医疗新知

卫教文章

Articulatory disorder 小兒構音異常

2016-12-13
Introduction

Communication is a multidimensional dynamic process that allows human beings to interact with their environment. Articulation disorders are difficulties with the way sounds are formed and strung together 

Causes of dysarthria
  1. Functional: 
    Dysarthria occurs because of environment or psychological factors, or learning faults. There are no physiological defects, including muscles and innervated nerves.  
  2. Organic:
    Including cleft palate (harelip), hearing impairment, related neurologic disorders, mental retardation, cerebral palsy, attention deficit, and hyperactivity disorder.
Symptoms
  1. omission sound:
    Omit the necessary sound with an abbreviated falls; take saying elephant as an example, normally we say it with the sound of “e-le-phnt”; with omitted sound, it sounds like “e-phet”. 
  2. substitution sound:
    Use of another pronunciation to alternate standard pronunciation, for example: when we say “mine” meaning “it belongs to me” in Chinese, it is enounced with “wo-da”; with substitution sound, it is enounced with “wo-ga”. As you can tell, d sound is replaced with a g sound. 
  3. addition sound:
    Add pronunciation which should not exist, for example: “Dai-zui” meaning dwarf “ai-zi”. 
  4. distortion sound:
    The pronunciation is completely twisted, losing it original sound type, for example: “hue-ling” meaning fatty for “phe-zen” in Chinese. 
Diagnosis

A speech evaluation should be performed by a speech-language pathologist. 

Treatment

When we approach a child with slurred speech, we should distinguish the causes of dysarthria into functional or organic. If it is due to organic abnormalities, correcting the abnormalities is the most important, for example, repairing cleft palate, treating hearing impairment, or frenectomy for tongue tie. For children of multi-organ dysfunction, besides ENT doctor, other related specialists should be involved, too. Kids will need speech-language therapy if they still have slurred speech or language disorders older than three-and-a half years old. Parental involvement is crucial to the success of a child's progress in speech or language therapy.

Prevention 

If there is a problem with articulation that is not developmental in nature, speech therapy is recommended.

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