Communication Disorders | Language Structure Usage & Linguistics IV

Communication Disorders or Disabilities

There are two types of communication disorders. They are: 

1. Speech disorders 

2. Language disorders 

1. Speech disorders 

Problems producing speech sounds (articulation), controlling sounds that are produced (voice), and controlling the rate and rhythm of speech (fluency) are generally considered speech disorders. 

The American Speech-Language-Hearing Association (ASHA, 1982) has developed formal definitions of each speech disorder: 

1. Articulation disorder 

It is defined as ‘the abnormal production of speech sounds’. When a student says, ‘The wabbit wan don the woad’ for ‘The rabbit ran on the road’, or ‘poon’ for ‘spoon’ or ‘gog’ for ‘dog’, he or she may use the spoken language appropriately, but may not produce sounds correctly. 

2. Voice disorder 

It is defined as ‘the absence or abnormal production of vocal quality, pitch, loudness, resonance, and/or duration’. Students with voice disorders sometimes sound hoarse or speak loudly or in a high or low pitch.

3. Fluency disorder 

It is defined as ‘the abnormal flow of verbal expression, characterized by impaired rate and rhythm which may be accompanied by struggling behavior’. S-saying th-the f-first s-sound o-of a-a w-word and th-then s-saying th-the w-word illustrates this problem.

2. Language disorders

Problems with using proper forms of language (phonology, morphology, and syntax), using the content of language (semantics), and using the functions of language (pragmatics) are generally considered language disorders.

All other communication problems are also considered language disorders. ASHA (1982) defines three kinds of language disorders, specifically, problems related to form, content, and function. 

1. Form
Language form refers to the utterance or sentence structure of what is said, phonology, morphology, and syntax.


2. Content
Language content refers to meanings of words and sentences, including abstract concepts, and semantics.

3. Function
Language function refers to the context in which language can be used and the purpose of communication, pragmatics, etc. Problems can be receptive (related to hearing, listening to, or receiving language) and expressive (related to producing or expressing language).

Language Form, Function, and Content

1. Phonology is concerned with the smallest sound units of a language (i.e. phonemes). 

2. Morphology is concerned with the minimum meaningful units in a language (i.e. morphemes) 

3. Syntax is concerned with combining language units into meaningful phrases, clauses, or sentences. Problems with phonology, morphology, and syntax are evident when students are unable to differentiate sounds (/p/ versus /b/), words (cat or cap), or grammatically correct sentences (John goes to the movies versus John go to the movies) or to produce appropriate sounds, words, or sentences. 

4. Semantics is concerned with word and message meanings (vocabulary, comprehension, following directions, etc.). Problems with semantics are evident when students are unable to identify appropriate pictures when word names are provided (‘Find the grapes’), answer simple questions (‘Are apples fruits?’), follow directions (‘Draw a line over the third box’), tell how words or messages are similar or different (‘How are apples, oranges, and pears alike?’), or understand abstract concepts (‘What is love?’). 

5. Pragmatics is concerned with the use and function of language in varying settings (i.e. following social conversational rules). Problems with pragmatics are evident when students are unable to use language in social situations to express feelings, create or understand images, give or request information, or direct actions of listeners. 

Common types of adult communication disorders

1. Aphasia (Greek ‘speechlessness’) 

It is a language disorder due to brain damage or disease resulting in difficulty in formulating, expressing, and /or understanding language. 

Definitions 

Aphasia is the loss or partial loss of normal language abilities as a result of damage to cortical and/or sub-cortical brain tissue. 

- Malmkjær (1991)

Aphasia is the loss of ability to produce or understand language. 

- Brown and Miller (2013)

 

Aphasia, a cover term, refers to a number of acquired language disorders due to cerebral lesions (caused by vascular problems, a tumor, or an accident, etc.). 

- Bussmann (1996) 

There are three types of aphasia. They are: 

1. Broca’s aphasia 

2. Wernicke’s aphasia 

3. Conduction aphasia 

1. Broca’s aphasia 

The serious language disorder known as Broca’s aphasia (also called ‘motor aphasia’) is characterized by a substantially reduced amount of speech, distorted articulation and slow, often effortful speech. What is said often consists almost entirely of lexical morphemes (e.g. nouns, verbs, etc.). The frequent omission of functional morphemes (e.g. articles, prepositions, etc.) and inflections (e.g. plural -s, past tense –ed, etc.) has led to the characterization of this type of aphasic speech as ‘agrammatic’. In agrammatic speech, the grammatical markers are missing. An example of speech produced by someone whose aphasia was not severe is the following answer to a question regarding what the speaker had for breakfast: 

I eggs and eat and drink coffee breakfast 

2. Wernicke’s aphasia 

The type of language disorder that results in difficulties in auditory comprehension is sometimes called ‘sensory aphasia’, but is more commonly known as Wernicke’s aphasia. Someone suffering from this disorder can actually produce very fluent speech which is, however, often difficult to make sense of. Very general terms are used, even in response to specific requests for information, as in the following sample: 

I can’t talk all of the things I do, and part of the part I can go alright, but I can’t tell from the other people.

3. Conduction aphasia 

One other, much less common, type of aphasia has been associated with damage to the arcuate fasciculus and is called conduction aphasia. Individuals suffering from this disorder sometimes mispronounce words, but typically do not have articulation problems. They are fluent, but may have disrupted rhythm because of pauses and hesitations. Comprehension of spoken words is normally good. However, the task of repeating a word or phrase (spoken by someone else) creates major difficulty, with forms such as vaysse and fosh being reported as attempted repetitions of the words ‘base’ and ‘wash’. What the speaker hears and understands, can’t be transferred very successfully to the speech production area.

2. Apraxia (Greek ‘non-action’)

It is a speech programming disorder which makes words and sentences sound jumbled or meaningless.

Definitions 

According to Bussmann (1996), apraxia is a neuropsychological term, referring to an impairment of the ability to execute movements willfully (i.e. on demand) in spite of the ability to move the respective body parts.

3. Dysarthria (Greek dys- ‘un-’; arthroũn ‘to utter distinctly’)

It is a group of speech disorders resulting from paralysis, weakness, or lack of coordination of the muscles required for speech. 

Definitions 

According to Bussmann (1996), dysarthria is a term denoting any number of speech-motor disorders in the central or peripheral nervous system in which articulation, phonation, or prosody are affected.

4. Dysphagia (Greek dys- ‘bad’; phag ‘eat’)

Dysphagia is a swallowing disorder and it is common with all of the above; and is also assessed and treated by speech-language pathologists. 

Definitions 

Dysphagia is difficulty in swallowing. Some people with dysphagia have problems swallowing certain foods or liquids, while others can’t swallow at all. Other signs of dysphagia include: coughing or choking when eating or drinking; bringing food back up, sometimes through the nose. 

- Wikipedia 

Dr. M.Somathasan, Ph.D., Assistant Lecturer in English, Advanced Technological Institute (ATI), Trincomalee, Sri Lanka