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134 Cards in this Set

  • Front
  • Back
T or F: correlation implies causation
False!
functional
not physical, or related to any known etiology
organic
physical reason, known disabilitiy
auditory discrimination
the ability of a normal speaker/listener to hear differences and distinguish between speech sounds
at what age can children distinguish sounds properly?
age 8-9
our ability to discriminate sounds is ___________
developmental
what does the research say regarding articulation problems and auditory discrimination?
it is not conclusive, some have problems discriminating, others do not
should we train auditory discrimination in therapy?
we should train phoneme specific discrimination and self-monitoring rather than general auditory discrimination- pick sounds, develop therapy program
Do missing incisors cause articulation problem?
in sojme cases but not all
malocclusion
"bad closure"
Malocclusion has a ________ relationship with misarticulation, not a __________ relationship
co-existing, causal
tongue tie
restricted frunum, very short and narrow
is tongue tie related to speech?
no
does cutting a tongue tie help pronunciation?
no, it will give more motility but will not help pronunciation
microglossia
very small tongue
macroglossia
very large tongue
size of palate effects __________
resonance
do children with articulation disorders have reduced oral sensory perception?
some do, some don't= inconclusive
when should tongue thrust go away?
by about 2.5-3 yrs
what is tongue thrust?
a reverse/deviant swallow- infantile. Tongue pushes on alveolar ridge or upper teeth
why might tongue thrust exist too long?
- bottle feeding too long
- thumb sucking
- swollen tonsils
myofunctional therapy
corrects tongue thrust. SLP needs to be certified, works closely with an orthodontist
what sounds might tongue thrusters have a problem with?
sibilants, lingua-dentals
diachokinesis
ability to do rapid movement of articulators, improves with age
is there a relationship between articulation and intellegence?
no, unless child is developmentally disabled
is there a relationship between language development and articulation problems?
yes. Phonological problems=language problem.
children with phonological problems will:
- demonstrate a reduced knowledge of phonological rules
- use less complex utterances
- use less complete sentences
- have increased comprehension errors
if there is are severe phonology problems what must we test?
language testing of comprehension and production
is there a relationship between reading and writing and phonological problems?
yes, because they are substates of language, but there is not a direct relationship
delayed
implies child will catch up
deviant
errors produced are not typical
do children with phonological disorders have the motor skills to produce sound?
yes, but they are not using them. Errors are not random, there are rules!
T or F: Errors tend to be consistent in certain word positions with phonological disorders
true
can children with phonological problems produce sounds on imitation?
yes
how is age correlated with phonological disorders?
there is a positive correlation- more errors=younger. After age 8 it is no longer a maturational issue- they will not grow out of it.
in general who has better articulation- older or younger sibblings?
older, but there is not a big different
idioglossia
twinspeak. twins developing their own language.
what are the organic factors of articulatory problems?
hearing loss, structural loss, neuromotor
hearing loss affects what?
-ability to monitor/learn sounds
- articulation
- causes inability to discriminate
When is it easier to understand someone who has an intelligibility problem?
- the more you listen the easier they become to understand
- multi syllabic words easier- more change to figure out what they are saying
What errors do HI individuals make?
- devoicing voiced consonants
- substiting initial consonants
- SODAS
- nasal emissions on initial consonants
- high frequency sounds most affected- they are distorted or omitted
ankyloglossia
partial (sometimes total) fushion of the tongue to the flor of the mouth due to abnormal lingual frenulum
what are the characteristics of ankyloglossia?
- tongue tip doesnt reach roof of mouth
- when tongue protruded becomes notched (clover leaf)
what are the problems associated with ankyloglossia?
- feeding problems
- can be significant at birth and decrease with time/oral growth
- problems with breast feeding or moving bolus of food in mouth
- dentition
- cosmetic
- speech
can you compensate with a half paralyzed tongue?
yes
dentition
if ankyloglosia attachment is high can pull gum line away and cause spaces in teeth by age 8-10
what will happen when there is problems with the soft palate?
- resonance problems
- sounds that need high intra-oral pressure will be effected
- air goes through the nose, not enough power- stops, fricatives, affricates
what can we do when velum is too short?
surgery
when there is velum difficulties children will sub high pressure sounds with what?
glottal stop or pharyngeal fricatives
what are the three resonance problems you can have?
- hypernasality
- hyponasality
- nasal emission
dysarthria
articulatory disorder secondary to brain damage
- affects phonation, articulation, respiration
- not a language disorder
- deterioration of muscles, nerve endings
apraxia
- articulatory disorder secondary to brain damage
- inability to voluntarily program the articulators
- not from paralysis/paresis
- doesn't effect phonation, articulation, respiration but serious problems with prosody
childhood apraxia of speech
- subtype of severe speech sound disorder in children
- abnormalities arising in linguistic or motor pressing level production
what characterizes childhood apraxia of speech
- vowel errors
- inconsistent errors during repeated production of products
- abnormal prosodic patterns
oral peripheral exam (ope)
examine:
- lips
- tongue
-teeth
- midline raphe (white line)
-then make statement about structure/function of oral mechanism
What can we use to give us quantitative information to judge severity?
a standardized test
clinicians make ______ judgements of severity
qualitative
what are the terms frequently used to categorize severity?
mild-moderate-severe
what factors do we consider in judgement of severity?
- overall intelligibility
- etiological factors
- potential impact on daily living
- family/cultural expectations of speech/language development
- chronological v developmental age
if there is a mismatch between chronological age and developmental age we have a speech __________,if patterns of errors are not seen in normal development we have a ___________-
speech delay, speech disorder
Why is it important to make a judgement of severity?
- when speaking to families
- when qualifying for services
prognosis
prediction of progress and recovery
What does a judgement of severity effect?
- prognosis
- length of therapeutic intervention
- frequency/intensity of intervention
what three things do we look at to assess level of severity?
- phonetic inventory of vowels and consonants
- phonological processes
-suprasegmental characteristics
level of severity: mild
- delayed phonetic inventory= vowels ok
- most consonants present/produced correctly
- errors most likely to be distortions
- a few lingering processes typical of younger child
- suprasegmentals usually correct
- intelligibility close to 100% but speech draws attn to itself
level of severity: moderate
- incomplete acquisition of consonants, vowels generally ok, child may not use accurately
- inconsistent accuracy- increases with complex words
- FCD, Cluster reducation
- may have a disorder along with a delay
- intelligibility reduced, may not talk as often as peers
level of severity- severe
- incomplete phonetic inventory, word shape, processes
- accuracy very low except in single word/short utterances
- gesture/eye contact may be used to supplement communication
- very low intelligibility
- may be unable to use multiword utterances
- depending on age of diagnosis prognosis may be poor
what might clients do in reaction to severe phonological problems?
- younger clients may not be using vocalizations consistently to communicate
- older clients may have developed avoidance strategies for oral communication
what are the four factors to consider when we look at the need for intervention?
1. intelligibility
2. severity
3. stimulability
4. error pattern analysis
PCC
Percent consonants correct. Number of consonants correct/number of total consonants times 100
reliability
if you give the test over and over or if two different people administer the test to the same person you should get close to the same score
validity
test actually measures what it proports to measure
what are the reasons to assess childs language?
- determine if speech system not within normal limits
- describe childs sound system
- plan therapy program
- measure change
-predict change
- screen a population
connected language sample
spontaneous, natural (engage in parallel play)
problems with collecting a spontaneous sample
- some children have severe artic. problems and we dont know what they are trying to say
- we may need to do single word testing
- too shy
- hard to represent all sounds
when we collect a speech sample we want to collect both _________ and ________
connected speech and single words
why is it important to assess child in natural environment?
- shows how they sound day to day
- allows us to get idea and assess overall intelligibility
- we can see when errors are produced consistently
what is our final aim of therapy?
to produce correct articulation in speech in context (connected speech)
What is the order of preference for the different types of speech samples?
1. spontaneous, conversation
2. picture description or reading
3. delayed imitation
4. imitation, sentence repetition
screening
splits population into two groups: pass or need further assessment
informal screening
pre school and early years: observe, play, ask teachers/caregivers
later elementary: talk about hobbies, have read passage
formal screening
standardized screening test- single word testing- show pictures that contain all sounds in all positions
Name a formal screening measure
Photo Articulation Test
single word articulation tests
- formal, standardized
- scoring and admin with specific instructions
- most focus on consonants/clusters
what do we not want to assume regarding how a word is produced during a test vs. day to day life?
dont assume they will be the same- may pronounce differently in context
Can we make generalizations from a child's articulation of one word to contextual speech?
no,children usually do better with single word
why are standardized tests important?
- data comparison
- reliability, validity
- we can compare performance to age norms
Should we use comparisons to age norms to make predictions?
NO, we should only use them for guidelines
testing for stimulability
- is the child stimulable or not?
- stimulable= can modify speech behavior with a model, not the same as imitation
what does stimulability tell us?
1. for sounds that are stimulable child will respond faster to treatment./correct sooner
2. could mean sound is emerging/on the verge of producing it correctly
T or F- knowing if a child is stimulable for certain sounds allows us to determine level of therapy to start
T
are contextual testing and connected speech sampling the same thing?
no
contextual testing
you control the phonetic environment- sounds preceding and following target sound. Helps us find where error is produced consistently
What is a deep test for articulation? (name it)
McDonald Deep test of Articulation
deep test
sound is tested many times
phonological process analysis
a method for describing immature patterns in the speech of normal children
- process= simplification
T or F: process and rule are the same thing
False, do not confuse the two
5 criteria for analyzing speech sample
1. does it describe pattern used by speaker?
2. ID how patterns are different from normal
3. Determine how these patterns affect communication?
4. analysis must prodvide info to develop goals/guidelines for therapy
5. Analysis must provide a basis to assess change during treatment
Ingram Process
criterion referenced. Way of analyzing phonological processes. 1. Phonetic analysis 2. homonym analysis
3. Substitute Analysis- ID subs and Proceses 4. transcribe language sample phonetically 5. analyze syllable structure
phonetic analysis
count number of sound child uses in each position and frequency of use in each position
homonym analysis
Forms of sounds that look alike and have different meanings- determines degree of intelligibility of child
analyzing syllable structure
list different word structures being used, vowels, CV, CVC, etc.
Analyzing SODA
- make a summary of SODAs: where occuring
- write phonemes that are correct
- ID phonemes used correctly sometimes, never, and that do not appear
- examine for phonological processes
phonetic goes along with...
articulation
phonemic goes along with.....
phonological
what ages is the CAAP (Clinical Assessment of Articulation and Phonology) designed for?
age 2;6- 8;11
CAAP
Clinical Assessment of Articulation and Phonology
What does the CAAP test?
Articulation and Phonology
what three scores does the CAAP give?
word scores, sentence scores, new phonology scores
HAPP-3
Hodson Assessment of Phonological Patterns- third edition
what ages was the HAPP-3 designed for?
3-8, grades preK-3rd
What are some of the benefits of the HAPP-3?
- criterion and norm referenced
- designed for children with highly unintelligible speech
- gives severity intervals along a continuum
What does KLPA-2 stand for?
Khan- Lewis Phonological Analysis, second edition
what two tests are co-normed?
the Kahn- Lewis 2 and the Goldman- Fristoe 2
what ages is the Khan Lewis for?
2 through 21
what does the khan-lewis test?
phonology
What does the PAT-3 stand for?
photo articulation test- third edition
what ages is the PAT-3 for?
3-8 gardes PreK-3rd
what does the PAT-3 test?
articulation test. vowels, consonants and dipthongs differentiated into initial, medial and final positions
how do you administer the PAT-3?
point to the picture and ask the child "what is this?"
Goldman-Fristoe Test of Articulation 2- what ages is it for?
age 2-0 through 21-11
what does the Goldman-Fristoe test?
articulation. Samples both spontaneous speech and imitative sound. Has a stimulability section.
What are the Pro's of the Ingram Approach for analysis?
1. it is a complete analysis
2. flexible in terms of size/type of sample you can use
3. adaptive for different children- can do just certain parts for certain kids
4. provides info at each step- phonetic and phonological process analysis
5. good enough to compare with normative data
what three ways can you analyze a language sample?
1. language analysis
2. phonetic inventory
3. phonological process analysis
what do we look for in a good speech sample?
1. must reflect childs productions in actual communication situation
2. should reveal inconsistent and consistent patterns'
3. want a sample that will contain the full set of English phonemes
what are the different problems we can have with the velum?
1. too short
2. paralyzed
3. cleft
What are the problems we can have with ankyloglossia?
1. functional: feeding
2. dentition
3. Cosmetic
What kind of skills do we need to speak with a half-paralyzed tongue?
compensatory
How do we test function of the oral mechanism?
diadochokinesis
what factors have an indirect relationship with articulation problems?
1. reading/writing
2. socioeconomic (stimulation)
what areas have a direct/causal relationship on articulation problems?
1. hearing loss
2. neuromotor
is childhood apraxia of speech functional or organic?
functional
Creadhead Phonological Analysis
Transcribe entire sample phonetically as a list of words, ID each word separately and then transcribe words by groups of consonants (initial,medial, final). Then so syllable structure analysis and phonological analysis (sodas)