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Voice disorders are conditions involving abnormal pitch, loudness or quality of the voice, thereby affecting speech production. A voice disorder describes differences in voice that are inappropriate for an individual’s age, gender, cultural background, or geographic location. A person has a voice disorder if they express concern about having an abnormal voice that does not meet their daily needs. Even in the case where others cannot perceive the difference. Voice disorders are classified in a number of ways.

Most simply, voice disorders can be considered in three categories:

Organic

Organic voice disorders are physiological in nature and occur when there is a change to respiratory, laryngeal, or vocal tract mechanisms within a person’s body. There are two types of organic voice disorders: Structural and Neurogenic.

  • Structural voice disorders are caused by physical changes to the voice mechanism such as vocal nodules and oedema where the vocal fold tissue is altered by misuse or structural changes to the larynx that happen as a part of aging.
  • Neurogenic voice disorders are caused by dysfunction of the central or peripheral nervous system innervating the larynx, which in turn affects functioning of the vocal mechanism. This includes voice changes such as tremors caused through Neurogenic diseases such as Parkinson’s disease, paralysis of one or both of the vocal folds or involuntary movements known as spasmodic dysphonia.

Functional

A functional voice disorder is caused by the improper or inefficient use of the vocal mechanism. This is despite there being no abnormalities to the physical structures involves in voicing. Functional voice disorders can be caused by the presence of an organic disorder that leads to habitual, mal-adaptive vocal habits. Even after the organic change or long standing vocal habits have been treated. Some examples of functional voice disorders include vocal fatigue, muscle tension dysphonia, diplophonia and ventricular phonation.

Psychogenic

A psychogenic voice disorder occurs when there is no structural reason for the voice disorder. There may or may not be patterns of muscle tension (functional voice disorder) and the primary cause is psychological. While psychogenic components within voice disorder do occur, voice disorders caused by a psychological disorder are relatively rare. These individuals may benefit more from a referral to appropriate professionals other than speech pathologist such as psychologist or psychiatrist for treatment.

Most voice disorders fall into the first two categories and overlap is very common. One of the most common cases is when an individual has a functional disorder. This is where they habitually misuse their voice, and this leads to a vocal trauma. Eventually this can lead to an organic disorder such as vocal nodules. It is important to determine the correct diagnosis and cause for voice disorders. Treatment will differ depending on the type and cause.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post What is a voice disorder? appeared first on ENT Wellbeing Sydney.

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Take the time this holiday season while the kids are on break to get the whole family involved in some fun interactive activities and get those language goals down pat at the same time by playing some fun Christmas and holiday themed game show activities. Here are a couple to get you started:

Holiday Family Feud

Work on improving semantic associations between words and increasing your child’s vocabulary with Christmas themed words by setting up teams to play family feud with vocabulary tailored to a Christmas theme and to the level that your child is working at. For example, if you are targeting increasing vocabulary for food, you can make up a list of Christmas food, write them up on a board and cover each answer. Then get team members to answer for the category “Things we eat at Christmas”. The team that guesses the most correct answers wins.

Who wants to be a millionaire this Christmas?

Language comprehension, through both listening and reading can be targeted easily in a fun game of who wants to be a millionaire this Christmas. Start with a written passage that is handed to the child that they can read through if you are working on written comprehension. If you are targeting auditory comprehension, you can use a passage that is read out instead. Once the passage has been read, go through a list of pre-prepared questions and present on a board (or on paper), a list of four answers (one correct and 3 incorrect) that your child can choose from. Add on a bonus hierarchy of prizes to work up to make the game even more fun and motivating.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Holiday Language Game Show Activities appeared first on ENT Wellbeing Sydney.

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DIY Speech Pathology Resources

Identifying emotions can be difficult for many children and young adults on the Autism Spectrum and for those with pragmatic difficulties. This can be a real struggle to deal with on a day-to-day basis. When you cannot identify how others around you are feeling, it can be hard to connect and respond appropriately. Therapy for difficulties with emotion identification often comes in the form of drill practice in recognising facial expressions. This can often be dry and repetitive.

I have come across an excellent tool lately that can make emotion identification more engaging and fun. This is a game called emotions bingo. You can create your own based on emotions that your child struggles to identify. Do not forget to add in some that they are able to identify so they can still enjoy the game.

Here are the steps to create your own Emotions Bingo game:

  1. Download the attached grid
  2. Take pictures of yourself and other family members or friends doing different faces with mixed emotions such as happy, sad, angry, surprised and any others that your child may struggle with.
  3. Print the pictures out and attach them to the board or upload them into the attached grid, one in each box. Make sure to have an even amount of each emotion on each board placed in various places so no two boards look the same.
  4. Print and cut out an extra copy of each face. Place the faces in a pile to be drawn out.
  5. Use small counters to place on the board to keep track of the emotions that have been drawn out. Use any small object if you do not have counters such as shells, small pebbles etc.
  6. Once you have all the pieces ready to go, you can start the game by drawing out one by one the faces cards and naming the emotion shown on the face. Place a marker on each of the faces that matches the card that was drawn out. The first to fill a row is the winner.

Contact us for results focused speech therapy

Ashleigh Fattah is a Speech Pathology Australia member and Speech Pathologist in Sydney. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Resource Creation – Emotion Bingo appeared first on ENT Wellbeing Sydney.

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Speech therapy is an instant fix

Many people assume that one or two visits to a speech pathologist will instantly solve a child’s speech or language disorder. Whilst this may be true for people that have swallowing difficulties that require modifications to their diet or utensils, this is not the case for speech and language. Speech overall often requires shorted periods of therapy, from roughly a few weeks to a couple of years for very severe cases.

Language on the other hand can take many years to catch children up to their peers especially given these kids are already starting behind their peers. They not only need to catch up to their peers but also keep up with the ongoing improvement required for normal development.

This is often why a ‘wait and see’ approach fails as the child continues to fall further and further behind, or in a more optimal case, they continue to develop at the same rate as other children and their initial language lag is maintained.  This can lead to poor ability to complete tasks, poor reading skills and subsequent difficulties keeping up with the required curriculum.

Early intervention is the key to bridging the gap and ensuring your child is able to learn and develop at school and socially with others to their best ability.

Speech therapy sessions alone will fix communication difficulties

A speech pathologist may see your child once a week for half an hour. Compared to the amount of time parents spend with their child at home, this is minimal. Just as changing a habit like biting your nails will not work if you only refrain for half an hour a week, speech pathology also requires follow through outside of the set weekly sessions.

Parents should be provided with daily homework and strategies on how to follow through with speech goals and therapy at home. It is also the responsibility of parents to follow through with homework tasks everyday and provided your speech pathologist with feedback on how your child is going at home.

A communication book such as a small notepad or folder is a great way to keep track of, what goals are being targeted that week, whether or not the child was able to achieve these goals as well as the components that your child struggled with, to be targeted in future.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Common misconceptions about speech pathology appeared first on ENT Wellbeing Sydney.

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There is a lot of evidence-based research to support the treatment of stuttering for pre-schoolers and adults. In Australia, there is near consensus among speech pathologists that the Lidcombe Program is the most effective treatment for pre-schoolers who stutter.  Clinical trials completed in Australia and across the globe have proven that it works for the majority of children countless times.

But what if it doesn’t? And what about children who are no longer preschool aged? We need better treatments for school-aged children who stutter. Research groups, like the Australian Stuttering Research Centre (ASRC) are working to develop and test new treatments. But front-line speech pathologists and families of school kids who stutter can’t afford to wait for the perfect treatment.

Why we can’t afford to wait for the perfect treatment?

Besides the fact that there is a possibility that no perfect treatment will ever be developed there are a number of reasons to treat stuttering for school-aged children as soon as possible. Here are just a few:

  1. Stuttering becomes harder to treat and control with age. Full recovery also continues to become less likely with growing age as the neural pathways in the brain become cemented and less malleable.
  2. With entry into school, stuttering can result in social and emotional problems (Conture & Guitar, 1993). They are at risk of bullying and teasing with studies showing more than 59-80% of stuttering children being bullied about their speech; 38% on most days or every day in primary school; 11-12 year old kids who stutter were almost three times as likely to be bullied as kids who did not stutter; and school children are far more likely to see peers who stutter as victims of bullying than children who do not stutter (Blood & Blood, 2007; Davis et al., 2002; Ezrati-Vinacour et al, 2001; Langevin et al., 1998).
  3. Studies have also shown that children from 4 onwards begin to experience negative reactions from peers and school-aged children that stutter often develop negative attitudes towards speech and communication, include actively avoiding speaking situations and this continues to worsen during the school years (Denil & Brutten, 1991, Vanryckeghem & Brutten, 1997; Langevin et al., 2009)
  4. Children who stutter are more likely than those who don’t to repeat a year at school (Boyle et al., 1994) and they also report a lower quality of life than children who do not stutter (Beilby et al., 2012).
  5. These negative effects do outlast high school and can affect the individual’s further education and job opportunities (Yaruss, 2001).  Adults that stutter are also 7 times more likely to have an anxiety disorder compared to those who do not stutter (Iverach et al. 2009). There is a strong association between bullying during the primary school and subsequent anxiety (Gladstone et al., 2006). Social anxiety often starts during early teenage years, which means it’s likely develops during the primary school years (Smith et al., 2014; Messenger et al., 2015).

With all that said, where do you turn if there is no treatment method with strong supporting evidence to treat school-aged children who stutter? Each individual is different and treatment needs to be carefully selected based on a number of factors. There is exciting new evidence to support a hybrid treatment using syllable timed speech and the Lidcombe program. Click here to out more. It is important to work closely with a qualified speech pathologist experienced at treating fluency disorders to determine the right course of action for your child.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with evidence based therapy targeted to your concerns. Contact us today.

Reference

Andrews, C., O’Brian, S., Onslow, M., Packman A., Menzies, R & Lowe, R. (2016). Phase II trial of a syllable-timed speech treatment for school-age children who stutter. Journal of Fluency Disorders 48, 44-55.

The post Should Primary School aged stuttering be treated early or will my child recover naturally? appeared first on ENT Wellbeing Sydney.

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