Recognizing and treating speech and language disabilities

American Rehabilitation, Winter, 1993 by Diane Paul-Brown, Charles C. Diggs

Human communication: a message sent by one person and understood by another. It is enhanced by shared beliefs, behaviors, values, customs, and experiences. Sometimes it is confusing because the message conveyed by the words is different from the message sent by the voice and by the body (e.g., "I'm so excited," said in a monotone with a completely blank expression on the face). Sometimes it is incomplete because a speaker does not want to reveal personal information or because a listener is distracted by thoughts of everything else that needs to be done that day.

Communication is difficult, even under the best of circumstances. But, for at least 3 million people with a speech or language disability, communication may be so difficult that personal, educational, and vocational growth is stifled. The purpose of this article is to describe speech and language disabilities, their impact, and how they are diagnosed and treated. The article concludes with ways to enhance your communication with people who have speech and language disabilities.

Impact of Speech or Language Disability

In the words of one young woman who learned to communicate with an electronic system, the inability to communicate is:

" ... very frustrating. It's very lonely. It hurts.

"Think about it. You feel, you think, you know and understand the words, yet you cannot speak them. You hear everyone around you in an interesting conversation, but you cannot join in.

"You cannot express any of the feelings or emotions that are just as deep inside of you as anyone else. You are furiously angry and you have to hold it in; or you are extremely happy and you can't show it. Your heart is so full of love you could just burst, but you can't share it....

"I know what it is like to be fed potatoes all my life. I hate potatoes! But then, who knew that but me?

"I know what it is like to be dressed in reds and blues when my favorite colors are mint greens, lemon yellows, and pinks...

"Mama found me one night curled up in a ball in my bed crying, doubled over in pain...she thought I had a bad stomachache due to constipation. Naturally a quick cure for that was an enema. It didn't help my earache at all!" (From Keyhole Communique, 3(3), May 1989.)

Without adequate communication, people often feel disconnected from others. They may question their selfworth and they may develop inappropriate emotional reactions to the problem that further impede commumication with others.

Speech and language skills are essential not only for communication but also for educational achievement. Even early elementary school students must be able to follow directions, make associations between sounds and letters, analyze words, make oral presentations, and learn the meaning of abstract words and concepts for mathematics such as few, many, some, all-except. The need for these skills increases rapidly as learning becomes more dependent on the teacher's oral presentations and on understanding the more complex language of textbooks. These demands increase at the same time as the academic curriculum deemphasizes skill building in phonics, vocabulary, number concepts, and language.

By the upper grades, understanding and using sophisticated language concepts--for example, metaphors, jokes, negotiation, and persuasions--is expected across a broad range of subject areas. Consequently, academic achievement will suffer for anyone who has significant speech or language difficulty.

Problems may extend into the workplace when a new job or a promotion places different demands on speaking, writing, and general communication skills. And, of course, others often meet the disability before the person. Ratings of the speech, intelligence, education, and friendliness of two attorneys with normal speech decreased significantly when they were taught to lisp (Mowrer, Wahl, & Doolan, 1978). Businessmen rated talkers whose voice boxes were removed and who were using an alternative, effective method of communication as more limited in the number of jobs they could handle and in the amount of public contact that was appropriate (Gilmore, 1974). Personality traits of shyness, anxiousness, lack of self-control, and social withdrawal were attributed more to men who stuttered than to a control group with normal fluency, despite the fact that research has failed to document a common personality type, a consistent neurosis, or a pattern of significant maladjustment in people who stutter (Woods & Williams, 1976). Recently, a government employee who routinely received "Outstanding" work evaluations but was passed up for promotion for 10 years reached an out-of-court settlement with his employer and dropped his lawsuit that alleged discrimination because of his stuttering and his age.

People with speech or language disabilities not only must acquire the communication skills required for a job but then must often convince employers that they can do the job. The Americans with Disabilities Act, which prohibits discrimination in employment and requires reasonable accommodations for applicants and employees with disabilities, will expand opportunities for people with speech or language disabilities but may not instantaneously eliminate prejudicial attitudes.