Articulation Difficulties
Speech Sound Disorders

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What are Articulation Difficulties / Speech Sound Disorders (SSD)?

Speech Sound Disorder is an umbrella term encompassing any physical or perceptual difficulty resulting in atypical production of speech. An example of a well-known speech sound disorder is a lisp (i.e., /s/ and /z/ sound distorted or unclear). It may also be known as articulation difficulties or articulation disorders. Many cases of speech sound disorders have no known cause; however, there are other types of speech sound disorders that have a known underlying cause: Motor/Neurological, Structural, Sensory/Perceptual.

Motor/Neurological

One neurological case of SSD is Childhood Apraxia of Speech (CAS), a neurological disorder where the precision and consistency of movements underlying speech are impaired in the absence of structural deficits. This disorder affects the brain pathways involving the sequence of movements involved in producing speech - this means the brain knows what it wants to say, but cannot plan and sequence the required speech sound movements.

Symptoms include distorting sounds, making inconsistent errors in speech, making mouth movements in attempts to make the right sound (groping), and odd rhythm and stress in speech.

Dysarthia is a motor speech disorder in which the muscles used in speech are weakened, damaged, or paralyzed. This prevents a person with dysarthia from using their tongue, vocal folds, larynx, and other surrounding muscles, making it difficult to speak clearly.

Symptoms can include affected speech speed (slower or faster), slurred, mumbled, or choppy speech, and trouble moving jaw, lips, and tongue.

Structural

Cleft lip and cleft palate are characterized by openings or splits in the upper lip, roof of the palate, or both. They are a result of facial structures that do not close completely in a developing baby. Cleft lip and cleft palate are among the most common birth defects, and are usually noticeable immediately after birth, though some types such as submucous cleft palate are not as obvious. They can be treated via surgery to repair the clefts.

Orofacial myofunctional disorders (OMD) are patterns where abnormal facial features interfere with growth, development, and/or function. This includes abnormal lips, jaw, or tongue positions during rest, swallowing, and speech. It is more common in younger children than adults.

Tongue thrusting, where the tongue pushes up against or between teeth during speech or swallowing, is a noted symptom that is most prevalent in children and tends to decrease with age. Symptoms include chronic open mouth positioning, abnormal tongue rest posture, tongue thrusting, drooling and poor oral control after age of 2 years, dental abnormalities (such as open bite, under bite, and overjet), and persistent sucking behaviours (pacifier, finger, or object sucking).

Sensory/Perceptual

Hearing impairment, or hearing loss, is the partial or total inability to hear. Prevalence of hearing loss increases dramatically with age, with higher prevalence as someone reaches elderly age. While age is one of the primary causes of hearing loss, it can also be caused by genetics, diseases, injuries, and noise. Being hard of hearing can affect a child's speech and language development dramatically. Thus, hearing loss can increase difficulty in learning and pronouncing words, using proper grammar, and putting together sentences.

Treatment

Treatment strategies for Articulation Difficulties / Speech Sound Disorders are individualized and often involves creating goals and addressing them with clients. There are a variety of approaches and strategies. Particular strategies may not be appropriate for everyone, and strategies can change over time to suit needs.

Therapy is tailored to each individual, and aims to improve the intelligibility and comprehensibility of those affected. Therapy may include regular and frequent one-on-one therapy sessions with speech language pathologists, and group settings where clients can practice communication skills in realistic scenarios.