutter from rooms/areas.
- Remind the patient to make eye contact with the speaker.
The person may have trouble producing clear, understandable speech or their speech may be slurred, which is the result of weakness or incoordination of the speech muscles. Dysarthria characteristics include a breathy, monotone or nasal voice; reduced loudness; face muscle weakness; lips and/or tongue weakness; and slow speech.
- Strategies for Working with Dysarthria Patients
- Reduce distractions and noise.
- Tell the person when you don't understand so he or she can try again.
- Try any type of communication, such as gestures or facial expressions.
- Be patient.
Dysphasia is when someone has trouble with chewing and/or swallowing food, liquid or saliva, and can be caused by stroke, brain injury, surgery, neurological disease or injury to the throat. Signs include trouble with beginning the swallow, holding food/liquid on one side of the mouth, coughing/choking/throat clearing during or after eating and/or drinking, and food/liquid "leaking" out of mouth.
Trouble with the normal fluency and time patterns of speech is called stuttering. There are many different theories on the causes of stuttering. The main characteristics of stuttering may include one or more of the following:
- audible or silent blocking of sounds/words
- repeating sounds/syllables
- prolonging words
- talking around the subject
- producing words with tension.
Characteristics of voice disorders include difficulty with pitch, intensity, quality or other communication problems. Voice disorders can be caused by changes in the tissue or structure, endocrine disorders or hormone imbalance, vocal fold motion/spasms, or misuse and abuse of the voice. Our speech therapists have also received specialized training utilizing the Lee Silverman voice treatment and Beckman oral motor techniques for treating patients with Parkinson's disease and other movement disorders.
Strategies for Taking Care of Your Voice
- Decrease the amount of talking.
- Decrease loudness.
- Quit smoking and/or use of certain drugs.
- Change environmental causes (dry, dusty or smoke-filled areas).