Communication and Swallowing Disorders

Swallowing Disorders (dysphagia)

Swallowing disorders (dysphagia) can cause food or liquid to enter the airway and result in coughing, choking, pulmonary problems, inadequate nutrition and/or hydration, and weight loss. Dysphagia can result from congenital or acquired neurologic damage such as cerebral palsy or stroke, progressive neurologic diseases such as Parkinson's disease, and surgical revision of the head and neck for treatment of diseases such as cancer.

Language Disorders 

Language disorders are characterized by deficiencies in comprehending, producing, and using language.

• Language disorders in children include difficulty in learning new vocabulary, expressing ideas clearly, understanding questions, and following directions that are heard and/or read.
• Aphasia occurs following brain damage and interferes with expressing thoughts and feelings, understanding what is said or written, and limits the ability to participate in communication activities.

Cognitive-Linguistic Disorders

Cognitive-linguistic disorders resulting from traumatic brain injury may affect attention, memory, reasoning, problem solving, executive functioning (e.g., self-awareness, planning, initiating, flexible thinking), receptive and expressive language, speech production, reading, and writing.  

Speech Disorders

Speech disorders affect how sounds and words are articulated.

• Dysarthria is a neurologic motor speech disorder characterized by slow, weak, uncoordinated movements of the speech musculature. It can be congenital (e.g., cerebral palsy) or acquired (e.g., stroke, brain injury, Parkinson's disease).
• Apraxia refers to a neurologic motor speech disorder resulting in difficulty coordinating and sequencing muscle movements to produce sounds in syllables and words.
• Speech sound disorders in children include problems with articulation (producing sounds) and phonological processes (sound patterns) resulting from a developmental delay or associated with a physical impairment such as cleft lip and/or palate or a hearing loss.

Resonance Disorders

Resonance disorders result from an imbalance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur if there is obstruction in one of the cavities, causing hyponasality or cul-de-sac resonance, or if there is velopharyngeal dysfunction (VPD), causing hypernasality and/or nasal emission.

Voice Disorders (dysphonia)

Voice disorders (dysphonia) range from mild hoarseness to complete loss of voice and limit the effectiveness of oral communication. Voice disorders are characterized by abnormal pitch, loudness, vocal quality, and/or vocal strain and fatigue resulting from disordered laryngeal function associated with vocal misuse, phonotrauma, medical or physical conditions (e.g., vocal nodules, vocal fold paralysis, laryngeal cancer, laryngopharyngeal reflux) or psychological factors.

Paradoxical Vocal Cord Dysfunction and Habit Cough

Paradoxical vocal cord dysfunction and habit cough may be associated with hyper-responsiveness of the larynx to reflexively protect the airway, particularly in the presence of irritants such as laryngopharyngeal reflux or post-nasal drainage.

Fluency Disorders (disfluencies)

Fluency disorders (disfluencies) refer to excessive breaks or disruptions in the normal flow of speech.

• Stuttering is characterized by repetitions of words or parts of words, prolongations of speech sounds, complete stoppages or blocks in speech, and interjections such as um or like.
• Cluttering is characterized by a speech delivery rate that is abnormally rapid and/or irregular (talking too fast or in spurts) and disfluencies that are frequent but not judged to be stuttering. Cluttering seems to result from disorganized speech planning and is often accompanied by language or phonological errors and attention deficits.