|
WHAT IS MEANT BY "COMMUNICATION DISORDERS"?
The term COMMUNICATION DISORDERS encompasses
a wide variety of problems in language, speech, and hearing. Speech and
language impairments include articulation problems, voice disorders, fluency
problems (such as stuttering), aphasia (difficulty in using words, usually
as a result of a brain injury), and delays in speech and/or language.
Speech and language delays may be due to many factors, including environmental
factors or hearing loss.
Hearing impairments include partial hearing
and deafness. Deafness may be defined as a loss sufficient to make auditory
communication difficult or impossible without amplification. There are
four types of hearing loss. Conductive hearing losses are caused by diseases
or obstructions in the outer or middle ear and can usually be helped with
a hearing aid. Sensorineural losses result from damage to the sensory
hair cells of the inner ear or the nerves that supply it and may not respond
to the use of a hearing aid. Mixed hearing losses are those in which the
problem occurs both in the outer or middle ear and in the inner ear. A
central hearing loss results from damage to the nerves or brain.
Many communication disorders result from
other conditions such as learning disabilities, cerebral palsy, mental
retardation, or cleft lip or cleft palate.
HOW MANY CHILDREN HAVE COMMUNICATION DISORDERS?
The overall estimate for speech and language
disorders is widely agreed to be 5% of school-aged children. This figure
includes voice disorders (3%) and stuttering (1%). The incidence of elementary
school children who exhibit delayed phonological (articulation) development
is 2% to 3%, although the percentage decreases steadily with age.
Estimates of hearing impairments vary considerably,
with one widely accepted figure of 5% representing the portion of school-aged
children with hearing levels outside the normal range. Of this number,
10% to 20% require some type of special education. Approximately one-third
of students who are deaf attend residential schools. Two-thirds attend
day programs in schools for students who are deaf or day classes located
in regular schools. The remainder are mainstreamed into regular school
programs.
WHAT ARE SOME CHARACTERISTICS OF CHILDREN
WITH COMMUNICATION DISORDERS?
A child with speech or language delays may present
a variety of characteristics including the inability to follow directions,
slow and incomprehensible speech, and pronounced difficulties in syntax
and articulation. SYNTAX refers to the order of words in a sentence,
and ARTICULATION refers to the manner in which sounds are formed. Articulation
disorders are characterized by the substitution of one sound for another
or the omission or distortion of certain sounds.
Stuttering or dysfluency is a disorder
of speech flow that most often appears between the ages of 3 and 4 years
and may progress from a sporadic to a chronic problem. Stuttering may
spontaneously disappear by early adolescence, but speech and language
therapy should be considered.
Typical voice disorders include hoarseness,
breathiness, or sudden breaks in loudness or pitch. Voice disorders are
frequently combined with other speech problems to form a complex communication
disorder.
A child with a possible hearing problem
may appear to strain to hear, ask to have questions repeated before giving
the right answer, demonstrate speech inaccuracies (especially dropping
the beginnings and endings of words), or exhibit confusion during discussion.
Detection and diagnosis of hearing impairment have become very sophisticated.
It is possible to detect the presence of hearing loss and evaluate its
severity in a newborn child.
Students who speak dialects different from
standard English may have communication problems that represent either
language differences or, in more severe instances, language disorders.
WHAT ARE THE EDUCATIONAL IMPLICATIONS OF
COMMUNICATION DISORDERS?
Many speech problems are developmental rather than
physiological, and as such they respond to remedial instruction. Language
experiences are central to a young child's development. In the past,
children with communication disorders were routinely removed from the
regular class for individual speech and language therapy. This is still
the case in severe instances, but the trend is toward keeping the child
in the mainstream as much as possible. In order to accomplish this goal,
teamwork among the teacher, speech and language therapist, audiologist,
and parents is essential. Speech improvement and correction are blended
into the regular classroom curriculum and the child's natural environment.
Amplification may be extremely valuable
for the child with a hearing impairment. Students whose hearing is not
completely restored by hearing aids or other means of amplification have
unique communication needs. Children who are deaf are not automatically
exposed to the enormous amounts of language stimulation experienced by
hearing children in their early years. For deaf children, early, consistent,
and conscious use of visible communication modes such as sign language,
finger spelling, and cued speech and/or amplification and aural/oral training
can help reduce this language delay. Some educators advocate a strict
oral approach in which the child is required to use as much speech as
possible, while others favor the use of sign language and finger spelling
combined with speech, an approach known as TOTAL COMMUNICATION. There
is increasing consensus that whatever system works best for the individual
should be used.
Many children with hearing impairments
can be served in the regular classroom with support services. In addition
to amplification, instructional aids such as captioned films and high
interest/low vocabulary reading materials are helpful. For most children
with hearing impairments, language acquisition and development are significantly
delayed, sometimes leading to an erroneously low estimate of intelligence.
Students whose physical problems are so
severe that they interfere with or completely inhibit communication can
frequently take advantage of technological advances that allow the individual
to make his or her needs and wants known, perhaps for the first time.
|