Characteristics of Children with Communication Disorders (page 3)

By — Pearson Allyn Bacon Prentice Hall
Updated on Jul 20, 2010

Voice Disorders

Voice is the sound produced by the larynx. 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” (ASHA, 1993, p. 40). A voice is considered normal when its pitch, loudness, and quality are adequate for communication and it suits a particular person. A voice—whether good, poor, or in between—is closely identified with the person who uses it.

Voice disorders are more common in adults than in children. Considering how often some children shout and yell without any apparent harm to their voices, it is evident that the vocal cords can withstand heavy use. In some cases, however, a child’s voice may be difficult to understand or may be considered unpleasant (Sapienza & Hicks, 2002). Dysphonia describes any condition of poor or unpleasant voice quality.

The two basic types of voice disorders involve phonation and resonance. A phonation disorder causes the voice to sound breathy, hoarse, husky, or strained most of the time. In severe cases, there is no voice at all. Phonation disorders can have organic causes, such as growths or irritations on the vocal cords; but hoarseness most frequently comes from chronic vocal abuse, such as yelling, imitating noises, or habitually talking while under tension. Misuse of the voice causes swelling of the vocal folds, which in turn can lead to growths known as vocal nodules, nodes, or polyps. A breathy voice is unpleasant because it is low in volume and fails to make adequate use of the vocal cords.

A voice with a resonance disorder suffers from either too many sounds coming out through the air passages of the nose (hypernasality) or, conversely, not enough resonance of the nasal passages (hyponasality). The hypernasal speaker may be perceived as talking through her nose or having an unpleasant twang. A child with hypernasality has speech that is excessively nasal, neutral, or central-sounding rather than oral, clear, and forward-sounding (Hall et al., 2001). A child with hyponasality (sometimes called denasality) may sound as though he constantly has a cold or a stuffed nose, even when he does not. As with other voice disorders, the causes of nasality may be either organic (e.g., cleft palate, swollen nasal tissues, hearing impairment) or functional (perhaps resulting from learned speech patterns or behavior problems).

Language Impairments

Language impairments can involve problems in one or more of the five dimensions of language: phonology, morphology, syntax, semantics, and pragmatics. Language impairments are usually classified as either receptive or expressive. As described previously, receptive language impairment interferes with the understanding of language. A child may, for example, be unable to comprehend spoken sentences or follow a sequence of directions. An expressive language impairment interferes with the production of language. The child may have a very limited vocabulary, may use incorrect words and phrases, or may not even speak at all, communicating only through gestures. A child may have good receptive language when an expressive disorder is present or may have both expressive and receptive disorders in combination. The term language-learning disabilities (LLD) is sometimes used to refer to children with significant receptive and/or expressive language disorders.

To say that a child has a language delay does not necessarily mean that the child has a language disorder. As Reed (2005) explains, a language delay implies that a child is slow to develop linguistic skills but acquires them in the same sequence as normal children do. Generally, all features of language are delayed at about the same rate. A language disorder, however, suggests a disruption in the usual rate and sequence of specific emerging language skills. For example, a child who consistently has difficulty in responding to who, what, and where questions but who otherwise displays language skills appropriate for her age would likely be considered to have language impairment.

Children with serious language disorders are almost certain to have problems in school and with social development. They frequently play a passive role in communication. Children with impaired language are less likely to initiate conversations than are their peers. When language-disordered children are asked questions, their replies rarely provide new information related to the topic. It is often difficult to detect children with language disorders; their performance may lead people to mistakenly classify them with disability labels such as mental retardation, hearing impairment, or emotional disturbance, when in fact these descriptions are neither accurate nor appropriate.

Children with oral language problems are likely to have difficulties in both reading and writing. Catts (1993) reported that 83% of kindergarteners with speech-language delays eventually qualified for remedial reading services. The problem is compounded because children with speech-language delays are more likely than their typically developing peers to be “treatment-resistors” to generally effective early literacy interventions (Al Otaiba, 2001).

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