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SPEECH SOUND DISORDERS Flashcards

1
Q

Allophones

A

Variations of phonemes
 Example: /p/ can be produced with or
without aspiration

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2
Q

Phoneme categorization

A

Vowel
 Consonant
 Distinctive features can be used to
describe vowels and consonants

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3
Q

Classification of Consonants

A

Classification of consonants by place,
manner and voice.
 Can be:
 Bilabial, labiodental, interdental,
alveolar, linguadental, palatal, velar,
glottal
 Voiced or Voiceless
 Obstruents: Stops, fricatives,
affricates
 Resonants: Nasals, approximants
 Approximants: Glides or liquids

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4
Q

Obstruents:

A

: Stops, fricatives,
affricates

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5
Q

Resonants

A

Nasals, approximants
 Approximants: Glides or liquids

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6
Q

Classification of vowels

A

Classification of vowels by tongue and lip
position and tension
 Part of Tongue Elevated
 Front, Center, Back
 Tongue Height
 High, Mid, Low
 Amount of Tension
 Tense, Lax
 Lips retracted or rounded
 Dipthongs
 Two vowels spoken in close proximity

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7
Q

Speech-Sound Development

A

Pre-Speech
 Disappearance of reflexive sounds
 Crying gets infant to use airflow across the vocal folds
 Noncrying vocalizations with feeding or interaction
 2-months: Gooing/cooing
 3-months: Vocalize in response to others
 5-months: Imitate pitch, babbling
 6-7 months: Reduplicated babbling
 8-12 months: Echolalic stage
 Variegated babbling
 Jargon
 Phonetically consistent forms

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8
Q

Toddler Speech

A

Toddler Speech
 First Word around 12-months
 Phonological Processes
 Example: Final Consonant Deletion
 Multisyllable words may be reduced
 Consonant blends may be shortened
 Sound Substitutions

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9
Q

PreSchool Speech

A

 PreSchool Speech
 Most phonological processes disappear
by 4
 Consonant blends continue to develop
 Phoneme acquisition gradual
 Children with phonological difficulties
 Continue with phonological processes
 Children with neuromuscular disorders,
sensory deficits, perceptual problems,
poor learning skills
 Difficulty acquiring all phonemes

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10
Q

School-Age Speech

A

Early elementary-resembles adult
phonology
 Morphophonemic contrasts
 5 years-difficulty with some
consonants and blends
 6-years-have acquired most speech
sounds
 8-years-Acquired consonant blends

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11
Q

Articulation

A

 Phone
 Motor-based
 Deficit refers to
difficulties in
motor production
aspects of speech
 Errors are
typically
consistent

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12
Q

Phonology

A

Phonology
 Phoneme
 Language-based
 Deficit refers
impaired system
of phonemes/
phonemic
patterns
 Errors are
typically
inconsistent

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13
Q

Phonological Impairments

A

Phonological Impairments
 Conceptualization of language rules;
open syllable vs closed syllable

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14
Q

Articulation impairments

A

Articulation impairments
 Production
 Substitutions
 Omission
 Addition
 Distortion
 May have disorders of both phonology
and articulation

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15
Q

Functional-

A

-a pattern of speech errors
in the absence of any observable
physical abnormality

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16
Q

Organic

A

attributed to physical
conditions i.e. cleft palate

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17
Q

Associated Disordered and
Related Causes

A

Correlates/related factors
 Developmental impairments in
children
 Language impairments
 Hearing Impairments
 Neuromuscular Disorders
 Childhood Apraxia of Speech
 Structural Functional Abnormalities
Developmental Impairments in children
 Delay-not producing age-appropriate
phonemes
 Disordered
 -Idiosyncratic in phoneme use
 Phonological Impairments
 -Average age of diagnosis is 4 years, 2
months
 Speech therapy can correct errors more
quickly
 Errors may have a negative impact

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18
Q

Disordered

A

-Idiosyncratic in phoneme use

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19
Q

Phonological Impairments

A

-Average age of diagnosis is 4 years, 2
months
 Speech therapy can correct errors more
quickly
 Errors may have a negative impact

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20
Q

 Language Impairments

A

Complex syllable structures are challenging
 -Speech-sound errors may resolve
 -Phonological errors may affect morphology
 -Speech-sound errors increase with sentence
complexity
 -Phonological errors affect reading and
writing
 -May have poor phonological awareness
skills

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21
Q

Hearing Impairments

A

-Intelligibility decreases with more
severe hearing loss
 -Frequent Otitis Media is a risk factor
 -Congenital Hearing Loss leads to
more severely affected speech
 -Speech deteriorates over time for
those who are profoundly deaf
 Hearing aids and training can help

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22
Q

SPEECH PERCEPTION AND
AUDITION

A

Normal audition is crucial
 Phonological disorders vary
depending on
 the type and severity of the
hearing loss
 age of hearing loss
 Age at which intervention
begins
 Ability to utilize residual
hearing

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23
Q

CHRONIC OTITIS MEDIA

A

Infection of the middle ear often
accompanied by fluid
 Results in a conductive hearing loss
 33% chance of speech delay for a 3
year old child with a history of OME
 Difficulty with producing final
consonants
 Impairment of plural endings

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24
Q

COCHLEAR IMPLANTS

A

Surgically implanted devices designed
to provide electrical stimulation to the
auditory nerve through the cochlea
which permits the perception of sound

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25
Dysarthrias
Spastic: Slow rate, imprecise articulation, harsh voice, hypernasality, prosodic abnormalities  Speech Training or AAC  Some with CP have normal intelligence  May have accompanying deficits  Motor functioning may deteriorate over time.
26
Spastic
Slow rate, imprecise articulation, harsh voice, hypernasality, prosodic abnormalities
27
Childhood Apraxia of Speech
Inconsistent Errors  Lengthened/disrupted transitions  Inappropriate prosody  Limited sound repertoires, groping, omissions or adding sounds, difficulty with running speech  Some may be nonverbal early on  Likely to have difficulties with phonological awareness, reading, writing, spelling  Prosodic abnormalities
28
Structural Abnormalities
Structural Functional Abnormalities  *Usually only gross abnormalities affect speech  *Cleft Palate is detrimental to speech  **Hard Palate  **Soft Palate
29
CLEFT PALATE
Hypernasality  Nasal emission  Compensatory articulation  Glottal stop  Vpi
30
Dentition
Ask client to bite teeth down together & smile  Dental classification systems provide info regarding alignment of upper & lower teeth: ◦ Class I- normal occlusion (alignment); dental arches close normally; but there may be crooked teeth ◦ Class II- lower molar & jaw too far back ◦ Class III- lower molar & jaw too far forward in relation to the upper arch ◦ Look for crossbites & open bites as well
31
role of dentition in articulation
The role of dentition in articulation disorders is not clear  Studies show that minor dental abnormalities rarely cause significant deviations in speech production  Severe dental abnormalities resulting from malocclusion (misaligned teeth) or deviations in jaw alignment, may lead to speech errors
32
Tongue Thrust
Infants & young children swallow by bringing tongue against hard palate and pushing the food or liquid forward Some believe that a persisting tongue thrust can lead to some speech sound errors, particularly in producing the [s] and [z] sounds
33
Oral Mechanism
Adequate oral structure and physiology are required for speech production  Some areas in addition to dentition that SLPs examine are: ◦ lips- symmetry and range of motion ◦ Tongue- size, range of motion ◦ Jaw- opening & closing & freedom of movement & stability is important for speech production ◦ Hard palate must be intact for oral sounds to be produced ◦ Soft palate must be able to close off the nasal cavity quickly & repeatedly during running speech
34
DOWN SYNDROME
Chronic otitis media  Dysarthria  Delayed in the onset of babbling
35
READING
Phonology is the prerequisite for reading  Need to know phonological rules  Phonological awareness  Dyslexia is a language based disorder
36
Language and Dialect Variations
Differentiate between dialect and disordered phonology  Characteristics of articulation and phonology  *Many variations (impossible to list)  *First language may interfere  Lifespan Issues  *Some adults choose to modify their accent  *Articulatory patterns may be firmly established  *Goal is to increase intelligibility/communication effectivenes
37
Goals of Assessment
*Describe speech-sound inventory  *Identify error patterns  *Determine impact of errors  *Identify etiological factors  *Plan treatment  *Make prognosis  *Monitor change
38
Screenings-
typically performed to determine if there is a problem and if further testing is warranted
39
 Full evaluation:
Obtain Case History ◦ Perform Formal Assessment (standardized testing) ◦ Obtain Spontaneous Speech Sample ◦ Perform Oral Mechanism Examination ◦ Check Stimulability ◦ Diadochokinesis
40
ASSESSMENT Description of phonological and articulatory inventory
Description of phonological and articulatory inventory  *Speech-sound inventory  *Syllable and word structure  *Sound Errors Inventory  *Phonological Process Analysis
41
Intelligibility
 Prognostic Indicators  *Consistency, stimulability, error sound discrimination
42
Case History
 Developmental milestones  Prenatal/perinatal/postnatal history  Medical History  Language background
43
STANDARDIZED TESTS  GFTA
Assesses sound production for consonants, consonant clusters in the word initial medial and final positions of words Assesses Stimulability Limited assessment of vowels and connected speech
44
Standardized Tests Advantages Disadvantages
Advantages: quick to administer/score; normed; good for children that are unintelligible Disadvantages: Not enough info on spontaneous speech; not representative of all word categories; can be morphosytactically complex
45
SPONTANEOUS SAMPLES
Considered the most useful source of information for phonological analysis and intervention planning  Child produces a range of sounds in a variety of phonetic and communicative contexts  100 MLU for children 3.0 or below higher MLU 250-300 words
46
Spontaneous Speech Sample Advantages Disadvantages
* Need to carefully obtain speech sample Advantages: more naturalistic Disadvantages: children may avoid difficult words; difficult to transcribe for highly unintelligible children
47
Perception testing  CAPD
CAPD  Impairments in the auditory perception and processing of phonetic, phonological, or linguistic information
48
Types of Phonological Processes
Substitutions ◦ Stopping ◦ Gliding ◦ Fronting ◦ Backing ◦ Nasalization  Syllable Structure Processes ◦ Unstressed syllable deletion ◦ Reduplication ◦ Consonant cluster reduction ◦ Final consonant deletion  Assimilation Process (Harmony Process) ◦ Progressive ◦ Regressive
49
Substitutions
Stopping ◦ Gliding ◦ Fronting ◦ Backing ◦ Nasalization
50
Syllable Structure Processes
Unstressed syllable deletion ◦ Reduplication ◦ Consonant cluster reduction ◦ Final consonant deletion
51
Assimilation Process (Harmony Process)
Progressive ◦ Regressive
52
Intervention  Establishment
 Establishment- try to determine if child is motorically able to produce forms in error; can they perceive differences relevant to errors
53
Intervention Generalization-
- try to ensure carryover
54
Intervention  Target Selection
*Goal  --Make client easier to understand and increase communication effectiveness  --Factors in target selection  *Phoneme frequency, likelihood of success  --Difficult targets may lead to greater generalization
55
INTERVENTION  Bottom-up drill approaches
Bottom-up drill approaches  *Progress from simple to more complex  *Target one sound at a time  *Speech assignments for generalization
56
Articulation Approaches
Focus on motor production  Imitation/ successive approximation
57
Articulation Approaches Traditional Approach
A- Perceptual Training (1) Identification (2) Isolation (3) Stimulation (4) Discrimination (2) Production- begins in isolation and increases to more complex contexts B- Sensory-Motor Approach
58
Language-based Approaches
Language-based Approaches  *Instruction is implicit  **Within language activities  Has proven to generalize to conversational speech  ** Follow drill-type therapy
59
Phonological-Based Approaches
Multiple speech-sound errors or highly unintelligible  Cycles Approach  *Minimal pair contrasts  Multiple Opposition Approach  *Maximal Contrasts  Metaphon Approach  *Metaphonological skills
60
 Cycles Approach
*Minimal pair contrasts
61
Multiple Opposition Approach
*Maximal Contrasts
62
Metaphon Approach
 *Metaphonological skills
63
INTERVENTION  Complexity Approach
Complexity Approach  *Training more difficult sounds leads to generalization of easier, untrained sounds  *More efficient  *May take more time initially  *Success depends on  -Severity  -Frustration Level  -Overall therapy goal
64
Treatment of Neurologically Based Motor Speech Disorders
Treatment of Neurologically Based Motor Speech Disorders  *Dynamic Temporal and Tactile Cueing  **Intensive, motor-based, drill-type treatment for severe childhood AOS  **Simultaneous productions, imitation, delayed imitation, spontaneous production  Lee-Silverman Voice Treatment  **Designed to increase loudness in adults with PD  **Effective with modifications for children with CP
65
INTERVENTION  Computer Applications
Computer Applications  **Computer programs and games  **In conjunction with direct therapy  **Opportunity for daily practice  **Can involve family members in treatment process
66
GENERALIZATION AND MAINTENANCE
May introduce self-monitoring activities early in treatment  Schedule follow-up sessions after dismissal  If progress is maintain, treatment was successful

Functional Disorders (8 decks)

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