Speech refers to the actual sounds of spoken language. Speech is Talking. Though it seems simple, it is a complex process. The muscles of the tongue, lips, jaws and vocal tracts have to be coordinated with precision to produce recognizable sounds. Speech is the output form of language.

Language refers to a whole system of words and symbols, written or expressed. Language is made up of socially shared rules that include the following

• What word means (e.g. “Star” can refer to a bright object in the night sky or a celebrity)
• How to make new words(e.g. friend, friendly, unfriendly)
• How to put words together(eg “Peg walked to the new store” rather than “Peg walk store new”.
• What word combination are best in what situations(“Would you mind moving your foot? Could quickly change to “Get off my foot please!” if the first did not produce results).

Just as speech and language differ, there is difference between speech and language disorders.

Language Disorder: When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.

Speech Disorder: When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder.

Be it Speech, Language, Voice, learning Disability or Dysphagia at Shravan at present we follow a protocol as under during the therapy process, to help our patients achieve better results

• Screening: To determine whether or not a complete evaluation and therapy is indicate
• Evaluation: A detail evaluation of each case is done. They will include indicated standardised and non- standardised test needed on case to case basis. The opinion of ENT specialist is evaluated. Based on the above a provisional diagnosis and therapy plan is prepared
• Therapy proper: Therapy is staged as under
  • Setting Goals: Every individual is different and their communication needs vary, therefore intervention will be individually tailored to meet their needs. This means your child’s intervention will be individually tailored to meet their needs. When assessment or evaluation has been completed, the Speech & Language Therapist will look at the results and set appropriate goals for your child these will be written on an intervention plan and shared with you
  • Therapy sessions: Sessions are usually 45 minutes, worked one on one according to the individualised plan laid down for each patient.
  • Re-assessment: Your child's communication needs will change and develop, therefore we will need to re-assess skills at various times during the year. Each goal set will be re- assessed every three month to record the improvement, and to set a new plan if needed
• 4. Success of Therapy: Evaluation: One person or professional cannot achieve this by working alone. To achieve success with the goals there should be close co-ordination between the Speech & Language Therapist, Teacher, Teaching Assistant and Parents. All must work together to achieve the goals.

Some of the speech impairments that we offer therapy are

• Articulation
  How speech sounds are made (e.g., children must learn how to produce the "r" sound in order to say "rabbit" instead of "wabbit").
  
  • Disorders (Speech sound disorders):
  • Omissions: "I go to coo on the buh" (I go to school on the bus); or "I ree a boo" (I read a book).
  • Substitution: "I like tooties and tate" (I like cookies and cake).
  • Distortion: A child tries to make the right sound, but cannot produce it clearly. For example, the /s/ sound may whistle, or the air may come out the sides of the mouth, making a "slushy" sound (“lateral lisp”); or, the tongue may push between the teeth causing a “frontal lisp”.
• Fluency
  The rhythm of speech (e.g.: hesitations or stuttering can affect fluency).
  
  • Disorders (Fluency disorders)
  • Stuttering: Stuttering is a speech disorder in which sounds, syllables, or words are repeated or prolonged, disrupting the normal flow of speech. These speech disruptions may be accompanied by struggling behaviours, such as rapid eye blinks or tremors of the lips. Stuttering can make it difficult to communicate with other people, which often affect a person’s quality of life.
  • Cluttering: Cluttering (also called tachyphemia or tachyphrasia) is a speech and communication disorder characterized by a rapid rate making speech difficult to understand, erratic rhythm, poor syntax or grammar.
  • Disfluencies: Most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by "um" or "uh." Disfluencies are not necessarily a problem, however, they can impede communication when a person produces too many of them.
• Voice
  Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).
  • Disorders (Voice disorders):
    
    The sound produced by the vibration of the vocal cords and resonated by the upper respiratory tract is the voice. All of us do experience problem with our voices sometimes. Like hoarseness of voice or when sound will not come out at all, or change in character of the voice.
  • Colds, allergies, bronchitis, exposure to irritants such as ammonia etc
  • Misuse of voice: Teachers, preachers, hawkers singers etc.
  • Single misuse: Cheering for your favorite sports team, Army / police commands etc
  • Growth / lesions: Vocal Cord Nodules, Polyps, Paralysis etc
  • Functional: Paradoxical Vocal Fold Movement, Spasmodic Dysphonia
  • Resonation disorders: Nasal polyps, rhinitis, DNS etc
  If voice change persists for over three weeks a detail evaluation including endoscopy study is a much. For non treatable case Voice therapy is the mainstay in the treatment plan in these patients.

Generalization of skills from one situation to another is one of the hardest things for children to achieve. To help your child you should be an active participant in the therapy process

• You should be aware of what your child's Speech & Language Therapy targets are
• Attend information/training sessions provided by the Speech & Language Therapists - they will help you to understand strategies and approaches that you can use to help your child.
• Think of opportunities to practice their communication skills at home and in everyday activities.
• Your child will achieve greater success if they practice in lots of different situations
• Take opportunities to meet regularly with your child's Speech & Language Therapist.
• Observe a session with your child. Provide feedback to the Speech & Language Therapist
• If your child attends appointments with other professionals, please let us know. This information may be useful in planning the support we give to your child.