The difficulty: Individual is non-verbal or speech is very limited or difficult to understand. Non-speech communication methods are needed for effective communication.

This may result from: A variety of communication deficits. Those individuals may benefit from using alternative and augmentative communication systems.

Therapy emphasis: Developing successful communication through a variety or modes, while enhancing verbal skills to the highest level possible. 

The difficulty: Using language to communicate. Limitations in gesturing, speaking, understanding, reading and writing.

This may result from: Stroke, brain injury, or other neurological disorders.

Therapy emphasis: Improving overall communication skills and compensating for long term difficulties. The Let's Talk Again group offers therapy for stroke survivors. 

The difficulty: Impaired communication due to altered thinking abilities. May include decreased attention and concentration, memory, organization, problem solving and abstract reasoning skills.

This may result from: 

• Stroke
• Brain injury
• Alzheimer’s disease
• Multi-infarct dementia
• Other neurological disorders

Therapy emphasis: Improve thinking, reasoning, planning and memory skills related to communication. Teach strategies to compensate for long term deficits.

The difficulty: Difficulty with memory functions affecting independent living skills. Therapy would emphasize developing techniques to maintain functional memory skills.

Therapy emphasis: Improve thinking, reasoning, planning and memory skills related to communication. Teach strategies to compensate for long term deficits.

The difficulty: Long term challenges with speaking, understanding information, reading and writing which may affect job performance and daily social interactions. Typical onset in childhood.

This may result from: 

• Central Auditory Processing Disorder
• Genetic syndromes
• Language impairment
• Learning disability
• Unknown cause

Therapy emphasis: Develop language and communication skills and strategies to promote success in education, employment and social settings.

The difficulty: Speech sounds are unclear and hard for others to understand.

This may result from: 

• Apraxia of speech
• Cerebral palsy
• Cleft palate
• Delay in acquiring age appropriate speech sounds
• Genetic syndrome
• Hearing impairment
• Oral motor delays/impairment
• Phonological impairment
• Second language learner
• Unknown origin

Therapy emphasis: Facilitating clear speech development for effective communication.

The difficulty: Speech is difficult to understand.

This may result from: 

• ALS
• HIV/AIDS
• Multiple Sclerosis
• Parkinson’s disease
• Stroke
• Other degenerative neurological conditions

Therapy emphasis: Improving or maintaining clarity of speech. Augmentative communication systems can be implemented as needed.

Stuttering difficulty: Frequent disruptions in speech, such as repetitions of words or parts of words, prolongations of sounds, or complete blockages of sounds. Speech may be accompanied by physical tension or struggle.

Cluttering difficulty: Rapid and/or irregular speaking rate, excessive disfluencies, and often other symptoms such as language or phonological errors and attention deficits.

This may result from: Genetically-influenced conditions that involve different neurological development in childhood. It is also possible to acquire stuttering or cluttering (e.g. after a brain injury, stroke, or reaction to medication).

Therapy emphasis: Teaching the individual to communicate effectively and efficiently any time, any place and to anybody.

Resources

The difficulty: Voice sounds hoarse, harsh or unnatural; problems with pitch and loudness.

This may result from: 

• Acid reflux (GERD)
• Cancer
• Chronic laryngitis
• Granuloma
• Laryngectomy
• Neurological conditions (e.g. Parkinson’s, Amiotropic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), etc….)
• Pitch breaks
• Quiet voice
• Spasmodic dysphonia
• Vocal abuse (i.e. excessive/faulty voice use)
• Vocal nodules or polyps
• Unknown cause

Therapy emphasis: Improving voice quality and function. Assistive devices may be used if needed.