Lesser Known Disorders
Each issue of this series contains at least three lesser known disorders. Some of these disorders may contain subtypes which will also be presented. You will also notice that each disorder has a code. These codes represent the coding system for all disabilities and disorders listed in the Educator’s Diagnostic Manual(EDM) Wiley Publications.
Disorders in this issue:
SL – 5.02- Resonance Disorders
Disability Category: Speech and Language Impairment
Definition
A type of voice disorder specifically associated with sound quality of speech. Resonance is defined as the vocal quality associated with the vibration of air in the oral and nasal cavities (American Cleft Palate-Craniofacial Association, 2004).
Explanation
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 pages (hyponasality).
SL 5.02a-Hypernasality Resonance Disorder (4)
Hypernasality resonance disorder occurs when too much air passes through the nasal cavities during production of sounds, giving the speaker a distinctive nasal quality or “twang.” Hypernasality is a speech disorder occurring when the palate and pharynx tissues do not close properly. This inadequate closure causes air to escape through the nose during speech instead of coming out of the sides and back of the throat, particularly with certain sounds such as “p,” “b,” “s,” and “k.” (American Academy of Otalaryngology, 2002).
Hypernasality is the most common resonance disorder in children. It occurs most frequently in children born with a cleft palate or other craniofacial anomalies (Children’s Hospital of New York, 2005).
In children, hypernasality can occur after cleft palate surgery, from a deformation of the face (such as Down Syndrome), or from neurologic problems. This condition rarely occurs after surgery to remove the adenoids and in otherwise healthy children. It can also be a learned behavior (American Academy of Otalaryngology, 2002). Hypernasality is often found in children with motor-based speech disturbances. Sluggish movements of the lips, tongue or soft palate can result in airflow which is directed more toward the nasal cavity (Children’s Hospital Medical Center of Akron, 2004).
SL 5.02b-Hyponasality Resonance Disorder
Hyponasality Resonance Disorder occurs when too much air passes through the nasal cavities during production of sounds. Nasal congestion from a cold or allergies or sometimes enlarged adenoids cause hyponasality (Children’s Hospital Medical Center of Akron, 2004). The speaker may sound as if his or nose is being held or has a cold.
SL- 5.03- Spasmodic Dysphonia (Laryngeal Dystonia)
Disability Category: Speech and Language Impairment
Definition
A type of neurological voice disorder specifically associated with involuntary “spasms” of the vocal cords causing interruptions of speech and affecting the voice quality. Spasmodic Dysphonia can cause the voice to break up or to have a tight, strained, or strangled quality (National Spasmodic Dysphonia Association, 2000).
Explanation
Spasmodic dysphonia (or laryngeal dystonia) is a neurological voice disorder that involves involuntary “spasms” of the vocal cords causing interruptions of speech and affecting the voice quality. It can cause the voice to break up or have a tight strained, or strangled quality (National Spasmodic Dysphonia Association, 2000). Individuals who have spasmodic dysphonia may have occasional difficulty saying a word or two or they may experience sufficient difficulty to interfere with communication. Spasmodic dysphonia causes the voice to break or to have a tight, strained or strangled quality.
SL 5.03a-Adductor Spasmodic Dysphonia
In adductor spasmodic dysphonia, sudden involuntary muscle movements or spasms cause the vocal folds (or vocal cords) to slam together and stiffen. These spasms make it difficult for the vocal folds to vibrate and produce voice. Words are often cut off or difficult to start because of the muscle spasms. Therefore, speech may be choppy and sound similar to stuttering (Baylor College of Medicine, 2006; National Institute on Deafness and Other Communication Disorders, 2002)
SL 5.03b-Abductor Spasmodic Dysphonia
In abductor spasmodic dysphonia, sudden involuntary muscle movements or spasms cause the vocal folds to open. The vocal folds can not vibrate when they are open. The open position of the vocal folds also allows air to escape from the lungs during speech. As a result, the voices of these individuals often sound weak, quiet and breathy or whispery (Baylor College of Medicine, 2006; National Institute on Deafness and Other Communication Disorders, 2002)
SL 5.03c-Mixed Spasmodic Dysphonia
Mixed spasmodic dysphonia involves muscles that open the vocal folds as well as muscles that close the vocal folds and therefore has features of both adductor and abductor spasmodic dysphonia (National Institute on Deafness and Other Communication Disorders, 2002)
SL – 6.05- Landau Kleffner Syndrome (also known as Infantile Acquired Aphasia, Acquired Epileptic Aphasia, or Aphasia with Compulsive Disorder)
Disability Category: Speech and Language Impairment
Definition
Landau-Kleffner syndrome (also called infantile acquired aphasia, acquired epileptic aphasia, or aphasia with convulsive disorder) is a language disorder. It frequently occurs in normally-developing children, usually between three and seven years of age, and is characterized by the gradual or sudden loss of the ability use or comprehend spoken language (New York Presbyterian Hospital, 2003).
Explanation
LKS occurs most frequently in normally developing children who are between 3 and 7 years of age. For no apparent reason, these children begin having trouble understanding what is said to them. Doctors often refer to this problem as auditory agnosia or “word deafness.” The auditory agnosia may occur slowly or very quickly. Parents often think that the child is developing a hearing problem or has become suddenly deaf. Hearing tests, however, show normal hearing. Children may also appear to be autistic or developmentally delayed (National Institute of Neurological Disorders and Stroke, 2005; National Institute on Deafness and Other Communication Disorders National Institutes of Health, 2002d; New York Presbyterian Hospital, 2003).
The inability to understand language eventually affects the child’s spoken language which may progress to a complete loss of the ability to speak (mutism). Children who have learned to read and write before the onset of auditory agnosia can often continue communicating through written language. Some children develop a type of gestural communication or sign-like language.
The loss of language may be preceded by an epileptic seizure that usually occurs at night. At some time, 80 percent of children with LKS have one or more seizures. The seizures usually stop by the time the child becomes a teenager. All LKS children have abnormal electrical brain activity on both the right and left sides of their brains (National Institute of Neurological Disorders and Stroke, 2005; National Institute on Deafness and Other Communication Disorders National Institutes of Health, 2002d).
SL – 8.01- Acquired Language Delay
Disability Category: Speech and Language Impairment
Definition
A type of language delay specifically associated with injury or illness as its cause (Royal College of Speech and Language Therapists, 2001).
Explanation
A language delay can be thought of as a language delay resulting from something traumatic occurring to the individual. Examples could include a car accident, sickness, or any other type of situation that has a direct cause and effect relationship to the language delay of the individual.
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