Cerebral Palsy (CG) is a neurological disorder caused by an injury to the brain or a brain malformation that occurs while the child s brain is still developing   in the mother s womb before birth, during birth, or immediately after birth.

This disorder affects the child s movement and muscle coordination and control. It also affects his:

Reflexes
Balance
Posture
Motor skills and
Oral motor functions
In easy to understand language, CG can impact the child s ability to walk, talk, sit, do simple tasks like eating, combing hair, talking, and other activities we take for granted. The physical impairment caused by cerebral palsy can affect all limbs, the face and head, or it may just affect one limb. Since CG affects muscles and a child s ability to control them, common symptoms include muscles that contract too much, too little, or all at the same time, leading to limbs that are stiff and forced into awkward positions. Other complications also arise such as intellectual impairment, seizures, or vision/ hearing and speech impairment.

How does Speech Therapy help?
Speech problems affect more than half of all children with cerebral palsy as they have difficulty controlling the muscles in their face, throat, neck and head. Apart from speaking, this also affects chewing and swallowing. It can also cause drooling and the ability to learn, difficulty hearing and understanding spoken language.

This is where speech and language therapy comes in. Speech therapy improves a child s speech and communication by strengthening the muscles used for speech. It also improves understanding of speech and language as well as help with swallowing disorders, like dysphagia.

Speech therapy helps exponentially as when children improve their speech and communication, they are able to express their needs, share their thoughts and interact with others, leading to an overall improvement in their overall quality of life.

Speech therapy can help with the following:

Listening
Articulation of words
Pronunciation
Fluency
Sound and word formation
Language and vocabulary development
Breath control
Chewing
Swallowing
Speech muscle coordination
Apart from this, the other primary benefits are boosting self esteem, socialization, independence and reducing shyness. 

Exercises used in Speech Therapy
Speech therapy treatment usually consists of exercises tailored to a child s specific needs. Different exercises are used in speech therapy like:

Articulation therapy: The therapist uses language cards to help focus attention on specific sounds to encourage the child to make sounds while looking in the mirror to help him understand how his mouth moves.
Blowing exercises: The therapist encourages the child to blow bubbles or a whistle to train the mouth muscles to produce sounds.
Breathing exercises: Work is exclusively on inhalation and exhalation to strengthen the diaphragm.
Jaw exercises: The child is encouraged to eat foods that require extra chewing to strengthen jaw muscles.
Language and word association: The therapist uses flashcards with different words and sounds written on them.

Cerebral Palsy (CP) - How Speech Therapy Can Help You?

Speech therapy is a very distinct form of science that is often misunderstood by people in general. While the benefits of such a therapy is countless, people misinterpret what the therapy actually involves and what it does not. If you are avoiding speech therapy due to the following reasons, you should stop doing so as these are nothing but fabricated myths.

Speech therapy is all about talking: Do not think that speech therapy only involves talking with the therapist. The therapy focuses on the overall communication skills of a person, which definitely involves the speech but also the intricacies of articulation and body language. Sign aids and comprehension skills are also paid attention to in such a therapy session. So, if you feel that you have a problem regarding any one of these aspects, you need to visit a speech therapist.
Speech therapy is uninteresting: Nothing can be further from the truth than this. In fact, a visit to a dentist can be boring, but a visit to a speech therapist will always involve interesting activities such as tongue twisters. The therapists often treat children, which means that their offices, house toys, and other games designed to indulge the minds of infants as well.
A qualified speech therapist is needed for the therapy: Another myth, which needs to be dispelled, is that only a qualified speech therapist can help improve the speech of a person. In fact, any person who has a vast knowledge of diction, linguistic insight, and knowledge of grammar can help people with speech impairment. So, before visiting the doctor, the adults in the family should try and clear out the impairment themselves.
Speech therapy fixes issues in the snap of a finger: As with any kind of treatment, speech therapy does not work like magic. It is a continuous and long process that needs to be followed through. The pace of this treatment depends on the patient. Some patients are more receptive to this therapy than others. So, there is no guideline for the treatment of all speech-impaired individuals and one needs to be treated and allowed to get better at their own pace.
Your child will automatically learn perfect speech: If your child suffers from a speech impairment, do not delay a therapy session by thinking that he/she will automatically learn to speak better as they grow up. This way of thinking is not beneficial and hinders the eventual treatment for the impairment. The speech therapist can help you better if you bring your child to him/her as soon as you detect an issue. 

Don't Let These Myths Turn You Off From Speech Therapy

It might happen that you may not find your child, at twelve months to two years of age, at the same level as their peers in verbal communication. You think it's just a developmental problem they are facing and put off seeking professional advice; an intrinsically wrong step to take, because your child might be suffering from Speech Delay.
Delayed speech, or alalia, can be roughly defined as a delay in the development and use of the biological mechanisms that produce speech.
The symptoms of speech delay are roughly categorized into age related groups, generally beginning at the age of 12 months and continuing through the early adolescence, and they are:
1. Age-12 months
a. It is indeed a symptom if your child cannot point at objects or cannot manage gestures, such as waving good-bye.
b. Another symptom is that if your child does not prefer to communicate verbally as much as his/her peers.
2. Age-15-18 months
a. If your child is unable to pronounce familiar syllables or simply cannot call you even by this time, it's a worrying symptom.
b. You find your child unable to, or simply not reciprocating to 'no', 'hello', 'hi', 'bye'.
c. If your child is unable to extend his/her vocabulary up to 15 words by fifteen months, then it's a symptom.
3. Age-2-4 years
a. You find your child unable to spontaneously produce speech and words.
b. Another worrying symptom is if your child is lacking consonant sounds at the beginning and end of words while speaking.
c. If you still find your child unable to form simple sentences and words, then it is indeed a troubling symptom, confirming the disorder.
The causes for the speech delay disorder are:
1. A primary cause can be physical disruption in parts of the mouth such lips or palate, which may be deformed.
2. Another serious cause can be an oral-motor dysfunction which is the disruption in the creation of the specific area of the brain which deals with speech and communication.
3. The disorder can also be attributed to impairment in the development of the child's intellectual, receptive and expressive abilities.
4. There can also be psychological causes involving school environment and peer relationships which might lead to disruption of speech patterns and reluctance in speech expression and development.

Causes and symptoms of Delayed Speech

Change in voice or voice mutilation happens when the voice breaks that commonly occur when a person reaches puberty. Before puberty, almost all the girls and boys have the same voice pitch. But after puberty, a boy s voice deepens an octave and the girl s voice deepens only several tones. Therefore, it becomes easy to identify the gender through voice. 

Another type of change in voice is known as voice crack. It happens when a person unintentionally enters a higher voice pitch zone for a brief period of time. It may be due to singing, shouting, talking in noise, and several other reasons. Also, there are several medical conditions leading to voice break or hoarseness. 

Medical Causes for Change in Voice

Acute Laryngitis: In this, the hoarseness or voice loss starts suddenly. One of the reasons can be a viral infection that causes swelling of vocal cords. Staying hydrated and less talk can treat it. 

Chronic Laryngitis: It can cause acid reflux disease. Exposure to irritating smoke, infections of vocal cords, or asthma can be some of the reasons. It can be cured only through medication.

Laryngopharyngeal Reflux Disease: This problem causes a change in voice. Due to this disease, people may also suffer from swelling issues, a lump in the throat, hoarseness in voice, and throat pain. 

Voice Misuse: Excessively loud voice, prolonged talking, and inefficient voice use can cause a change in voice and also known as voice misuse. 

Risk Factors That Can Cause Voice Disorder

Aging, alcohol use, and allergies are some of the major reasons for the voice disorder. Apart from these, smoking and throat cancer also results in a change in voice or voice disorders. All these are highly risky causes for the throat and may result in long-time problems. 

Some other risk factors are thyroid, psychological stress, and neurological disorder. 

How to Treat Voice Disorder?

One can use an air humidifier to keep the air of the surrounding moist because breathing moist air is a simple solution to the problem.

Giving rest to voice is also a solution.

One must drink plenty of liquids to keep the throat hydrated.

One must avoid whispering and decongestants to take care of the throat.

One must avoid shouting for a long time.

Avoid staying in a polluted area for a long time.

Gargling the throat every day with lukewarm water is good.

Staying warm during winters is also necessary.

All these remedies are simple and can be tried comfortably. A simple change in voice can turn out to be serious if not taken proactive measures. Therefore, one must not ignore any small unintentional change in the voice.

Conclusion
One must consult ENT doctor immediately for any sudden change in voice and if the problem lasts for a long period of time. 



Change In Voice - What Can Cause It?

Speech therapy helps in improving the speech, understanding the language skills, and also help in communicating in non-verbal ways such as listening and taking turns. Speech therapy treats various kinds of communication and swallowing problems.

Children with Cleft Palate are diagnosed with an opening in the upper tissue palate in the mouth. This condition causes Velopharyngeal dysfunction (VPD) which results in excessive airflow from the nose while speaking. Although it can be corrected with surgery, the patient will still be affected by VPD.

Speech therapists help in this condition by assisting the patient with speech and language skills. The speech therapy for such a patient can be categorized as auditory feedback and articulation practice.

Auditory Feedback

Before involving the patient with any speech therapy, it is essential for the patient to understand the difference between normal voice and nasal voice output.

For this purpose, the child is instructed to use a tube to listen to the voice of the normal person. To understand the difference, one end of the tube is then held near the ear of the child and the other is held near his nasal and then he is instructed to make sounds so that he understands the nasal voice.

After this understanding, the different approaches to speech therapy starts.

Articulation Practice

This is usually where speech therapy begins. In this practice, the different type of condition is understood that relates to different speech organs. The understanding of different vowels, consonants and related sounds is taught to the child for making the speaking sound less nasal.

Some of the methods for achieving these sounds are:

Pharyngeal Plosives: This sound is produced when the tongue is moving backward. The practice of making  ng  sound, and dropping the tongue and producing  k  sound.

Pharyngeal fricatives: When the tongue retracts but is not able to make contact with the pharyngeal wall is when this sound is produced. The speech therapists make the child learn the techniques of making sounds of  t ,  ts ,  ch , or  sh , and provide feedback for learning the proper positioning of the tongue.

Nasal Plosives: This sound usually occurs when the tongue is positioned improperly and it obstructs the vocal tract. A speech therapist may make the child yawn so that the back of the tongue is pushed down, and feel as the mouth stretches.

Palatal-Dorsal Productions: It occurs due to the malocclusion of the teeth. Practicing sounds like  t ,  d ,  n ,  k ,  g , and  ng  often helps in such condition.

Take Away
Cleft Palate is generally developed due to improper growth while the child was in the womb. The difficulty of producing proper sounds when there is excessive airflow in the mouth can be overcome by training and practicing certain sounds, as instructed by a speech therapist.

 Cleft Palate - How Efficient Is Speech Therapy?

Language disorder is commonly known as language impairment, it is a common childhood disorder, which makes it difficult for kids to understand what the people around them are saying to them and to face difficulty in following simple directions, it also includes difficulty in expressing the thoughts and feeling through speech.

Language disorder can be classified as:

Receptive language disorder: This disorder makes it difficult to understand what the other person is saying to the one suffering from it.
Expressive language disorder: Kids suffering from it are not able to express themselves and their thoughts.
Mixed receptive expressive disorder: These kids have combined symptoms of receptive language disorder and expressive language disorder, making it difficult to understand and to make someone else understand.
Symptoms of language disorder:

Difficulty in understanding: The ones suffering from language disorder, finds it difficult to understand what the people around them are saying.
Limited vocabulary: It is one of the prominent symptoms, in which the vocabulary of the kids is very limited as compared to other kids of that age.
Trouble learning new things: Learning new things is a difficult task for the kid suffering from language disorder
Repeat usage of certain phrases: Kids tend to use the same phrase again and again, which is one of the basic symptoms.
Frustration: As the kid is either not able to understand or to make other understand or both, kids with this disorder tend to remain more frustrated in comparison to other kids, as they are unable to do things. 
Sentences which do not make sense: Making incomplete or senseless sentences is a key indicator of language disorder.
What you should do?

Speech therapist: The treatment may include speech therapy, in which the speech therapist will work towards building the vocabulary and improving the grammar of the kids suffering, making the kids more confident and feel good about themselves.
Psychotherapy: If the kid is also suffering from emotional issues because of the language disorder, then one should also undergo Psychotherapy, as it not only improves the morale of the patient, but also provides the guidance on how to keep improving further from the language disorder.
Positive Atmosphere: The kids suffering from such a disorder should be made comfortable enough to enjoy their being, giving plenty of time to your young ones is the best way to cure such disorder, so one should always communicate well with his kids and make them learn new things, sing to them, listen to various sounds, show different pictures, colours, shapes to make them learn.
Parental Support: The parents should also understand the issue well, be patient, and should support the kid to work out on the disorder. Parents should also interact with other parents, who have been there, to learn more about the language disorders and how their kids overcome the disorder.
As language disorder is one of common issue in kids, this can be managed and cured well to improve after all the required knowledge and best practices to follow.

Language Disorder - How to Diagnose it?	

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