Aphasia

Aphasia is an acquired neurogenic language disorder resulting from an injury to the brain; most typically, the left hemisphere. Aphasia involves varying degrees of impairment in four primary areas:

• Spoken language expression

• Spoken language comprehension

• Written expression

• Reading comprehension

Apraxia of speech

Apraxia of speech (AOS) is a "neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech" (Duffy, 2013, p.4).  AOS frequently co-occurs with dysarthria and/or aphasia and sometimes with limb apraxia, oral apraxia, apraxia of gait, and apraxia of swallowing. AOS does not involve muscle weakness, paralysis, spasticity, or involuntary movements typically associated with dysarthria, or language comprehension or production deficits that characterize aphasia.

Cognitive-Communication Difficulties/Disorders

• Reduced awareness and ability to initiate and effectively communicate needs

• Reduced awareness of impairment and its degree (i.e., loss of ability to assess one's own communication effectiveness)

• Reduced memory, judgment, and ability to initiate and effectively exchange routine information

• Difficulty performing personal lifestyle management activities effectively (i.e., pay bills)

• Reduced ability to anticipate potential consequences, with reasonable judgment and problem solving

• Reduced social communication skills and/or ability to manage emotions, often causing loss of relationships

• Disruption of ability to fulfill educational or vocational roles, including potential loss of employment

• At risk for injury due to inability to communicate in an emergency and/or anticipate the consequences of own actions

Dementia

Dementia is a syndrome resulting from acquired brain disease. It is characterized by a progressive decline in memory and other cognitive domains that, when severe enough, interferes with daily living and independent functioning.  A significant decline from previous levels of performance in one or more cognitive domains, including complex attention, executive function, learning and memory, language, perceptual motor, or social cognition (preferably documented by standardized testing or clinical assessment)

Dysarthria

We use many muscles to talk. These include muscles in our face, lips, tongue, and throat, as well as muscles for breathing. It is harder to talk when these muscles are weak. Dysarthria happens when you have weak muscles due to brain damage. It is a motor speech disorder and can be mild or severe.

If you have dysarthria you may:

• Have "slurred" or "mumbled" speech that can be hard to understand.

• Speak slowly.

• Talk too fast.

• Speak softly.

• Not be able to move your tongue, lips, and jaw very well.

• Have changes in your voice. You may sound hoarse or breathy. Or, you may sound like you have a stuffy nose or are talking out of your nose.

Adult Dysphagia

A swallowing disorder, known as dysphagia, may occur as a result of various medical conditions. Dysphagia is defined as problems with passing food potentially involving the oral cavity, pharynx, and/or esophagus.  It is especially common in the elderly specifically with individuals with neurological conditions. The term dysphagia refers to difficulty passing food or liquid from the mouth to the stomach. Dysphagia may be caused by factors such as poor dentition; acid reflux; stroke; progressive neurological disorder; the presence of a tracheotomy tube; a paralyzed vocal fold; a tumor in the mouth, throat, or esophagus; or after cancer or surgery to the head, neck, or esophagus. 

Social Communication Difficulties/Disorders

Social communication disorder is characterized by difficulties with the use of verbal and nonverbal language for social purposes. Primary difficulties are in social interaction, social cognition, and pragmatics. Specific deficits are evident in the individual’s ability to

• communicate for social purposes in ways that are appropriate for the particular social context;

• change communication to match the context or needs of the listener;

• follow rules for conversation and storytelling;

• understand nonliteral or ambiguous language; and

• understand what is not explicitly stated.

Speech Disorders

A speech disorder is an impairment of the articulation of speech sounds, fluency and/or voice.

1. An articulation disorder is the atypical production of speech sounds characterized by substitutions, omissions, additions or distortions that may interfere with intelligibility.

2. A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and repetitions in sounds, syllables, words, and phrases. This may be accompanied by excessive tension, struggle behavior, and secondary mannerisms.

3. A voice disorder is characterized by the abnormal production and/or absences of vocal quality, pitch, loudness, resonance, and/or duration, which is inappropriate for an individual's age and/or sex.

Source: ASHA