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INTRODUCTION

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LEARNING OBJECTIVES

  1. Differentiate the organization of language with respect to the role of phonological, lexical, syntactic, and semantic systems.

  2. Understand the role of the motor speech system in the speech production process.

  3. Discuss and characterize the classic aphasic syndromes.

  4. Identify and explain the critical factors in the evaluation of recovery and rehabilitation of aphasia.

  5. Identify and describe general approaches to aphasia rehabilitation and some specific treatment methods.

  6. Identify etiologies of cognitive-communication disorders.

  7. Compare and contrast deficits in executive function, pragmatic language, and motor speech in persons with cognitive-communication disorders.

  8. Describe the primary types of dysarthria and rationales for dysarthria treatment.

  9. Describe apraxia of speech and its treatment.

  10. Gain an understanding of swallowing disorders.

  11. Describe the goals and rationales for the use of augmentative communication systems.

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Most people take the ability to produce and understand speech for granted and pay little attention to the nature and function of the processes involved in communication. Yet speech, like tool making, sets us apart from animals and is one of our most human behaviors. Even in primitive societies, humans have used the oral–motor speech code to share experiences, ideas, and feelings. Not all communities have developed writing and reading systems.

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The use of speech for communication contributes to our identity as human beings and to the perception of "self." As a result, disruptions in the ability to communicate, whether caused by structural abnormalities (e.g., cleft palate), neurological conditions (e.g., stroke, Parkinson's disease), or nonorganic conditions (e.g., nonorganic articulatory disorders) may affect a person's daily life in important ways. For some, the acquisition of a communication disorder may have sufficient impact to cause an individual to withdraw from the workforce. For those whose communication disorders have persisted since childhood, the disorder may represent a significant vocational handicap. In other cases, a disorder that does not impede an individual's vocational life nonetheless interferes with everyday socialization. Communication disorders are complex, multifaceted behavioral impairments often associated so closely with a person's self-image as to threaten the quality of his or her life.

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The term communication encompasses all of the behaviors, including speech, that human beings use to perceive and transmit information and interact with others. Speech comprises a delicate and rapid sequence of sensory and motor events requiring the coordinated activity of several parts of the body. The use of speech for communication involves many levels of human activity, ranging from the fine motor coordination of components of the oral–motor system to the subtle shades of meaning that occur at the cognitive/semantic level. Gestures, pantomime, and other nonverbal pragmatic language behaviors, such as turn taking, are also essential elements of communication.

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Among unimpaired speakers, speech behavior varies greatly, yet the oral–motor system is efficient for the exchange of even complicated information. The range of variability is so wide that individuals generally produce different sound waves with different characteristics even when producing the same word. But listeners do ...

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