The term Articulation disorder describes various problems in the individual sound formation of a person, which deviate from the standard. This means that certain sounds are either not formed at all or are formed incorrectly. The causes of an articulation disorder can be very diverse, treatment is usually carried out by a speech therapist.
What are articulation disorders?
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The medical term for an articulation disorder is Dyslalia. In this type of speech disorder, individual or connected sounds (such as the sound sequence “sch”) are pronounced incorrectly, put together incorrectly or completely omitted when speaking.
These errors occur particularly often with the so-called sibilants. This incorrect pronunciation of the letters and sound sequences "s", "z", "ch" and "sch" is known as lisp in everyday language. Articulation disorders are particularly common in childhood. During the language acquisition phase, nearly fourteen percent of children between the ages of four and six have this type of disorder.
Dyslalia can generally be divided into two groups, but can also occur as a hybrid of the two. On the one hand, there are phonological disorders in which individual sounds can be pronounced correctly, but this is not possible for those affected in the flow of speech. For example, a person may be able to pronounce the letter “s” correctly, but still lisps when speaking.
On the other hand, there are phonological disorders in which sounds and sequences of sounds cannot generally be pronounced correctly, not even in isolation. For example, it is generally not possible for the person concerned to pronounce the letter "s" correctly.
causes
The causes of an articulation disorder are diverse. First of all, congenital or acquired malformations of the articulation organs (lips, tongue, palate, jaw) can lead to the complaints. Such deformities make correct articulation difficult. Hearing disorders can also lead to dyslalia. Those affected do not hear their own faulty pronunciation and this can lead to articulation disorders.
With a myofunctional disorder, the muscle tension in the area of the mouth is impaired. This disruption of muscle tension leads to incorrect pronunciation of sounds or sound sequences.
Most articulation disorders have no organic cause at all. Rather, the problem lies in bad habits. For example, children can have wrong speech models, which means they get used to not pronouncing sounds and sequences of sounds correctly. Or the implementation of the correct sounds is not practiced precisely enough.
Once a person gets used to this incorrect pronunciation, there is also an articulation disorder. The longer children keep the incorrect pronunciation and thus automate it, the more difficult the treatment becomes.
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An articulation disorder can lead to a number of different symptoms and complaints and in general significantly reduces the patient's quality of life. Most of those affected cannot pronounce different sounds or letters correctly. This leads to a language disorder, so that communication with other people is also disturbed.
This can lead to bullying or teasing, especially in childhood, and thus to psychological complaints and moods. The complete omission of sounds and letters can also occur due to the articulation disorder. As a result, child development is significantly restricted and delayed. If the articulation disorder is not treated, it can lead to complications or language problems in adulthood.
Many patients also suffer from lisp. In the case of malformations or deformities in the oral cavity, these can in some cases also lead to swallowing difficulties, which make it much more difficult to take food and fluids. A stroke can also cause the articulation disorder and usually occurs with other symptoms.
Often the parents or relatives of the affected child also suffer from psychological complaints and depression due to the articulation disorder and therefore also need psychological treatment.
Diagnosis & course
The diagnosis of articulation disorders in childhood is mostly made from the environment. Parents, friends, teachers or educators will initially notice the incorrect pronunciation. Then either the pediatrician or a consulted speech therapist will decide whether the abnormality is only temporary or requires treatment, i.e. whether it is actually an articulation disorder.
Speech therapists have special and reliable test procedures that provide information. The course of the disorder depends on the one hand on its causes and on the other hand on its (early) treatment.
Complications
Articulation disorders can arise due to various causes and accordingly have various complications. On the one hand, congenital malformations can cause articulation disorders. This includes, for example, a cleft lip and palate (cheilopalatognathoschisis). With this condition, people often have to go to hospital and undergo treatment, which is a psychological problem.
In addition, children are often ridiculed for their appearance and pronunciation, which increases the psychological problem. This leads to social isolation very early on, which in adulthood can develop into depression, which is characterized by alcohol and drug behavior. In addition, those affected often think about suicide.
In addition, a cleft lip and palate causes a problem with the ingestion of food. Simultaneous breathing while drinking is no longer possible. A stroke also often leads to articulation problems. In addition to difficulties in pronunciation, those affected also have problems understanding what is being said. It is not uncommon for paralysis to occur. Affected people can usually not move their legs or arms and are paralyzed on one side.
Bladder or fecal incontinence can often also occur, so that the patients usually need care. Mental performance is also impaired, and patients often develop dementia and amnesia. In addition, the personality can change. In the worst cases, a stroke leads to failures in vital processes, so that this leads to death.
When should you go to the doctor?
As a rule, an articulation disorder should be examined by a doctor as early as possible and ultimately treated. In doing so, complications in adulthood can be avoided. It also prevents teasing and bullying, especially with children. A doctor should be consulted if the child is unable to express themselves properly or if an articulation disorder suddenly develops for no particular reason. The causes of the articulation disorder can be very different.
In many cases, those affected suffer from psychological complaints, but physical limitations can also lead to articulation disorders. Articulation disorders are not uncommon, especially after a stroke. Unfortunately, these cannot always be treated, so that in many cases those affected depend on the help of other people.
In order to guarantee a complication-free development of the child, a doctor should be consulted at the first signs of an articulation disorder. As a rule, a pediatrician or a speech therapist can be visited directly, who can initiate appropriate treatment for the articulation disorder.
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Treatment & Therapy
Articulation disorders are usually treated by a speech therapist. They create their treatment plan individually according to the patient and his language problems. First of all, it is about the perception of the problem. The person concerned should first become aware that his pronunciation of sounds or sound sequences deviates from the standard.
Articulation disorders are usually treated by a speech therapist. They create their treatment plan individually according to the patient and his language problems. First of all, it is about the perception of the problem. The person concerned should first become aware that his pronunciation of sounds or sound sequences deviates from the standard.
Correct pronunciation is then gradually trained using various exercises and methods. Among other things, breathing exercises, word formation exercises based on individual letters and syllables, listening exercises and much more are possible. This type of training is done in a playful way in children. The level of difficulty is gradually increased so that, for example, incorrect automatisms are slowly corrected. The aim is always to improve pronunciation towards the norm.
If the cause of an articulation disorder is a hearing problem, an ear, nose and throat specialist should be consulted who will investigate the physical causes of the problem. But even in this case, speech therapy can make sense.
In the case of malformations in the area of the speaking tools, different procedures can be useful. In the case of a so-called cleft palate, for example, surgical intervention may even be necessary to improve it. However, deformities can also be used in speech therapy for articulation disorders, as they show other ways of using the affected regions of the speaking tools.
Outlook & forecast
The early diagnosis of an articulation disorder ensures that the child has a good chance of recovery. The sooner a speech therapist can create an individual treatment plan, the earlier therapy can begin. Since the learning success of the language center is fundamentally greater the younger the child is, the possibility of learning to make sounds without accents and symptoms gradually decreases over the first years of life.
The differentiation of new sounds is trained in a therapy process. This forms the basis for correct sound formation. If the individual sounds can be perceived well separated from one another, the probability that they can be reproduced correctly increases. Using various breathing and word techniques, learning how to make sounds is trained until the disturbance has been completely eliminated.
If there is a physical cause for the articulation disorder, it can be corrected in a surgical procedure. Here, too, the chances of recovery are very good.
The prognosis for freedom from symptoms changes if the cause is a mental illness or emotional distress. In psychotherapy, the reasons for the articulation disorder must first be clarified and remedied so that the vocalisation can improve. The duration of a mental healing process is individual and can last several months to years. Speech therapy is often only promising afterwards.
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You cannot prevent the physical causes of articulation disorders. Prevention is only possible in the case of disorders that have no physical cause. Children should have good speaking role models who value the correct pronunciation of sounds. If a child develops problems in articulation, the caregiver should take corrective action so that this behavior does not become automated. If the incorrect behavior does not improve on its own, the pediatrician or a speech therapist should be consulted.
Aftercare
Whether aftercare is even necessary for a treated articulation disorder depends on the individual case.In general, forms of dyslalia treated in childhood have an excellent prognosis and the therapies are considered effective. Relapses are rare but possible. This often depends on the personal circumstances and above all on a possible psychological stress.
Follow-up care in the broadest sense would therefore consist of occasional further visits to therapy offers. Self-help groups can also be relevant if the language disorder is not overcome despite therapy. Outside of therapy, exercises for self-control are also suggested, which those affected can continue to solve their dyslalia even after the therapy in order to constantly control themselves.
Control examinations are usually not necessary, as a flare-up articulation disorder can be noticed by the person concerned and by those around him. None of the therapeutic and speech therapy measures include medication, so no follow-up care is required.
It is worth mentioning that there may be increased psychological stress due to an articulation disorder. This is mostly due to the reactions of the environment as well as own insecurity. In such cases, follow-up measures may be necessary after treatment of the articulation disorder has been carried out in order to rebuild and strengthen the lack of self-confidence.
You can do that yourself
If children have difficulty articulating certain sounds and sound combinations, a few simple language-promoting aids from parents can be very useful. Speaking begins at home and so parents have the best opportunities to make it easier for their child to learn to speak with their linguistic role model. It is important to let the child speak, to listen to them in peace, to watch them speak and not to improve their pronunciation while they are talking.
Parents repeat complicated sentences with simple, child-friendly words and correct them in this way. Attention should be paid to the correct grammar. However, the child must not be forced to repeat it afterwards. Singing, dancing, looking at picture books, rhyming, telling little verses and stories form the basis for a good development of speaking. Quiet, stressed and slow speaking by the parents is beneficial.
It helps some children to illustrate the difference in meanings that can result from some sound interchanges. It makes a difference whether the soup is boiling "in the pot or in the head" or whether you hold a "bank or ribbon" in your hand. Many children understand through these so-called minimal pairs how important it is to listen carefully and speak. In case of doubt, it can be useful to seek advice from a speech therapist.
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