Resources for Families

Resources for Families

Developmental Reading & Writing Disorder
Hearing Loss
Laryngectomy
Speech and Language Difficulties following a Stroke
Stuttering
Swallowing Difficulties
Traumatic Brain Injury

 

Click here for a link to an interview with a speech-language therapist on Radio New Zealand talking about speech and language development in children on 12th August 2010.  Christian Wright (MNZSTA) – Speech and language Therapist answers listeners questions on children’s speech and language problems. (duration: 22′03″)

Developmental Reading & Writing Disorder

These disorders occur when children fail to acquire adequate reading and writing skills (literacy skills), despite appropriate exposure and instruction.

Difficulties with reading and writing commonly occur in special populations (e.g. children with Down Syndrome), as well as in adult populations (e.g. traumatic brain injury). Children who have a spoke language impairment are four to five times more likely to experience literacy difficulties, than children without a language impairment.

While many factors contribute to childrens’ written language development, aspects of children’s spoken langauge are vital for literacy success. There are three important skills that provide the foundation for literacy development:

  • oral language skills
  • awareness of the sound structure of spoken language (known as phonological awareness)
  • letter knowledge

 

Characteristics

There are a number of characteristics of difficulties with reading and writing. These include:

  • struggling with reading instruction at school, when compared with his or her peers
  • experiencing difficulty in spelling and “sounding out” words
  • experiencing difficulty expressing themselves verbally
  • experiencing difficulty in understanding language
  • having a history of speech and/or language difficulties at preschool
  • demonstrating limited phonological awareness skills such as breaking words into individual sounds, identifying individual sounds in words, or identifying or producing rhyme
  • demonstrating limited awareness of letter-sound relationships
  • avoiding book reading situations at home or school

 

Cause

The exact cause for reading and writing difficulties, such as dyslexia, is unknown. However, there appears to be a genetic component; if a family history of written or verbal speech and/or language difficulties exists, it increases the likelihood that a child will experience those same difficulties.

 

Role of the Speech-language Therapist

Speech-language Therapists have an important role in assisting children with reading and writing difficulties. Their role includes:

  • assessment and treatment of underlying speech and language skills/difficulties
  • working with teachers, families, and other education specialists to treat reading and writing difficulties
  • identifying pre-school children at risk of developing a reading and writing disorder, and implementing early intervention programs for these children

 

What you can do

If you are concerned about your child’s literacy development, try these strategies:

  • ensure your child’s hearing and vision have been assessed
  • encourage participation in joint book reading – draw your child’s attention to text and pictures; talk about letters and the sound(s) they make
  • meet with your child’s teacher to discuss their literacy development
  • contact a Speech-language Therapist

 

More Information

For more information about developmental reading and writing disorders, or to contact a Speech-language Therapist, contact the following:

  • your doctor
  • your local Ministry of Education Special Education office http://www.minedu.govt.nz/
  • the Yellow Pages
  • Massey University Speech-language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
  • the University of Auckland Speech-language Therapy Clinics: (09) 303 5979
  • the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
  • the NZSTA Private Practice Register

Hearing Loss

Loss of hearing may be mild, moderate, severe, or profound.

There are two main types of hearing loss:

  • Conductive hearing loss: sound is prevented from travelling through the outer and/or middle ear through to the inner ear
  • Sensorineural hearing loss: the inner ear or auditory nerve has suffered damage so that messages cannot be passed on to the brain

 

Characteristics

There are a number of characteristics associated with hearing loss. These may include:

  • difficulty hearing conversation within a group of people (e.g. at meetings or social gatherings)
  • difficulty hearing high-pitched sounds (e.g. the telephone ringing)
  • difficulty hearing others over the telephone
  • frequent misunderstandings
  • frequent requests for repetitions of words or phrases
  • difficulty hearing in public places where sounds sources are at a distance away from the listener (e.g. at church)
  • children with hearing loss may omit certain sounds in speech, or may have difficulty understanding what is said to them

 

Causes

There may be a number of causes of hearing loss in individuals. Common causes may include:

  • exposure to loud noise
  • family history
  • middle ear infections (“glue ear”)
  • the natural aging process
  • illness or birth defects

 

Role of the Speech-language Therapist

The degree to which a Speech-language Therapist may be involved in cases of hearing loss varies. However, their role may include one or some of the following:

  • administering an initial hearing screening
  • referring to an Audiologist for a comprehensive hearing assessment
  • provision of communication strategies for individuals with hearing loss
  • provision of strategies for coping with background noise, lighting, and distance
  • assisting with treatment of children with Auditory Processing Disorder (APD)
  • provision of information about prevention of hearing related communication and language disorders

 

What you can do

If you know someone who has a hearing loss, try using the following strategies in assisting them in their communication:

  • look directly at the person when speaking
  • speak clearly and not too quickly in a normal tone of voice
  • do not shout
  • do not exaggerate your lip movements
  • reduce background noise and visual distractions
  • reduce the distance between you and the person with a hearing loss
  • ensure their is sufficient lighting to support lip-reading (where appropriate)
  • if the person does not understand, reword your sentence, rather than repeat it
  • be patient when misunderstandings occur

 

More Information

For more information about hearing loss, or for contacting a Speech-language Therapist, try getting in touch with one of the following:

  • local Audiologist
  • local doctor
  • the Yellow Pages
  • Massey University Speech-language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
  • the University of Auckland Speech-language Therapy Clinics: (09) 303 5979
  • the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
  • the NZSTA Private Practice Register

 

The New Zealand Audiological Society (NZAS)
mail@audiology.org.nz
0800 625 166 (Free phone in NZ only)
www.audiology.org.nz

National Foundation for the Deaf
enquiries@nfd.org.nz
0800 867 446 (Free phone in NZ only)
www.nfd.org.nz

Laryngectomy

A laryngectomy is the surgical removal of the larynx (voice box). Most laryngectomies are performed on individuals who have cancer of the larynx. Laryngectomies may also be performed as a measure to help people breathe.

When the larynx is removed, there is no longer a connection between the mouth and the lungs. Consequently, individuals who undergo a laryngectomy breathe, cough, and sneeze through an opening in their neck (called a “stoma”) created during surgery.

In general, the individual continues to swallow food and liquid through the mouth as they did before surgery.

 

Effects on Voice

When a laryngectomy is performed, the greatest loss is often the loss of voice. In normal speech, the voice is the sound produced by the larynx. Sound travels up to the mouth, where the sounds needed for speech are formed. When an individual undergoes a laryngectomy, the source for voice is lost. However, the ability to coordinate the lips, tongue, and palate (for speech) is unaffected by surgery.

 

Role of the Speech-language Therapist

The main role of the Speech-language Therapist, in working with individuals who have undergone a laryngectomy, is to help the individual speak again using an alternative source of sound. There are three main methods in which this is done:

  • Oesophageal speech: the individual learns to squeeze air down into the oesophagus (food tube) and then bring it up again in a controlled fashion, causing the muscles at the top of the the oesophagus to vibrate and produce sound for speech.
  • Tracheo-oesophageal prothesis: a valve is inserted between holes in the tracea (wind pipe) and oesophagus, allowing air to pass from the lungs to the oesophagus. The valve is one-way, and does not allow food to pass from the oesophagus to the lungs. When the patient breathes out and covers the stoma with a finger or valve, air is forced through the muscles at the top of the the oesophagus, which then vibrate, producing a sound source that can be used for speech.
  • Electro-larynx: a small instrument that makes a noise when you press a button. If this instrument is held firmly against the neck, or through a tube into the mouth, the sound can be delivered to the lips, tongue, and palate to produce speech.

 

What you can do

There are a number of “dos” and “don’ts” for communicating with an individual who has undergone a laryngectomy. These include the following:

  • understand the person’s need to express their feelings
  • be patient and wait for the person to talk
  • allow the person to speak for themselves
  • encourage the person to practice any speech exercises for short but frequent periods
  • encourage the person to speak slowly
  • help the person to keep active with friends
  • find out about mouth to neck resuscitation
  • do not overprotect the person
  • do not anticipate the person’s needs
  • do not speak for the person
  • do not “nag” the person to practice
  • do not encourage whispering
  • try not to expose the person to dust, smoke, fumes, or extremes of temperature

 

More Information

For more information about laryngectomy, or to contact a Speech-language Therapist, try contacting one of the following:

  • your doctor
  • your local hospital
  • the Yellow Pages
  • Massey University Speech-language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
  • the University of Auckland Speech-language Therapy Clinics: (09) 303 5979
  • the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
  • the NZSTA Private Practice Register
  • your local hospital’s Ear Nose and Throat clinic

Cancer Society of New Zealand
admin@cancer.org.nz
(04) 494 7270
www.cancer.org.nz/

Speech and Language Difficulties following Stroke

A stroke is caused by a sudden interruption in the blood supply to parts of the brain, preventing adequate provision of oxygen and nutrients to those parts. Strokes can take the form of an haemorrhagic stroke (bleeding on the brain) or an ischemic stroke (a blockage of an artery feeding into the brain).

Given one side of the brain controls the opposite side of the body, a stroke on the right side of the brain may affect control or sensation of the left side of the speech mechanisms (and vice versa). When a stroke occurs on the left side of the brain, this often results in an impairment in language functioning (since this is usually where the “language centre” of the brain is located).

 

Speech Difficulties following a Stroke

Speech difficulties following a stroke is most often called “dysarthria”. This usually results in weakness or imparied control of muscles used for breathing, producing voice, and producing speech. Sometimes, an individual may have difficulty with sequencing and coordination of these same muscles and structures – this is known as “apraxia of speech”.

 

Language Difficulties following a Stroke

A language difficulty following a stroke is known as “aphasia”. There are a number of different types of aphasia, but an individual may have difficulty with language expression and/or comprehension, reading, writing, or using numbers. Individuals may have difficulty with music, including reading, performing, or listening to music.

 

Characteristics of Speech Difficulties

Because speech involves muscles for breathing, and producing voice and speech sounds in a rapid and accurate way, dysarthria or apraxia may cause an individual’s speech to sound:

  • “slurred” or distorted
  • too fast or too slow
  • breathy
  • hoarse
  • harsh or strained
  • nasal

 

Characteristics of Language Difficulties

A stroke may affect an individual’s ability to use and understand language in a number of different ways. These may include one or more of the following:

  • difficulty understanding what is being said – it may appear as if the person has not heard or misheard you, or it may take them a long time to respond
  • difficulty understanding stories, jokes, or general conversation
  • difficulty “finding” words, especially people’s names or names of places
  • difficulty telling stories or holding a conversation
  • written and verbal sentences may be “jumbled”
  • difficulty reading or understanding what has been read
  • difficulty spelling
  • repeating a word or phrase over and over again (this may be a real or a nonsense word)

 

Role of the Speech-language Therapist

Speech-language Therapists play an important role in the assessment and treatment of communication disorders following a stroke. Some of their tasks may include:

  • assessment and diagnosis of speech and/or language difficulties
  • liaising with the individual, their family/carers, and the rehabilitation team
  • establishing treatment/management plans specifically for the individual
  • maximising the person’s ability to communicate independently
  • referring to other organisations or agencies where appropriate
  • advising on the best way to communicate with the person who has had a stroke

 

What you can do

There are a number of strategies you can use to facilitate communication with individuals who have suffered a stroke. These include:

  • provide opportunities for one-to-one conversation
  • keep background noise to a minimum
  • face the person when speaking to them
  • allow the person plenty of time to respond
  • avoid speaking quickly
  • talk to the person, rather than about them
  • accept and encourage all means of communication, including gesture and facial expressions
  • find out from your Speech-language Therapist about the person’s communication difficulty and the best way to communicate with them

 

More Information

For more information about speech and/or language difficulties following a stroke, or to contact a Speech-language Therapist, contact the following:

  • your doctor
  • your local District Health Board or hospital
  • the Yellow Pages
  • Massey University Speech-language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
  • the University of Auckland Speech-language Therapy Clinics: (09) 303 5979
  • the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
  • the NZSTA Private Practice Register

 

The Stroke Foundation of New Zealand
strokenz@stroke.org.nz
0800 78 76 53
www.stroke.org.nz

Stuttering / Stammering

Stuttering (sometimes known as stammering) is a disorder in the normal flow and rhythm of speech. Individuals who stutter know what they want to say, but are unable to say the words momentarily because their speech is involuntarily repeated, prolonged, or blocked. Individuals who stutter may also present with “unsual” body or facial movements, in their effort to speak (e.g. twitching or eye blinking).

Half of the children who stutter will have begun to do so by the time they are 5 years old. At any one time, 1% of the population has a stuttering disorder. More males than females stutter, with a 3:1 ratio in children and a 4:1 ratio in adults.

Read an article from the NZ Herald to raise awareness about stuttering at Lifetime spent tripping on words.

Read an article from the NZ Listener  Speaking Easy – Listener article 22 Jan 11

 

Characteristics

There are a number of characteristics associated with stuttering. These include:

  • avoiding eye contact
  • avoiding speaking in certain situations
  • avoiding speaking to certain people
  • appearing shy or quiet
  • not participating in group conversations
  • not expressing him or herself well

Each person who stutters reacts differently. Some individuals have described feeling:

  • inferior
  • anxious
  • tense
  • angry
  • frustrated
  • embarrassed

 

Cause

The exact cause of stuttering is unknown, although a number of theories exist. There does appear to be a genetic component. If a family member has a stutter, it increases the likelihood that their child will stutter.

 

Role of the Speech-language Therapist

Speech-language Therapists have a significant role in the assessment and treatment of stuttering.

Stuttering may be prevented from progressing if identified and treated early enough. The earlier the stutter is identified and treatment started, the better the outcome. Assessment at an early age is highly recommended.

There is no cure for adults who stutter. However, a variety of treatment strategies exist that assist with controlling stuttering. These can be implemented with the aid of a Speech-language Therapist.

 

What you can do

When communicating with an individual with a stutter:

  • do not look away when they stutter
  • do not speak for the person
  • be patient
  • understand and recognise that the individual’s intellectual or emotional functioning is no different from those who do not stutter

If your child stutters:

  • maintain normal family interactions (e.g. do not slow down your rate of speech)
  • give your child plenty of time to say what they want to say
  • avoid telling them off for stuttering
  • avoid “correcting” their speech

 

More Information

For more information about stuttering, or to contact a Speech-language Therapist, contact:

 

The New Zealand Speak Easy Associationwww.speakeasynz.org.nz/

The Stuttering Treatment And Research Trust (START)
www.stuttering.co.nz

Swallowing Difficulties

Difficulties with swallowing are known as “dysphagia”. Dysphagia occurs when there is difficulty moving food or liquid safely from the mouth down into the stomach. Food or liquid may pass into the trachea (windpipe) and then into the lungs, instead of the stomach. This may cause obstruction of the airway, and may result in pneumonia. In some cases, food might move slowly or ‘stick’, or liquid may be regurgitated into the nose.

Swallowing difficulties may occur at any age, for a variety of reasons (see below).

 

Characteristics

There are a number of signs that may indicate or suggest a swallowing difficulty. These include:

  • coughing or choking when eating or drinking
  • unexplained coughing or choking after meals
  • a “gurgly” sounding voice after eating or drinking
  • a feeling of food “stuck in the throat” after swallowing
  • difficulty chewing and controlling food in the mouth
  • taking a long time to finish a meal
  • needing to swallow several times to clear each mouthful of food
  • excessive drooling, especially immediately after meals

Other signs that may be noticed after a period of time may include:

  • repeated chest infections
  • unexplained weight loss
  • loss of appetite
  • fear of eating

 

Causes

There are a number of causes of dysphagia, which include:

  • neurological disorder which affects the control of the muscles of swallowing (e.g. stroke, Motor Neurone Disease, Parkinsons Disease, or Multiple Sclerosis)
  • disease or injury that affects the swallowing structures (e.g. cancer of the tongue)
  • surgery to the head, neck, or oesophagus (food tube)
  • injury to the head, neck, throat, or oesophagus
  • presence of a tracheostomy tube

 

Role of the Speech-language Therapist

Following a referral, the Speech-language Therapist will assess an individual’s swallow, and make recommendations around diet texture, bite size (mouthful size), feeding utensil, and optimal posture. The Speech-language Therapist will then monitor progress.

The Speech-language Therapist will liaise with the individual, family/carers, and members of the swallowing team, and will make appropriate referrals (e.g. dietician or neurologist).

 

What you can do

If you, or someone you know, has difficulty swallowing, seek professional advice from your local doctor or hospital. There are many reasons why swallowing difficulties may exist, and it is important to investigate underlying causes as soon as possible.

Avoid any food or liquid that is difficult to swallow, until you see a Speech-language Therapist.

Ask your nurse, or doctor to teach you how to safely use the “Heimlich manoeuvre”.

More Information

For more information about dysphagia, or to contact a Speech-language Therapist, please consult:

  • your doctor
  • your local hospital
  • the Yellow Pages
  • Massey University Speech-language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
  • the University of Auckland Speech-language Therapy Clinics: (09) 303 5979
  • the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
  • the NZSTA Private Practice Register

Traumatic Brain Injury (TBI)

Approximately 9,000 people are admitted to hospital in New Zealand each year with a TBI. Many more individuals suffer mild head injuries or concussions in conjunction with other injuries (e.g. spinal injuries). Approximately 50% of those suffering a TBI are between the ages of 15 and 34.

 

Causes

There are a number of causes of TBI. These include:

  • road traffic accidents
  • sports injuries
  • assault
  • playground accidents
  • workplace accidents

 

Characteristics

Individuals who suffer a TBI may present with a wide variety of difficulties. These may include one or more of the following:

  • difficulties with attention, concentration, problem-solving, remembering information, and planning
  • speech difficulties ranging from speech that is unable to be understood by others (unintelligible) to mildly slurred speech
  • language difficulties such as difficulties understanding speech, difficulties expresing thoughts, finding the right word, and difficulties with reading and spelling
  • difficulties communicating and/or behaving appropriately in social situations
  • depression, irritability, or mood disturbances
  • difficulty eating and drinking
  • reduced or altered physical movement and sensation (e.g. balance problems, fatigue, or slow reactions)
  • altered senses of sight, smell, hearing, and taste

All of these difficulties can affect an individual’s ability to:

  • return to work
  • maintain social roles and responsibilities
  • continue with previous hobbies or interests
  • drive
  • maintain independance in sel-care (e.g. dressing, washing, feeding, or cooking)
  • difficulty maintaining social relationships

In addition, these difficulties often affect an individual’s sense of identity, confidence, and self-esteem.

 

Role of the Speech-language Therapist

Speech-language Therapists often have a significant role to play in the rehabilitation of individuals with a TBI. Some of their tasks include:

  • assessment and diagnosis of any communication or swallowing disorders
  • formulation of goals/treatment plans for communication and/or eating/drinking with the individual, their family/carers and the rest of the rehabilitation team
  • provision of advice to family/carers and the rest of the rehabilitation team on how to communicate effectively with the individual with a TBI
  • referrals to other organisations or groups when appropriate
  • aiming to maximise the individual’s ability to communicate effectively

 

What you can do

In order to assist someone you know who has suffered a TBI, you can:

  • find out from the Speech-language Therapist about his or her communication difficulty and the best way to communicate with them
  • be aware of the effects of impaired attention and concentration on communication
  • find out from the Speech-language Therapist about any swallowing difficulties and any recommendations around this

 

More Information

For more information about TBI, or to contact a Speech-language Therapist, try contacting:

  • your doctor
  • your local hospital or school
  • the Yellow Pages
  • Massey University Speech-language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
  • the University of Auckland Speech-language Therapy Clinics: (09) 303 5979
  • the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
  • the NZSTA Private Practice Register

 

The Head Injury Society of New Zealand
nat-office@head-injury.org.nz
0508 444 357

Accident Compensation Corporation (ACC)
information@acc.co.nz
(04) 918 7700
www.acc.co.nz