Exceptional Development

Language Disorders, ADD and ADHD

Group 4
Language Disorders
Language or Speech Disorders

● Diseases or disorders when a person:

○ Is unable to speak correctly or fluently
○ Has problems with his or her voice
○ Has difficulties pronouncing words or sounds
■ Examples:
● Articulation disorders
● Stuttering
Language or Speech Disorders: Causes

● Congenital Conditions are caused by other developmental problems in children

such as:
○ Autism spectrum disorder
○ Hearing loss
○ Cerebral palsy
○ Cleft Lip & Palate
○ Learning Disabilities
● Acquired Conditions may be due to:
○ Brain or head Injury
○ Damage to the central nervous system (Aphasia)
Language or Speech Disorders: Treatment

● Special language development programs for the parents/families

● Individual or group speech and language therapy

● Special Services in school

Aphasia
Aphasia

● Loss of the ability to produce or comprehend language caused by damage

to brain areas specialised for these functions
○ Left hemisphere
● The type and severity of language dysfunction depends on the location and
extent of brain damage
● Most commonly seen in adults
● Very rare in children
Aphasia: Symptoms

● Inability to comprehend language

● Inability to pronounce
● Inability to form words
● Inability to name objects
● Paraphasia (substitution of letters or words)
● Agrammatism (inability to speak in a grammatically correct form)
● Uncompleted sentences
● Inability to write
● Inability to read
Aphasia: Is there any treatment?

In some instances, an individual will completely recover from aphasia

without treatment.
In most cases language therapy should start as soon as possible and be
tailored to the individual needs of the patient.
Rehabilitation with a speech pathologist involves:
● Exercises in reading
● Exercises in writing
● Exercises in following directions
● Repetitions of what they hear
● Computer-aided therapy
BROCA’S APHASIA
(Non-fluent or Expressive Aphasia)
Broca’s Aphasia

● Disordered way of speaking due to brain damage to the Broca’s Area

● Broca’s Area- located in the front left side of the brain
● Usually occurs after a stroke
● Characterized by the inability to form complete sentences and difficulty to
understand sentences
● Disruption in speech production, comprehension, and/or understanding
● Patients essentially speak in nouns and leave out some words like “the”,
“and”, and “is”. They also have trouble repeating sentences.
Broca’s Aphasia: Causes

➢ Anything that kills brain cells (when blood and oxygen flow is stopped or
diminished)
➢ Stroke
➢ Brain Tumor
➢ Injury in the brain, such as from severe blow to the head or
➢ Gunshot wounds
➢ Infection in the brain
➢ Progressive Neurological conditions, such as Alzheimer’s disease
Broca’s Aphasia: Treatment
● May improve without treatment but the following are recommended when
talking to a patient with Broca’s aphasia:
○ Keep sentences short and simple, don’t speak to them as if they are a child.
○ Remember that their interests have not changed, only their ability to talk about
them.
○ Ask a lot of yes and no questions, or questions that require very simple
answers.
○ Use gestures or props to get your point across.
○ Fold in simple interactions such as sitting quietly in nature, where you can
enjoy each other’s presence without speaking too much.
SAMPLE OF BROCA’S APHASIA
Wernicke’s Aphasia
 Wernicke’s Aphasia
● A.k.a. Fluent aphasia, receptive
aphasia, sensory aphasia, or
posterior aphasia.
● Wernicke’s area
○ left posterior temporal region of the
brain’s cerebral cortex associated with
speech
○ Described in 1874 by Karl Wernicke, a
German neurologist and
neuropathologist
Wernicke’s Aphasia: Signs and Symptoms

● Poor auditory processing

● Fluent speech full of neologisms and paraphasias
○ Neologism- made-up words
○ Paraphasia- jumbled syllables or words and meaningless sentences
● Poor repetition
● Impaired comprehension
● Poor word retrieval
● Unawareness of one’s language mistakes
● Reduced retention span
● Reading and writing impairments
Wernicke’s Aphasia: Causes

● Stroke (Aphasia affects 25% - 40% of stroke patients)

● Head trauma or injury
● Brain Tumors
● Infections
● Migraine and other headache disorders
● Neurological disorders
○ Alzheimer’s Disease
○ Parkinson’s Disease
○ Epilepsy
○ Dementia
Wernicke’s Aphasia: Treatment

● Individual Speech Therapy

○ Better use of existing language abilities
○ Improving language skills by relearning them
○ Ability to communicate in a different way, making up for missing words in speech

● Group Therapy
○ A small group of people with aphasia meet and communicate under the supervision of a
therapist
○ offers the opportunity to use new communication skills in a comfortable setting
Wernicke’s Aphasia: Treatment

● Promoting Aphasic's Communicative Effectiveness (PACE)

○ a kind of therapy that improves the patient's communication skills by engaging them in
simple to increasingly complex conversation

● Computerized Script Training (CST)

○ This involves a computer-delivered script based on day-to-day conversations. It gives the

patient an opportunity to practice their communication skills using realistic situations.
Communicating with a Wernicke’s Aphasia patient

Family members are encouraged to:

● Get the person's attention before starting to speak, and maintain eye contact.
● Keep your voice at normal volume, but speak more slowly than usual.
● Simplify language by using short, uncomplicated sentences.
● Repeat the content words or write down keywords to clarify meaning as needed.
● Minimize distractions, such as a blaring radio, whenever possible.
● Include the person with aphasia in conversations.
● Ask for and value the opinion of the person with aphasia, especially regarding family matters.
● Encourage any type of communication, whether it is speech, gesture, pointing, or drawing. Try to keep a notepad or
some paper and a pen to hand, as this may help to communicate.
● Avoid correcting the individual’s speech.
● Allow the individual plenty of time to talk.
● Help the individual become involved outside the home. Seek out support groups such as stroke clubs.
 GLOBAL APHASIA
● A severe form of nonfluent
aphasia
● caused by damage to the
left side of the brain, that
affects receptive and
expressive language skills
(needed for both written
and oral language) as well
as auditory and visual
comprehension.
GLOBAL APHASIA
Acquired impairments of communicative
abilities are present across all language
modalities, impacting language
production, comprehension, and
repetition.

Patients with global aphasia may be able

to verbalize a few short utterances and
use non-word neologisms but their overall
production ability is limited. Their ability to
repeat words, utterances, or phrases is
also affected.
 SIGNS AND SYMPTOMS

The general signs and symptoms include:

• the inability to understand, create, and repeat speech and
language.
• difficulties in reading, writing, and auditory comprehension
abilities.
• Vocabulary impairment-inability to read simple words or
sentences
• May be accompanied by weakness of the right side of the face
and right hemiplegia (paralysis)
• can occur with or without hemiparesis (weakness).
 CAUSES OF GLOBAL APHASIA

• Injuries to multiple language-processing areas of the brain (both

Wernicke’s and Broca’s areas.
• Thrombotic stroke (blood clot in the brain)
• TBI or traumatic brain Injury
• Brain Tumors
• Progressive neurological disorders
 TREATMENT
• Speech and language therapy
▪primary treatment
▪Goal: increase communication abilities to a functional level
▪Collaboration between speech language pathologists, patients,
and their family or caregivers.
▪Group or individual
 TREATMENT
• Visual Action Therapy (VAT)
▪a non-verbal gestural output program
▪teaches unilateral gestures as symbolic representations of real life
objects.
• Constraint-induced language therapy (CILT)

▪involves teaching the patient to use speech in small segments but

avoid using gestures and familiar words .
▪The speech language pathologist provides positive feedback and
ignores any mistakes made by the patient.
ADD and ADHD
ADD and ADHD

● Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder

(ADHD)
○ The difference: ADHD includes the symptom of physical hyperactivity
or excessive restlessness while In ADD, the symptom of hyperactivity
is absent. People with ADD can be calm and serene, not hyperactive or
disruptive.
ADD and ADHD
● Developmental disorders marked especially by persistent symptoms of :
■ Inattention
■ Inability to focus on tasks or subjects
■ Distractibility
■ Forgetfulness
■ Disorganization
■ Hyperactivity and impulsivity
● affect how well someone can sit still, focus, and pay attention.

● Patients with ADD/ ADHD have differences in the parts of their brains that
control attention and activity.
ADD and ADHD
● Affects children and teens and can continue into adulthood.

● ADHD- the most commonly diagnosed mental disorder of

children.
ADD and ADHD

● The three main categories of ADHD are:

○ Inattentive: difficulty focusing or staying focused on a task
or activity
○ Hyperactive-impulsive: excessive activity and impulsivity
○ Combined: focusing problems plus excessive activity and
impulsivity
ADD and ADHD: Causes

● Exact cause is unknown but could be due to a combination of GENETIC

and ENVIRONMENTAL risk factors

● Dopamine

○ a small molecule responsible for communication between neurons

○ plays an important role in attention, task orientation, and action

ADD and ADHD: Treatment

● Available treatments are adapted to meet the needs of the individual child following
a biopsychosocial assessment.
● Treatments include:
○ Specific Medications
○ Psychoeducation
○ Social Skills Training
○ Special Supervision At School
○ Individual Psychotherapy
ADD and ADHD: Treatment
● Stimulants
○ most common type of medication prescribed for attention deficit
disorder
○ have the longest track record for treating ADHD and the most
research to back up their effectiveness.
○ The stimulant class of medication includes widely used drugs such
as:
■ Ritalin
■ Adderall
■ Dexedrine
ADD and ADHD: Treatment

● Parents may also receive help to better understand attention deficit

disorder and improve their parenting skills.
● All children are assessed to determine their response to drug treatments in
terms of both behaviour and possible side effects.
Attention deficit hyperactivity disorder
(ADHD)