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84 Cards in this Set
- Front
- Back
- 3rd side (hint)
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During the first 2-3 years of life children are acquiring ____ _____
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Single Words
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articulation errors can cause a problem when they interfere with ________
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communication
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5 and 6 year olds can
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produce the majority of speech sounds with out error
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By 7 years old
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articulation is typically without error
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When is there a problem?
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When sph is not understandable/intelligible
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3 and 4 year old children begin to have
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"conversations" and learn things about using language
If their speech is not understandable, it delays this type of communication |
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Articulation
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Physical Act of producing sound
Peripheral (motor) process Independent of Language learning |
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Phonology
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branch of linguistics
study of phonemes and how used within lang (4 parts of phonology) abstract linguistic concepts only identify by minimal pairs |
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1) Phoneme Inventory
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English has one of the more complex inventories
includes more vowels includes dental fricatives (only seen in a few other langs) |
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2) Allophonic Rules
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variations of a phoneme
Can vs Cat |
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3.Phonotactics
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Morpheme Structure Rules
English: roots+prefix/suffix Other Lang: Infix, circumfix "Sequential Constraints" only certain combination allowed beginning of word /st/ end of word /ts/ |
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4) Morphophonemic rules
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Just like allophones- there are allomorphs
bats [s] dogs [z] houses [ez] |
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Phonological disorders
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Central linguistic issues
May affect other arease of language |
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Causes of ARTIC Disorders
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Developmental
Structural Sensory or Motor Impairment |
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Developmental Causes
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Developmental causes:
Most common cause of artic disor in kids slow maturation of sph development |
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Structural Causes
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Cleft lip/palate
macro/microglossia cancer, car accident |
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地
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땅, 지
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earth, soil, place
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Cerebral Palsy
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Disorder of motor control that results from brain damage
abnormal muscle tone impaired motor control impaired coordination and balance weakness loss of sensation |
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Acquired neurological problems
Unilateral Facial Paralysis |
Bells Palsy
damage to 7th cranial nerve cause unknown-associated w/ trauma, virus 1/5000 |
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Hearing loss in Children
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Conductive
Sensorineural Mixed congenital or acquired |
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Typical Speech Errors for Children with Hearing Loss
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Vowel Errors
-substitutions (long for short) -neutralization (ae to ^) -prolongation -diphthongization Consonant errors: -ICD<FCD -voice/voiceless -diminutives in clusters -hypernasality |
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Assessment of SSD
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Consider age and developmental norms
involves: -evaluation of artic for sph -diagnose nature of artic problem |
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Examine Sound Production
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In Single Words:
-Initial, Medial, and Final position In Conversation: -rate, intelligibility |
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Types of Artic Errors
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SODA
substitutions omissions distortions additions |
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Patterns of errors:Phonological
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Phonological assessment:
-words/pairs -patterns Ex FCD, delete unstressed syllable, reduce consonant cluster |
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Artic Treatment
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-Imitation (provide model)
-Discrimination (own production vs others) -Generalize (simple words, complex w, sentences, stories, spon convo, Environment- waiting rm, classroom, parent friend) |
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Phonemic Therapy
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Focus on Patterns
Phonology Contrast-diff sounds diff meaning Naturalistic context Minimum Pair Contrast |
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Fluency Disorders
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Developmental stuttering
Life-long stuttering Neurogenic stuttering (PD, stroke) Psychogenic Stuttering Cluttering (in writing) |
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Normal Disfluencies
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Word repetitions
phrase repetitions sentence repetitions hesitations interjections |
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Stuttering Disfluencies
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Syllable rep
sound rep sound prolongation sound blocks associated non speech behaviors (facial grimacing, eye blinking) |
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What is stuttering
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Abnormal disruptions in speech fluency
Occur frequently, facial grimacing eye blinking, head jerking anxiety, fear, shame telephone, meeting strangers avoiding words/sounds |
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Stuttering Stats
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Prevalence 1%
Incidence 5% 3:1 males to females Family history of stuttering 30-50% cases |
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Causes of Stuttering
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Environment- traumatic experience
Genetic Neurological |
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Predictable patterns of Stuttering
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disfluencies more likely to occur at the beginning of words
stressed syllables/words |
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What makes stuttering worse?
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social approval
time pressure public speaking speaking on the telephone |
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Decrease Stuttering
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Singing
Slowed speech chorus reading |
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Recovery from stuttering
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maturation
genetics environmental *recover by age 4 typically |
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Fluency Evaluation
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Clinically Significant
Nature Impact on person's life -fluency changes depending on the situation, so examine different contexts |
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Early Childhood Treatment Stuttering
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Indirect approach (eliminate pressure, council parents)
Direct approach ("good speaking"; that was a bumpy word can you say that nice and smooth?) |
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Treatment of Adolescents and Adults
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1) Stutter modification
-stutter with less tension, less avoidance 2) Speech modification -stretched syllable to keep it fluent gentle voicing onsets |
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Newborns VF=
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2.5-2.8 mm long
two times as long as they are thick |
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Congenital anomalies
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Laryngeal Web
-fixed web VF fail to separate -high pitched weak cry -may not be evaluated until 2/3 yrs old Stenosis -glottal stenosis-no opening, tiny hole -sub glottal stenosis-larger hole, need tracheostomy |
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Tracheostomy
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surgical opening created
tube inserted to keep opening open tube must be small enough for air to come up around the tube |
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Laryngomalacia
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Noisy breathing on inhale only
Not a fixed obstruction, not the same all the time Floppy cartilages (firm up over 8-12 mo) Surgery sometimes needed |
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VF Paralysis
Bilateral |
Airway
Voice Mostly Closed/Open Injury to Vegas-cranial nerve 10 |
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Assessment
Perceptual: visual, auditoty, tactile |
posture, alignment, jaw sticking out, talking to the floor
listen feel throat- sensitiivity |
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Assessment
Instrumental-acoustic, aerodynamic, EGG |
supplement
helps track voice over time |
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Visualization: videostroboscopy
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-help determine how ppl are using their voice
-imaging -verify correct medical diagnosis -counsel patient about expectations -doesn't tell you what therapy to do |
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Etiologic Platforms
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Technique (posture, muscle use)
Lifestyle (when & how voice used) Psychological (personality & emotion) Chronic Irritation (smoke, meds, allergies) |
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Laryngeal Growth
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VF structure becomes more adult like
completed by about age 16 |
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Preschool & school aged
Hyperfunction: nodules |
•No lesions
•Hurts, gets tired, lost voice, gradual onset, after a cold, sudden, common factor: no lesions Nodules: -bilateral -big or small -little boys more common -adult women more common |
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Hyperfunction: cyst
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•Round ball- will Not go away with therapy
•You can get a nodule that forms on the other side, so they both look like nodules, but one is a cyst •When nodules aren’t going away, or voice isn’t getting better you want to get a strobe to you can detect if it’s a cyst •An encapsulated ball, sitting on the VF |
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Therapy
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Resonance: kazoo
Safer yelling Props: drum Body posture: yoga Piano: different pitches |
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Recurrent Respiratory Papillomatosis
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viral
need medical diagnosis epithelium disease benign tumors that grow must be removed over and over and over again chemotherapy injections |
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Teen years
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Chronic Irritation: allergies, asthma
Work with MDs (asthma med bad for voice) Modify-lifestyle, technique, environment |
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Mutational Falsetto: juvenile voice
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Weak, strained voice
vocal fatigue and pain high pitch |
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What is a cleft
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An abnormal opening or a fissure in an anatomical structure that is normally closed
Congenital |
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Cleft Lip
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the result of a failure of parts of the lip to come together during embryologic development
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Cleft Palate
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Occurs when the roof of the mouth does not fuse normally leaving a large opening between oral/nasal cavities
bony hard palate either/or muscular soft palate |
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Some famous people with cleft lip/palate
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King Tut
Joaquin Phoenix Abe Lincoln Peyton Manning (animals get it too) |
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Etiology
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Genetics
-runs in families -spontaneous occurence Environmental -vitamin deficiency -drugs -radiation -maternal infection -teratogens (excessive vitamin A) |
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Associated syndromes to CLP
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Velocardiofacial syndrom
Pierre Robin Sequence (underdevelopment of mandible) Stickler Syndrome Crouzon and Apert Syndrome |
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Time line for surgical procedures
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lip repair 2-3 mo
palatoplasty 6-18 mo pharyngeal flap 5 yr lip/nose revision 5 yr alveolar graft 9 yrs orthognathic 15 y F, 18 y M lip/nose revision adolescence fistula repair - when needed |
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Intervention for VPI
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surgical
-pharyngeal flap -sphinctor pharyngoplasty Prosthetic intercention -speech bulb -palatal lift -obturator |
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Voice and Resonance (CLP)
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10-50% have phonatory problem
(5% gen pop) Hoarseness Volume of phonation (appropriate loudness) |
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Neuromotor Speech Disorders
Dysarthria Apraxia of Speech |
Congenital or Acquired
Progressive or Nonprogressive |
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Dysarthria is:
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A collective name for a group of related speech disorders that are due to disturbances in muscular control of the speech mechanism resulting from impairment of any of the basic motor processes involved in the execution of speech
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Types of Dysarthria
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Flaccid
Spastic Ataxic Hypokinetic Hyperkinetic Mixed |
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Flacid Dysarthria
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Caused by lower motor neuron lesions
(will sound very diff depending on which nerve is effected) |
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Spastic Dysarthria
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Lesions to regions "above" lower motor neurons (upper motor neurons)
(extra activity) |
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Flaccid Vs Spastic
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Flaccid
- normal artic rate -nerves impaired Spastic - slow artic rate -movement patterns impaired |
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Ataxic dysarthria
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lesions of the cerebellum
-dyscoordination: difficulty controlling force, speed, range, timing, directions of movements -low muscle tone social- sounds like they've been drinking |
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HypOkinetic dysarthria
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rigidity
bradykinesia (slow/small movements) (basal ganglia) festination (speeding up) |
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HypERkinetic Disorders
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Categorized by speed/rate of involuntary movements
tics ballism tremor myoclonus chorea athetosis dystonia can be rhythmic or nonrhythmic |
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Mixed dysarthria
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majority of dysarthrias are mixed
Ex: traumatic brain injury |
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Evaluation of Clients with dysarthria
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look, touch, listen
measure possibly refer |
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Management of clients with dysarthria
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medical-surgical (palatal lift)
prosthetic behavioral |
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Behavioral management: examples
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Artic practice
Speech rate modification Nonspeech exercises ?? AAC |
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Video- Boy with Cerebral Palsy
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general motor tests
oral mechanism exam test for effect of "fixing" velopharyngeal leak |
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Video- Boy with myotonic dystrophy
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tongue tap (delayed muscle relaxation)
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Video-Girl with torsion dystonia
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progressive condition
all speech subsystems impaired moves around a lot may need completely alternatice communication mode |
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Video Girl with progressive ataxia
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Use of AAC
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Childhood Apraxia of Speech
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a neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits...
The core impairment in planning and/or programming spatiotemporal parameters of movement sequences results in errors in speech sound production and prosody |
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Video- boy with CAS
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speech errors differ from dysarthria
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