Speech disorder – This book covers the entire syllabus of “Psychiatric Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate the latest information and topics. This book is an examination-friendly setup according to the teachers’ lectures and examination questions.
At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Speech disorder
Signs of Problems in Language and Speech Development
- 6 months: Will not respond to sounds coming from side or behind (does not turn eye and head)
- 10 months: Will not respond for his name 15 months: Will not understand and respond for ‘bye-bye’ or ‘no-no’
- 18 months: Does not have a vocabulary of 10 words
- 21 months: Does not respond to direction or instruction
- 24 months: Will not use 2-word phrases repeats spoken word incorrectly
- 30 months: Has speech, i.e. not intelligible to any family member
- 36 months: Has not started to ask any simple question or unable to use simple sentences. Has speech that is not intelligible to strangers.
- 42 months: Consistently falls to produce fmal consonants
- After 4 years: Stutters/dysfluent
- After 7 years: Has speech sound errors
- At any age: Monotonous voice, inappropriate pitch, loud or not audible
✔Quality of voice should be assessed, e.g. hoarseness or whispered
✔Is the pitch of the voice is normal for that age or not
✔Articulation of voice; child’s speech should be intelligible by three years of age
✔Fluency: Between 2-6 years of age, majority of children will have dysfluent speech, e. g.
✔repeating the beginning of words or whole words or syllables slow
✔If bilingual household, usually slow in speech occurs
✔Certain times children will follow their elders way of communicating
✔Usually eating difficulties will be associated with speech difficulties
Management
1. Counselling and reassurance of parents is essential as the parents were emotionally, disturbed and worried for child stuttering problem.
2. Ask the parents to avoid competition with other children of same, age group and undue comparison frequently.
3. Primary stuttering and non-fluent speech of a young child (between 2-5 years of age) can be neglected as it may pass off as the child’s age is progressing. Parents should be advised, not to show undue attention, concern, pressurize the child to repeat or to correct or to become conscious of his problem
4. The children with secondary stuttering should be given emotional support and to seek professional guidance, i.e. speech-language therapist or language pathologist for achieving adequate communication skills
5. Educate the parents about:
- The factors stressors predisposing for communication disorders
- Signs of delay in language and speech development
- The child with stuttering problem will not have any defect in their intelligence levels and stuttering is reversible
- Encourage the family to have prompt follow-up care for any voice changes or car
- infections, early interventions are required
6. Child should be supplemented with proper nutrition and rest
7. The child should be helped to lead normal life.
8. Encourage the child to expand sentences which aids in language acquisition
9. Promote personal growth, self-esteem and confidence among child
10. Help the parents to resolve conflicts and recognize the need for consistent discipline as it can decrease the child’s emotional stress
11. Encourage the parents to speak, act and proceed the family activities in a relaxed manner and to avoid stress
12. Promote slow, quiet rhythmic physical activities, e.g. listening to music will calm up the excitement of child
13. Answer to the childs’ questions honestly, never talk to the child sarcastically
14. Prevention of communication disorders begins with effective prenatal care, prompt follow-up care and stimulating child’s speech will decreases delay in language development.
[Ref: KP Neeraja/1/Vol-2/480-111
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