INTRODUCTION
Communication is the element that links all human beings together. True communication is spontaneous and unique and involves all the senses.
As individuals age, their ability to perceive the information received through their senses is often distorted or impaired. Age-related sensory changes can tremendously impact the quality of life and the quality of communication for older adults. Aging adults must find ways to compensate for these changes, and families need to be particularly sensitive to the often silent process of sensory deterioration in their aging family member.
The healthcare provider is a critical component in the prevention, assessment, intervention, and evaluation of age-related sensory changes and resulting communication disorders.
DISORDERS OF LANGUAGE AND SPEECH
The term communication disorders encompasses a range of conditions in language, speech, and hearing. A communication disorder is an impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal, or graphic symbol systems. A communication disorder can be evident in the processes of hearing, language, and/or speech and range in severity from mild to profound. It may be developmental or acquired and may result in a primary disability or be secondary to other disabilities. Individuals can have one or any combination of communication disorders (American Speech-Language-Hearing Association [ASHA], 1993).
- Speech disorders are impairments of the articulation of speech sounds, fluency, and/or voice and include:
- Articulation disorders—atypical production of speech sounds characterized by substitutions, omissions, additions, or distortions that may interfere with intelligibility.
- Fluency disorders—interruptions in the flow of speaking characterized by atypical rate, rhythm, and repetitions in sounds, syllables, words, or phrases (often accompanied by excessive tension, struggle behavior, and secondary mannerisms).
- Voice disorders—characterized by the abnormal production and/or absences of voice quality, pitch, loudness, resonance, and/or duration inappropriate for an individual’s age and/or gender.
- Language disorders are impaired comprehension and/or use of spoken, written, and/or other symbol systems. The disorder can involve the form of language, the content of the language (semantics), and/or the function of language in communication.
- Hearing disorders are the result of impaired auditory sensitivity of the physiological auditory system and can limit the development, comprehension, production, and/or maintenance of speech and/or language. Individuals with this type of disorder are often described as deaf or hard of hearing.
- Central auditory processing disorders (CAPD) are deficits in the information process of audible signals that cannot be attributed to impaired peripheral hearing sensitivity or intellectual impairment. This involves the listener’s ability to hear, discriminate, or identity sounds; store and retrieve information efficiently; or attach meaning to a stream of sounds.
Communication disorders result from many factors, including diseases, medications, tumors, the aging process, trauma, and environmental factors such as noise. Communication disorders can dramatically change an individual’s life. The affected person often feels frustrated, angry, or isolated from family, friends, or the community.
This next section describes some of the most common types of language, speech, and hearing disorders and discusses the diagnosis and treatment of each.