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| __Incidence of Speech Sound Disorders__ | __Incidence of Speech Sound Disorders__ | ||
| - | The field of speech-language pathology is still emerging in mainland China. According to Aungst and Battle (2007), China has fewer than 200 trained SLPs to treat those with a communication disorder. According to a 1987 census in China (the sample was 1.5/1000 people of the entire population), 1.68% (i.e. 26,518 people) of the total population surveyed said they were hearing and/or linguistically impaired. This is the recent statistic found for the incidence of speech sound disorders in China. | + | The field of speech-language pathology is still emerging in mainland China. According to Aungst and Battle (2007)((Aungst, R. & Battle, D. (2007). Communication Disorders in China : Audiology and Speech-Language Pathology. //The ASHA Leader.//)), China has fewer than 200 trained SLPs to treat those with a communication disorder. According to the 1987 census in China (the sample was 1.5/1000 people of the entire population), 1.68% (i.e. 26,518 people) of the total population surveyed said they were hearing and/or linguistically impaired . Although this is not a current statistic regarding incidence of speech sound disorders in China, it is the most recent one available for the country. |
| - | Source: Aungst, R. & Battle, D. (2007). Communication Disorders in China : Audiology and Speech-Language Pathology. //The ASHA Leader.// | ||
| __Range of Acceptable Intelligibility__ | __Range of Acceptable Intelligibility__ | ||
| - | Bebout and Arthur (1997) studied how Chinese-Americans viewed certain speech disorders and their attitudes toward them. In the study, speech sound disorders were referred to as misarticulations. When asked if older children (i.e. 8-12 year olds) with misarticulations were likely to be less intelligent that other people, the focus group noted that this was probably true. They also said that in comparison to other groups with a speech disorder (e.g. dysfluency, cleft palate), children with misarticulations would most likely improve their speech, but not from medical treatment. | + | ===Views in China=== |
| + | In China, teachers in preschools and schools often associate a student’s decreased speech intelligibility with a lazy attitude and believe that, if they were given time, the student would just grow of this stage ((Hua, Z. (2009). Mandarin-speaking children with developmental speech disorders. //Speech and Hearing Review, 3//: 245-276)). | ||
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| + | ===Views in America=== | ||
| + | Bebout and Arthur (1997) ((Bebout, L. & Arthur, B. (1997). Attitudes toward speech disorders: Sampling the views of cantonese-speaking americans. //Journal of Communication Disorders, 30//: 205-229)) studied how Chinese-Americans viewed certain speech disorders and their attitudes toward them. In the study, speech sound disorders were referred to as misarticulations. When asked if older children (i.e. 8-12 year olds) with misarticulations were likely to be less intelligent that other people, the focus group noted that this was probably true. They also said that in comparison to other groups with a speech disorder (e.g. dysfluency, cleft palate), children with misarticulations would most likely improve their speech, but not from medical treatment. | ||
| - | Source: Bebout, L. & Arthur, B. (1997). Attitudes toward speech disorders: Sampling the views of cantonese-speaking americans. //Journal of Communication Disorders, 30//: 205-229. | ||
| __Treatment__ | __Treatment__ | ||
| - | Teachers in preschools and schools often associate a student’s decreased speech intelligibility with a lazy attitude and believe that, if they were given time, the student would just grow of this stage. This view is reflected in limited provision of services for children with a speech sound disorder. These children are often misdiagnosed and do not receive the appropriate treatment. Those with hearing impairments, dysphagia, and those who stutter have generally been given priority with speech services. In clinical settings, children with speech sound disorders are mainly misdiagnosed with a short frenulum as the cause of speech problems. Their frenulum would be cut to reduce speech difficulties, but their intelligibility would not improve. Training for SLPs is still limited in China and have a goal of clear speech. Drilling is the main style of treatment for children with a speech sound disorder because professionals playing with these children is not a part of the culture. | + | China's view of a child's decreased intelligibility in schools is reflected in limited provision of services for children with a speech sound disorder ((Hua, Z. (2009). Mandarin-speaking children with developmental speech disorders. //Speech and Hearing Review, 3//: 245-276)). These children are often misdiagnosed and do not receive the appropriate treatment. Those with hearing impairments, dysphagia, and those who stutter have generally been given priority with speech services. In clinical settings, children with speech sound disorders are mainly misdiagnosed with a short frenulum as the cause of speech problems. Their frenulum would be cut to reduce speech difficulties, but their intelligibility would not improve. |
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| + | In China, the traditional role of a SLP in schools has been assessment and designing treatment activities for students who have a communication disorder ((http://www.isec2000.org.uk/abstracts/papers_s/so_1.htm)). The current role of SLPs is being an advisor and collaborator within the assessment and treatment process. In addition, SLPs may co-teach in language classrooms with teachers, who are qualified, in order to reduce conflicting duties. The main goal of treatment for these children is clear speech. This is accomplished though drill practice. | ||
| - | In China, the traditional role of a SLP in schools has been assessment and designing treatment activities for students who have a communication disorder. The current role of SLPs is being an advisor and collaborator within the assessment and treatment process. In addition, SLPs may co-teach in language classrooms with teachers who are qualified in order to reduce conflicting duties. | ||
| - | Source: Hua, Z. (2009). Mandarin-speaking children with developmental speech disorders. //Speech and Hearing Review, 3//: 245-276. | ||
| ====India==== | ====India==== | ||
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| __Incidence__ | __Incidence__ | ||
| - | Incidence statistics collected in the 1975 found that defective articulation ranged from 10.25% to 21.6%. One study found that the most common type of defect was substitution at 72.3%. Next, were distortion and omission, which were found to be 18.1% and 9.6% respectively. | + | Incidence statistics collected in the 1975 found that defective articulation, one of many Indian terms used for speech sound disorders, ranged from 10.25% to 21.6%. One study (Kalran, Sukhiany, Misra & Dayal, 1975) ((Kalra, K., Sukhiany, A.M, Misra, U.C. & Dayal, R.S. (1975). A clinical analysis of speech defects in children. Indian Journal of Pediatrics, 42(7): 200-208.))conducted in the community and schools of Agra City, found a 21.6% incidence rate, with the highest incidence being in the 6 to 12 age group . Another study (Kalra, Lumba, Lal & Dayal, 1975) ((Kalra, K., Lumba, M., Lal, M. & Dayal, R.S. Defective articulation in children. Indian Journal of Pediatrics, 42(9): 257-263))conducted with 1,200 children between the ages of 5 to 12 in the schools of Agra City found a 10.25% incidence rate. This study found that the most common type of defect was substitution at 72.3%. Next, were distortion and omission, which were found to be 18.1% and 9.6% respectively. They also noted that velar sounds were most commonly affected in the children that participated in their study. |
| __Range of Acceptable Intelligibility__ | __Range of Acceptable Intelligibility__ | ||
| - | Speech sound disorders, more commonly referred to as “misarticulation” or “speech defect” are diagnostic entities in India, but they are not given a high priority. Stammering (stuttering) is the speech disorder given the most attention with voice disorders also being given high priority. The lack of clinical attention given to speech sound disorders seems to indicate that there is a wide range of acceptable intelligibility. This wide range of acceptable intelligibility may also be due to the large number of languages and dialects in India. | + | Speech sound disorders, more commonly referred to as “misarticulation” or “speech defect” are diagnostic entities in India, but they are not given a high priority. Stammering (stuttering) is the speech disorder given the most attention with voice disorders also given high priority ((Sri Ramachandra University: Departments – Speech, Language and Hearing Sciences. Viewed 18 February 2010, http://www.srmc.edu/aspxtesting/university/departmentsinner.aspx?collid=8&deptid=33)). The lack of clinical attention given to speech sound disorders seems to indicate that there is a wide range of acceptable intelligibility. This wide range of acceptable intelligibility may also be due to the large number of languages and dialects in India. |
| __Treatment__ | __Treatment__ | ||
| - | Treatment of speech sound disorders in India is provided by speech therapists. The first speech therapists in India registered with the newly founded Indian Speech and Hearing Association in 1967. There are now over 1,500 registered audiologists and speech therapists. Admission requirements for academic programs are the same as medical school and a bachelor degree is the entry level clinical educational requirement, while individuals with masters degrees frequently teach in a University setting along with those who receive Ph.D.s. | + | Treatment of speech sound disorders in India is provided by speech therapists. The first speech therapists in India registered with the newly-founded Indian Speech and Hearing Association in 1967((Indian Speech and Hearing Association. Viewed 10 February 2010, http://speech-language-therapy.com/isha.htm)). There are now over 1,500 registered audiologists and speech therapists. Admission requirements for academic programs are the same as medical school and a bachelor degree is the entry level clinical educational requirement, while individuals with masters degrees frequently teach in a university setting along with those who receive Ph.D.s. |
| - | Treatment of speech sound disorders in India can involve a wide range of methodologies. Some clinics use modeling and practice of the target sound while others endorse frenulum-clipping surgery. Phonetic drills have also been listed as a common practice for some therapists. Some therapists also have strong feelings regarding parental correction of a child’s misarticulated speech. These therapists believe that parents who correct their child’s speech will effectively cure their child’s articulation disorder. They also say that parents who do not correct their children’s articulation encourage habitual misarticulation. Other therapists believe that children with articulation difficulties should be referred to a child psychiatrist. There also seems to be a predominant view that articulation treatment should at least begin with a wait and see approach. | + | Treatment of speech sound disorders in India can involve a wide range of methodologies. Some clinics use modeling and practice of the target sound while others endorse frenulum-clipping surgery. Phonetic drills have also been listed as a common practice for some therapists. Some therapists also have strong feelings regarding parental correction of a child’s misarticulated speech. These therapists believe that parents who correct their child’s speech will effectively cure their child’s articulation disorder. They also say that parents who do not correct their children’s articulation encourage habitual misarticulation. Other therapists believe that children with articulation difficulties should be referred to a child psychiatrist. There also seems to be a predominant view that articulation treatment should at least begin with a wait and see approach ((Viewed 12 February 2010, http://www.indiaparenting.com/faqs/speech_ent/speech_pronunciations.shtml)). |
| - | References: | ||
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| - | Kalra, K., Sukhiany, A.M, Misra, U.C. & Dayal, R.S. (1975). A clinical analysis of speech defects in children. Indian Journal of Pediatrics, 42(7): 200-208. | ||
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| - | Kalra, K., Lumba, M., Lal, M. & Dayal, R.S. Defective articulation in children. Indian Journal of Pediatrics, 42(9): 257-263. | ||
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| - | Indian Speech and Hearing Association. Viewed 10 February 2010, http://speech-language-therapy.com/isha.htm | ||
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| - | India parenting: pronounciation problems. Viewed 12 February 2010, http://www.indiaparenting.com/faqs/speech_ent/speech_pronunciations.shtml | ||
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| - | Sri Ramachandra University: Departments – Speech, Language and Hearing Sciences. Viewed 18 February 2010, http://www.srmc.edu/aspxtesting/university/departmentsinner.aspx?collid=8&deptid=33 | ||
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| __Incidence of Speech Sound Disorders__ | __Incidence of Speech Sound Disorders__ | ||
| - | According to the National Institute of Special Education, the incidence of school-age children in special education with an articulation disorders has increased from 27.4% in 1973 to 36.1% in 1991. | + | According to the National Institute of Special Education, in 1991, the incidence of school-age children in special education with an articulation disorders had increased from 27.4% in 1973 to 36.1% ((www.nise.go.jp/kenshuka/josa/kankobutsu/pub_a/nise.../nise_a-9_5.pdf)). This is the most recent statistic available for the country. |
| __Range of Acceptable Intelligibility__ | __Range of Acceptable Intelligibility__ | ||
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| __Treatment__ | __Treatment__ | ||
| - | Treatment for children with speech and language needs began with remedial education in the post-war period. These children would attend an after-school speech-language training or therapy class that would target either those with reading difficulties or incorrect articulation in their respective dialects. Over the last 30 years, treatment transformed from an after-school program to a part-time class during school, and finally to a resource-room training based on something called “tuukyu sidou.” | + | Treatment for children with speech and language needs began with remedial education. These children would attend an after-school speech-language training or therapy class that would target either those with reading difficulties or incorrect articulation in their respective dialects. Over the last 30 years, treatment transformed from an after-school program to a part-time class during school hours, and finally to a resource-room training, called “tuukyu sidou." The actually site of the resource-room training is usually referred to as the “speech-language training class.” This training method is based on the following characteristics: |
| - | + | *The method is structured on the basis of research on Japanese phonetics. | |
| - | Source: www.nise.go.jp/kenshuka/josa/kankobutsu/pub_a/nise.../nise_a-9_5.pdf | + | *Detailed step-by-step teaching of articulation is prepared. |
| + | *Sufficient pathological research is conducted for each type of speech-language disorder. | ||
| + | *Teachers are in close contact and coordination with medical institutions. | ||
| + | *The training method is constructed with emphasis on functional training. | ||
| + | *A solid record is prepared, training record sheets, photographs, and audio and video recordings ((www.nise.go.jp/kenshuka/josa/kankobutsu/pub_a/nise.../nise_a-9_5.pdf)). | ||
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| __Incidence__ | __Incidence__ | ||
| - | Speech sound disorders are not generally recognized as a disability in Vietnam. Consequently, there is no formal statistical data regarding the incidence of speech sound disorders in Vietnam. Hwa-Froelich & Westby (2003) found that blindness, deafness and physical conditions that affected a persons’ abilities to carry out daily activities were seen as disabilities, but that cleft palate, speech or learning problems and mental retardation were not considered disabilities. Instead, these conditions are believed to be caused by the child’s nature, stubbornness, laziness or fate. | + | Speech sound disorders are not generally recognized as a disability in Vietnam. Consequently, there is no formal statistical data regarding the incidence of speech sound disorders in Vietnam. Hwa-Froelich & Westby (2003) ((Hwa-Froelich, D.A. & Westby, C.E. (2003). Frameworks of education: Perspectives of Southeast Asian parents and Head Start staff. Language, Speech and Hearing Services in Schools, 34: 299-319)) found that blindness, deafness and physical conditions that affected a persons’ abilities to carry out daily activities were seen as disabilities, but that cleft palate, speech or learning problems and mental retardation were not considered disabilities. Instead, these conditions are believed to be caused by the child’s nature, stubbornness, laziness or fate. |
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| __Treatment__ | __Treatment__ | ||
| - | Vietnam has limited speech language pathology support for children with a speech sound disorder. Fewer than ten individuals living in Vietnam have held the title of “speech therapist” and none of those individuals have a degree in speech-language pathology. These individuals have degrees in medicine, physical therapy, dentistry, linguistics, psychology, nursing and other areas. When practicing as speech therapists in Vietnam, these individuals primarily focus on voice disorders, aphasia, cerebral palsy, Down syndrome and speech issues related to cleft palate. Fortunately, visiting clinicians doing trainings and/or providing services have met with great enthusiasm both for donated services and also for the idea of starting a field of speech-language pathology in Vietnam. | + | Vietnam has limited speech language pathology support for children with a speech sound disorder. Fewer than ten individuals living in Vietnam have held the title of “speech therapist” and none of those individuals have a degree in speech-language pathology((Ducote, C. (2001). A speech-language pathologist in Vietnam. Viewed 5 February 2010, http://www.asha.org/about/publications/leader-)). These individuals have degrees in medicine, physical therapy, dentistry, linguistics, psychology, nursing and other areas((Ducote, C. (2010). Speech therapy in Vietnam. Viewed 18 February 2010, http://www.speech-language -therapy.com/Vietnam.htm). When practicing as speech therapists in Vietnam, these individuals primarily focus on voice disorders, aphasia, cerebral palsy, Down syndrome and speech issues related to cleft palate. Fortunately, visiting clinicians doing trainings and/or providing services have met with great enthusiasm both for donated services and also for the idea of starting a field of speech-language pathology in Vietnam((Trinh foundation: Recent history of speech language therapy in Vietnam. Viewed 8 February 2010, http://www.trinhfoundation.org/index_files/Page931.htm)). |
| The overall level of special education services available in Vietnam is increasing. The first teacher-training program to offer training in special education took place in 2003. However, speech sound disorders do not qualify as a disability. Consequently, children with speech sound disorders are generally included in general education settings and do not receive special education services. | The overall level of special education services available in Vietnam is increasing. The first teacher-training program to offer training in special education took place in 2003. However, speech sound disorders do not qualify as a disability. Consequently, children with speech sound disorders are generally included in general education settings and do not receive special education services. | ||
| - | References | ||
| - | Hwa-Froelich, D.A. & Westby, C.E. (2003). Frameworks of education: Perspectives of Southeast Asian parents and Head Start staff. Language, Speech and Hearing Services in Schools, 34: 299-319. | + | ====Clinical Implications==== |
| + | |||
| + | ===China=== | ||
| + | Treatment for speech sound disorders in China is limited due to high priority given to other speech and language needs (i.e. hearing impairments, dysphagia, and those who stutter). Individuals from China in the US may not realize that services for speech sound disorders are provided in the US. | ||
| - | Ducote, C. (2001). A speech-language pathologist in Vietnam. Viewed 5 February 2010, http://www.asha.org/about/publications/leader- | + | ===India=== |
| - | Tang, G. & Barlow, J. (2006). Characteristics of the sound systems of monolingual Vietnamese-speaking children with phonological impairment. Clinical Linguistics & Phonetics. 20(6): 423-445. | + | India has an emerging field of speech-language pathology. Although exact incidence numbers and perception of speech sound disorders are not clear, they are a diagnostic entity and are treated by speech therapists. |
| - | Ducote, C. (2010). Speech therapy in Vietnam. Viewed 18 February 2010, http://www.speech-language -therapy.com/Vietnam.htm | + | ===Japan=== |
| + | The treatment for speech sound disorders in Japan has really evolved over the last 30 years. Teachers who work with children in the speech-language training classrooms are taught to use a very systematic process for treatment, whether in individual or group treatment. | ||
| - | Trinh foundation: Recent history of speech language therapy in Vietnam. Viewed 8 February 2010, http://www.trinhfoundation.org/index_files/Page931.htm | + | ===Vietnam=== |
| + | Speech sound disorders are not considered a disability in Vietnam. Because of the lack of identification as well as absence of trained speech-language pathologists, speech sound disorders are neither identified nor treated. It is possible that individuals in the US of Vietnamese origin may not be aware of speech therapy services for speech sound disorders. | ||
| - | ~~DISCUSSION:on~~ | + | ~~DISCUSSION:off~~ |