Speech, Language And Voice Disorders

Speech impairments include a variety of disorders, which may affect one or more functions of speech comprehension or use. The degree of severity is also widely spread, ranging from mild loudness disorders (especially S formation) to the most severe central organic speech disorders in all age groups. There are fluent transitions to other forms of disability, especially to learning and behavioural disorders.

Furthermore, speech, language and voice disorders can occur in connection with physical disabilities (e.g. dysarthrophonia) and as a secondary consequence of hearing impairment. Accordingly, the specific conditions and aids for career choice and professional (re-)integration are differentiated. The article focuses on pedagogical-psychological rehabilitation. Medical aspects are not in the foreground.

Complexity of the manifestations:

Language is bound to a complicated interplay of sensory, motor, emotional and social-communicative functional areas. The non-uniformity of the appearance of speech, language and voice disorders is an expression of the multidimensionality of normal and disturbed language development. Due to practical experience, it is becoming increasingly difficult to distinguish speech, language and voice disorders in the narrower sense from learning disabilities and behavioural disorders (behavioural disorders).

Likewise, reading and writing disorders are increasingly observed in complex speech development disorders (partial performance disorders), which reach into adulthood and can lead to illiteracy. Aphasia in adulthood with high psychosocial relevance and significance for life is becoming increasingly important.

Effects on communication:

In child language acquisition there is a dynamic interaction between hearing, sensomotoric and kinesthetic (body movement related) feedback processes, between cognitive and linguistic functions. Therefore, the individual developmental dimensions of speech, language and voice disorders have different effects on the development of basic qualifications.

The impairments of communication, which can be caused by the person with speech impairment as well as by the reaction or prejudiced attitudes in the social environment, are correspondingly diverse. Under certain circumstances, the subjective experience of the communication disorder (misunderstanding and rejection on the part of the environment) weighs more heavily for the individual than the objective degree of the disorder itself. The negative environmental reaction, on the other hand, can worsen the speech disorder like a control loop.

Age distribution:

Over 80 percent of mild speech, language and voice disorders and severe speech impairment occur in children between the ages of four and twelve. In most cases these are disorders of speech development with the main symptoms in the area of pronunciation and grammar. Most of these disorders can be reduced until puberty.

As far as longer lasting or permanent (speech) disabilities are concerned, these are often observed in the context of comprehensive disturbance pictures. Because of the age pyramid in our society, the proportion of elderly people is increasing more and more and at the same time more and more people survive a stroke due to medical progress, the percentage and absolute proportion of people with aphasia is increasing.

Self-image of the speech therapy school:

Depending on the degree of speech impairment, children with speech disorders attend general schools or special schools for speech impaired/speech therapy schools. From the original conception, only children who, with intact hearing and normal or slightly impaired intelligence, are unable to follow the educational path of the general school sufficiently due to their linguistic impairment, and for whom additional outpatient measures due to the complexity of the disorder phenomena are not sufficient to bring about a reduction in the disorder, are admitted to the speech therapy school. In principle, the school for the speech impaired/speech therapy school is conceived as a transit school with the declared task of retraining and retraining and the associated alignment with the curriculum of general schools. Thus, the focus is on the primary school sector. Accordingly, most schools for people with speech impairments are only run up to the fourth or sixth grade.

Changes in the student body:

As the school for the speech impaired/healing language school transfers its pupils to the general school as quickly as possible, the class size decreases upwards. This also changes the student body in the upper classes. While disruptions of language development are disproportionately frequent when children enter school, the proportion of children with central organic damage and stuttering increases with increasing grade level.

In recent years, more and more children with complex language development disorders have been admitted who, in addition to comprehensive disorders at several language levels, also have impairments of learning and social behaviour.

Phase of upheaval in schooling:

The previous statements concentrate on the conception of the traditional speech school, which has been considerably expanded in this form in the last two decades. This development has now come to a standstill. Current trends vary from state to state.

In some federal states the preservation of the Sprachheilschule stands in the foreground. Other federal states are testing the establishment of inter-disability support centres in which children from former speech therapy schools, schools for the learning disabled and special schools and schools for people with behavioural disorders are brought together.

There is an overarching tendency to create more opportunities for joint schooling and school organisational integration. The changes mentioned are in line with the recommendations for special educational support in schools in the Federal Republic of Germany of 6 May 1994, which replaced the recommendations of the Kultusministerkonferenz (KMK) of 1972.

Instead of a focus on an institution-related view of the need for special education, this is associated with a more person-related, individual child-centred support, in which the individual needs for support have to be determined again and again. The local school authorities and the Employment Agency provide information on possible school-leaving qualifications and other details of secondary school attendance.