Pediatric Flashcards
similarities and differences between CAS/Dysarthria
CAS: Groping, limited consonant inventory, inconsistent and unpredictable speech errors, difficulty sequencing sounds, syllables, morphemes, or words
Dysarthria: Distortions, predictable errors, phonation, imprecise
similarities and differences between CAS/Phonological Disorder
CAS: groping, inconsistent and unpredictable speech errors, Vowel/diphthong errors common, Automatic speech easier than volitional speech, prosody affected
SSD: No weakness, incoordination, or paralysis, stimulable, Errors are consistent regardless of word/phrase length, Prosody normal, No difference between automatic and volitional speech, Phonation normal
CAS Characteristics
uncoordinated musculature
groping
limited consonant inventory
inconsistent and unpredictable speech errors
Substitutions, omissions (initial deletion may be present), repetitions, simplified word forms
Vowel/diphthong errors common (can be unpredictable; often centralized)
Errors common, inconsistent, and unpredictable
Difficulty sequencing sounds, syllables, morphemes, or words
Automatic speech easier than volitional speech
May have altered or inconsistent rate, pitch, loudness, and/or difficulty with stress
Resonance may be mixed or inconsistent due to coordination of velum
Dysarthria Characteristics (Child)
Weakness, fasciculations, tremor, involuntary movement, abnormal reflexes; look for signs of weak respiration muscles- short phrases, loudness issues, and forced expiration/inspiration
Difficulty may occur due to weakness
Groping not typically noted
Sounds in inventory often distorted
Usually consistent and imprecise
Usually distortions; consonants may be imprecise and articulation may sound ‘blurred’
Vowel distortions may occur
Sounds may be less precise in connected speech compared to single words
Voicing errors may occur; may see difficulty maintaining boundaries between voiced and voiceless sounds
No difference between automatic and volitional speech
Aberrant rate, rushes of speech, reduced/excessive/equal stress, prolonged intervals and inappropriate silences; difficulties depend on type of dysarthria
May be rough, breathy, hoarse, harsh, strained, and/or hypo/hypernasal- depends on type of dysarthria
Typically no significant discrepancy between receptive and expressive skills
SSD Characteristics
No weakness, incoordination, or paralysis
Maybe limited inventory, stimulability generally good
Substitutions and omissions (final more common); word forms may be simplified
Uncommon to have vowel errors
Errors are consistent regardless of word/phrase length
Prosody normal
No difference between automatic and volitional speech
Phonation normal
Sometimes differences between receptive and expressive skills
Essential assessment for pediatrics
OME (structural-functional evaluation) including DDKs/AMRs
Speech sound assessment
analyze patterns/processes, identify developmental and nondevelopmental errors
Single words AND connected speech characteristics
Syllable/word shapes analyzed
Motor speech examination
Rating scales (severity)
Intelligibility ratings
CAS/SSD overlap
- Inventory constraints
- Omissions of segments and structures
- Segmental errors
- Altered prosody
- Increased errors with increased utterance length or complexity
- Use of simple but not complex syllable and word shapes
Ideal Goals for MSDs
Appropriate
Functional
Meaningful
Build the system
Complexity theory from phonology does not apply with MSDs; only add one new component at a time
improved communicative interactions in daily life
Consider Activity and Participation level concerns; client input (even with kids!)
Easy to succeed
Easy to monitor
Encourage literacy
Goals for Dysarthria
Multi-system approach, especially respiration, phonation, articulation
Goals for CAS
Increase sound inventory, syllable shapes, multisyllabic utterances
Build up, not trickle down
One goal at a time
