Speech Sound Disorders - Exam 4

Front 1

What are the 4 causal factors related to speech sound disorders?

Back 1

-neurological impairment
-structure of speech mechanism
-function of speech mechanism
-hearing mechanism

Front 2

What are the causal correlates related to speech sound disorders?

Back 2

-cognitive linguistic correlates
-psychosocial correlates

Front 3

What are the variables related to speech sound disorders?

Back 3

-causal factors
-causal correlates
-phonological differences

Front 4

True or false: Causal correlates of speech sound disorders cause the SSD.

Back 4

False; co-exist with it

Front 5

What type of diagnosis is needed for a neurological impairment?

Back 5

medical (not SLP)

Front 6

What are the 3 forms of neurological impairments?

Back 6

-at birth
-acquired
-degenerative

Front 7

Cerebral Palsy (CP) and static encephalopathy are examples of what type of neurological impairment?

Back 7

at birth

Front 8

Traumatic Brain Injury (TBI) and Cerbrovascular Accident (CVA) are examples of what type of neurological impairment?

Back 8

acquired

Front 9

Parkinson's, Amyotrophic Lateral Sclerosis (ALS), and Multiple Sclerosis (MS) are examples of what type of neurological impairment?

Back 9

degenerative

Front 10

What is static encephalopathy?

Back 10

brain damage - unknown cause

Front 11

Dysarthria is a motor planning or neuromuscular control issue?

Back 11

neuromuscular control issue

Front 12

Apraxia is a motor planning or neuromuscualar control issue?

Back 12

motor planning issue

Front 13

What is dysarthria?

Back 13

-brain impairment can affect impulses sent to muscles to make them move
-abnormalities in subsystems necessary for speech
-abnormalities in speech movements

Front 14

What is apraxia?

Back 14

-brain impairment can affect the planning needed to execute speech movements

Front 15

True or false: One or more systems may be affected in dysarthria.

Back 15

True

Front 16

What subsystems do dysarthria affect?

Back 16

-respiratory
-phonatory
-resonatory
-articulatory
-prosody

Front 17

What effects might you see on the respiratory system for a person with dysarthria?

Back 17

forced inhalation/exhalation for speech production

Front 18

What effects might you see on the phonatory system for a person with dysarthria?

Back 18

-pitch breaks
-mono-pitch
-loudness difficulties
-harsh/breathy voice
-strained voice

Front 19

What effects might you see on the resonatory system for a person with dysarthria?

Back 19

-too much air going thru nasal cavity (hypernasal)
-trouble closing off nasal passage (hyponasal)

Front 20

What effects might you see on the articulatory system for a person with dysarthria?

Back 20

-imprecise consonant production
-irregular articulation breakdowns
-prolonged phonemes (especially vowels)
-vowel distortions

Front 21

What effects might you see on prosody for a person with dysarthria?

Back 21

-slower rate
-may talk in shorter phrases
-reduced stress or excess stress or stress in unnecessary places

Front 22

For dysarthria, what abnormalities in movement might you see?

Back 22

-strength (weak lip and tongue)
-speed (slower)
-range (limited, can almost reach area)
-steadiness (of sound, shakey voice)
-tone (firmness of muscles at rest, mouth might hang open, possible drooling)
-accuracy (poor control)

Front 23

What are the 6 classifications of dysarthria?

Back 23

-flaccid
-spastic
-ataxic
-hypokinetic
-hyperkinetic
-mixed

Front 24

What is flaccid dysarthria?

Back 24

-related to weakness
-hypotonia
-reflexes are not as good

Front 25

What is spastic dysarthria?

Back 25

-too much muscle tone
-slower movements
-reduced range of motion
-reduced force

Front 26

What is ataxic dysarthria?

Back 26

-loss of coordination
-reduced tone
-inaccuracy in force, range, timing, and direction of speech movements

Front 27

What is hypokinetic dysarthria?

Back 27

articulators are very rigid

Front 28

What is hyperkinetic dysarthria?

Back 28

involuntary movements (can be rhythmic or irregular, rapid or slow)

Front 29

What is mixed dysarthria?

Back 29

may not be clear cut, overlaps of different types of dysarthria

Front 30

What is Apraxia of Speech (AOS)?

Back 30

-an acquired impairment caused by neurological trauma in left hemisphere
-impaired capacity to plan or program sensoimotor commands to direct speech movements

Front 31

True or false: AOS may be accompanied by oral apraxia.

Back 31

True

Front 32

True or false: AOS cannot co-exist with dysarthria and/or aphasia.

Back 32

False

Front 33

What abnormalities might you see in speech production of a person with AOS?

Back 33

-articulation (vowel and consonant distortion, lots of substitutions, voicing errors)
-rate and prosody (slower and more effortful speech, variation in vowel length, difficulties with juncture, trouble with inappropriate speech)
-fluency (false starts, articulatory grouping, sound and syllable repetitions)

Front 34

What is the difference between AOS and CAS (Childhood Apraxia of Speech)?

Back 34

-AOS usually affects adults
-CAS occurs at birth

Front 35

What is CAS also referred to as?

Back 35

-Developmental Apraxia of Speech (DAS)
-Developmental Verbal Dyspraxia (DVD)

Front 36

Why is CAS the preferred label?

Back 36

-insurance (doesn't like to cover for things labeled developmental)
-geography (preferred in U.S.)

Front 37

True or false: CAS is not caused by hearing problems, cleft palate, muscle weakness, and/or cognitive impairment.

Back 37

True

Front 38

What are the etiologies of CAS?

Back 38

-neurological etiologies (intra-uteran stroke, intra-uteran infection, intra-uteran trama)
-complex neurobehavioral disorders
-some evidence of genetic transmission
-idiopathic (unknown cause)

Front 39

Why is CAS difficult to diagnose?

Back 39

because there is not validated diagnositc criteria that separates it from other SSD's, and there is lots of overlap

Front 40

What is the prevelance of CAS in the population? AND why is there such a large increase in the last decade?

Back 40

1-10 in 1,000 children have CAS; earlier diagnosis and likely overdiagnosed

Front 41

What is the ratio of males to females with CAS?

Back 41

3:1

Front 42

True or False: There is a lot research done on CAS.

Back 42

False; limited research. hard to define (how do you select participants?). research stuck on diagnosis, not a lot on treatment

Front 43

What are the speech characteristics of CAS? (there are TONS....but I have that this is important for the exam)

Back 43

-difficulty sequencing articulation movements
-difficulty formulating and executing motor plans for speech
-inability to carry out purposeful voluntary speech movements
-groping/silent posturing
-difficulty wth connected speech
-variability in production
-inconsistency in production
-deletions most common
-substitutions might involve 2-3 processes
-vowel and diphthong errors are common
-unusual errors: metathesis, additions
-prosodic impairment
-severe unintelligibility
(all of these result in CAS)

Front 44

True or False: CAS involves the language domain.

Back 44

False; it's a motor disorder, not a language disorder

Front 45

True or false: With CAS, there may be accompanied linguistic problems.

Back 45

True

Front 46

True or false: With CAS, expression is better than comprehension.

Back 46

False; comprehension is better

Front 47

True or false: Academic problems are common with CAS.

Back 47

True

Front 48

For CAS, does the IQ range follow the normal distribution?

Back 48

Yes

Front 49

What is typical of the family history for those with CAS?

Back 49

-family history of S-L disorders
-family members share same prosodic markers

Front 50

What occurs with the social skills of those with CAS?

Back 50

-some evidence of social withdrawal (difficult to conversate)
-behavioral challenges are common (communicate with behavior, since speech is difficult)

Front 51

What additional neurological involvement may accompany CAS?

Back 51

-congenital impairment
-MRI and neuro workups don't show lesions
-often see soft neurological signs
-may be accompanied by oral apraxia or fine/gross motor challenges

Front 52

What signs are there for oral apraxia associated with CAS?

Back 52

-drooling
-trouble with volitional movements
-feeding issues

Front 53

What is the prognosis for CAS?

Back 53

-slow improvement
-lack of retention/generalization
-long program of Tx
-difficulties may persist into adulthood

Front 54

What is code mixing?

Back 54

use words for one language in the other language (eg. My casa is green.)

Front 55

What is code switching?

Back 55

being able to switch between one linguistic setting to another

Front 56

What will result when someone has a phonological difference and a disorder?

Back 56

-reduced intelligibility
-misarticulations in both languages
-idiosyncratic pattern usage

Front 57

What are the structures of the speech mechanism?

Back 57

-lip
-teeth
-tongue
-hard and soft palate
-nasopharynx

Front 58

With a cleft lip, what type of consonants will be affected?

Back 58

bilabials; bottom lip will need to compensate

Front 59

What is a Class I malocclusion? AND how does this affect articulation?

Back 59

-crooked teeth
-does not affect articulation (there is proper jaw alignment)

Front 60

What is Class II malocclusion?

Back 60

-overbite (upper teeth protrude over lower teeth)
-lots of articulation errors because it is hard for the tongue to know placement

Front 61

What is Class III malocclusion?

Back 61

underbite (less common, lower jaw outgrows upper jaw)

Front 62

What is an open bite? AND describe articulation errors with this issue.

Back 62

-front teeth (upper and lower) don't meet together (there is jaw alignment)
-tongue and air come thru front too much
-open bites show the most articulation problems

Front 63

What is a closed bite?

Back 63

top teeth overlap too much, so the bottom teeth are touching the alveolar ridge (there is jaw alignment)

Front 64

What is a cross bite?

Back 64

one or more of the top teeth are tucked inside the bottom teeth (there is jaw alignment)

Front 65

What is ankyloglossia? AND What function problem does this cause? AND What types of sounds does this affect?

Back 65

-frenum is too short
-tongue can't protrude far enough
-alveolar and interdental sounds affected

Front 66

What is macroglossia? AND What articulation error does this often produce?

Back 66

-tongue is too big for oral cavity (common in Down Syndrome)
-cause lots of interdentalization

Front 67

What is microglossia?

Back 67

tongue is too small for oral cavity (not very common)

Front 68

Is a cleft of the hard palate likely to affect articulation?

Back 68

No

Front 69

What articulation issue is associated with cleft of the soft palate?

Back 69

-velopharyngeal competence is an issue
--this will produce a hypernasal voice quality which is very hard to correct for the soft palate

Front 70

What is the incidence of cleft of hard/soft palate?

Back 70

1/500-1,000

Front 71

In the nasopharynx, if the adenoids are too large, what will the outcome be?

Back 71

hypernasality

Front 72

In the nasopharynx, if the adenoids are removed (too much tissue is taken away), what will the outcome be?

Back 72

hyponasality

Front 73

True or false: Tongue thrust is normal during infancy.

Back 73

True

Front 74

What are the types of tongue thrusting? AND describe each.

Back 74

-habitual: continue to swallow as they did as an infant
-obligatory: tongue is obligated to come out (tongue is too big, too large of tonsils, etc.)

Front 75

At what phase does tongue thrusting cause the most damage to dentition?

Back 75

rest

Front 76

What are alternative names for tongue thrusting?

Back 76

infantile swallow, reverse swallow, deviant swallow

Front 77

What type of activties may lead to habitual tongue thrusting?

Back 77

-keep pacifier after 6 months
-sucking on thumb

Front 78

What type of articulation error is produced from tongue thrusting?

Back 78

interdentilization

Front 79

For oral sensory function (non-speech movements), is treatment provided?

Back 79

not currently

Front 80

True or false: Diadochokinesis testing can be done with very young children.

Back 80

False; their articulation is not proficient enough for this test

Front 81

What is the process of the diadochokinesis testing?

Back 81

Tell them to say: /pʌ/, /pʌ/,...
Then: /tʌ/, /tʌ/,...
Then: /kʌ/, /kʌ/...
And finally: /pʌ/, /tʌ/, /kʌ/, /pʌ/, /tʌ/, /kʌ/,...

Front 82

True or false: A hearing loss affects phonological acquisition.

Back 82

True

Front 83

What is auditory discrimination?

Back 83

-being able to discriminate between different sound productions

Front 84

There is a ________ (low or high) correlation between normal IQ and articulation.

Back 84

low

Front 85

There is a ________ (lower or higher) correlation between IQ and articulation in the mentally handicap population.

Back 85

higher

Front 86

True or false: Children with severe speech sound disorders are more likely to have language problems too.

Back 86

True (50 to 75% do)

Front 87

True or false: Children with severe SSD's are at a higher risk for academic problems.

Back 87

True

Front 88

What is the critical age hypothesis?

Back 88

If SSD exists after age 6, there is a higher risk of a reading disorder (because they have imprecise representations of sounds)

Front 89

What is a strong predictor of literary competence?

Back 89

phonological awareness

Front 90

True or false: If SSD's are nondevelopmental, the child is more likely to have a reading disorder.

Back 90

True

Front 91

Why are SSD's and literacy related to one another?

Back 91

Because SSD's and language co-occur, and we know language is related to literacy.

Front 92

At what age should children have proper articulation in all areas?

Back 92

8

Front 93

Do males or females develop phonologically first?

Back 93

females

Front 94

Is the relationship between socioeconomic status and articulation errors strong?

Back 94

no, minimal relationship

Front 95

What types of sibling make-up show less articulation errors?

Back 95

-only child
-oldest child
-child with a sibling 8+ years older than them
(these children receive more attention from parents)

Front 96

Are there types of personalities that are prone to articulation disorders?

Back 96

No

Front 97

True or false: A phonological difference is a disorder and needs to be treated.

Back 97

False

Front 98

For regional/geographical dialectal differences in the U.S., what segment of speech is there the most difference?

Back 98

vowels

Front 99

For social dialect differences in the U.S., what segment of speech is there the most difference?

Back 99

consonants

Front 100

True or false: phonological differences are not systematic or highly regular, and they do not cross all liguistic parameters.

Back 100

False; they are systematic, highly regular, and they cross all linguistic parameters