Cincinnati Children's Hospital Medical Center Logo

Family Support Information

Glossary

The Department of Speech Pathology at Cincinnati Children's Hospital Medical Center provides this glossary to help you understand words you may hear during your child's evaluation and treatment.

Aphasia
An acquired language disorder resulting from central nervous system damage.
Aphonia
A total lack of voice
Apraxia
This speech disorder affects a child's ability to correctly pronounce sounds, syllables and words. The child can't position his tongue, lips and jaw to produce speech sounds and to sequence them into syllables or words. The area of the brain that tells the muscles how to move to make particular sounds is damaged or not fully developed.
Articulation (Speech) Disorder
An articulation (speech) disorder is characterized by difficulty with the physical production of individual speech sounds.  There may be incorrect placement of the lips, teeth, tongue or even the soft palate during speech, resulting in inaccurate production of certain sounds. 
In children, it is important to compare speech production with other children the same age. Speech sounds develop gradually over time, but most sounds should be correctly produced by the age of 3, and all sounds should be correctly produced by the age of 6.
When an articulation disorder is identified, treatment in the form of speech therapy is needed. Without treatment, social and vocational consequences often result.
Augmentative and Alternative Communication
Any approach designed to support, enhance, or supplement the communication of individuals who cannot independently communicate in all situations. AAC may include sign language, picture boards and/or computer assisted devices
Autism
Autism is a life-long disability which begins before 3 years of age. It is a neurological disorder; the brain doesn't function normally and communication and socialization are severely impacted. Autism occurs in 1/250 individuals; most commonly in boys. It is found throughout the world in all races.
Babbling
Long strings of sounds that children begin to produce at about four months of age.
Bilateral Vocal Cord Paralysis (BVCP)
A type of vocal cord paralysis whre both vocal cords do not move.
Central Auditory Processing
Cleft palate
Cleft palate is a separation in the roof of the mouth that occurs when it fails to join, or fuse, as a child is developing before birth. Surgery to correct a cleft palate is usually performed between 9 months and 2 years of age, and may require several stages of repair. Possible long-term problems include speech problems, crooked teeth, frequent head colds and frequent ear infections.
Cochlear Implant
Cochlear implantation represents one of the greatest advances in the management of children with severe to profound sensorineural hearing loss ("nerve deafness"). By implanting a computerized device into the inner ear, functional hearing can be restored to children not benefitting from traditional amplification with hearing aides.
Communication Disorders
Young children with communication disorders may not speak at all, or may have a limited vocabulary for their age. Some children with communication disorders have difficulty understanding simple directions or are unable to name objects. Most children with communication disorders are able to speak by the time they enter school, however, they continue to have problems with communication.

 

 

School-aged children often have problems understanding and formulating words. Teens may have more difficulty with understanding or expressing abstract ideas.

 

The symptoms of communication disorders may resemble other problems or medical conditions.

Compensatory Articulation
A child may learn to produce sounds in an alternate way (compensatory articulation) by using the air pressure in the throat for speech.
Craniofacial Anomalies
Craniofacial anomalies (CFA) are a diverse group of deformities in the growth of the head and facial bones. Anomaly is a medical term meaning "irregularity" or "different from normal." These abnormalities are congenital (present at birth) and there are numerous variations - some are mild and some are severe and require surgery.
Cue
Some type of aid (visual, auditory, tactile) that promotes a correct response.
Cul de sac Resonance
Occurs when sound resonates (vibrates) in the throat or nose, and is trapped in that area with no outlet. The speech is perceived as muffled due to the fact that the sound is stuck in a cavity with no direct means of escape. The cause of cul de sac resonance can vary, but it is usually due to an area of blockage somewhere in the throat or nose.
Disfluency
Any breakdown in the natural flow natural forward flow of speech and of the intended message may be referred to as disfluency or stuttering.
Drill Therapy 
A method of treatment in which the therapist leads the child in targeting specific goals.  Multiple repetitions are used to increase accuracy. Typically it starts with production of sounds in isolation, and then progresses to syllables, words, and sentences.
Dysphagia
The term used for feeding or swallowing problems that can occur in infants and in children of all ages.
Dysphonia
The degree of voice disorder
Early Intervention
Early intervention is a key to successful treatment. If a child's communication skills are significantly behind those of peers, it's time to seek help. Before age 6, the brain is very flexible for language and speech learning; after 6, it's much harder and takes longer to correct disorders. Also, habits aren't as strong earlier, and the child's ability to learn hasn't yet been hurt. It's also important to get speech therapy before a child enters school, because there's a lot of teasing. Therapy can help avoid the emotional effects when a child has difficulty communicating.
Echolalia
Immediate, whole or partial vocal imitation of another speaker.
Eosinophilic Esophagitis
A disease characterized by elevated levels of eosinophils in the esophagus.
Expansion
Adult's more mature version of a child utterance that preserves the word order of the original child utterance. For example, when a child says "Doggie eat" and adult might reply "The doggie is eating".
Expressive Language
Refers to the ability to choose words and combine the words appropriately to communicate with sentences.
Extension
Adult's semantically related comment on a topic established by a child. For example, when a child says "Doggie eat", and adult might reply "Yes, doggie hungry".
Feeding Team
Feeding is a complex process involving gross motor, fine motor, oral motor, and reflex development, as well as nutritional and behavioral factors. An oral-motor/feeding problem may involve one or more of these factors, and may have an organic and/or environmental etiology. Physiological abnormalities may interfere with normal development of feeding patterns, and environmental factors may contribute to the evolution and/or maintenance of such problems. The technological advances used for supplementary means of nutritive support (e.g. nasogastric tube feedings) may also contribute to the problem. Such problems have been estimated as occurring in as much as one-third of the handicapped population, and approximately 21 percent of those with feeding problems have behavioral mismanagement as a primary etiology.

While it is most common for children with feeding problems to be referred to a single discipline (e.g., Speech Pathology, Psychology, etc,) an interdisciplinary approach has been advocated and shown to be the most comprehensive treatment of choice.

The Cincinnati Children's Interdisciplinary Feeding Team provides a mechanism for integrating the knowledge and expertise of these varied disciplines in order to provide more effective and efficient treatment planning for children with feeding problems.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
Fiberoptic endoscopic evaluation of swallowing (FEES) is a procedure to evaluate the swallowing process in pediatric patients with swallowing disorders due to a variety of etiologies. FEES is a procedure which evaluates the pharyngeal stage of the swallow and helps to assess the airway protection mechanisms during swallowing.
Fluency
Speech fluency refers to the natural forward flow of speech.
Gesture
Movement of any part of the body to express or emphasize an idea, emotion or function.
Grammar
Rules that outline the way words can be put together to form meaningful sentences in spoken or written language.
High-Risk Infant Follow-up Program
The High-Risk Infant Follow-up Program at Children's Hospital Medical Center was established to care for low birth weight infants and evaluate their long-term outcome. Since then, the program has expanded to offer tertiary level outpatient clinical care, consultation services, and specialized medical and developmental supervision for high risk infants.
Home Program
Helping parents and children unscramble speech disorders is the work of the speech and language pathologists at Cincinnati Children's. They help families manage with one-on-one sessions coupled with trained parental help.  They teach the parents to the therapists at home.
Hypernasality
Hypernasality occurs when too much sound resonates (vibrates) in the nasal cavity (nose) during speech. This type of resonance makes the patient sound as if he or she is talking through the nose. This can be due to an abnormal opening between the nose and the mouth during speech due to velopharyngeal dysfunction.
Hyponasality
Hyponasality occurs when there is not enough sound resonating (vibrating) in the nasal cavity (nose) during speech. This type of resonance makes the patient sound "stopped up." This can be due to blockage or congestion in the throat or nose.
Language Disorder
A child with this disorder has difficulty with the meaning conveyed in speech. The child may be unable to understand others' speech. Other indications of possible language disorder are a limited vocabulary, use of inappropriate words or reliance on short phrases and sentences. The child may also put sentences together incorrectly.
Mean
The average in a group of numbers or scores.
Nasal air emission
Nasal emission (including a nasal rustle or nasal snort) can be associated with hypernasality. Nasal air emission refers to the audible release of the air pressure through the nasal cavity and nose during speech.
Nonverbal
Without oral speech
Oral Apraxia
Type of apraxia that affects ability to voluntarily control non-speech movements. The child might have difficulty sticking out and wagging his tongue when asked. Or the child may have difficulty sequencing movements for the command, "Show me how you kiss, now smile, now blow".
Oral-Motor
Oral Myofunctional Disorders
Oral Myofunctional Disorders are differences in the position or function of the muscles of the face and/or mouth, including the lips and tongue. These differences in dental, skeletal, and muscular structures may interfere with appropriate swallowing, speech, and/or oral rest postures. At times, these often-subtle differences may also negatively impact dental and facial growth patterns.
Phonemes
Sounds in a language that distinguish between words.  For example [p] and [b] are English phonemes that distinguish between the words "pea" and "bee" .
Phonation
The act of producing sound with the vocal folds.
Phonology
The study of speech sounds in a language.
Play Therapy
Method of treatment in which the child is allowed to play freely with a selected group of toys.  The clinician follows the child's lead during the therapy session.
Pragmatics
Set of rules governing the use of language in context.  For example waving your hand from side to side means "hello" or "good-bye".  Making eye contact allows the listener know you are interested in what they are saying. 
Receptive Language
Receptive language is the ability to understand the speech of others.
Resonance
Is the quality of the voice that results from sound vibrations in the pharynx (throat), oral cavity (mouth) and nasal cavity (nose). The relative balance of sound vibration in these cavities determines whether the quality of the speech and voice is perceived as normal, or as abnormal due to a type of "nasality."
Phonation
The act of producing sound with the vocal folds.
Sign Language
American Sign Language (ASL). Communication method used by the deaf in which gestures (signs) function as words.
Stuttering
A child with stuttering has an abnormal number of repetitions, hesitations or prolongations in the natural flow of speech.  The child is often tense during speech and avoids speaking because of a fear of stuttering.
Speech Pathologist (SLP)
An individual who is qualified to diagnose speech, language, and voice disorders and to prescribe and complete therapy programs.   An SLP has a degree and certification in speech and language pathology.  May also be called a speech therapist, speech clinician, or voice therapist. 
Standardized Test
A test that has standardized procedures for administration and scoring.  An individual's performance can be compared to the performance of others who are the same age. 
Syllable
A unit of speech consisting of a vowel that stands alone or is surrounded by one or more consonants (i.e. "i", "in", "me")
Unilateral Vocal Cord Paralysis (UVCP)
A type of vocal cord paralysis where only one vocal cord does not move.
Velopharyngeal Insufficiency (VPI)
Velopharyngeal insufficiency refers to the inability to separate the nasal cavity from the oral cavity during speech. The result is abnormal resonance and the production of distracting noises during speech. Decreased intelligibility results due to the distortion of consonants and vowel sounds.

Not all velopharyngeal insufficiency requires treatment. In those cases where speech intelligibility is affected various treatment options are available and need to be tailored to the findings obtained on nasopharyngoscopy.

Speech therapy may be an option in those patients where articulation errors are the source for the hypernasality. Speech therapy is often necessary to correct compensatory speech problems that develop secondary to velopharyngeal insufficiency. Speech therapy is generally required after surgical intervention so that the patient can obtain maximal benefit from the surgical procedure.

Physical intervention varies from procedures lasting less than 10 minutes to those requiring 1-1/2 hours to complete. The areas where the patient is loosing sound energy from the oral cavity into the nasal passages require some form of treatment to obstruct this abnormal escape. Generally, tissues from the back wall of the throat are rotated in such a way that the patient is able to separate the nasal cavity from the oral cavity during speech.
Voice
Is the sound that is generated when air pressure is forced through closed vocal folds, which are two muscles in the larynx, causing them to vibrate.  Voice provides the power and sound to deliver a verbal message.
Voice Disorder
A  voice disorder is when the vocal folds do not vibrate efficiently or evenly in order to produce a clear sound. It is characterized by abnormal vocal pitch, loudness, quality or resonance.

Contact Us

For more information about the Division of Speech Pathology at Cincinnati Children's Hospital Medical Center, contact the department at 513-636-4341 or speech@cchmc.org.