A phonological disorder refers to errors in how sounds are combined to make words. These errors are called phonological processes. While there are many phonological processes, only the most common are detailed below:
Substitutions – replacing one sound with another sound, in this case, the child is capable of producing the sound but does not use the sound in the correct place within a word (ex. “tea” for “key”).
Stopping- occurs when a sound that should have continued air flow (/s/, /f/ etc) is ‘stopped’ and produced as a short sound (ex. “to” for “shoe” or “mitt” for “miss”).
Syllable Reduction- occurs when a child drops a syllable from a multiple syllable word (ex. “nana” for “banana”).
Consonant Cluster Reduction- a sound is eliminated from a consonant cluster (ex. “top” for “stop” or “side” for “slide”).
• Receptive language – what the child understands when spoken to (ex. Follows directions, understands vocabulary, etc.)
• Expressive language- what the child says (ex. Age appropriate vocabulary, irregular forms of words (eat vs. ate), all grammar, etc)
The term “Language Impairment” covers a wide range of errors, which occur when a child is learning language.
• Receptive disorders impact a child’s ability to follow directions, understand vocabulary, and further understand and process what is said to them.
• Expressive disorders are characterized by a limited vocabulary, grammatical errors (word order, past tense, plural ‘s’, etc.), sentence length, etc.
• Vocal Nodules: a small node that develops on the vocal fold, similar to callus.
• Polyps – similar to nodules but they are softer and may be filled with fluid or have vascular tissue
• Papilloma – a wart like growth caused by HPV, usually treated by surgery and often requires speech therapy after surgical treatment
• Vocal Fold Thickening -prolonged use of vocally abusive behaviors can cause the vocal folds to thicken (chronic cough, throat clearing, screaming)
• Granuloma – ulcer on vocal cords
• Laryngeal Trauma – injury to the larynx (burns, car accident, sports-related accidents, attempted strangulation, etc.)
• Laryngeal Web – a membrane that grows across the anterior portion of the glottis (area between the vocal folds)
• Gastroesophageal Reflux (GERD) – voice disorders can result due to chronic GERD (heart burn), caused by acid from the stomach spilling into the esophagus, which can then lead to sore throat, hoarseness, and possibly contact ulcers on the vocal cords
• Paralysis and Ankylosis – a vocal cord can be paralyzed when the nerve supply is cut off (injury during surgical procedures, progressive neurological diseases, malignant diseases, intubation trauma, stroke, etc)
• Spasmodic dysphonia – involuntary movement of the vocal cords during speech, voice will have audible tremors and can be difficult to produce
• Carcinoma and Laryngectomy – laryngeal cancer often results in voice disorders following treatment. Laryngectomy is the removal of the larynx requiring treatment for esophageal speech, or assistive device for voice production.
• Other neurological diseases with associated voice disorders
Amyotrophic Lateral Sclerosis (ALS)