Spasmodic Dysphonia (SD) is commonly misdiagnosed due to its similarity’s to other voice disorders. Numerous people go to the doctor because of this reason thinking they might have a severe cold or something in that nature. Patients with SD start out with either an immediate or slow onset of trouble speaking, interruptions of breathy pauses in their voice during production of specific sounds or words. It is also reported that they feel like it takes a lot more time and effort to speak than normal causing their voice to sound breathy, tense, or even low and quiet like a whisper. Symptoms can vary like any other disorder depending on the severity and how long they have been present. SD can come in three different types causing several symptoms that are especially hard to specifically diagnose requiring specialist to rule out other disorders before being able to diagnose SD. To be diagnosed with SD the patient must have a detailed medical history, phonatory symptoms, and an exam using an endoscope to look at the larynx musculature. …show more content…
Spasmodic Dysphonia has no real know causes, SD was thought to be psychogenetic occurring in nature. But, with some extensive research it is now thought to be a neurogenic voice disorder. “Some clinicians and genetic researchers believe SD may be hereditary because members from the same family often suffer from this disorder” (Mathew, 2014). It seems that SD develops in more women than men in a case study that was mentioned in Tanner, (2011) “the race or ethnicity (99% white) and gender representations (94 women, 56 men) were also consistent with those of the general population of individuals with SD.” Adductor Spasmodic Dysphonia occurs when the vocal folds harden when they are closed together, causing the vocal folds to spasm and not to be able to vibrate normally. Clients often find it hard to start talking because words are cut short due to spasms. “The voice will sound normal when the client is shouting, singing, laughing, and crying” (Mathew, 2014). Symptoms can be similar to choked, stressed voice with sudden interruptions during speech especially during vowels. This is the most commonly happening form. Abductor Spasmodic Dysphonia occurs when the vocal folds have muscle spasms causing the folds not to close correctly, which keep the folds from producing voice because they cannot vibrate together.
Normally the voice will sound weakened and breathy because air is escaping from in-between the folds from the lungs while the client is talking. “Voice sounds normal when the client is shouting, singing, laughing, and crying” (Mathew, 2014). Symptoms can include a breathy sounding interruptions in the voice causing the clients to seem like they are whispering. Abductor Spasmodic Dysphonia is less common than adductor spasmodic dysphonia however, it is still more frequent than mixed spasmodic dysphonia.
Mixed Spasmodic Dysphonia is an extremely rare form of SD occurring when different muscles have spasms causing the vocal folds too close and open. Like the name recommends both abductor and adductor symptoms are apparent in mixed spasmodic
dysphonia. “In a study of 10 patients with SD 2 out of 10 individuals reported that their symptoms had worsened during an 18-year period, whereas the remaining 8 reported symptom improvement or plateau. Aronson reported a median onset age of 50 years in 100 cases of SD, with symptoms progressing during the first year after onset. Later Aronson concluded that SD symptoms often plateau within the first year after onset, although some individuals experience progressive worsening over time” (Tanner, 2011). Botulinum toxin A (Botox) injections have proven to be best short term treatment, some oral medication can be subscribed none have proven to be as effective as Botox. The Botox injection is injected directly into the larynx where it limits the involuntary muscle contractions causing the vocal fold to either open or close allowing proper vibration to be produced. “Spasmodic dysphonia is often undiagnosed in its early stages, because the symptoms are similar to other voice disorders. A detailed history must be obtained by an otolaryngologist who is specially trained in voice disorders, with special emphasis on the onset and progression of the voice dysfunction” (Mathew,2014). SD belongs to family of disorders called Dystonia which is involuntary muscle movements and prolonged muscle movement. In the Dystonia family there is Laryngeal dystonia, muscle tension dystonia, chronic stuttering, and essential tremor. The way all of these disorders are related is because all cause involuntary muscle movement. SD is also related to voice disorders because of interruptions in voice production and the breathy, whisper like voice. The anatomical/physiological bases of Spasmodic Dysphonia are the vocal folds, larynx “voice box”, air from lungs, nasal cavity, tongue, esophagus, and trachea. According to Yang, (2015) “Spasmodic dysphonia manifests as a nonovulatory spasm of 1 or multiple muscles during phonation, resulting in hyper-adduction or hyper-abduction of the vocal folds, which leads to spasmodic phonation or phonation interruptions, which in turn affects the speech communication ability of the patient.” The base impairment in Spasmodic dysphonia is the vocal folds because with adductor spasmodic dysphonia the vocal folds have spasms causing the folds not to close properly causing air to escape from the lungs when the patient is talking which produces very breathy and whisper like speech. In abductor spasmodic dysphonia the vocal folds are unable to open because the spasms cause the folds to harden when closed together not allowing the air or vibrations to be produced. Mathew, E. T. (2014). Spasmodic Dysphonia. MEDSURG Nursing, 4-7. Tanner, K., Roy, N., Merrill, R. M., Sauder, C., Houtz, D. R., & Smith, M. E. (2011). Spasmodic Dysphonia: Onset, Course, Socioemotional Effects, and Treatment Response. Annals of Otology, Rhinology & Laryngology, 120(7), 465-473. Yang, Q., Xu, W., Li, Y., & Cheng, L. (2015). Value of Laryngeal Electromyography in Spasmodic Dysphonia Diagnosis and Therapy. Annals of Otology, Rhinology & Laryngology, 124(7), 579-583. doi:10.1177/0003489415570932
In recent years researchers have made significant advances in the field and have come up with many neuroleptic (antipsychotic) medications to treat the disorder. However along with these medical breakthroughs problems have occurred. The most severe side effect is called Tardive Dyskinesia, literally meaning "late movement disorder." (1) Coined in 1964, it is identified by the involvement of numerous "abnormal, involuntary movements of the orofacial area or extremities." . (2) More specifically, it is characterized by rocking, twisting, jerking, toe tapping, lip smacking, blinking, and most commonly an unusual movement of the tongue. . (1) (2)(3). Interestingly enough, these side effects disappear during sleep. (3)
The most common speech symptom is hypophonia which is reduced vocal loudness. Hypokinetic dysarthria often is associated with variables of pitch and loudness where a patient may be monopitch or exhibit monoloudness (Johnson & Adams, 2006). Speech movements ...
Stuttering affects the fluency of speech. Stuttering is characterized by disruptions in speech sound productions, also known as a disfluency. Mostly, stuttering has a significant effect on some daily activities. Though some people have disfluency deficits only in certain situations. Some people limit their participations in different everyday activities because they are often embarrassed or sad about their situation and are concerned about how other's will react to stuttering. In stuttered speech repetitions of words or also of parts of words are included. Prolongations of speech sounds may also occur. It is a characteristic of some people who
Stress can cause anyone to feel anxiety. Whether the anxiety is minimal or severe depends on each individual person. Under stress, it is common and acceptable for people’s voice to falter. Speakers under stress might tense the muscles used to produce speech, increasing their vocal pitch. That generally wouldn’t happen in a stress-less situation. Typically when under stress people talk more rapid. This occasionally causes them to stumble over words or get stuck on a syllable. More often than not, they tend to repeat words or phrases as they struggle to talk, present, etc. under the stress. Another common ‘symptom’ under stress is adding interjections, such as “like”, “uhm” and “uh” during speech. These are considered normal and acceptable dysfluencies. The simple task of saying colors in front of an audience was used as a study. They found that under stress, pressure, anxiety and whatever else is felt during public speaking, non-stutterers went from zero percent dysfluencies to four percent. On the other hand, those who normally stuttered went from one percent to nine percent dysfluencies. (Perkins) One interesting fact, is that stutterers are able to talk normally to babies, children, and animals. These audiences are nonthreatening and the speaker is at ease. It is also common for stutterers to talk aloud to themselves without or with very little
This silent fear reflects that I grew up with a history of speech impediments. Spending countless hours as a child driving from one speech therapist to another, repeating a range of exercise from “fee-fi-fo-fum” to watching my tongue placement in a mirror, I was your
Throughout our day to day lives we are exposed to many sounds such as the sound of traffic, coversation, TV, nature and music. More often than not these sounds that we experience are at a low safe level, levels that will not affect or harm our hearing. Unfortunatley when we are exposed to sound levels that are too high or loud sounds over a long period of time there is a chance that the delicate inner workings of the ear can be permanatly damaged. This is known as noise induced hearing loss (NIHL)
The role of a speech-language pathologist (SLP) is a challenging but imperative role to society. When there is pathology present in an individual’s communication, either language-based or speech-based, serious adverse effects can impact the quality and functionality of their lives. This is why I am perusing a career as an SLP. The ever-changing profession as an SLP allures me to the field because the learning never ends. As an academic, I am always prepared to absorb new information, and SLP’s must stay updated on the most current research, to ensure that they are providing the most appropriate services for their clients. Also, because every client is unique with diverse
According to ASHA, more than 2 million people in the United States have a severe communication disorder that impairs their ability to talk. This problem may be short or long term, and may be congenital (present at birth), acquired (occurring later in late), or degenerative (worsening throughout life). Some disorders could be from lack of oxygen at during the birth process, premature birth, genetic disorders, Cerebral Palsy while others may be caused by aTraumatic Brain Injury, or degenerative diseases.
In my life, I've had a major setback that has changed how I live life day to day. When I was five, I was diagnosed with permanent hearing loss. I have hearing loss in both ears, mostly in higher frequencies, but I still have some hearing loss in the lower ones too. Since I was 5, it has only gotten worse, just in the past year there has been drastic changes in the frequencies that I can't hear. Hearing loss affects me day to day, for example if anyone whispers something to me, nine of ten times I can't hear what they are saying. My academics also get affected because sometimes I can't hear what we have for homework over all of the background noise of people packing up, so sometimes I just don't do homework because I never heard it in the first place. Not doing homework because I can't hear it affects my grades as I will get zeros for not doing it.
An individual that suffers from an articulation disorder can delete sounds, add sounds, have distorted sounds and substitute sounds. Articulation is considered to be the process of the movement of muscles in your mouth. The most important articulators include: jaw, lips, teeth, tongue, velum, alveolar ridge, and hard/soft palate. These articulators are used when producing a sound or when having a conversation. An articulation disorder can be caused by illness, developmental disorders such as autism, neurological disorders, hearing loss, and genetic syndromes such as Down
The voice is our primary mean of communication and expression. We rarely last more than a few minutes without its use whether it is talking to someone else or humming quietly to ourselves. We can use the voice artistically in many ways. For example, singing carries the rhythm and melody of speech. It creates patterns of pitch, loudness, and duration that tie together syllables, phrases and sentences. We use the voice for survival, emotion, expression, and to reflect our personality. The loss of the voice is a severe curtailment to many professions. It is affected by general body condition which is why we need to consider the location of the larynx and how that organ produces voice. Surprisingly, this complex biological design is mechanical in function. It is mechanical to the point that when it has been excised from a cadaver and mounted on a laboratory bench, the larynx produces sounds resembling normal phonation. (Titze, Principles)
Often within classroom environments, as well as at home, children learn through visual and auditory perception. Visual and auditory processing are key ways to learn; they are used for recognizing and interpreting information taken from the two senses of sound as well as sight. So clearly it is understood that having this disorder can make it a bit more difficult and troublesome to learn through vision and hearing, but definitely not impossible.
Stuttering is a disorder of oral communication and it is characterized by disruptions in the production of speech sounds, also called "disfluencies" (American Speech-Language-Hearing Association, 2014). It usually emerges in childhood and affects around 5% of the population (Guitar, 2006), even though there is some variation in the incidence of stuttering in different studies. During infancy, it is common for children to present dysfluency because of the complex process of language acquisition and development. These disfluencies are normal and tend to disappear in 80% of the children, however for some it may evolve into a chronic state that is called developmental stuttering. Stuttering can also occur in two other circumstances, from injuries, which is called acquired or neurogenic stuttering and another one, involving psychological aspects (Oliveira et. al., 2012). Perkins, Kent and Curlee (1991) focused on the theories to explain the possible causes of disfluency and theorized that speech disruption and time pressure are the two important variables that may account for the stuttered dysfluency.
Dyspraxia interferes with a person’s ability to make controlled and/or coordinated physical reaction to a situation; their reactions may be inappropriate to the situation.
Speech impediments are exactly what they say they are. They are something that impedes the speech of an individual. They can make speech slower or harder to understand to the average ear. They can be anything from a slight lisp to muteness causing a lack of ability to speak at all, and many different types in between. In a school setting especially, speech impediments can be frustrating for children. Not only does it make it harder to communicate with peers, but it could also make it more difficult to communicate with teachers. It is often taken for granted to have the ability to speak without any hindrances, such as stutters and cluttering, but having a voice that sounds much different from the voices of your peers can have a lasting effect on people. In this paper, I will explore possible causes of speech disorders, the tests used to diagnose a disorder, some possible treatments or cures, and the lasting effects that having a speech disorder can have emotionally on children, even going into adulthood.