Speech, Airway Health, And Education

Speech-language impairment inhibits academic achievement. Empirically supported classifications identified as early as age five continue to be relevant into late childhood. There is a clear relationship between auditory-motor adaptation and phonological awareness, since phoneme representations emerge before literacy acquisition, and sensorimotor representations set the ground for phonological awareness¹. For these children, the need is urgent for early intervention². To this end, speech-language pathologists collaborate regularly with teaching staff. Verbal and written speech and language skills are inextricably linked and key to spelling development and progress³. Population-level data provide strong evidence that all children who present with language difficulties, even in kindergarten, face further written academic challenges, even if their issues resolve over time⁴⁵. This has been shown to exist as far as the age of 19 years⁶. The same relationship is generally true in voice disorders, another vital point of intervention by SLPs⁷. The prevalence is high. In one emblematic study, 50.1% had at least one of the assessed disorders; of those, 33.6% had an oral language disorder, 17.1% had orofacial motor skill impairment, and 27.3% had an auditory processing disorder. There were significant associations between auditory processing skills’ impairment, oral language impairment, and age⁸. This general situation exists across all socio-economic groups⁹, with some variation between boys and girls¹⁰. In many places, these children are underserved¹¹¹². This is even more pronounced in bilingual populations¹³. However, speech and language intervention for children in mainstream schools, even when delivered by specialist teaching assistants, is measurably effective¹⁴¹⁵.

Emotional and Social Consequences

Anxiety and depressive disorders are common among children with speech and language impairments from elementary school until youth¹⁶. These, and other emotional behavior disorders, in turn, corrode narrative, structural language, and social communication skills, particularly in alternative school settings. Here, there is a particularly strong need for speech-language pathologists to be engaged¹⁷. This can extend to classroom bullying. Poor language skills at three and five years of age are associated with peer victimization at five years of age. Poor language skills at five and eight years of age are associated with peer victimization and bully perpetration at eight years of age. The association between poor language skills at five years of age and bully perpetration at eight years of age is stronger for girls. Persistent paths of language difficulties at three, five, and eight years of age show the highest risk of peer victimization and bully perpetration¹⁸.

Underlying Disorders and Physical Habits

Sometimes there are underlying disorders to speech and language problems. Dyslexia is one such disorder. SLP programs have improved reading comprehension performance and increased motivation to read in dyslexic schoolchildren¹⁹. Sometimes the problem is a function of physical habits. Mouth breathing, an area of specialization at BreatheWorks™, is a good example. Studies have shown, as we tell educators repeatedly, that for a number of reasons, mouth breathers are more likely to have learning difficulties than nasal breathers²⁰. It may also be that basic problems in dentition form the basis of trouble with speech sound production in children with or without articulatory speech disorders. It is more important to draw attention to symmetrical eruption and individual timing patterns of eruption in these children. Research findings suggest a decreasing risk of faulty speech sound production with the advancing eruption of some permanent teeth still present in seven-year-old children²¹.

Other Related Issues

Beyond reading and speech, problems like childhood dysphonia frequently exist in school settings. This has many origins, the most common initial symptom being altered vocal quality. We find, as research also shows, that auditory-perceptual and acoustic parameters can be moderated, and that, with help, vocal characteristics can improve with age²².

Dysphagia is another potential problem in school-age children. Speech-language pathologists in schools are increasingly evaluating and treating children with dysphagia associated with medically complex conditions. There is a rising incidence of preterm births and the survival of medically fragile children, suggesting that a greater number of children will be at risk for dysphagia in the future. School-based SLPs are uniquely positioned to identify swallowing and feeding problems, evaluate and treat children with dysphagia, participate on dysphagia teams in the school setting, and interact with medical teams²³.

Finally, and most broadly, there is a common, circular syndrome in disordered sleep. The wide prevalence of nocturnal bruxism (tooth-grinding) is a marker for this, a known comorbidity of sleep and systemic neurobehavioral disturbances. The causes of disordered sleep can be widely varied. Its classroom consequences, if unarrested, can be profound. In this too, speech and language therapists, particularly those trained in oromyofunctional airway disorders, can be extremely valuable²⁴.

References

MyoNews from BreatheWorks™ is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure, or prevention of any disease or syndrome.

Footnotes

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2. Beitchman JH, Wilson B, Brownlie EB, Walters H, Lancee W. Long-term consistency in speech/language profiles: I. Developmental and academic outcomes. J Am Acad Child Adolesc Psychiatry. 1996 Jun;35(6):804-14. doi: 10.1097/00004583-199606000-00021. ↩
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16. Lee YC, Chen VC, Yang YH, Kuo TY, Hung TH, Cheng YF, Huang KY. Association Between Emotional Disorders and Speech and Language Impairments: A National Population-Based Study. Child Psychiatry Hum Dev. 2020 Jun;51(3):355-365. doi: 10.1007/s10578-019-00947-9. ↩
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