Communication Disorders

Communication Disorders: An Introduction for Community-Based Rehabilitation Workers

Gillian Clezy
Stephanie Stokes
Tara Whitehill
Ann Zubrick
Copyright Date: 1996
Pages: 184
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  • Book Info
    Communication Disorders
    Book Description:

    Community-based rehabilitation is based on the belief that allied health and education workers in the field provide a vital support service to specialist agencies which are often centrally located and unable to meet the long-term needs of the wider community. Increasingly, specialist speech and language pathologists undertake a consultative role in order to meet community demands for services, particularly in rural settings. Initial identification and follow-up management of commonly occurring communication disorders may be the role of non-specialist rehabilitation workers.This book developed out of the authors' involvement in teaching a course in communication disorders to physicians in China as part of a one-year programme in community-based rehabilitation. The purpose of the book is to introduce the principles of assessment, management and research to community-based rehabilitation workers.

    eISBN: 978-988-220-082-1
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Acknowledgements
    (pp. vii-viii)
    Gillian Clezy, Stephanie Stokes, Tara Whitehill and Ann Zubrick
  4. Preface
    (pp. ix-x)
  5. Introduction
    (pp. 1-2)

    This text is designed to act as a reference and source of basic information and material on communication disorders. It covers the most commonly occurring problems which are seen in both children and adults, and reflects current perspectives applicable to community-based care.

    Communication is the major way of achieving everyday exchanges of life. Through communication we make requests, share feelings, negotiate business, issue commands or instructions, teach, learn or convey messages from other people. Our most precious skill, which is often taken for granted, is our ability to communicate our wants and needs to others so they may come to...

  6. Part 1 Principles

    • 1 Principles of Communication Development or Disorder
      (pp. 5-10)

      Communication is an exchange of feelings, knowledge and wants between two or more people. It may be either non-verbal or verbal and includes everything from the subtle comfort and exchange between a caregiver and a young child to the sophistication of a lecture delivered to a professional group.

      While many animals give evidence of some abilities to communicate, human beings are set apart from other species by the sophistication of their language system for communication. Language and communication are not the same thing. Language is an accrued system of words and rules that makes it the most organized and sophisticated...

    • 2 Principles of Counselling
      (pp. 11-18)

      The term ‘counselling’ encompasses the relationships, skills and processes used when one person helps another with a problem or series of problems. Often this help takes place during a discussion or within an interview. For the rehabilitation of communication disorders we require both counselling and interviewing skills. These will also be useful in all our human relationships whether with family members, friends or colleagues. Counselling skills develop over many years and are dependent on our personalities, interpersonal skills and knowledge. How we apply these will vary a little according to the culture to which we belong; however, the application will...

    • 3 Principles of Documentation and Evaluation
      (pp. 19-22)

      In examining the issue of documentation, there are two broad categories: data collection and reports.

      Data collection refers to the systematic collecting of data. This applies both to an individual patient and to an overall programme.

      Data collection is essential if we are to have a means to evaluate our programmes. In order to assess patient progress, we must have an initial assessment of status (baseline), as well as careful records of performance and progress. It is necessary to be precise in describing patient status and progress. Data collection should be a routine part of our therapy/sessions. Careful records need...

    • 4 Principles of Prevention
      (pp. 23-26)

      Prevention has long been recognized as an essential concept in the fields of medicine and public health. The importance of prevention in communication disorders has been recognized more slowly but is now also recognized as essential in the effective management of communication disorders.

      The American Speech-Language-Hearing Association Committee on the Prevention of Speech, Language and Hearing Problems defined the issue: ‘In a general sense, prevention of communication disorders is the elimination of those causes which interfere with the normal acquisition and development of communication skills.’ (ASHA, 1982:425)

      The committee differentiated between primary, secondary, and tertiary phases of prevention as follows:...

    • 5 Principles of Research
      (pp. 27-40)

      Research designs can be experimental or descriptive. Experimental designs will be outlined below. Descriptive research can be:

      1. Comparative research. This involves studying the performance of two different groups on one measure, e.g., deaf children and hearing children.

      2. Developmental research. This measures change over time (longitudinal research). The independent variable is maturation.

      3. Correlational research. Here, the interest is not in the differences between groups, but how one or many (dependent) variables affect another, independent variable.

      4. Survey research. These are designed to examine attitudes, prevalence of disease, or life-style or work-style practices, and commonly include questionnaires and/or interviews. These need to be...

  7. Part 2 Applications

    • 6 Speech Problems
      (pp. 43-58)

      Speech is the primary means by which most people convey their language — or mutually understood code — to others. In terms of assessment and remediation, it is important to understand the difference between speech and language. By speech we mean the articulatory process through which sounds and words are produced in the vocal tract. Speech and language are mutually dependent and therefore care must be exercised in considering them as separate entities. Speech includes both the perception and production of sound. Speech perception is a complex function heavily dependent on the hearing and processing of sound sequences according to...

    • 7 Child Language Problems
      (pp. 59-74)

      Although most children seem to learn their native language relatively easily, with no formal assistance, this task can be very difficult for some children. There may be a medical basis to explain all or part of a child’s problems. Children with significant hearing impairments do not have the same opportunities as others to listen to normal speech and language. Children with mental handicap will acquire speech and language at a slower rate than their peers with normal intelligence. Children with a severe emotional problem may see no point in developing communication. However, there is a small group of children (1–...

    • 8 Hearing Disability
      (pp. 75-108)

      Aural rehabilitation (AR) is the study, diagnosis and remediation of communication disorders resulting from hearing loss. The populations to whom it applies are:

      children born with hearing loss

      pre-lingually deafened children

      hearing children of deaf parents

      signing people wishing to talk

      adults with increasing deafness

      those who have received a cochlear implant

      Aural rehabilitation requires the maximum use of residual hearing and facilitation of normal communication rather than the use of compensation such as sign and other methods. AR is the method of rehabilitation recommended initially because, in the case of children, all parents wish them to be as near...

    • 9 Voice Problems
      (pp. 109-114)

      Voice disorders are categorized into disorders of intensity (a speaking voice which is too loud or too quiet), disorders of frequency (a voice which is too high in pitch or too low), or disorders of quality (a voice which is rough, hoarse, harsh or otherwise unpleasant in sound). A voice disorder is said to exist when a person’s quality, pitch, and loudness differ from those of other persons of similar age, sex, cultural background, and geographical locations.

      Details of the anatomy and physiology of voice production can be obtained from many text books (e.g., Aronson, 1980; Boone, 1977; Greene, 1972)....

    • 10 Laryngectomee and Glossectomee
      (pp. 115-122)

      A laryngectomee is a person who has had the larynx surgically removed. A glossectomee is a person who has had the tongue, or part of the tongue, surgically removed.

      Management of the laryngectomee or glossectomee involves several components: medical, psychological and daily living. However, the most obvious problem for the laryngectomee is loss of voice and for the glossectomee, a dramatic change in the ability to speak.

      The main reason for removal of the larynx or tongue is cancer. The primary cause of oral cancer is the use of tobacco products such as cigarette smoking, pipe smoking, cigar smoking and...

    • 11 Cleft Lip and Palate
      (pp. 123-136)

      Cleft lip and palate is a congenital malformation of the oral-facial region.

      Clefts are caused by the failure of certain structures to fuse (unite) in the developing embryo during pregnancy. Clefts of the lip are caused by failure of the fronto-nasal process and the lateral maxillary process to fuse. In the normally developing fetus, this should happen approximately six weeks after conception. Isolated cleft palates are due to the failure of the palatal shelves to join. This occurs in the normal embryo around the eighth or ninth week.

      The cause of cleft is not clear and, in individual cases, often...

    • 12 The Stroke Patient
      (pp. 137-150)

      Stroke or cerebrovascular accident (CVA) may give rise to two disorders of speech (dysarthrias and dyspraxias) and/or disorders of language (aphasias). In this section we will consider both types of disorders and their management.

      Stroke is the commonest, but not the only, disease which leads to acquired disorders of speech and language, and the principles and practices described below are generally applicable to other neurogenic disorders affecting speech (e.g., Parkinson’s disease, motor-neurone disease) or language (e.g., cerebral tumours, head injury).

      Background to the pathophysiology and medical management of stroke can be found in any of the major medical textbooks and...

    • 13 The Non-verbal Patient
      (pp. 151-158)

      Some people are unable to speak or are unable to speak clearly enough to make themselves understood. For them speech alone is not an effective means of communication. One definition of this population is ‘a group of individuals for whom speech is temporarily or permanently inadequate to meet all of their needs, and whose inability to speak is not due primarily to a hearing impairment’ (ASHA, 1981).

      Some of these people are unable to speak at all. They need an alternative method of communication. Others are able to speak but their speech is unclear. They cannot meet all their communication...

  8. Glossary
    (pp. 159-172)