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89 Cards in this Set
- Front
- Back
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what are advantages and disadvantages of recording of a sample: audio or video
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assessment of phonemes
advantages: - allows time to transcribe if enough time is not allowed during sample - can be used later to demonstrate progress to client (show them how much they improved) disadvantages: - time consuming when transcribing later - accuracy of analysis is dependent on quality of recording. ways to improve quality include: --- use of external microphone: quality is usually better than built-ins --- microphone positioning: proper positioning involves not too close as to distort sounds and close enough to accurately discriminate sounds (usually 6 to 8 inches from client but check first) |
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what are additional measures to screen for in language voice?
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hearing screening
language testing specific auditory perceptual testing |
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what is required in a hearing screening test
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pure tone at 20 dB at 1000, 2000, and 4000 Hz (may be conducted by other professional such as school nurse)
- if fails, referral to audiologist (for full evaluation) may also include: - history of infections - visual inspection of ear including Tympanic membrane |
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what is required in language testing
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if concern is strictly articulation, then is very important to rule out that a language disorder exists since this area of disorders cluster with articulation/phonology disorders
comprehensive language assessment needed - if area of concern involves language - screening revealed weaknesses (didn't do well in test) |
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what should screening in each area of language include
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semantics: expressive vocabulary test & language sample
syntax/morphology: full test or subtest & language sample pragmatics: language sample |
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Explain specific auditory perceptual testing
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usually completed when client substitutes 2 or more phonemic sounds into 1 sound
helps determine whether child can perceive differences between sounds or phonemic contrasts - some published tests are available - most common to create own using the specific phonemes in error and pictures |
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what are different ways to create your own specific auditory perceptual test
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can be word level: match word with picture that clinician says using target and error phonemes
can be sentence level (more difficult to create): sentences are rad that contain target and error phonemes and child selects picture that best represents whats being said (the sentence) |
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what does the evaluation of speech mechanism (oral peripheral exam) look at?
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structure of oral mechanism
- size - shape - symmetry function of oral mechanism - can client move structure on command - adequacy of movement --- range, smoothness, speech, symmetry, strength |
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what is the purpose of the oral peripheral exam?
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- determine any gross difficulties that may signal organic cause of speech difficulties
- may signal need for referral to a physician - no abnormalities noted does not equate to no organic cause: may be fine difficulties not detected - slight deviancies does not signify a problem: just that further evaluation may be necessary |
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what are structures to look for in an oral peripheral exam?
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head/facial structures
breathing oral/pharyngeal cavities |
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what should be noticed when looking at head/facial structures
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size/ shape/ symmetry of head and face
- should be in proportion to each other and body (can signal a syndrome) |
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what should be noticed when looking at breathing
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at rest:
- should have mouth closed with no noticeable movement of clavicle - equality between inspiratory and expiratory phases during speech production: - expiratory phase should be at least 2 times the length of inspiratory - any unusual patterns such as jerks, spasms or forced inhalation/exhalation should be noted |
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what areas should be noticed when looking at oral/pharyngeal cavities
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dentition (may affect production of some sounds)
tongue hard & soft palate (use gloves) |
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what should be noticed when looking at dentition
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occlusions:
- class 1: normal: lower molars 1/2 of a tooth ahead of upper molars - class 2: malocclusion overbite: maxilla protruding in relation to mandible - class 3: malocclusion underbite: mandibular molar more than 1/2 a tooth ahead of maxillary molar additional issues with bite - open bite: gap between biting surfaces - cross bite: crossing of rows of teeth due to misalignment of teeth presence/spacing of teeth: - note any teeth that are missing - axial orientation: positioning of individual teeth |
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what should be noticed when looking at the tongue
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size in relation to oral cavity:
- macroglossia: too large - microglassia: too small color and muscle tone - shriveled tongue appearance may signify paralysis surface: - fissures, lesions, fasciculation (visible bundling of muscles) symmetry at rest: - should be symmetrical without any muscle twitching or movements |
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what should be noticed when looking at the hard & soft palate
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color:
- usually pink and whitish at midline - bluish tint may signify a submucous cleft: if observed, feel along the midline to see if bony structure is intact size & shape - depth of palatal vault presence/absence of clefts, fissures or fistulas (openings or holes) uvula - bifid uvula may signify submucous cleft fauces/pharyngeal area - size/color - excessive redness and/or swelling of area including adenoids/tonsils may indicate inflammation and warrant referral to physician |
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what functions should be evaluated in an oral peripheral exam
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head/face
oral/pharyngeal cavity breathing combination of structures |
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what functions should be observed when examining the head/face
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eyebrow raising is symmetrical
smile/frown - on command - symmetry lips - protrude lips - and the spread lips - rapid lip movements (pa-pa-pa) (symmetry during opening/closing) mandible - lower on command - move to left/right side |
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what functions should be observed when examining the oral/pharyngeal cavity
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tongue
- stick out on command - smoothness and speed of movement --- upward/ downward/ left to right corner of mouth - around lips (licking lips) clockwise/counterclockwise - backward from alveolar ridge for length of hard palate velopharyngeal function - adequate velar movement during phonation of "ah" - puff up cheeks - maintain intraoral air pressure (puffed cheeks) when slight pressure applied to cheeks - absence of nasal emission (mirror underneath nose = fog) |
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what functions should be observed when examining breathing
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at rest
- through nose or mouth - thoracic or abdominal during speech - through nose or mouth - thoracic or abdominal - can sustain "ah" for 5 seconds |
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what functions should be observed when examining combination of structures
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diadokinesis: repetition of /p/ /t/ /k/ alone and in combination
- smoothness - speed - sequencing |
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what is included in a diagnosis
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organizing data
determine major emphasis conduct analysis determine severity determine priorities for therapy write goal |
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how do we organize data
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phonemic inventory
listing of errors phonemic contrasts |
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what is the phonemic inventory
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list of speech sounds that the client can articulate (usually only done for very severe or for research)
- requires extensive data to ensure that all phonemes were tested in all possible configurations - can be organized in a matrix of all phonemes produced (correct and incurred) or multiple matrixes that represent different word positions --- distribution of speech sounds: reference to where the norm and error productions occurred within a word |
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listing of errors
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can use results of articulation/phonology published test and/or speech sample
needs to include distribution of productions - word position (initial, medial, final) - relation to vowel nuclei (prevocalic, intervocalic, postvocalic) can be analyzed for phonological and/or articulation errors |
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what are phonemic contrasts
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look for phonemic contrasts that occur and those that do not
- consistent loss: substitution occurring every time in the client's realizations - inconsistent realizations: substitutions//deletions that occur only in certain contexts summarize collapses of phonemes: look for any substitutions that represent more than one target phoneme for grouping (ie. /t/ is substituted for /k/ and /s/) |
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what are the different major emphasis
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articulation
- errors do not affect linguistic meaning (phonemic contrasts are intact) - seems to be more motoric in nature: error is consistent independent of context - distortions rather than substitutions, deletions, or additions phonology - errors affect linguistic meaning (phonemic contrasts) are affected - substitutions, deletions, and/or additions - seems to be more linguistic in nature can be both |
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conduct analysis
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if articulation emphasis, conduct an analysis of errors
if phonological, choose type of analysis: - phonological process (most common) (natural phonology) - distinctive features - generative |
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what are rules in determining severity
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consider level of intelligibility
- percentage of words understood: number of words understood divided by total number of words in a sample multiple by 100 - percentage of consonants correct: number of correct consonants divided by total number of consonants in a sample multiplied by 100 --- not hard and fast but can use a guideline (90%+ mild, 65-85% moderate, 50-65% moderate-severe, 50%- severe) analysis table vs. phonological table - phonological process analysis: - can use either table to see if child is disorder - can use a sound by sound table consider developmental guidelines - six months delay for a phoneme is considered disordered (1 year for public school setting) - determine which type of normative guidelines --- sound: age of mastery of sound (different authors use different % of mastery) --- phonological process: age of suppression of phonological process use of standardized score from published articulation/phonology test (not as common is school setting) consider amount of adverse attention that it causes to the child SLP determines level of severity based on experience keeping in mind all of the above setting determines severity as long as it affects intelligibility or causes adverse attention to child's moderate level of severity as long as it affects intelligibility or causes adverse attention to child's speech. moderate is minimum level of severity for eligibility for therapy in the school setting |
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what are rules in determining priorities for therapy
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consider what affects intelligibility the most
- frequency of occurrence in language (ie. /s/ more frequent than /zh/) consider what is most developmentally delayed consider what might generalize to more sounds and have greatest impact - number of phonemes in sound class that are in error - ie. stopping sounds help towards many sounds consider stimulability: two schools of thought: - don't target stimulable sounds first because they will come in on their own - target stimulable sounds first since it will be easier to remediate and therefore increase intelligibility the most |
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how will you write a goal in a diagnosis
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goals vary depending on setting
- organized by main goal with smaller steps such as objectives and/or benchmarks (ie. main goal/benchmarks) - what behavior desired (ie. correct production of /s/) - amount of time for achievement - what context: hierarchy of difficulty: initial -> final -> medial - what setting (speechroom, class, home) - how measured (test, observation) - what accuracy (80-90%) |
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what is an example of goals for articulation
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Goal: by 9/5/13, Johnny will correctly produce /s/ in all positions of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation
objective/benchmark 1: by 12/1/12 Johnny will correctly produce /s/ in initial position of words with 90% accuracy over two sessions int he therapy room setting as measured by SLP observation objective/benchmark 2: by 3/1/13, Johnny will correctly produce /s/ in final position of words with 60% accuracy over two sessions in the therapy room setting as measured by SLP observation objective/benchmark 3: by 6/1/13, Johnny will correctly produce /s/ in medial position of words with 90% accuracy over two sessions in the therapy room setting as measured by SLP observation |
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what are the stages of therapy?
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- establishment: elicit target behaviors from client and stabilize them at voluntary level
- generalization (transfer): learning 1 behavior in a particular environment often carries over to similar behaviors - maintenance and dismissal: stabilize and facilitate retention of those behaviors acquired during other stages |
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explain the children who enter at the establishment stage
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- do not have sound an dare not stimulable
- produce it but cannot produce it on demand - cannot perceive sound in minimal pairs do not use sound in particular context or position - produce sound on demand but do not incorporate it into syllabic units |
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what are two strategies for establishing behaviors?
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perceptual training prior to production training
exclusive focus on production tasks - belief that perception will also improve as component of production |
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what are the types of perceptual training?
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discrimination training
conceptualization or contrast training |
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explain discrimination training
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- include only error sounds in training (identifying errors in production)
- traditionally, discriminates between clinician's productions, then own productions - not clear whether perceptual training without production training will improve productions |
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explain conceptualization or contrast training
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- train child to contrast and compare speech sounds and syllable structures at word and sentence level
- start with minimal pairs (words that differ by just one phoneme), can focus on phonological processes too - more effective than discrimination training |
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what are the goals in production training?
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- elicit target behavior from client
- stabilize it at voluntary level - make certain that target speech sound is perceived in minimal pairs (more common in phonological approach) |
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what are the approaches to production training?
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- imitation: present auditory models of desired behavior (ask child to watch mouth and listen, and ask to repeat)
- contextual utilization: look for contexts in which uses target sound correctly (may find these facilitating contexts through testing) - phonetic placement: provide specific instruction on how to produce a sound (can tell child where to put articulators and how to produce sound, provide visual and tactile cues, and analyze and describe differences between error production and target sounds) - successive approximation: shaping/sound modification (start with elicitation of a phoneme that client can produce and reinforce closer approximations |
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what are the establishment guidelines?
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- perceptual training may be useful if child cannot perceive phonological contrast or phonological rule
- use any or all of the 4 approaches if needed - look for target sound in client's repertoire through stimulability, contextual testing, and connected speech samples - when several sounds in a class in error, look for correct production of one sound, stabilize it, and use for generalization |
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explain generalization
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- move to generalization when behavior can be produced on demand and child can make appropriate perceptual judgments of minimal pair contrast involving target sound
- ability to generalize will vary between children, target and contexts. it is not automatic - requires much reinforcement (praise, token) |
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what are specific types of generalization?
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- across word: position begin with initial and general to other position
- across context generalization: sound in 1 stimulus word generalizes to another word in the same position - across linguistic: unit generalization (isolation to syllables to words, ie. phrases -> words) - across sound an dfeature: to similar sounds ie. /k/ to /g/ - across situations: what is taught in therapy is able to be produced in classroom, at home, etc. |
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explain maintenance and dismissal
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during maintenance: child should assume responsibility for self-monitoring and should receive intermittent reinforcement
child should be tested in running speech before dismissed |
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what is articulation therapy?
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traditional approach: tried and true, can also combine with other approaches
- progress from identification of error productions to establishment of correct productions, transfer, and then maintenance - assume that faulty speech perception related to speech errors and errors indicate inadequate development of oral motor skills |
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what are the components of articulation therapy?
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perceptual training/ear training: not always done prior to work on production
production training: target sound is production in isolation, then syllables, words, and running speech |
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explain perceptual training in articulation therapy
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- identification: clinician demonstrates sight, sound, and feel of target sound and child recognizes it in isolation
- isolation: child indicates when hears it or does not and can identify its position in word - stimulation: clinician bombards child with target sound in different contexts - discrimination: child discriminates correct and incorrect production in more complex contexts |
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explain production training in articulation therapy
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with all except isolation, move from easiest position (initial) to more difficult (final) to most difficult (medial) within each of the follow linguistic contexts/levels:
- isolation - syllables: use sequence of CV, VC, and choose facilitating contexts - words: use sequence of CVC to multi-syllabic words (train a small group of core words and expand) - phrases: move to two- and four-word phrases (ie. "have a" initial, "on it" final) - sentences: work from the target to all words in sentence that have target phoneme (student creates sentence and focuses on correct production of target; then move to student using correct production in all contexts in the sentence) - structured conversation: SLP guides conversation with questions - unstructured conversation: spontaneous running speech |
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how does phonological therapy differ from articulation therapy
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1. addresses a class of phonemes rather than individual sounds
- belief that it is faster than traditional articulation therapy 2. brings a linguistic meaning to error and target productions - child sees that a change in sound equals a change in meaning *** - belief that it will be more relevant and therefore motivating 3. better generalization across: - word positions - class of phonemes - linguistic levels (words, phrases, sentences) |
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what are similarities between phonological therapy and articulation therapy
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may need to teach "how" to produce sound if child does not have phoneme in inventory
may use the same context hierarchy (ie. syllable to words to phrases etc) |
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what are types of phonological therapies?
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contrasts: designed for children who have sounds in repertoire but do not use contrastively *change in sound = change in meaning)
cycles approach |
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what are the different types of contrast therapies?
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minimal pairs
maximal oppositions multiple oppositions unknown |
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explain minimal pairs in phonological therapy
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most common
contrastive pair that differs by one phoneme in one position - target vs. error (ie. sip vs tip) - can be in initial or final position rationale: - child will see that error changes meaning - target contrast will generalize to similar phonemes/errors |
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explain maximal oppositions in phonological therapy
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contrastive pair that differs by one phoneme in one position
- target vs. maximally different (ie. kit vs. mitt) (picking one that is way different from target, minimal pairs) - can be initial or final position rationale: - saliency of contrast will facilitate learning - target contrast will facilitate broad learning by naturally filling in gaps |
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explain multiple oppositions in phonological therapy
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use when child collapses several different phonemes into one (ie. producing /t/ for /s, th, sh/
contrast of multiple targets that differ by one phoneme with single error - targets vs. error (ie. sip, lip, ship vs. tip) - can be in initial or final position rationale - address multiple errors in a timelier manner additional uses - this approach lends itself to use with initial and final consonant deletion since these phonological processes involve multiple phoneme deletions |
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explain unknown sets in phonological therapy
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contrastive pair that differs b one phoneme in one position
- target vs. target (ie. sip vs. rip) (2 sounds that the child cannot produce) - can be initial or final position rationale: - saliency of contrast will facilitate learning - target contrast will facilitate broad learning by naturally filling in gaps |
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what is the cycles approach?
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focuses on acquiring correct rules rather than eliminating developmentally inappropriate patterns
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what are the steps in cycles approach?
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1. combination of linguistic and motor-oriented approaches to remediation designed for unintelligible children
2. treatment cycles of 5-6 to 15-16 weeks with each phoneme targeted for 60 minutes per cycle 3. provide stimulation for 2 or more target phonemes in consecutive weeks before changing to next target pattern 4. a pattern should be targeted if occurs in at least 40% of instances in which opportunity for occurrence in single-word naming task (in figuring out which processes to target) 5. auditory bombardment: read 12 words containing target sound, including in sentences at beginning and end of session (they do not repeat, you are just reading it to them) 6. use auditory, tactile, and visual stimulation for correct production at word level 7. select next phoneme based on stimulability |
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what are additional components to the cycles approach
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art project with targets
homework |
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explain the role of the SLP
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conduct a "least biased" assessment
differential diagnosis: (difference vs. disorder) sort out typical phonolgoical patterns (influenced by the client's communicty) from phonological disorders |
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explain african american dialect (AAE)
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phonological development
- produce same phonetic inventory as GAE but differences in frequency of features - exhibit systematic error patterns |
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what happens when english is acquired after the native laguage
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the phonological system of the native language (L1) can impact pronunciation of the second language (L2)
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what is the primary language?
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native language, first language learned
can be more than 1 language as long as they were both acquired simltaneously never changes |
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what is the dominant language?
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strongest language
can have mixed language dominance: L1 and L2 are equally as fluent can have variation in language of dominance in different linguistic areas (ie. semantics is stronger in L2 but syntax/morphology is stronger than L1) can change across lifetime |
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what is in the spanish phonology
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vowels (5 primary)
- front /i/ /e/ - back /u/ /o/ /a/ consonants (18) - stops /p/ /b/ t/ /d/ /k/ /g/ - fricatives /f/ /x/(hw) /s/ - affricate /tf/ /ch/ - glides /w/ /j/ - flap - lateral /l/ - trill /r/ - nasals /m/ /n/ /n/ |
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explain asian languages
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phonology
- structures of asian languages vary greatly - fewer syllable final consonants in each language as compared to English tone language: most asian languages are tonal - differences in word meaning are signified by differences in pitch |
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what are assessment considerations for least biased assessment
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prime consideration is account for dialect features
- paramount in determining the correct diagnosis - dialect differences are not errors clinician's need to be aware of their own dialect and it's affect on the assessment process if the client speaks two languages, the assessment often needs to be conducted in both languages. language dominance will needs to be determined. assess in LI |
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how can an SLP assess in L1
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use instruments created for language/dialect testing
- if assessment is in a language other than that of the SLP, use caution and close monitoring of trained translator interpreter may need to use alternative assessment if standardized measures are not available in language being tested - when appropriate to do so, alter published test but use only as criterion referenced (analyzed by content not score) ie. fristoe - create own measurements: may need to enlist help from other professionals, family of client - obtain list of phonemic inventory of the language being tested - use phonemic developmental charts specific to the particular language consider and be sensitive to cultural differences in interacting with the client |
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explain intervention of a dialect
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speakers of other dialects should not be treated unless errors in other dialect or wants to learn standard american dialect (not in schools)
in the case of a disorder, treatment is best conducted in dominant language - if SLP does not speak the language of intervention, a trained para-professional can be used to assist - in cases/settings where that is not possible and english is the only language of intervention, only treat those english phonemes that are also in error in the dominant language consider and be sensitive to cultural differences in interacting with the client |
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define phonological awareness
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an umbrella term that refers to the ability to identify distinct linguistic units such as words, syllables and/or phonemes that make up the speech system.
phonological processing, phonetic/linguistic awareness and phonological sensitivity |
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define sublexical
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representation of the linguistic units occur at a level separate from meaning
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define metalinguistics
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the ability to focus on language as an object of thought
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define phonological awareness development
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development occurs across a continuum that includes a hierarchy of sensitivity to linguistic units (largest to smallest that make up the speech signal)
- awareness of words (2-5 years) - awareness of syllables (4-5) - awareness of phonemes (6-10) |
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explain parts of the awareness of words
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awareness of rhyme: awareness of words that sound the same. the very beginning of phonological awareness
- sensitivity begins as early as 2 years of age - ability to detect and produce rhymes gradually increase to about 5 years of age awareness of alliteration: sharing of a phoneme across two syllables or words. at this level, children show recognition of a phonological similarity between two words but are not yet aware that it is due to a shared phoneme - acquisition in years is similar to awareness of rhyme (2-5) but lags behind it |
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explain the awareness of syllables
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- begins with recognition that multi-syllabic words can be divided at the level of syllables
- children learn to manipulate words at the syllable level (hotdog is hot & dog) - ends with distinction of syllable elements of onset (initial consonant) and rime (vowel and final consonant) |
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explain the awareness of phonemes
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(phonemic awareness):involves the ability to identify phonemes as the units comprising syllables and words
overlaps with child's ability to learn to read - some controversy over whether there is a causal relationship with phonemic awareness and ability to read or whether they have a reciprocal relationship phonemic synthesis (6-7): the ability to take sounds that are heard and make a larger unit (ie. /p//a//n//d/ says pond) phonemic analysis aka phonemic segmentation (6-10): ability to sequentially isolate all phonemes in a unit such as a syllable or word -develops much more gradually than synthesis and can take up to 10 years of age |
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what are the components necessary for decoding
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phonemic awareness
phonics - knowledge of letter names - phonological recoding: recognition of the systematic correspondence between letters and phonemes |
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phonological awareness and disorders of speech production
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- children who display an articulation disorder are not at any greater risk for reading difficulties
- children with phonological impairments are at risk for reading difficulties - children who exhibit phonological and language impairments are at the greatest risk for problems with reading |
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what is the role of the SLP in ASHA's position and what does it include
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can (and should) play a significant role in promoting phonological awareness as well as literacy skills in preschool and school age children
prevention identification assessment intervention |
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what is the etiological categorical approach to language disorders
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focuses on classification of language disorders by causes, or etiologies
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what is the classification system by McCormick and Schiefelbusch
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- disorders associated with motor disorders (brain pathology, cerebral palsy, and nervous system damage)
- disorders associated with sensory deficits (hearing and visual impairments) - disorders associated wit severe emotional social dysfunctions (psychosis, schizophrenia, or autism) - disorders associated with cognitive disorders (mental retardation) |
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what is the descriptive developmental approach to language disorders
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describes rather than classifies child's language disorders and compares with normal children
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define specific language impairment (language disorder)
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developmental language disorder in absence of hearing loss, cognitive issues, injury or emotional social dysfunction (language disorder has no apparent cause)
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what are the classification systems for language disorders
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bloom and lahey
linguistic parameters broad types of language |
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what are bloom and lahey's classification system
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- problems with form: morphology, syntax, phonology
- problems with content: conceptualization and formulation of ideas about objects, events, and relations - problems with use: adjusting message for listener, using communicative functions, speaking and understanding in certain contexts - association problems: problems with integrating form, content, and use (message is inappropriate for situation) |
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what are the linguistic parameters
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most common in schools
can further describe receptive vs expressive within each parameter (ie. receptive syntax disorder) - semantics - syntax - morphology - pragmatics - phonology (usually reported with articulation under the category of speech) |
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what are the broad types of language
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more common for preschoolers in the schools
- receptive - expressive |
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what are the guidelines for considering language disorders
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- components of language that are impaired: form, content, use or syntax, morphology, phonology, semantic, and pragmatics
- modalities that are impaired: auditory or visual input, verbal, gestural, or written output - processes that are impaired: sentence processing, abstracting information for storage from memory, and information retrieval from memory |
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what is the definition of language according to asha
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the abnormal acquisition, comprehension, or expression of spoken or written language. the disorder may involve all, one, or some of the phonology, morphology, semantics, syntax, or pragmatic components of the linguistic system. individuals with language disorders frequently have problems in sentence processing or in abstracting information meaningfully for storage and retrieval from short and long term memory
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