Articulation Disorders: Articulation involves the movement of oral structures to produce the sounds of speech. An articulation disorder implies that an individual has difficulty producing sounds correctly.

Phonological Disorders: Phonological processes are patterns that young

children use during normal speech and language development. However,

between the ages of 3-5 years, most children stop using all phonological

processes. Children who continue to use these processes exhibit speech

that is very difficult to understand.

Language Disorders/Delays: A disorder can involve both the comprehension (receptive language) and production (expressive language) of language. A language delay means that the acquisition of normal language occurs at a substantially slower rate than would be expected in typically developing children. A language disorder refers to acquisition patterns that are significantly different from the normal developmental sequence. Children with language disorders may exhibit a limited amount of language, deficient grammar, inappropriate or inadequate social communication, and academic problems in school.

Reading Disorders: The major components of reading instruction are phonological/phonemic awareness, phonics, decoding, vocabulary development, fluency, and comprehension. Children with persistent reading difficulties, such as dyslexia, require intensive intervention to compensate for their processing differences and do not tend to catch up if given more time or if material is presented in a slower manner.

Autism Spectrum Disorders: Autism is a pervasive developmental disorder that typically occurs during the first three years of life and has no known cause. Autism is a “spectrum” disorder, which means that the degree of impairment can be mild to severe. These children have a limited range of communication functions, typically fail to develop normal verbal and nonverbal communication skills, and demonstrate pragmatic and conversational deficits.

Voice Disorders: Voice problems can affect a person’s vocal pitch, volume, and/or quality. Changes in one’s voice can profoundly affect that individual’s life. Most voice disorders are associated with physical changes of the laryngeal mechanism due to inflammation, edema, nodules, polyps, ulcers, and cancer. However, some voice disorders are psychogenic and occur in the presence of normal laryngeal structures. Treatment of voice disorders often includes surgical intervention, medication, counseling, therapy, or a combination of these approaches.

Traumatic Brain Injury: Traumatic brain injury (TBI) is an open or

closed head injury resulting from impact or penetrating force. Car

accidents, bicycle accidents, child abuse, and gunshot wounds are

leading causes of TBI. Communication disorders associated with TBI

include confused language, dysarthria, naming difficulties, auditory

comprehension deficits, reading and writing problems, and generally

disturbed social interaction.

Aphasia: Aphasia is a neurologically based language disorder characterized by a reduced ability to understand what others are saying and/or difficulty with verbal expression. Individuals with this disorder may have a complete loss of language, may have only mild difficulties recalling names or words, or may have problems putting words in their proper order in a sentence. Reading, writing, and nonverbal modes of communication may also be impaired. Strokes are a major cause of aphasia.

Dysarthria: Dysarthria is a motor speech disorder that interferes with normal muscular control of the speech mechanism. Speech may be slurred or difficult to understand due to a lack of ability to produce speech sounds correctly. Dysarthria results from stroke, brain tumors, head trauma, and neuromuscular diseases such as Parkinson’s, multiple sclerosis, myasthenia gravis, and bulbar palsy.


Apraxia: Verbal apraxia is a neurologically based articulation disorder characterized by difficulty in positioning speech muscles and sequencing muscle movements for the voluntary production of speech. Apraxia may be developmental in nature or result from stroke, trauma, tumors, and disease processes such as Alzheimer’s.

Fluency Disorders: Dysfluency, also known as stuttering, is anything that disrupts the smooth flow of speech. A person who stutters may repeat syllables, words and phrases; prolong sounds; hesitate or pause frequently when speaking; and exhibit eye blinking, facial grimacing, and other distracting behaviors.

Auditory Processing Disorders: Auditory processing involves what we do with what we hear. A person with an auditory processing deficit has normal ability to hear sounds but may have difficulty with auditory sequencing, memory, and discrimination of sounds. An auditory processing disorder should be diagnosed after a comprehensive evaluation by a certified audiologist.

Cleft Palate: A cleft palate refers to an opening through the soft palate and the bony roof of the mouth. The upper lip can also have a cleft. There are many kinds of clefts of the lips, hard palate, and the soft palate. There are many speech and resonance problems associated with cleft palate due to the mal-formation of the oral structures needed for speech production.

Oral-Aural/Audiologic Rehabilitation:  Aural habilitation/rehabilitation services for children and adults depend on individual needs as dictated by the age of the patient, the age of onset of the hearing loss, the age at which the hearing loss was discovered, the type and severity of the hearing loss, the extent of the hearing loss, the age at which amplification was introduced, and the current mode of communication.  Intervention may include training in auditory perception; using visual cues that give meaning to a message; improving speech; developing language; improving communication skills in different listening situations; and managing hearing aids, cochlear implants, and other assisted listening devices.

Dysphagia: Dysphagia is the medical term to describe difficulty swallowing.  A wide range of diseases can cause swallowing disorders.  These include things like amyotrophic lateral sclerosis, multiple sclerosis, Parkinson’s disease, strokes, achalasia, and esophageal narrowing from acid reflux or tumors.  In children, dysphagia symptoms may be difficulty coordinating sucking and swallowing, gagging during feeding, difficulty chewing, not accepting a variety of age-appropriate liquids and foods, or displaying inappropriate mealtime behaviors.

Language Services

Bristol Clinic

111 Commonwealth Ave., Suite 100

Bristol, Virginia 24201

T: 276.669.6331

F: 276.669.2950

Lebanon Clinic

68 Pioneer Drive

Lebanon, Virginia 24266

T: 276.889.1389

F: 276.889.5847