Christina is a speech-language pathologist. She works with children and adults who have impairments in their speech, voice, or language skills. These impairments can take many forms, as her schedule today shows. First comes Robbie. He's a cutie pie in the first grade and has recently been diagnosed with childhood apraxia of speech-or CAS. CAS is a speech disorder marked by choppy speech. Robbie also talks in a monotone, making odd pauses as he tries to form words. Sometimes she can see him struggle. It's not that the muscles of his tongue, lips, and jaw are weak. The difficulty lies in the brain and how it communicates to the muscles involved in producing speech. The muscles need to move in precise ways for speech to be intelligible. And that's what she and Robbie are working on. Next, Christina goes down the hall and meets with Pearl in her third grade classroom. While the other students are reading in small groups, she works with Pearl one on one, using the same storybook. Pearl has a speech disorder, too, but hers is called dysarthria. It causes Pearl's speech to be slurred, very soft, breathy, and slow. Here, the cause is weak muscles of the tongue, lips, palate, and jaw. So that's what Christina and Pearl work onstrengthening the muscles used to form sounds, words, and sentences, and improving Pearl's articulation. One more student to see-4th grader Mario, who has a stutter. She's helping Mario learn to slow down his speech and control his breathing as he talks. Christina already sees improvement in his fluency. Tomorrow she'll go to a different school, and meet with different students. But for today, her day is…Robbie, Pearl, and Mario. Definition There are many kinds of speech and language disorders that can affect children. In this fact sheet, we'll talk about four major areas in which these impairments occur. These are the areas of: Articulation | speech impairments where the child produces sounds incorrectly (e.g., lisp, difficulty articulating certain sounds, such as "l" or "r"); Fluency | speech impairments where a child's flow of speech is disrupted by sounds, syllables, and words that are repeated, prolonged, or avoided and where there may be silent blocks or inappropriate inhalation, exhalation, or phonation patterns; Voice | speech impairments where the child's voice has an abnormal quality to its pitch, resonance, or loudness; and
