Term Paper on "Speech and Language Disorders in Adults"

/>Neurodebenerative Diseases

Alzheimer's disease (AD) causes the degeneration of the neurosystem. AD causes progressive cognitive deterioration. As AD progresses, daily life becomes difficult in many ways. In its early stages, short-term memory and minor details are easily forgotten. However, as the disease progresses language skills are affected, along with movement. The ability to recognize people and things becomes difficult (BayBio Institute 2007). These affects are caused by the atrophy of neurons in the temporoparietal and frontal cortex (BayBio Institute 2007). Plaques and neurofibrillary tangles cause the symptoms to worsen (BayBio Institute 2007). Currently there is no known cure for AD.

Amyotrophic lateral sclerosis (ALS) is also known as Lou Gehrig's Disease. Like AD, it is a progressive neurodegenerative disease in which the nerves slowly deteriorate until they die completely (BayBio Institute 2007). ALS affects the neurons that are responsible for the transference of signals from the brain to the muscles. The first symptoms are general weakness in the arms, legs, and the muscles responsible for speaking (BayBio Institute 2007). There is no known cure for this disease, but certain treatments, such as Amyotrophic, have been shown to slow the progression of the disease (BayBio Institute 2007).

Huntington's disease (HD) is another neurological disorder. This disorder is inherited and can be diagnosed via genetic testing. The mechanism of Huntington's disease derives from a gene mutation that produces a mutant protein responsible for cell death in the brain (BayBio Institute 2007). As the brain slowly dies, function and movement abilities decrease. There is no cure for HD, but medications can help to manage the disease (BayBio Institute 2007).

Multiple Sclerosis (MS) is a disease in which the protective tissue of the neurons in the CNS is damaged. In this disease, the person's own autoimmune system attacks the myelin sheaths around the nerves (BayBio Institute 2007). This damage renders the nerve no longer able to function properly. The symptoms of MS vary from person to person depending on the nerves that are affected. They can include language and speech dysfunctions. There are four different types progression categories, which range from occasional flare-ups to a form with constantly worsening of symptoms (BayBio Institute 2007). A related disease is Myasthenia Gravis. Myasthenia Gravis (MG) is a neuromuscular disease that is similar to MS where the antibodies that block receptors for certain proteins at the neuromuscular junction. This prevents the stimulative effect necessary for proper muscular function (BayBio Institute 2007). Immunosuppressors can help to slow the disease.

Parkinson's Disease is a dysfunction of the neurotransmitters between the nerve cells. Parkinson's disease destroys brain cells, resulting in a shortage of dopamine. The first signs of Parkinson's are typically subtle, such as softer or slower speech. As the disease progresses, tremors begin, which eventually worsen until hey cause considerable difficulty performing everyday tasks. Treatments to replace dopamine can help to slow the disease.

Brain injuries are typically not listed under the category of disease. However, they are included in this research because they can cause certain forms of neurological dysfunction that can have an effect of speech and language (BayBio Institute 2007). Brain injuries can trigger diseases such as epilepsy. Some forms of epilepsy can cause speech impairments. Typically, when one thinks of epilepsy, they think of a short-term grand mal seizure, in which case speech impairment is not the major concern. However, some forms of epilepsy have a more permanent effect of speech and language. They can cause progressive brain damage, if treatments are unsuccessful. In cases such as this, they would be similar to a CNS disease as far as treatment is concerned.

Traumatic brain injuries are classified into penetrating injuries and closed head injuries. Penetrating entries involve a foreign object that enters the brain from an outside force. Injuries from these types of objects are limited to the areas affected by the impact. Closed head injuries result from a blow to the head, such as strikes from a car accident. These types of injuries cause more widespread damage (ASHA, 2007d). After an accident, there is a certain amount of primary damage. This damage stops and is considered to be complete at the time of injury.

The second type of damage is called "secondary damage" and can occur progressively for days or hours after the initial trauma (ASHA, 2007d). This means that speech and language problems might not be apparent at the time of injury, but will develop as time passes. This is important in evaluation of a traumatic brain injury. Damage to the right hemisphere of the brain is more likely to cause communication problems associated with cognitive function than damage to the left (ASHA, 2007f). In addition, symptoms from damage to the right side of the brain are more subtle than those to the left hemisphere (ASHA, 2007f).

From a speech and language perspective, the primary difference in the various types of diseases that affect the CNS is the mechanism and part of the CNS that they attack. CNS diseases are unpredictable and it is difficult to determine how disease progression will occur in any patient. In some forms of CNS diseases language and speech difficulties will occur at early onset. In others language and speech difficulties will not appear until later stages of disease progression. One thing that is the same in all of the CNS diseases is that they are progressive. Medications can help slow the progression in some cases, but all of these diseases progress, except possibly with brain injury.

Speech and Language Therapy in CNS Diseases

Due to the progressive nature of CNS disease, it is safe to say that at some point, almost every patient will need the services of a speech and language therapist. The ability to speak and communicate with other human beings is an essential part of the patient's quality of life. Speech and language therapy can greatly improve many areas of the patient's condition. The most basic of these needs surrounds being able to communicate one's needs. Another important need is the ability to communicate with others for social contact and emotional needs. A third level is that preserving the ability to talk also helps improve other brain functions as well. Speech and language therapy is an important part in the maintenance of quality of life for patients with CNS diseases.

There are two considerations for speech and language in CNS diseases. The first is the ability to speak physically. The second involves the loss of cognitive abilities involved with language. For instance, with ALS the patient loses the ability to control their muscles. The muscles atrophy and then begin to twitch involuntarily. However, the patient never loses their cognitive function (NIH 2007). The progression of ALS cannot be stopped. Therefore, from a therapy standpoint, the person must be assisted in making continuing adaptations in the area of speech and language to help compensate for continued loss of function. ALS patients might experience difficulty speaking or forming words (dysarthria). Other problems might cause trouble with speaking such as exaggerated reflexes (hyperreflexia) or trouble swallowing (dysphagia) (NIH 2007).

With many progressive diseases of the CNS, as the disease progresses and the person loses their ability to speak, therapy might focus on non-verbal forms of language. Therapists might develop a method for responding to yes or no questions using their eyes. They can help the patient use speech synthesizers, and other computer-based communication devices (NIH 2007). There are a wide range of these devices available. They can be matched to the person's specific… READ MORE