Speech and Speech(language)

Disorders

Dr. Minal Patel, MBBS, M.Sc., Ph.D., MD

Professor,
Department of Physiology,
PSMC, Karamsad
 Learning Objectives
• What is Speech?
• Role of categorical hemisphere
• Development of Speech
• Speech areas and their role in speech
• Language disorders (Aphasia)
 What is speech?
• Speech is a method of communication. It
involves:
1. Hearing
2. Vision
3. Speaking
4. Reading
5. Writing
6. Sometimes, even silence is the best speech.
 What is speech?
• Most of the speech is acquired, requiring
conscious effort, but it may also occur
subconsciously in small amount.
• Speech is the expression of thoughts and
ideas by speaking or by writing.
• The categorical hemisphere is concerned with
language(Speech) functions.
 Categorical hemisphere and language
function
• In 96% of right-handed individuals, who constitutes
91% of the human population, the left hemisphere is
the dominant or categorical hemisphere.

• In the remaining 4% of right-handed individuals, the

right hemisphere is dominant.

• In 15% of left-handed individuals, the right

hemisphere is dominant, but, in the remaining70% of
left-handers,left hemisphere is dominant.
Categorical hemisphere and language function
• In majority of humans, left cerebral
hemisphere is the dominant or categorical
hemisphere.

• It is concerned with language (speech),

reasoning, mathematical calculations,
numerical and scientific skills.

• Right hemisphere is more concerned with

recognition of faces, music, art, and
emotions.
Development of language or speech
1. The potential for development of language-specific
mechanisms in the left hemisphere is present at
birth.

2. The assignment of language functions to specific

brain areas is fairly flexible in the early years of life
before puberty.

3. Damage to the perisylvian area of left hemisphere

during infancy or early childhood, causes
temporary, minor language impairment, but similar
damage in adults causes permanent speech defects.
Development of language or speech
1. If the left hemisphere is traumatized in older
children, functional language ability may be
reestablished to some extent in the right
hemisphere. Language develops in these
children.

2. By puberty, the transfer of language

functions to the right hemisphere is less
successful, and language skills are lost
permanently.
Speech areas and their role in speech
• Normal Speech actually requires practically all
areas of cerebral cortex, but 4 areas are
crucial for the development of normal speech:

• Broca’s speech area(Area 44) or Motor

speech area
• Wernicke’s speech area(Area 22) or General
interpretative area
• Angular gyrus (Area 39)
• Arcuate fasciculus
Speech areas
Speech areas involved in speaking
a heard word
Pathway for speaking a heard word
Speech areas involved in speaking
a written word
Pathway for speaking a written
word
Cortical areas involved in speech
 Functions of Wernicke’s area
• A region at the posterior end of the superior
temporal gyrus in the categorical hemisphere is
called as Wernicke’s area(General Interpretative
Area)

• Comprehension of auditory and visual

information(to understand the question and what to
answer)

• Formation of thoughts to be expressed

• Choice of words to be used

 Functions of Broca’s area
• Broca’s area is situated in the frontal lobe
immediately in front of the inferior end of the
motor cortex

• Broca’s area processes the information

received from Wernicke’s area into a detailed
and coordinated pattern for vocalization

• It then projects the motor pattern of

vocalization via a speech articulation area in
the insula to the motor cortex
Function of motor cortex in speech
• Motor cortex (area 4) initiates the contraction
of muscles responsible for appropriate
movements of the lips,tongue,soft palate,
larynx and respiratory muscles to produce
sound.

• The areas involved in speech and hand

movements are specially large in the motor
cortex; use of the pharynx, lips, and tongue to
form words are activities in which humans are
especially skilled.
Function of angular gyrus(Area 39)
• It is situated behind the Wernicke’s area

• Angular gyrus is responsible for interpretation

of meaning of written words,pictures,and
various objects.

• It also process information from words that

are read in such a way that they can be
converted into the auditory forms of the
words in Wernicke's area.
 Role of cerebellum in speech
1. The cerebellum is important in speaking and
writing, which involve coordinated muscle
contractions.

2. Cerebellar ataxia is manifest in defects of the

skilled movements involved in the
production of speech, so that slurred, or
scanning, speech results.
 Language disorders (Aphasias)
• Aphasias are abnormalities of language functions
that are not due to defects of vision or hearing or
to motor paralysis.

• They are caused by lesions in the categorical

hemisphere (usually Left hemisphere).

• The most common cause is embolism or thrombosis

of a cerebral blood vessel(Stroke).

• ‘Aphasia' means a disturbance of the ability to use

language, whether in speaking, writing or
comprehending.
 Classification of Aphasias
1. Non-fluent aphasia or expressive aphasia or
Broca’s aphasia
2. Fluent aphasia (Wernicke’s aphasia)
3. Fluent aphasia (conduction aphasia)
4. Fluent aphasia (anomic aphasia)

• Writing is abnormal in all aphasias in which

speech is abnormal, but the neural circuits
involved are unknown.
 Non-fluent aphasia
• In nonfluent aphasia, the lesion is in Broca’s
area.
• Speech is slow, and words are hard to come
by.
• Patients with severe damage to this area are
limited to two or three words with which to
express the whole range of meaning and
emotion (Expressive aphasia).
 Non-fluent aphasia
• Damage to Broca’s speech area results in
nonfluent aphasia, an inability to properly
articulate or form words.
• People with nonfluent aphasia know what
they wish to say but cannot speak.
• Speech therapy play an important role in
rehabilitation of patient.
• Speech therapy may improves patient’s
communication with others.
 Fluent aphasia (Wernicke’s
aphasia)
• In this aphasia, the lesion is in Wernicke’s
area
• Speech itself is normal and sometimes the
patient talk excessively.
• However, what they say is full of jargon and
neologisms that make little sense.
• The patient also fails to comprehend the
meaning of spoken or written words.
• Speech therapy is of little value in these
patients.
 Fluent aphasia(conduction
aphasia)
• Patients of conduction aphasia can speak
relatively well and have good auditory
comprehension but cannot put parts of
words together or conjure up words.
• Their prognosis is better as compared to a
patient of Wernicke’s aphasia.
• Conduction aphasia occurs due to lesions in
and around the auditory cortex(areas
40,41.and 42).
 Anomic aphasia(angular gyrus
aphasia)
• When a lesion damages only angular gyrus
(area 39), patient has no difficulty with speech
or the understanding of auditory information.
• Patient of anomic aphasia has difficulty in
understanding written language or pictures,
because visual information is not processed
and transmitted to Wernicke’s area.
• Patient is unable to name the object shown to
him (anomic aphasia)
 Summary
1. Language is one of the fundamental bases of
human intelligence and a key part of human
culture.
2. Speech is a complex code that includes the
acts of listening,reading,writing,and speaking
3. In 90% of the population the left hemisphere
is specialized to produce language-the
conceptualization of what one wants to say
or write, the neural control of speaking or
writing, and recent verbal memory.
 Summary
• The development of language functions
occurs in a critical period that closes at
puberty.
• After damage to the dominant hemisphere,
some language function can be acquired by
the opposite hemisphere– the younger the
patient, the greater the transfer of function.
• Aphasias are abnormalities of speech that are
not due to defects of vision or hearing or to
motor paralysis.