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Feeding aversion/Failure to thrive
Many children are described as “picky eaters” and have a limited variety of select foods that they willingly eat. When weight, nutrition, behavior, social functioning or extreme parental frustration during mealtime becomes a problem, this issue may require a diagnosis and intervention from a professional. Various medical diagnoses such as craniofacial anomalies or genetic disorders may also cause feeding and swallowing to be problematic. Adults may also have feeding difficulty following a stroke, other neurological issues, dementia or post surgery. Therapy typically involves various oral motor exercises, creating an environment most likely to encourage eating, playing with different textures and making feeding fun. Feeding aversion becomes a failure to thrive when weight and nutrition are negatively affected and the ability to maintain life functions is compromised. Children with feeding aversion or failure to thrive typically do not improve significantly without direct intervention.
Simply put, articulation describes a person’s ability to produce speech. Specifically, it is the use of articulators (lips, tongue, etc.) to produce speech sounds. Certain speech sounds are acquired at different ages. When children do not acquire these sounds at the correct age, or when they are difficult to understand overall, intervention may be recommended.
This is the ability to understand language. Receptive abilities involve the understanding of verbal expression as well as other forms of language (sign language, writing, etc.), the understanding of age appropriate concepts, and how language is organized in the brain. There are a number of different causes for deficits in receptive language in both children and adults. Treatment differs depending on the type and severity of receptive deficits.
Expressive language is the ability to express oneself. It involves language expression through speech and gestures, and how information and thoughts are put into words and sentences. This includes vocabulary, sentence structure and grammar, semantics (meaning in language) and formulation. Again, there are many different disorders associated with expressive language impairments and treatment differs accordingly.
Memory and Cognition
Difficulty in this area may occur in children with developmental disorders or after trauma in adults due to aging, neurological deficits, dementia or stroke. There are different types of memory and each is an integral skill needed for overall language functioning.
Apraxia of Speech may occur in children or adults. Apraxia is a neurologically based motor planning disorder that is characterized by difficulty producing purposeful movements. Muscle weakness is not typically associated with this disorder. This is a complicated disorder to treat and requires a speech pathologist with additional training in this area.
Oral motor refers to the tone, range of motion and function of numerous muscles involved in the production of speech and feeding/swallowing. For different reasons, these muscles may be hypotonic (weak) or hypertonic (excessively tense) or a combination of both. Oral motor deficits may cause decreased intelligibility while speaking and difficulties with chewing or manipulating food while eating. Adequate oral motor function is necessary for successful speech production and eating.
Voice refers to the quality of sound that the vocal chords produce. Your voice is an important aspect of your identity. There are numerous specific voice disorders that have various causes and treatments. Overall, when the voice quality is atypical, there is usually an underlying medical or functional cause that needs to be addressed. Voice is measured in terms of pitch, quality, loudness, nasal resonance and oral resonance. Therapy involves education on the optimal way to use and take care of your voice as well as exercises, breathing and phonation training.
Cleft palates/lips occur prenatally and are typically not detected until birth. Speech may be negatively affected and require intervention. Infants with clefts often exhibit difficulties feeding due to decreased intraoral pressure as well.
Aphasia is the loss of language abilities and function as a result of brain damage. Receptive aphasia may involve loss of concepts, organization, personal information, and the ability to process information. Expressive aphasia may involve the inability to speak fluently, difficulty finding the correct word, difficulty speaking coherently, and deficits in reading and writing. There are numerous types of aphasia depending on the areas damaged in the brain. Therapy is typically most beneficial up to two years post stroke or trauma, but ability may continue to improve with intervention after two years.
Autism is a social language disorder that is characterized by significant deficits in speech and language development as well as nonverbal communication. Persons with autism often exhibit poor communicative intent and inappropriate social behaviors. There is a wide range of severity with autism and it is described as the “autism spectrum”. Therapy is typically ongoing and addresses all aspects of receptive, expressive and social language development.