Dysarthria is a speech impairment caused by weak or uncoordinated muscles of the mouth, face, respiratory system or voice. People with dysarthria find it difficult to speak clearly. Dysarthria can be the result of damage during pregnancy, at birth, or later in life due to tumors, stroke, head injury, neurological disease or other nervous system damage.

Dysphagia, or difficulty swallowing, occurs when there is a problem with the swallowing process anywhere from the mouth to the stomach. It is especially common in elderly people. Special evaluation methods are used to diagnose and treat dysphagia, including swallow studies, X-rays, fiberoptic scopes and VitalStim® Therapy.

Apraxia is caused by damage to the parts of the nervous system related to speaking. People with apraxia know what they want to say, but their brains cannot coordinate the muscle movements necessary to say the words or put the sounds and syllables in the right order. They may say something completely different, even nonsensical. This condition is also referred to as apraxia of speech, verbal apraxia or dyspraxia.

Aphasia is the result of damage to the language centers of the brain. People with aphasia have difficulty understanding language, including reading and listening. They also have trouble expressing themselves when speaking and writing. Recognizing objects/pictures and sounds (agnosia) may be challenging as well, depending on the location of the brain damage.

Cognition (thinking skills) includes an awareness of one's surroundings, attention to tasks, memory, reasoning, problem solving, and executive functioning (such as goal setting, planning, initiating, self-awareness, self-monitoring and evaluation). Problems vary depending on the location and severity of the injury to the brain and may include the following:

• Trouble concentrating when there are distractions (such as carrying on a conversation in a noisy restaurant or working on a few tasks at once).
• Slower processing or "taking in" of new information. Longer messages may have to be "chunked" or broken down into smaller pieces. The person may have to repeat/rehearse messages to make sure he or she has processed the crucial information. Communication partners may have to slow down their rate of speech.
• Problems with recent memory. New learning can be difficult. Long-term memory for events and things that occurred before the injury, however, is generally unaffected. For example, the person will remember names of friends and family.
• Executive function problems. The person may have trouble starting tasks and setting goals to complete them. Planning and organizing a task is an effort, and it is difficult to self-evaluate work. Individuals often seem disorganized and need the assistance of families and friends. They may also have difficulty solving problems, and they may react impulsively (without thinking first) to situations.

This text is taken from www.asha.org.

Sister Kenny's pediatric speech-language pathologists address speech (articulation, phonological disorders, stuttering), language (expressive/receptive language delay and processing disorders), voice and feeding/swallowing concerns due to a variety of developmental delays, syndromes and/or medical disorders.

Voice disorders occur when there is a change in the way the larynx (voice box) functions. As a result people have difficulty producing a normal voice. Disorders like hoarseness, vocal nodules, reflux laryngitis and paralyzed vocal cords can be caused by overuse or misuse of the voice, infections or inflammatory processes, benign or malignant growths, neuromuscular diseases and/or psychological issues.

Paradoxical vocal fold motion (PVFM) or Vocal Cord Dysfunction causes the vocal folds to close when they should open, for example when breathing in or out. PVFM can be mistaken for asthma as it leads to noisy, difficult breathing. PVFM can co-occur with asthma. Several "triggers" include stomach acid, allergies, post nasal drip, inhaled irritants and stress.