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Communication : It is the flow of messages. Language is its marvelous vehicle. It could be verbal and non – verbal. It includes listening, speaking, gesturing, reading and writing

Languagee is a code made up of rules that include what words mean, how to make words, how to put them together, and what word combinations are best in what situations. Speech is the oral form of language

When a person cannot understand the language code: receptive difficulty

When a person does not know language rules to share thoughts, ideas and feelings completely: Expressive Difficulty

 

Speech: It is an oral form of Language. Speech disorders can be categorized in three major categories: Articulation disorder,Voice disorder and Fluency disorder.

What is Abnormal Speech ?
“Speech is abnormal when it deviates  so far from the speech of other people that it calls attention to itself , interferes with communication , or causes the speaker or his listeners to be distressed…i.e.

Conspicuous
Unintelligible
Unpleasant

Hearing:
Hearing is one of the five senses. It is a complex process of picking up sound and attaching meaning to it. The human ear is fully developed at birth and responds to sounds that are very faint as well as sounds that are very loud. Even in utero, infants respond to sound. The ability to hear is critical to the attachment of meaning to the world around us.

Normal development of speech and language milestones.
Every child is unique and has an individual rate of development. This chart represents, on average, the age by which most children will accomplish the listed skills. Children typically do not master all items in a category until they reach the upper age in each age range. Just because the child has not accomplished one skill within an age range does not mean the child has a disorder

Hearing and Understanding	Talking
Birth-3 Months Startles to loud sounds. Quiets or smiles when spoken to. Seems to recognize your voice and quiets if crying. Increases or decreases sucking behavior in response to sound.	Birth-3 Months Makes pleasure sounds (cooing, gooing). Cries differently for different needs. Smiles when sees you.
4-6 Months Moves eyes in direction of sounds. Responds to changes in tone of your voice. Notices toys that make sounds. Pays attention to music.	4-6 Months Babbling sounds more speech-like with many different sounds, including p, b and m. Vocalizes excitement and displeasure. Makes gurgling sounds when left alone and when playing with you.
7 Months-1 Year Enjoys games like peek-o-boo and pat-a-cake. Turns and looks in direction of sounds. Listens when spoken to. Recognizes words for common items like “cup”, “shoe,” “juice.” Begins to respond to requests (“Come here,” “Want more?”).	7 Months-1 Year Babbling has both long and short groups of sounds such as “tata upup bibibibi.” Uses speech or non-crying sounds to get and keep attention. Imitates different speech sounds. Has 1 or 2 words (bye-bye, dada, mama) although they may not be clear.
1-2 Years Points to a few body parts when asked. Follows simple commands and understands simple questions (“Roll the ball,” “Kiss the baby,” “Where’s your shoe?”). Listens to simple stories, songs, and rhymes. Points to pictures in a book when named.	1-2 Years Says more words every month. Uses some 1-2 word questions (“Where kitty?” “Go bye-bye?” “What’s that?”). Puts 2 words together (“more cookie,” “no juice,” “mommy book”). Uses many different consonant sounds of the beginning of words.
2-3 Years Understands differences in meaning (“go-stop,” “in-on,” “big-little,” “up-down”). Follows two requests (“Get the book and put it on the table.”).	2-3 Years Has a word for almost everything. Uses 2-3-word “sentences” to talk about and ask for things. Speech is understood by familiar listeners most of the time. Often asks for or directs attention to objects by naming them.
3-4 Years Hears you when call from another room. Hears television or radio at the same loudness level as other family members. Understands simple, “who?,” “what?,” “where?,” “why?” questions.	3-4 Years Talks about activities at school or at friends’ homes. People outside family usually understand child’s speech. Uses a lot of sentences that have 4 or more words. Usually talks easily without repeating syllables or words.
4-5 Years Pays attention to a short story and answers simple questions about it. Hears and understands most of what is said at home and in school.	4-5 years Voice sounds clear like other children’s. Uses sentences that give lots of details (e.g. “I like to read my books”). Tells stories that stick to topic. Communicates easily with other children and adults. Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th. Uses the same grammar as the rest of the family.

2-3 Years  Understands differences in meaning (“go-stop,” “in-on,” “big-little,” “up-down”). Follows two requests (“Get the book and put it on the table.”).	2-3 Years Has a word for almost everything. Uses 2-3-word “sentences” to talk about and ask for things. Speech is understood by familiar listeners most of the time. Often asks for or directs attention to objects by naming them.
3-4 Years Hears you when call from another room. Hears television or radio at the same loudness level as other family members. Understands simple, “who?,” “what?,” “where?,” “why?” questions.	3-4 Years Talks about activities at school or at friends’ homes. People outside family usually understand child’s speech. Uses a lot of sentences that have 4 or more words. Usually talks easily without repeating syllables or words.
4-5 Years Pays attention to a short story and answers simple questions about it. Hears and understands most of what is said at home and in school.	4-5 years Voice sounds clear like other children’s. Uses sentences that give lots of details (e.g. “I like to read my books”). Tells stories that stick to topic. Communicates easily with other children and adults. Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th. Uses the same grammar as the rest of the family.

How Do I Know if I Have a Hearing Loss?

For adults

• You frequently complain that people mumble, speech is not clear
• You often ask people to repeat what they said.
• Your friends or relatives tell you that you don’t seem to hear very well.
• You do not laugh at jokes because you miss too much of the story.
• You need to ask others about the details of a meeting that you just attended.
• Others say that you play the TV or radio too loudly.
• You cannot hear the doorbell or the telephone.
• You find that looking at people when they talk to you makes it somewhat easier to understand, especially when you’re in a noisy place or where there are competing conversations.

For children

• Your child is inconsistently responding to sound
• Language and speech development is delayed
• Speech is unclear.
• Sound is turned up on electronic equipment (radio, TV, cd player, etc.)
• Your child does not follow directions
• Your child often says “Huh?”
• Your child does not respond when called.

Effects of Hearing Loss on Development
Children with listening difficulties due to hearing loss or auditory processing problems continue to be an under identified and underserved population.

There are four major ways in which hearing loss affects children-

1.It causes delay in the development of receptive and expressive communication skills (speech and language).

2.The language deficit causes learning problems that result in reduced academic achievement.

3.Social isolation and poor self-concept.

4.Limited vocational choices.

Specific Effects
Vocabulary
Sentence Structure
Speaking
Academic Achievement
Social Functioning

Why do Children have difficulty learning to talk
The following are only a few of the common problems we have seen:

LIMITATIONS IN HEARING
Frequently, temporary medical conditions effect young children’s hearing as well as actual biological hearing problems.

SLOWER MUSCULAR DEVELOPMENT
It is harder for some children to make the rapid movements needed to combine speech and sound for language.

SLOWER UNDERSTANDING OF ADULT LANGUAGE
It is more for our children to process long strings of information that they are often exposed to.

LESS PRACTICE INTERACTING WITH PEOPLE
Some children often spend much less time interacting with people and practicing their communication.

TOO PASSIVE A ROLE IN SOCIAL LIFE
Some children are too often on the taking than the giving end of relationships, thus affording less of the active participation they need for speech development.

TOO MUCH PERFORMANCE LANGUAGE; NOT ENOUGH SOCIAL TALK
Many children use language to recite things and perform show and tell feats. But, they often do not have the easy conversations that build friendships.

TOO MUCH PLAYING ALONE
Children can learn a lot by playing alone with toys. But, in order to learn communicate they must play with people who are doing things the child can do.

Causes of Speech and Language Delay

• Aphasia
• Apraxia in Adults
• Attention Deficit Hyperactivity Disorder
• Childhood Apraxia of Speech
• Dysarthria
• Head and Neck Cancer
• Language-Based Learning Disabilities
• Late Blooming or Language Problem?
• Right Hemisphere Brain Damage
• Selective Mutism
• Spasmodic Dysphonia
• Stroke
• Stuttering
• Traumatic Brain Injury
• Vocal Fold Nodules and Polyps
• Vocal Fold Paralysis