speech impairment
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In childcare institutions (CCIs) in India, children with mild or moderate levels of disability are often placed with non-disabled children for care and protection. Generally, children with intellectual disability (ID), learning disability, hearing and speech impairment and multiple disabilities with ID are found to be living in these CCIs. In this best practice article, the challenges faced by these children with disabilities and the potential for inclusion within the CCI are discussed based on the field action project intervention of the Tata Institute of Social Sciences (TISS), Mumbai, with selected government CCIs. The article suggests a multi-pronged intervention approach for the Children with disability (CWD) at the levels of the individual CWD, peer group, CCI and the juvenile justice (JJ) System, which are together recognised as the stakeholders of an ‘inclusive ecosystem’. The article arrives at the ‘Inclusive Ecosystem Model of Rehabilitation’ by drawing from the individual–environment interaction model of disability.

Assistive technology (AT) is defined as any device or technology ranging from low to high that helps to improve functional skills of individuals with cognitive, physical, or neurological disorders. These technologies are devised to improve the functional activities of persons. ATs focussing on cognitive disorders like dementia, autism spectrum disorders, etc. can be categorized as ATs for cognition (ATC) and augmentative and alternative communication (AAC). AAC interventions consist of tools that aid the challenges faced by individuals with speech impairment during communication. AACs used often are speech-generating devices (SGD), software programs, and communication apps for efficient production of speech. ATCs include social stories and video modeling strategies. The use of assistive technology in autism spectrum disorder (ASD) has great importance due to increased requirement for interventions in helping students. There are several lines of evidence showing the effectiveness of technology-assisted training in ASD patients.

The author is interested in researching the practice of the marriage contract with the bride and groom who have limitations in pronouncing the contract (impaired), from practice in the field it is often the case that the marriage contract of the non-verbal bride is carried out by a representative but without a clear power of attorney, it is not entirely wrong. Because sometimes both parties believe that there will be no dispute in the appointment of representatives. The bride and groom base the implementation of their marriage contract on the encouragement of the community, clerics, customs, and indeed an agreement between the two parties. The approach method used in this paper is a juridical-normative approach in the study of fiqh. A juridical approach by examining legal rules and a normative approach in the study of fiqh is used in analyzing problems that occur in society. For provisions that require the granting of power in writing, basically it is not stipulated in the book of fiqh. In fact, fiqh explicitly stipulates that it can be in the form of words (عبارة) or in written form. There is nothing wrong with the provisions stipulated by the Compilation of Islamic Law, which are promulgated, following the rules of al-maslahah al-mursalah which have been explained or the concept in the book of Bughyah al-Mustarsyidn which says that government decrees which are not forbidden by the Shari'a must be obeyed physically and mentally. If it is against the Shari'a, such as obliging something that is haram, then it is enough to obey outwardly. In article 17 paragraph (3) of the KHI which reads "For the prospective bride and groom who suffers from speech impairment or deafness, consent can be stated in writing or signs that can be understood," so without a power of attorney there is nothing wrong or allowed. What is clear is that the marriage is still valid, the KUA does not require the speech-impaired bride and groom to make or show a power of attorney.

The aim of the study was to determine the clinical features of anti-NMDAR encephalitis in children. Materials and methods of research: 11 patients were selected from the group of children with autoimmune encephalitis, who met the diagnostic criteria for reliable anti-NMDAR encephalitis. A retro-prospective analysis of clinical symptoms, laboratory, neurophysiological and neuroimaging data, treatment, duration of primary hospitalization and long-term results of treatment was carried out, neuropsychological testing of patients was performed in the follow-up. Results: the age of the patients was 8.5±4.4 years, the gender composition of boys/girls was 1/10 (9.1%/90.9%). The average follow-up period was 17±12 months. In 73% of cases, there was an acute onset of the disease without a prodromal phase and with rapidly growing signs of neurological dysfunction: behavior change (11/100%), epileptic seizures (11/100%), speech impairment (10/90.9%), movement disorders (10/90.9%), disturbed sleep/wakefulness rhythm (9/81.8%), hallucinations (5/45.5%), autonomic disorders (6/54.5%), sensory disturbance (1/9,1%). In 82% of cases, therapy was required in the intensive care unit. When analyzing EEG monitoring in children, the extreme delta brush pattern was revealed in only one patient. Neuroimaging revealed no specific changes in the substance of the brain. The paraneoplastic nature of the disease could not be established in any case. 4 patients (36.36%) had relapses of the disease after 1.5–27 months. from the onset of the disease. All children showed a favorable outcome without a gross neurological deficit, but complaints of increased fatigue, headaches, poor memory, a decrease in vocabulary, and impulsive behavior persisted.

Mandibular torus is a slow-growing bone exostosis with well-defined borders, usually oval and bilateral in shape. Diagnosis is made through clinical and radiographic findings. Surgical removal is necessary when there is a prosthetic indication, recurrent trauma, and in rare cases, due to phonetic disorders. The interference in speech caused by the torus, is due to its size and location, which interferes with the usual positioning of the tongue, changing the articulation points, and thus making pronunciation difficult. Therefore, the aim of this study is to report a clinical case of excision of a bilateral mandibular torus due to speech impairment. A 47-year-old male patient sought dental care complaining of bone growth in the mandible. The clinical examination showed a bilateral increase in the lingual region of the mandible, which was unilobular on the right side and trilobular on the left side, measuring approximately 20x20mm. The patient underwent a surgical procedure to remove the torus under local anesthesia. In the 7-day postoperative period, suture dehiscence was observed, as well as traumatic ulcers and pain complaints. The patient reported that he did not pay attention to postoperative care. As a method of treatment of suture dehiscence, a metronidazole paste was used, as well as a laser therapy protocol, ensuring soft tissue healing. After complete healing, in the clinical evaluation, the patient did not present difficulties in pronunciation. Therefore, it is concluded that, although uncommon, the torus, due to its growth, can interfere with the positioning of the tongue and, consequently, with phonetics, which is a plausible indication for the surgical procedure. Once, the normal bony contours of the mandible are re-established, as well as repositioning and lingual function.

Purpose: The purpose of this study was to investigate the presence and progression of self-perceived speech and swallowing impairments in newly diagnosed people with Parkinson's disease (PD) longitudinally across 6 years. Method: Longitudinal data from the Parkinson's Progression Markers Initiative were analyzed across six consecutive years in a cohort of 269 newly diagnosed people with PD, and a subset of those ( n = 211) who were assessed at every time point across the 6 years. Dependent variables included self-perceived ratings of speech and swallowing impairment severity from the Unified Parkinson's Disease Rating Scale. Patient-centered factors of age at diagnosis and motor phenotype were also assessed to determine if they were related to the change in self-perceived speech and swallowing impairments. Results: Overall, self-perceived speech and swallowing impairments were present in newly diagnosed people with PD, although over time, the degree of severity for both remained in the mild range. However, the rate of change over time was significant for perceived speech impairment, F (5.5, 1158.8) = 21.1, p < .001), and perceived swallowing impairment, F (5.2, 1082.6) = 8.6, p < .001. Changes for speech and swallowing impairment were both in the direction of progressive severity. There were no effects of age at diagnosis or motor phenotype on the degree of change for either speech or swallowing. Conclusions: Self-perceptions of speech and swallowing impairment changed significantly over time in newly diagnosed people with PD (PWPD). Consistent with existing literature, self-perceptions of speech impairment were rated as more severe than those of swallowing impairment. These findings reveal that even in the early years postdiagnoses, PWPD are experiencing changes to speech and swallowing function, albeit within the mildly severe range. The presence of self-perceived mild speech and swallowing impairments in the initial years postdiagnosis may support the need for intervention to improve and or sustain function over time.

В данной работе рассматриваются проблемы нарушения речи в современном мире. Для решения задачи обнаружения дефектов речи на этапе предварительной диагностики в статье предлагается использовать интеллектуальный анализ для определения есть ли у человека нарушение речи или нет. This paper examines the problems of speech impairment in the modern world. To solve the problem of detecting speech defects at the stage of preliminary diagnostics, the article proposes to use intelligent analysis to determine whether a person has a speech impairment or not.

AbstractA child with a hearing and speech impairment has the same right to education as all children. An equal access to education as an investment to their future. The Acceleration of Digitization and restrictions on activities that occurred during the pandemic and the fourth industrial revolution have led to a challenge of education process, especially for hearing and speech impairments students. This cross-sectional study aims to discover the quality of education and evaluate the knowledge gained from participating in an educational course by giving pre-test and post-test questionnaire. A polling method was conducted to assess the participants' attitudes and psychomotor. This study was attended by 627 respondents including SLB B teachers 267 respondents (43%), parents of students 191 respondents (30%) and the public 169 respondents (27%).  The average pre-test score was 47,67 (+15,69) and the post-test average was 80,67 (+22,73). A mean difference between pretest and post-test score was significant at p < 0.0001. The principles of the education for a child with a hearing and speech impairment is to building children's independence by 293 respondents (23%), using innovative methods of teaching 143 respondents (20%) and increase the utilization of educational facilities and infrastructure 64 respondents (10%).  The strategies to teach a child with a hearing and speech impairment is using innovative methods, starting with understand the children’s character and needs. One of the keys to a successful academic experience for children with disabilities is a productive and supportive relationship between parents and teachers.Keywords : Hearing impairment, speech impairment, educational, independence AbstrakAnak dengan tuna rungu dan wicara memiliki hak dasar. Salah satu hak dasar adalah mendapatkan akses pendidikan yang berkualitas untuk  memberikan bekal untuk kehidupan masa depan.  Pandemi, revolusi industri 4.0 terjadi percepatan digitalisasi informasi yang terjadi dan pembatasan fisik menjadi tantangan terhadap proses pendidikan untuk anak tuna rungu dan wicara. Studi cross sectional untuk menilai kualitas dan upaya peningkatan kualitas pendidikan dilaksanakan dengan seminar pendidikan dan dilakukan pre test sebelum kegiatan dan post test setelah kegiatan untuk menilai peningkatan pengetahuan. Survei jajak pendapat dilakukan untuk menilai sikap dan psikomotor peserta. Studi ini diikuti oleh 627 responden meliputi guru SLB B 267 orang (43 %), orang tua anak didik191 orang (30 %) dan masyarakat umum 169 orang (27 %). Aspek pengetahuan didapatkan hasil pre test 47,67 (+15,69). Hasil rata rata post test 80,67 (+22,73). Perbandingan hasil pre test dan post test  didapatkan hasil yang berbeda signifikan (p<0,0001) sehingga didapatkan peningkatan pengetahuan sebelum dan setelah kegiatan. Sedangkan fokus pendidikan untuk anak tuna rungu dan wicara adalah menumbuhkan kemandirian anak di masa depan 293 orang (47 %), inovasi metode pembelajaran 143 orang (23 %), 127 orang (20 %) dan Penguatan sarana dan prasarana pembelajaran 64 orang (10 %). Perlu inovasi dalam metode pendidikan untuk anak tuna rungu dan tuna wicara. Inovasi dimulai dengan memahami karakter dan kebutuhan anak tuna rungu dan wicara. Kolaborasi antara segenap elemen orang tua dan guru menjadi kunci keberhasilan pendidikan untuk anak tuna rungu dan tuna wicara yang bertujuan untuk kemandirian dan bekal di masa depanKata kunci : Tuna rungu dan tuna wicara, pendidikan, kemandirian