Mental Health Impact of Speech Disorders

A few key moments have stayed with me from Disney’s 1942 animated classic Bambi.  There’s the gut-wrenching “your-mother-can’t-be-with-you-anymore” scene and the one where Bambi learns his first word, mispronouncing “bird” as “buhd”.  As he stammers and stutters toward getting it right, he did what most children experience while learning to talk by demonstrating the hurdles that are part of the speech and language developmental process.

Generally speaking, children develop verbal communication skills from infancy until the age of five, absorbing environmental and social cues as they progress.  Others might be on their own schedule. It is normal for individual children to have minor variances in this progression, and those small stumbling blocks are often eliminated simply by getting older.

Role Of The SLP:

If the speech/language development process is severely delayed, becomes problematic, or reaches an impasse, caregivers may wish to meet with an SLP (Speech Language Pathologist) for more insight. An SLP is a therapist who is equipped to assess and diagnose a speech or language disorder.  An SLP can then develop a treatment plan specifically tailored to the child’s circumstances, thus enabling them to advance their speech and language skills. An SLP works in school, hospital, and home healthcare settings, and can be extremely beneficial for patients with a range of developmental issues.  If Bambi hadn’t nipped this issue in the “bud” so to speak, he may have experienced the same quality of life Elmer Fudd had due to his adulthood rhotacism, which was not a nice one.

Speech and Language disorders are separate categorically.  Speech and language disorders can present independently or together.  They can be quite complex and vary in severity and prognosis.  For example, childhood stuttering, which is the most common speech disorder, can be either developmental or neurogenic.  The former refers to a child’s speech/language skill set and/or contributing genetic factors, while the latter refers to a brain injury.

Speech Disorders:

Childhood Apraxia Of Speech

Traumatic Brain Injury, Stroke

Auditory Related Disorders

Autism Spectrum Disorders/Pervasive Development Disorders

ADHD

Cerebral Palsy

Fluency: Trouble forming select words or sounds correctly

Stuttering or stammering, Adding extra syllables or filler words like “um”

Certain Voice Disorders

Intellectual Disability

 

Language Disorders:

Auditory Processing

Language Delay

Aphasia

Learning Disabilities

Selective Mutism

 

Speech Language Therapy vs. Wait and See Method vs. Recast?

There are different schools of thought on the benefits of speech therapy for children.

Using the same example of stuttering, an SLP would examine and evaluate the child’s stuttering patterns and their overall speech/language competency. Then they would determine 1.) if they will eventually grow out of it and 2.) what is the overall impact of the impediment on the child’s daily life.  Once the assessment is complete, the SLP will make the recommendation as to whether therapy is potentially beneficial for the child’s circumstance.

This is all usually done with the best of intentions–and caregiver oversight is designed for the child to begin to overcome their deficiency, beginning to flourish in school and among their peers.

Of all childhood disabilities, speech and language disorders are the most prevalent, affecting 1 in 12 children.  According to an article by Dr. Patricia Prelock, et. al of the Department of Communications at the University of Vermont, neglecting to address speech/language problems leads to “behavioral challenges, mental health problems, reading difficulties, and academic failure including in-grade retention and high school dropout”.

Indeed, many researchers emphasize the utmost importance of early intervention, explaining that it’s critical in improving overall cognitive, behavioral, and social skills.

 In one study, autistic children who had received the comprehensive approach were more likely to have their diagnoses reduced in severity from Autism Spectrum Disorder to Pervasive Development Disorder, not otherwise specified.  It was concluded that non-verbal ASD children may display comparatively improved cognition, speech, language, and behavior from early intervention in their toddler years.  ASD is a delicate subject as the presentation of symptoms can run the length of the spectrum in any given individual.  Just like ASD isn’t a “catch-all” diagnosis, but a constellation of symptoms, early intervention speech and language therapy won’t unfailingly cure Apraxia of Speech or improve maladaptive social behavior.  In this specific study, however, it improved cognition and behavior to the point that an entirely new DSM classification was in order, which is significant.

However, the most important thing before determining whether speech therapy should even be considered is if pros outweigh the cons.  Sometimes, the added pressure of speech therapy can cause a child to feel even more self-conscious about their impediment.  They may become anxious or depressed, especially if parents and caregivers become expressively impatient.  They may make efforts to speak less or withdraw socially.  Therapy may be interpreted as a punishment, triggering them to become hyperactive or act out.

Conversely, not dealing with a speech or language issue could create some of those same problems.  Embarrassment, anxiety, and depression can be a factor in coping with an untreated speech disorder.  These are potentially further complicated by related academic complications.  Over time, these symptoms could manifest into a pathology, such as a fear of public speaking, social anxieties, or agoraphobia.  It could trigger panic attacks.  It simply comes down to assessing each child’s situation and all the factors.

“Recasting” is an alternative to therapy and a proactive way to guide children in a positive way toward correct pronunciation, usage, syntax, and grammar.  For example, if the child were Bambi saying, “I see a buhd.”  Thumper, the recaster, might say, “Yes, that is a birrrd!  And in the movie, he does a version of this instinctively, emphasizing the r and d so that Bambi hears what needs to be changed.  Caretakers, teachers, and SLPs can also do recasting as an alternative to formal speech therapy if a child is struggling but doesn’t have “another diagnosis such as Down Syndrome, Hearing Loss, or Autism Spectrum Disorder”.

It is important for parents, teachers, and caregivers to bear in mind that speech and language skills are developed at different rates and, sometimes, children will skip a skill in an age bracket and then, later on, catch up.  These issues can be self-resolving and don’t necessitate structured speech and language therapy, where it may actually do more harm to their long term psyche than good towards expediting good articulation.

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