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1
Q

3 components of language with their parts

A
  1. Content: Meaning (lexicon, vocabulary, semantics)
  2. Form: Structure (morphology, phonology, syntax)
  3. Use: Communication (pragmatics)
2
Q

Phonemes

A

unit of sound conveying meaning (p, b)

3
Q

phonotatics

A

rules for combing phonemes into syllables and words

4
Q

plural s sounds

A

added to the end of voiced consonants (z), voiceless (s)

5
Q

e.g. of bound morphemes

A

plural -s or passed tense -ed (changes meaning and sometimes word class as well)

6
Q

Mean length utterance (MLU)

A

100 consecutive utterances (total number of morphemes/total number of utterances)

7
Q

2 types of meaning

A

denotative, and connotative

8
Q

3 language stages for infant/toddler

A
  1. pre intentional (1-8 months)
  2. prelinguistic (8-18 months)
  3. emerging language (18-36 months)
9
Q

Preschool language development stage

A

developing language stage (between 2-3 and 5 years of age)

10
Q

pre intentional language

A

reflexive, vegetative sounds, vowel like sounds dominate

11
Q

2 types pre linguistic language

A
  1. gestures

2. vocalizations (babbling: reduplicated and non) and (jargon)

12
Q

3 stages of emerging language

A
  1. first words
  2. two word combinations
  3. simple sentences
13
Q

MLU for developing language

A

> 2 but <5

14
Q

by 3 years most children (5 things)

A
  1. use subject-verb-object (SVO) sentences
  2. negatives
  3. interrogative (questions)
  4. use some basic grammatical markers
  5. may over regularize
15
Q

school aged language focus on 2 things (with 4 other stages)

A
  1. semantics (new words)
  2. pragmatics (context)
  3. higher order meaning (e.g. connotative meaning - figurative meaning, idioms, metaphors, jokes)
  4. discourse (conversation, narratives, persuasive)
  5. metalinguistic awareness (helps them start to read)
  6. Literacy Development
16
Q

Literacy Development

A

oral comprehension –> reading comprehension
oral production –> writing expression
phonological awareness –> letter sounds

17
Q

language disorder: language skills below…

A

environmental and norm references expectations

18
Q

3 facts about language disorders

A
  1. quite common
  2. heterogeneous (often additional problems)
  3. enduring (continued difficulties)
    - -> better long term outcomes for initial speech impairments than language impairments
    - -> more favourable prognoses for specific LD than those secondary to other deficits
19
Q

3 groups that need help in the pre intentional stage

A
  1. identified at birth for being at risk (e.g. drug exposure, premature, low birth weight, genetic disorder)
  2. infants in infancy (first year) as high risk (hearing impairment, global delay, autism, neglect)
  3. older children functioning at pre-intentional stage
20
Q

4 factors for those that need help in the pre linguistic stage

A
  1. low rate of communicating
  2. limited inventory of speech sounds
  3. limited range of functions/purposes
  4. difficulties with receptive language
21
Q

Emerging language - who needs help (3 groups, and 4 risk factors)

A
  1. fewer than 50 words
  2. no two word combinations
  3. risk factors (family history, learning problems, low SES, high parental concern)
22
Q

Late talkers - delayed expressive language with all 5 of the following

A
  1. no risk factors
  2. normal play
  3. normal nonverbal communication
  4. normal receptive language
  5. some speech by 30 months
23
Q

2 groups who need help in developing language stage

A
  1. children with developmental language disorders (SLI, intellectual impairment)
  2. children with other disorders (ASD, TBI, hearing)
24
Q

specifically language impairment problem with…

A

no explanation for this - accepted neurological and genetic factors

25
Q

4 communication features of SLI

A
  1. shorter utterances
  2. limited vocabulary
  3. more grammatical errors (omissions unusual for age)
  4. risk for reading disability
26
Q

School aged - 3 groups who needs help

A
  1. language based learning disability
  2. dyslexia (specific reading disability)
  3. language impairments associated with other specific disorders
27
Q

language based learning disability (LLD)

A

emerges when in school (reading and writing, literacy problems), intelligence is otherwise normal or higher, not the result of vision, hearing, handicap, emotions, or cultural differences

28
Q

LLD 3 academic underachievement (in more than one of…)

A
  1. receptive language (listening, reading)
  2. language processing (thinking, conceptualizing, integrating, problem solving)
  3. expressive language (talking, spelling, writing)
29
Q

SLI/LLD impairments in some of all of 3 things

A
  1. oral language
  2. academics
  3. learner skills
30
Q

SLI/LLD 5 oral language problems

A
  1. phonological awareness (aware of sounds)
  2. vocal and word finding (often ummm, hmmm, pausing)
  3. higher order language
  4. discourse/texts (narrative, expository, persuasive)
  5. pragmatic/social communication
31
Q

SLI/LLD 4 academic language problems

A
  1. reading (decoding, comprehension)
  2. writing (encoding, spelling, mechanics. content)
  3. mathematics (word problems
  4. curriculum based language
32
Q

SLI/LLD learner skills language problems

A

self monitoring, self advocacy, planning, organizing, independent work

33
Q

dyslexia

A

deficit in decoding print (processing phonological features), despite adequate educational opportunity/exposure, used to be attributed to visual deficits (but was discredited),

34
Q

3 features of dyslexia

A
  1. impaired phonological awareness
  2. difficulty decoding/encoding words (word sight exceeds sounding out)
  3. read/spell with slow rate, poor fluency, lack of automaticity
    - -> have good reading comprehension (if able to decode)
    - -> have good written language content, organization (if able to decipher poor spelling)
35
Q

ASD

A

neuro-developemental disorder, multifactorial aetiology, with/without other intellectual and language impairments

36
Q

ASD 2 core symptom clusters

A
  1. deficits in social communications and social interaction

2. restrictive, repetitive patterns of behaviours, interests or activities

37
Q

ASD 3 typical early communication impairments

A
  1. reduced communciative intents
  2. fewer conventional gestures
  3. immediate or delayed echolalia
38
Q

ASD strengths/weaknesses in those who are verbal

A
  1. strengths in form (phonology, morphology, syntax)
  2. weakness in semantics/pragmatics (pronoun reversal ‘you for themselves’, social problems, nonreciprocal communication, monotone, staccato)
39
Q

ASD features in those who are verbal

A
  1. high functioning ASD or Asperger syndrome
  2. advanced intellectual ability
  3. impaired pragmatics
  4. active but off
  5. topic obsession
40
Q

Intellectual Impairments

A

IQ below 70 (2 SD below mean), deficits in adaptive functioning (independence, social activities)

41
Q

other terms for Intellectual Impairments

A

mental retardation, developmental disability, intellectual disability, cognitive disability

42
Q

known causes of Intellectual Impairments

A

down syndrome, fragile X, Williams syndrome

43
Q

4 common characteristics of Intellectual Impairments

A
  1. less diverse vocab
  2. shorter utterances
  3. omit grammatical morphemes
  4. language pragmatics less flexible
44
Q

Weaknesses in specific syndrome of Intellectual Impairments

A
  1. Down syndrome –> form (morphology and syntax)

2. Fragile X –> use (pragmatics) - high co-occurance with fragile X and autism

45
Q

areas of assessment for language disorders

A

decontextualized way (finding if they know the actual meaning) –> standardized tests

  1. receptive (in context - familiar situation, nonverbal cues)
  2. expressive (in context - spontaneous language sampling)
46
Q

3 methods of assessment for language disorders

A
  1. standardized (norm referenced) tests (PLS-5, CELF-5)
  2. criterion referenced tests
  3. language sampling
47
Q

criterion referenced tests for language disorders

A

informal tasks individualized to child that probe particular communicative skills in depth (specific to a skill)

48
Q

language sampling for language disorders - spontaneous language is 4 things:

A
  1. recorded during natural interactions
  2. transcribed verbatim
  3. analyzed for target structures/uses
  4. compared to age related criterion
    - -> younger the kid, the wider the range of normal
49
Q

Child language intervention - 4 service delivery approaches

A
  1. modify environment
  2. compensation
  3. prevention/promotion
  4. remediation
50
Q

Child language intervention - modify environment

A

reduce language/literacy demands (facilitative language techniques), add supports (nonverbal, frameworks, outlines)

51
Q

Child language intervention - compensation

A

give child tools to function better with limitations
e.g. model compensatory strategy –> support practice –> withdraw support until child uses independently (e.g. oh i can’t think of that word, the first sound is sssss, or its soccer)

52
Q

Child language intervention - prevention/promotion

A

prevent early, stimulate language, for children at risk, provide optimal environment parent training (e.g. it takes two to talk - hand program, temps child to communicate)

53
Q

Child language intervention - remediation

A

improve childs language by teaching specific skills, traditional role of SLP, takes many forms

54
Q

3 repudiation approaches for language disorders

A
  1. adult centered (clinician directed - structures behaviourist approach)
  2. child centered (indirect language stimulation during natural interactions)
  3. hybrid (environment to elect targets and provide naturalistic reinforcement)
55
Q

allophones

A

variations in the same phoneme (caT vs Take)

56
Q

international phonetic alphabet (IPA)

A

42 symbols (18 vowel and 24 consonants)

57
Q

3 IPA consonant classification

A
  1. manner (how air is modified)
  2. place (greatest closure in the vocal tract)
  3. voice (vibrating of vocal cords or not)
58
Q

6 manner of articulations

A
  1. stop (plosive)
  2. fricative
  3. affirmative
  4. nasal
  5. liquid (tongue shape)
  6. glide (sound like vowels - j (yellow) and w (white)
59
Q

cognates

A

speech sounds that share the same manner and place of articulation but differ along voicing dimensions

60
Q

vowels (features and 2 differentiation)

A

open vocal tract, vocal folds vibrate, differentiation determined by

  1. tongue position (place of articulation and height)
  2. lip position (rounded or unrounded)
61
Q

speech development milestones

A
  1. reflexive, vegetative sounds (crying, lip smacking)
  2. vowel like and consonant like sounds
  3. front sounds dominate (raspberries)
  4. prosaic play (duration and pitch, yells, squeals)
  5. canonical babbling (reduplicated - mamma)
  6. prosody like speech
  7. nonredplicated/variegated balling
  8. jargon
62
Q

by 18 months, 2 years, 3 years and 4 years

A

18 months –> 1-2 clear vowels and few consonants
2 years –> most vowels produced, 70% consonants, 50% intelligible words
3 years –> 80% intelligible, affirmatives, liquids
4 years –> 100% intelligible, even to stranger (some consonant errors)

63
Q

speech sound disorder (SSD) - 2 types of impairments

A

problem with speech differ from age and cultural expectations
includes both
1. articulation and 2. phonological impairments

64
Q

SSD articulation impairment

A

inability to articulate certain sounds, results in phonetic errors (sounds distorted or mispronounced but still the same phoneme)

65
Q

SSD phonological impairment

A

rules that govern patterns, results in phonemic errors (different phoneme or sound omitted, resulting in change of meaning)

66
Q

3 etiologies of SSD

A
  1. physical/structural problem
  2. motor or neurological problems (cerebral palsy/childhood apraxia)
  3. functional cause (majority of cases)
67
Q

cerebral palsy

A

motor SSD –> motor deficit due to CNS damage or developmental problem - results in dysarthria (weakness, slowness, or uncoordinated motor speech movement)

68
Q

childhood apraxia of speech (developmental apraxia of speech DAS)

A
neurological SSD --> impaired planning of motor speech, difficulties in programming, combining, sequencing speech movement 
features include
1. inconsistent speech errors
2. unusual speech errors
3. difficulty with volitional speech 
5. grouping (making sounds into words)
69
Q

SSD functional impairment

A

many have phonological impairments (rule based problem), childs errors help us understand what rules the child is simplifying and using

70
Q

2 assessments of speech development

A
  1. single word tests
    - gather an example of initial, medial and final position
    - standardized, provide inventory of sounds (norms)
  2. speech sample
    - many examples of sounds - spontaneous conversation
    - percent consonants correct (PCC)
    - -> if one or two sound errors, likely phonetic/articulation problem
    - -> if large number of incorrect sounds, look to see patterns and phonological processes
71
Q

4 speech sounds error patterns

A
  1. substitutions (replace t for k - they instead of key)
  2. deletion (one or entire class) - can be syllable simplification (nana for banana)
  3. distortion (sound is altered, but still same phoneme) –> lateral or frontal lisp
  4. addition (addition of unstressed vowels - balue) - not as common as the other ones, except for consonant blends in young children)
72
Q

3 phonological processes/patterns

A
  1. final consonant delation
  2. cluster reduction
  3. stopping of fricatives
73
Q

4 other speech assessment considerations

A
  1. stimulability
  2. intelligibility
  3. oral facial assessment
  4. audiometric testing
74
Q

stimulability speech assessment considerations

A

can child imitate sounds - if they can, more likely to change

75
Q

intelligibility speech assessment considerations

A

how do errors impact ability to understand the child? (bigger when larger number of errors, and omission errors)

76
Q

oral facial assessment speech assessment considerations

A

AKA oral peripheral mechanism examination (OPE)

  • determine if structure and function of oral mechanisms are adequate to support speech
    1. exam structure defects, tone, symmetry
    2. examine function of structures for non speech and speech movements (diadochotkinesis)
77
Q

diadochotkinesis

A

rapid, alternating syllable strings (paddock or buttercup)

78
Q

audiometric testing - speech assessment considerations

A

hearing impairment can lead to articulation impairment (vowel errors, quit consonant sounds)

79
Q

2 main speech therapy approaches - intervention for SSD

A
  1. articulation approach (for child unable tis ay individual sound)
  2. phonological approach (can say sound, but doesn’t understand the rule)
80
Q

articulation approach - intervention for SSD

A

using sensory information, repetitive motor practice
A) visual tactile support (showing and feeling differences)
B) PROMPT
1. provide auditory, visual, and physical cues
2. try to improve automaticity
3. increase length/complexity of stimulus
4. learns outside therapy room
5. child monitors how well they are saying sound

81
Q

phonological approach - intervention for SSD

A

teach rules, emphasis changing in meaning (contrastive approaches - rhyming, minimal pairs, cycles approach)

82
Q

3 cultural considerations for speech

A
  1. dialect
  2. accent
  3. phonological interference
83
Q

2 types of non-develoepmental stuttering

A
  1. neurogenic

2. psychogenic

84
Q

stuttering onset

A

typically between 2-5 years of age (heritable)

85
Q

stuttering decreases during 3 things

A
  1. novel speaking manner (singing, putting on an accent)
  2. while alone, speaking to animals or kids
  3. disruptions in auditory feedback
86
Q

stuttering increases during 3 things

A
  1. anticipating stuttering
  2. having to say specific word
  3. talking on the phone
87
Q

8 primary characteristic of stuttering

A
  1. part word repetition
  2. single syllable word repetition
  3. multi syllable word repetition
  4. prolongation (not on stop sounds)
  5. silent/tense pause (block)
  6. phrase repetition
  7. interjection (hum, uh, umm)
  8. revision or incomplete phrase
88
Q

bodily movements in stuttering

A
  1. facial griminess
  2. head movements
  3. loss of eye contact
  4. bodily movements
89
Q

psychological behaviours in stuttering

A
  1. avoidance (fillers, pretending to thing, avoiding situations and people, appearing shy)
  2. emotional responses before speaking
  3. emotional responses after stuttering
90
Q

distinguishing normal non fluency and borderline stuttering

A

normal non fluency
- repetitions of: sentences, phrases, words
- interjections revisions, hesitations, no frustration
borderline stuttering
- repetitions of: syllables, individual sounds
- bursts of speech, body movements

91
Q

what causes primary stuttering - constitutional factors

A
  1. genetic predisposition
  2. neurological dysfunction (cerebral organization - over activation of right, and under activation of left hemisphere) –> difficulty with auditory or proprioceptive feedback
92
Q

what causes secondary stuttering

A

online some von onto develop secondary stuttering and become chronic

  1. speech stressors (developmental or environmental)
  2. susceptible to conditioned associations between primary and secondary stuttering (stimulus/response - e.g. if i blink i won’t stutter)
  3. sensitive or reactive temperament
93
Q

neurogenic non-developemental stuttering

A

neurological damage or disease (strong, head injury, parkinson, MS), exposure to toxins

  • -> equally disfluent across situations
  • -> secondary behaviours and negative emotions less common
94
Q

psychogenic non-developemental stuttering

A

may be intermittent
unusual or bizarre speech patterns
may respond quickly to treatment

95
Q

cluttering

A

frequent whole word and phrase repetition, rapid rate, irregular rate, misarticulating (slurred or deleted phonemes, substitutions)

96
Q

how is cluttering distinct from stuttering

A

part word repetitions are infrequent, secondary behaviours not usually present, often more fluent in situations where stutters are less

97
Q

other characteristics of people who clutter

A

disorganized, poor attention and concentration, hyperactive/impulsive (ADHD), reception and expressive language difficulties, pragmatic language difficulties, poor handwriting

98
Q

mild vs. severe stuttering

A

mild: easy reputations
severe: sound blocks, prolongations, body movements

99
Q

treatment for early stuttering

A
uses indirect methods
 - changes in environment
 - reinforce fluent speech
 - family involved
Lidcombe program: clinician mediated, parent implemented, behavioural treatment (standard of care for preschoolers and adapted for school aged), goal: no stuttering,
100
Q

3 treatments for stuttering

A
  1. fluency shaping
  2. stuttering modification
  3. nontraditional treatment approaches
101
Q

fluency shaping - treatments for stuttering

A

modify all aspects of behaviour (behaviour modification - relearning speech movements), learn new pattern (reduced rate, vowel prolongation, slow and smooth onset), potential for rapid, dramatic change

102
Q

fluency shaping - treatments for stuttering –> problems

A
  1. abnormal artificial speaking pattern
  2. skills not easily transferred out of therapy
  3. attention to speaking pattern ongoing
103
Q

stuttering modification - treatments for stuttering

A

addresses individual movements of stuttering

  1. stutter more fluently with less tension
  2. use light articulation contact
  3. reduce situational fears and negative associations - feel in control
104
Q

stuttering modification - treatments for stuttering –> problems

A
  1. slower change

2. may still have moments of stuttering

105
Q

non-traditional treatment - treatments for stuttering

A
  1. hypnotherapy
  2. drug therapy (dopamine blockers)
  3. electronic devices (resemble eating birds - delayed auditory feedback)
106
Q

when does CL/P occur

A

1st trimester of pregnancy (embryonic period, 5-8 weeks)

107
Q

CL/P according to sex

A

2: 1 males for cliff of lip with or without palate
2: 1 females for isolated cleft palate

108
Q

vermillion

A

red part of lips

109
Q

columella

A

between nostrils - short and misaligned in CL

110
Q

most common CL

A

left unilateral (if bilateral, usually cleft palate also)

111
Q

signs of sub mucous cleft palate

A
  1. bifid uvula

2. notch in hard palate

112
Q

isolated cleft palate associated with

A

a broader genetic syndrome (Pierre Robin sequence, velocardiofacal syndrome)

113
Q

known aetiologies of CL/P

A
  1. chromosomal/genetic disorder
  2. family history
  3. increased parental age
  4. teratogens in utero (nicotine, alcohol)
  5. maternal nutritional deficiencies
114
Q

voice issues in CL/P

A
velopharyngeal closure (velopharyngeal insufficient VPI --> hyper nasal sounds) 
evaluated with mirror, listening device or nasometer
115
Q

articulation issues in CL/P

A

due to VPI, no pressure with stops/fricatives

  1. nasal emissions (snorting/blowing sounds out of the noise
  2. compensatory articulation errors (glottal stop, pharyngeal fricatives)
116
Q

5 treatments for CL/P

A
  1. surgery
  2. dental
  3. psychosocial
  4. hearing (myringotomy tubes)
  5. speech language therapy
117
Q

2 surgery for CL/P

A
  1. pharyngeal flap: flap of skill off back of through, bring it forward and sow it to back of velum - smaller area to close
  2. pharyngoplasty: narrow all the skin, make tube around velum and pharyngal wall into small hole
118
Q

dental treatment for CL/P

A

prosthodontics (obturator, speech bulb, palatal lift)

119
Q

Speech language therapy for CL/P

A

<10%, focus on hyper nasal resonance, reduction of glottal stops,

  1. traditional articulation therapy,
  2. visual feedback via electropalatography –> gives feedback on tongue placement feedback on