A deeply ingrained listening distortion can actually lead to the loss of desire to listen, which in turn will diminish the desire to communicate, either because the person suffering from this distortion lacks confidence, or because he or she simply gives up trying to communicate.
Let’s recall that having well-tuned listening is not necessarily a consequence of having good hearing. Listening is characterized both by a real intention to communicate and by the quality of perception and of interpretation of the received sound message.
Well-tuned listening is therefore not a function of how well we hear or of our ear’s sensitivity, but rather of how well we process what we hear, that is, of the quality of exploitation of our hearing.
Even though the phrase ‘communication disorders’ is undeniably generalized, and although difficulties with communication may have diverse and varied causes, it is nevertheless the case that a considerable number of communication problems originate in known distortions of the listening function.
Difficulties in communication may take on a variety of different forms. For example, they may show up as an inability to perceive sounds in the environment without feeling aggressed by them; for some people with a communication disorder, the honking of a car horn, the slamming of a door, the noisy ambiance of a restaurant, and even the familiar voices of co-workers, parents or friends may be perceived as aggressive.
Others suffering from different communication disorders find it difficult, even impossible, to use their voice as a true tool of communication, due to a lack of mastery over its different melodic components – intonation, inflection, rhythm, intensity, etc.- and these peoples’ voices may consequently be perceived as aggressive, cold, or void of any power of expression by another interlocutor. By specifically working on the reception and emission of sound, the Tomatis Method acts effectively on communication.
The term ‘communication disorders’ encompasses a wide variety of problems in language, speech, and hearing. Speech and language impairments include articulation problems, voice disorders, fluency problems (such as stuttering), aphasia (difficulty in using words, usually as a result of a brain injury), and delays in speech and/or language. Speech and language delays may be due to many factors, including environmental factors or hearing loss.
Hearing impairments include partial hearing loss and deafness. Deafness may be defined as a loss sufficient to make auditory communication difficult or impossible without amplification. There are four types of hearing loss:
Many communication disorders result from other conditions such as learning disabilities, cerebral palsy, mental retardation, or cleft lip or cleft palate.
The overall estimate for speech and language disorders is widely agreed to be 4-6% of school-aged children. This figure includes voice disorders (3%) and stuttering (1%). The incidence of elementary school children who exhibit delayed phonological (articulation) development is 2-3%, although the percentage decreases steadily with age.
Estimates of hearing impairments vary considerably, with one widely accepted figure of 5% representing the portion of school-aged children with hearing levels outside the normal range. Of this number, 10-20% require some type of special education. Approximately one-third of students who are deaf attend boarding schools. Two-thirds attend day programs in schools for students who are deaf or day classes located in regular schools. The remainder are mainstreamed into regular school programs.
A child with speech or language delays may present a variety of characteristics including the inability to follow directions, slow and incomprehensible speech, and pronounced difficulties in syntax and articulation. SYNTAX refers to the order of words in a sentence, and ARTICULATION refers to the manner in which sounds are formed. Articulation disorders are characterized by the substitution of one sound for another or the omission or distortion of certain sounds.
Stuttering or dysfluency is a disorder of speech flow that most often appears between the ages of 3 and 4 years and may progress from a sporadic to a chronic problem. Stuttering may spontaneously disappear by early adolescence, but speech and language therapy should be considered.
Typical voice disorders include hoarseness, breathing, or sudden breaks in loudness or pitch. Voice disorders are frequently combined with other speech problems to form a complex communication disorder.
A child with a possible hearing problem may appear to strain to hear, ask to have questions repeated before giving the right answer, demonstrate speech inaccuracies (especially dropping the beginnings and endings of words), or exhibit confusion during discussion. Detection and diagnosis of hearing impairment have become very sophisticated. It is possible to detect the presence of hearing loss and evaluate its severity in a newborn child.
Students who speak dialects different from standard English may have communication problems that represent either language differences or, in more severe instances, language disorders.
Many speech problems are developmental rather than physiological and, as such, they respond to remedial instruction. Language experiences are central to a young child’s development. In the past, children with communication disorders were routinely removed from the regular class for individual speech and language therapy. This is still the case in severe instances, but the trend is toward keeping the child in the mainstream as much as possible. In order to accomplish this goal, teamwork among the teacher, speech/language therapist, audiologist, and parents is essential. Speech improvement and correction are blended into the regular classroom curriculum and the child’s natural environment.
Amplification may be extremely valuable for the child with a hearing impairment. Students whose hearing is not completely restored by hearing aids or other means of amplification have unique communication needs. Children who are deaf are not automatically exposed to the enormous amounts of language stimulation experienced by hearing children in their early years. For deaf children, early, consistent, and conscious use of visible communication modes such as sign language, finger spelling, and cued speech and/or amplification and aural/oral training can help reduce this language delay. Some educators advocate a strict oral approach in which the child is required to use as much speech as possible, while others favor the use of sign language and finger spelling combined with speech, an approach known as TOTAL COMMUNICATION. There is increasing consensus that whatever system works best for the individual should be used.
Many children with hearing impairments can be served in the regular classroom with support services. In addition to amplification, instructional aids such as captioned films and high interest/low vocabulary reading materials are helpful. For most children with hearing impairments, language acquisition and development are significantly delayed, sometimes leading to an erroneously low estimate of intelligence.
Students whose physical problems are so severe that they interfere with or completely inhibit communication can frequently take advantage of technological advances that allow the individual to make his or her needs and wants known, perhaps for the first time.