Articulation/Speech sound disorders

Question 1

Describe the main theories of articulatory and phonological development
1. Behavioral Theory
2. Natural Phonology
3. Generative Phonology
4. Linear vs. Nonlinear
5. Optimality

Answer 1

Behavioral theory
- Behavioral explanation of speech sound acquisition is based on conditioning and learning

Natural Phonology Theory
- Proposes that natural phonological patterns are innate processes that simplify the adult target word.
- Children learn to suppress processes that do not occur in their languages.

Generative Phonology Theory
- Theory of the sound structure of human languages. Two major ideas:
1. Phono descriptions are dependent on information from other linguistic levels.
2. Phonological rules map underlying representations onto surface pronounciations.

Linear vs Nonlinear Phonology Theories
Linear: All speech segments are arranged in a sequential order, all segments have equal value, and all distinctive features are equal.
Nonlinear: Alternative for linear theory - assumes that there is some sort of hiearchy that helps to organize both segmental and suprasegmental phono units or patterns, but takes account the influence of stress and tone features

Optimality Theory
- Used to describe adult languages.
- The aim during children’s speech development is for the child’s output to match the adult target.

Question 2

In what years of life does the vocal tract anatomy and function change?

Answer 2

first 3 years of life

Question 3

What is acquired first? Vowels or consonants?

Answer 3

Vowels

Question 4

What consonants are the earliest to be aquired?

Answer 4

/m/ /n/ and /ŋ/ . Usually mastered by 3 years of age

Question 5

Which ones are mastered first? Stop sounds or fricatives?

Answer 5

Stop sounds. Mastered by 3-4 yrs. The /p/ may be the first to be mastered

Question 6

Which ones are mastered first? Fricatives or glides?

Answer 6

Glides /w/ and /y/ are mastered first. Between 2-4 years.

Question 7

Around what age are liquids mastered?

Answer 7

Pretty late. Between 3-7 years

Question 8

Which are mastered earlier? Fricatives/affricates or stops/nasals

Answer 8

Stops/nasals.

Question 9

What is the earliest developing fricative?

Answer 9

/f/ at around 3. others are around 3-6.

Question 10

In general terms, how to determine the need for therapy?

Answer 10

The poorer the intelligibility, the more likely the child needs therapy

Question 11

Intelligibility expectations for children 2,3 and 4 yrs old

Answer 11

2 - 60-70%
3 - 75-80%
4 - 90-100%

Question 12

Vocalization

Answer 12

Consonant is substituted by vowel ex. noodle –> noodoo

Question 13

Gliding

Answer 13

liquid consonant is produced as a glide
ex. ring –> wing

Question 14

Velar fronting

Answer 14

Alveolar or a dental replaces a velar
ex. king –> ting

Question 15

stopping

Answer 15

fricative or affricate is replaced by a stop
ex. tchoo –> too

Question 16

Depalatization

Answer 16

substitues an alveolar affricate for a palatal affricate
ex. wish –> wis

Question 17

Affrication

Answer 17

affricate is produced instead of a fricative or stop

Question 18

Development of prelinguistic, non-reflexive vocalizations (5 stages)

Answer 18

1. Phonation stage (birth - 1 month)
   
   • Speech-like sounds are rare, most vocalizations are reflexive (ex. burping, coughing, crying)
2. Cooing stage (2 - 4 months)
   
   • Most of the infant’s productions are acoustically similar to /u/.
3. Expansion stage (4 - 6 months)
   
   • Infant is “playing” with the speech mechanisms, exploring his or her capabilities through such productions like growls, squeals, yells, and raspberries.
     - Some CV combinations may be produced
4. Canonical or reduplicated babbling stage (6-8 months)
   
   • Infant produces strings of CV syllables (mamamamama, dadadadada, dededede)
   • By 8 months, children with hearing losses fall behind hearing peers in language development.
5. Variegated or nonreduplicated babbling stage (8 months - 1 year)
   
   • Infant continues to use adult-like syllables in CV sequences, but a variety of consonants and vowels appear in a single vocalization (ex. duwabe)

Question 19

What age (and prelinguistic stage) does a child with a hearing impairment fall behind peers in language development?

Answer 19

8 months, canonical/reduplicated babbling stage

Question 20

Describe what an Allophone is. Give an example.

Answer 20

Variations of a phoneme.
Ex. the /k/ sounds different in the words “kitten”, “bucket”, and “cook”

Question 21

Describe what progressive, regressive and voicing assimilations are.

Answer 21

Progressive assimilation
- Assimilation pattern in which an earlier occuring sound influences a later occuring sound (ex. kik/kis, bup/but)

Regressive assmilation
- Assimilation pattern that occurs due to the influence of a later occuring sound on an earlier sounds (ex. guk/duk, bip/zip)

Voicing assimilation
- Assimilation pattern that can either voice (ex. bad/pad) or devoice (pik/pig)

Question 22

Syllable structure pattern which involves the omission of an unstressed syllable (ex. meito/tomato, hind/behind, efant/elefant)

Answer 22

Unstressed or weak syllable deletion

Question 23

Addition of /i/ to the target form (ex. dogi/dog, eggi/egg)

Answer 23

Diminutization

Question 24

Production of sounds in a word in reversed order, also known as spoonerism (ex. likstip/lipstick)

Answer 24

Metathesis

Question 25

Syllable structure pattern in which the final consonant is omitted

Answer 25

Final-consonant deletion

Question 26

Syllable structure pattern in which a schwa is inserted between the consonants in an initial cluster (ex. teree/tree, belack/black)

Answer 26

Epenthesis

Question 27

Which ones of these factors affect speech sound disorders?
1. Gender
2. Intelligence
3. Birth order and sibling status
4. SES
5. Language development and academic performance
6. Auditory discrimination skills

Answer 27

1. Gender: More boys than girls tend to have SSDs
2. Intelligence: Not a strong factor/little evidence
3. Birth Order: Some evidence that firstborn/only children have better articulatory skills. Also, the greater the age, the better the articulatory skills. If one child has SSD and has sibling close to age, they may provide a model of inadequate articulation for the younger child
4. SES: Not a strong factor
5. Language dev.: Younger children with severe SSDs are more likely to demonstrate language problems than children with mild-moderate language delays
6. Auditory discrimination: Not a strong relationship/not enough evidence

Question 28

Is ankyloglossia a frequent cause of misarticulation?

Answer 28

No. Cutting the frenum used to be a common surgical procedure but research shows that children with ankyloglossia can have normal articulation.

They may however have difficulty with the /t/ and /d/ as they are alveolar sounds.

Question 29

3 classes of malocclusions

Answer 29

Malocclusion I: Some individual teeth are misaligned.
Malocclusion II: Overbite
Malocclusion II: Underbite

Question 30

Anatomical or physiological characteristic of the orofacial structures that interferes with normal speech or physical, dentofacial, or psychosocial development

Answer 30

Orofacial myofunctional disorders (OMD)

Question 31

T or F? A child with OMD typically experiences a deviant swallow

Answer 31

True.

Question 32

What is the type of therapy used for OMD?

Answer 32

Oral myofunctional therapy

Question 33

Popular motor-speech Ax used for differential diagnosis of CAS

Answer 33

Dynamic Evaluation of Motor Speech Skill (DEMSS)

Question 34

What does Tx for dysarthria look like?

Answer 34

Very repetitive and structured. It involves increasing muscle tone and strength, increasing range of motion and treating other parameters (ex. respiration) that affect intelligibility
Intensive and systematic drill, modeling, phonetic placement, and emphasis on accuracy of sound production.

Question 35

T or F? Research shows children with CAS may have deficits in phonological awareness and are also at risk for language, reading and spelling problems

Answer 35

True.

Question 36

what is the overall goal for children with CAS with the DTTC program?

Answer 36

To have the child produce words correctly spontaneously both inside and outside the clinic. The rationale for practicing a small set of functional words is that it will foster neural maturation of motor planning and programming substrates, which will in turn facilitate future speech motor learning

Question 37

Is multimodal cueing important for children with CAS?

Answer 37

Yes. SLPs should use visual, auditory and tactile cues to teach treatment targets.

Question 38

What consonant types does a child typically have in the first year of life

Answer 38

Nasals
Plosives
Fricatives
Approximants
Labials
Linguals
[b d m n] are the most frequently reported

Question 39

What consonants do children typically develop between 1-2 years?

Answer 39

[t] [d] and [w]

Question 40

What consonants do children typically develop between 2-2.5 years?

Answer 40

[ŋ] [k] [g] [w] [h]

Question 41

What types of consonants are generally mastered by the age of three, according to studies?

Answer 41

plosives, nasals, fricative [h] and approximant [w]

Question 42

What consonant clusters are generally predominant in 2 year olds?

Answer 42

Word-initial consonant clusters containing /w/ (e.g., [bw, kw]), where the target is [br, kl]

Question 43

What consonant clusters are common in 2-3 year old children?

Answer 43

Common final consonant clusters for 2-3 year old children contain nasals
[r] consonant clusters are rarely produced correctly by 2 year old children

Question 44

Describe the development of vowels in children.

Answer 44

Low, non-rounded vowels are favoured in the first year
Front-back vowel differences appear later than height differences
^ other papers however have found that there is variability in what order vowels are acquired, but they are acquired early
Number and diversity of vowels increases as children approach their second birthdays

Question 45

At what age should children generally be understood most of the time?

Answer 45

By 5 years old, typically developing children should be understood most of the time, even to unfamiliar listeners.
One study found that TD 3 year olds were 95.68% intelligible, 4 year olds were 96.82 intelligible, and 5 year olds were 98.05% intelligible to an unfamiliar listener

Question 46

What consonants should a child between the ages of 3;6 and 4;6 have in their inventory?

Answer 46

[p, b, t, d, k, g, m, n, ŋ, f, v, s, z, h, w, j, l, ʃ, , ​​tʃ, dʒ, (ɹ)]
Some studies have found that 3 year olds have acquired all major phoneme classes except for liquids

Question 47

What consonants should a child between the ages of 4-5 have in their inventory?

Answer 47

[p, b, t, d, k, g, n, ŋ, f, v, s, h, w, j, l, ​​tʃ, dʒ, ɹ, ʒ, ʃ, ð, θ]
Most studies indicate that 5 year old children produce over 90% of vowels, consonants, and consonant clusters correctly

Question 48

Describe the changes in phonological errors in children?

Answer 48

Fewer occurring as children age
Some we still see b/w ages 3-5, weak syllable deletion, final consonant deletion, cluster reduction, fronting, stopping, deaffrication, and gliding (WILL see fewer as kids get older, REFER TO CHART to see when each process should outgrown)

Question 49

What is prosody and when does it develop?

Answer 49

Ability to produce different stress patterns continues to develop
Age 3, typically will master trochaic stress pattern (e.g., strong-weak stress patterns such as garden, and butterfly)
Takes approximately 7 years to master words with non-final weak syllables in words (e.g., ambulance, caterpillar, computer, potato, vegetable)

Question 50

What is the critical age hypothesis?

Answer 50

Children who have speech difficulties that persist to the point when they need to use phonological skills for learning to read are at a high risk for reading problems

Question 51

What occurs to the oral cavity after the age of five?

Answer 51

b/w 5-7 children start to lose their primary teeth
Age 6 child’s skull reaches adult size
Lower face grows from 7-10
Lips and tongue grow from 9-13
Mandible, lips, tongue grow until age 16 for girls and 18 for boys
Throughout childhood and into adolescence refinement of movements of tongue tip, tongue body and jaw continue

Question 52

What DDK and max phonation time should a child have after the age of 5?

Answer 52

5 syllables/ second on DDK task

Sustain vowel ah for 10-11 seconds

Question 53

Describe a child’s speech development by the time they enter school.

Answer 53

Should be intelligible.
Typically have all consonants and vowels and most consonant clusters with 90% accuracy
Can produce all syllable shapes
May still struggle with fricatives /v/, /th/ and /z/ and approimant /r/ are acquired later.
Continuing to develop /s/ and/r/ blends.
Mastery of complex prosody (used by adults) continues to develop in school years, even beyond age 10

Question 54

How does a child’s environment effect the development of normal phonology?

Answer 54

Socioeconomic status:
Inconclusive evidence. Some studies have found no difference in speech acquisition between groups of varying levels of SES. Other studies have found that children from higher SES households acquire speech earlier and have better phonological awareness skills.

Maternal Education:
Higher maternal but not paternal education has been linked to more advanced speech and language skills across many studies.
Few studies however have considered this factor as it relates to speech acquisition and the results are mixed.

Question 55

How does word frequency and the age of acquisition of words effect the development of normal phonology?

Answer 55

Word Frequency:
Words occur in languages at different rates (i.e., high frequency or low)
High frequency words → more likely to be accurate during speech acquisition, and may be better for facilitating progress in intervention.

Age of Acquisition of Words:
Some words are acquired earlier than others. The role of the age of acquisition speech accuracy is inconclusive. E.g., some studies find that voicing is learned with earlier acquired words, and others find the opposite.
Clinical application: including later acquired words in intervention induces greater phonological generalization

Question 56

How does vocab size effect the development of normal phonology?

Answer 56

Children vary in the number of words they know/use
Bidirectional relationship b/w vocab size and speech accuracy
Early speech production abilities drive word learning → as children learn more words, their speech improves. More words may mean more detailed underlying phonological representations.

Question 57

Define neighbourhood density and how it impacts a child’s phonological development.

Answer 57

The number of words that differ from a given word by one phoneme
E.g., dense neighbourhoods have a lot of words that differ by one phoneme (e.g., “cat” has 35 neighbours)
Words from dense neighbourhoods tend to be less variable in production in younger children
Clinically unclear how to apply findings as there are benefits to including both types of words in intervention.

Question 58

Define phonotactic probability and how it impacts a child’s phonological development.

Answer 58

The likelihood of occurrence of a given sound or sound pair in a given language → thought to influence phonological representation. (e.g., “ca” in cat is more common than “cu” in cup)
More common sound sequences tend to be learned more quickly and with greater accuracy during the course of typical speech development → however some contrasting evidence that this is not related with speech accuracy

Question 59

Define functional load and how it impacts a child’s phonological development.

Answer 59

How often a phoneme contrast with other phonemes in a language
E.g., sounds with a high functional load = w, m, b, r, h, s, k, n, t b/c there are a lot of words that begin with these sounds. “Th” contrasts b/c not many words have this sound.
Words with high functional loads tend to be acquired first.

Question 60

Define the phonotactic structure of words and how it impacts a child’s phonological development.

Answer 60

The length and syllabic complexity of words influences children’s accuracy of speech production → simpler =easier
Found across languages

Question 61

Define the phoneme input frequency and how it impacts a child’s phonological development.

Answer 61

How often a phoneme occurs in a language
Example: very few words use “th” but the ones that are, are used frequently
In general more frequently heard phonemes are learned earlier
Phoneme input frequency can be offset though by other factors. E.g., “th”, b/c it has a lower functional load, and is more complex to articulate.

Question 62

What are some affective factors that can impact the development of normal phonology?

Answer 62

Pragmatic Factors:
Children might avoid saying specific words/sounds because others have found their speech difficult to understand. This can be observed in typically developing children and clinically referred children.
Might even avoid saying certain words upon Ax/Tx

Personal Factors:
Performance on a task may be impacted by the time of day, whether they are hungry, tired, bored, anxious, or disinterested in the task

Question 63

What are some motor factors that can impact the development of normal phonology?

Answer 63

Phonetic/Articulatory Complexity:
How difficult a consonant is to produce from an artic perspective
Kent (1992) proposed different levels of articulatory complexity:
Level 1 (least complex/easy): [p, m, n, w, h]
Level 2: [b, d, k, g, f, j ]
Level 3: [t, r, l ]
Level 4 (most complex): s, z, sh, d3, v, th (both)

Question 64

What are the different categories of speech sound disorders?

Answer 64

Functional (no known cause)
Organic (developmentally acquired):
- Motor/neurological
- structural
- sensory/perceptual

Question 65

What are functional speech sound disorders?

Answer 65

Include those related to the motor production of speech sounds and those related to the linguistic aspects of speech production. Historically, these disorders are referred to as articulation disorders and phonological disorders, respectively.

Question 66

What are articulation disorders?

Answer 66

Articulation disorders focus on errors (e.g., distortions, substitutions, addition or unusual idiosyncratic processes) in production of individual speech sounds

Question 67

What are phonological disorders?

Answer 67

Focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound. It is often difficult to cleanly differentiate between articulation and phonological disorders; therefore, many researchers and clinicians prefer to use the broader term, “speech sound disorder,” when referring to speech errors of unknown cause

Question 68

Name and describe some common motor/neurological speech sound disorders in children.

Answer 68

Dysarthria (execution):
Don’t see too many of these
Weakness or paralysis of speech musculature that affect respiration, phonation, articulation, and/or resonance

Motor Speech Disorder-NOS
Mixed signs of motor planning and subtle motor control difficulties but not enough to indicate a motor planning disorder or dysarthria

Childhood Apraxia of Speech (planning):
Very rare
Difficulty executing the volitional motor plan for speech in the absence of paralysis

Question 69

Name some structural speech sound disorders

Answer 69

Cleft palate

Structural deficits due to trauma or surgery

Question 70

Name some sensory/perceptual speech sound disorders.

Answer 70

Hearing impairment.

Question 71

Name the plosive sounds (voiceless then voiced)

Answer 71

Bilabial: p b
Alveolar: t d
Velar: k g

Question 72

Name the nasal sounds.

Answer 72

Bilabial: m
Alveolar: n
Velar: ŋ

Question 73

Name the fricative sounds (voiceless then voiced).

Answer 73

Labiodental: f v
Dental: θ ð
Alveolar: s z
Postalveolar: ʃ ʒ
Glottal: h (voiceless)

Question 74

Name the affricate sounds (voiceless then voiced)

Answer 74

postalveolar: t̬ʃ dʒ

Question 75

Name the approximate sounds.

Answer 75

Alveolar: r (voiced)
Palatal: j (voiced)
Velar: w (voiced)

Question 76

Name the lateral approximate sounds.

Answer 76

alveolar: l (voiced)

Question 77

What are some syllable-structure/context related changes kids might make?

Answer 77

Metathesis: occurs when two sounds or syllables in a word change places (e.g., ask → [æks])
Migration: only one sound moves within the word (e.g., snake → [neks]).
Coalescence: occurs when two sounds in a word are replaced by a single sound, which has the features of the two replaced sounds but is neither of the original sounds. ex. An example is spoon → [fun]: the /f/ has the stridency of /s/ and the labial component of /p/
Reduplication: is the repetition of phonemes or syllables that young children demonstrate as a typical part of developing language (e.g., bottle → [baba]
Epenthesis: the insertion of a sound. The most common form of epenthesis is the addition of /ə/ between two consonants in a cluster, such as black → /[balæk].

Question 78

What speech sound issues might you see with a child with a cleft lip and palate?

Answer 78

Tend to be less complex than TB but at a higher risk for speech delay.
Glottal stops are used by some children to “mark” the final consonant in a word until the sounds are developed and often seen after repairs.
Nasalized Vowels or ŋ/l Substitution→ Nasalized plosives or vowels can persist after surgical correction
Nasalized /ɚ/ The final /ɚ/
Phoneme-specific nasal emission (PSNE) is the result of the use of either a pharyngeal or posterior nasal fricative as a substitution for other fricatives or affricates
Pharyngeal Plosives are usually substituted for k/g

Question 79

What speech sound issues might you see in a child with hearing loss?

Answer 79

Adequate hearing is needed so that children are aware of the speech and language being used in their homes and surroundings. A hearing loss can affect the child’s ability to hear, which in turn may affect the acquisition of speech. Additionally, hearing is needed so that the children can monitor their speech as it is developing.

The age of onset of a loss affects both speech and language acquisition. Children with severe/profound hearing losses since birth have a difficult time acquiring speech and language. If the hearing loss occurs later, the child may maintain some skills learned up to that point, but these skills typically deteriorate over time. Better language development is associated with early identification of hearing loss and early intervention

Question 80

How does intelligence impact speech sound acquisition?

Answer 80

When intelligence falls into the cognitively delayed range (e.g., intelligence quotient [IQ] <70), however, there does tend to be a correlation: the lower the IQ, the higher the prevalence and frequency of speech sound errors

Question 81

What are some educational impacts of speech sound disorders?

Answer 81

Children with SSDs are more likely to have difficulties with phonological awareness and literacy
Critical age hypothesis: children who continue to have difficulties with SSD at the beginning of literacy instruction (around 5y old) are at most risk for having later literacy difficulties
Lowered academic expectations and limitations on teacher child relationships
Difficulty with initiation and maintenance of peer relationships,
Increased parental anxiety and difficulty forming a nurturing parent child relationship
Negative impact on sibling relationships
Increased risk for reading difficulties and workplace difficulties
Children whose speech errors interact with academic performance are more severely impacted (ie. /w/ for /r/ substitution error)

Question 82

What is cross language association?

Answer 82

Appears to be a transfer between phonology from L1 to L2, and from L2 to L1.
Cross-language associations among multilingual children are commonly known as cross-linguistic transfer. These effects can occur at the phonological, lexical–semantic, and morphosyntactic levels of language. Transfer effects between languages can be positive (facilitating language performance) or negative (impeding language performance), with the extent of transfer depending on how similar the languages are

Question 83

What are some aspects of a case history that are important for children?

Answer 83

Demographic information: Name, DOB, age, sex, address, phone, email address
The family’s needs and concerns: Reason for the referral + other areas of concern
Communication history: Babbling, first words, combining two words, current communication abilities, areas of concern, previous Ax and Tx from SLP, family Hx of speech, language, communication and academic difficulties
Cultural and Language Hx: countries family has lived in. Languages spoken, competency in each language. See comprehensive language profile below for more details.
Hearing Hx: number of ear infections & how they were treated, hearing tests, diagnoses, hearing aids, cochlear implants
Birth Hx: pregnancy, significant birth events, gestation age at birth
Developmental Hx: Milestones (sitting/walking), significant events during childhood
Feeding & Eating: difficulties with breast feeding, bottle feeding, swallowing, food preferences and allergies
The child and his/her environment: child’s interests, strengths, concerns, family members, friends, school, activities
Family preferences: for Ax and Tx (e.g., service delivery, parent-caregiver roles)

Question 84

What types of assessments might you do to gain information about intelligibility?

Answer 84

Can be screened using the Intelligibility in Context Scale or rating scales provide quick screening measures of intelligibility, but there are disadvantages. Different listeners may make different judgements and specific intervention targets can’t be determined from the results.
Single word
Children produce a set of single words to assess intelligibility
Examples: children’s speech intelligibility measure (CSIM), computer mediated single word intelligibility … more examples on page 248

Connected speech measures that quantify word and syllable identification
Good face validity b/c judgements of speech intelligibility are more closely related to everyday conversational contexts
Connected speech samples have mostly relied on sentence repetition & sentence reading
Sentence reading not best measure b/c it’s dependent on how well the child can read (intelligibility can be impacted greatly –not valid)
Intelligibility index: quantifies the number of words understood by the listener. Involves transcribing utterances and determining how many syllables are understood.

Question 85

How might you assess acceptability of a child’s speech?

Answer 85

Example rating system:
0= within normal limits. Speech is normal
1= Mild: speech deviates from normal to a mild degree
2=Moderate: speech deviates from normal to a moderate degree.
3= Severe: speech deviates from normal to a severe degree.

Question 86

List some possible areas of assessment for children

Answer 86

Language profile.
Intelligibility
Acceptability
Comprehensibility
Stimulability
Oral structure and function
Hearing and speech perception
Contextual testing
Assessment of children’s communication participation.
Screening of language, voice, and fluency.

Question 87

What is SODA and when would you use it?

Answer 87

Substitution, omission, distortion, addition.
SODA is the colloquial term for traditional articulation analysis, sorting speech errors in a sample by the four categories.

Question 88

What sound issues would a lateral lisp present with?

Answer 88

/s,z/ distortions with a lateral fricative across word-initial, within word, and word-final positions in both singletons and consonant clusters. Similar sounds may also be distorted.

Question 89

What sound issues would an interdental lisp present with?

Answer 89

Substitution of both th sounds for /s,z/ across word-initial, within word, and word-final positions in both singletons and consonant clusters.

Question 90

What is the benefit of a rational and independent speech sound disorder analysis?

Answer 90

It provides insight into what a child can produce regardless of the errors in their speech (independent analysis) and what children can correctly produce (relational analysis).

Independent analysis has 3 components:
A phonetic inventory
Syllable inventory
Shape inventory

Relational Analysis primarily looks at phonological processes analysis.

Question 91

What are the different types of stress?

Answer 91

Lexical: stress paterns in words, can be Sw (eg. paper), or wS (e.g. giraffe)
Sentence: stress in connected speech
Emphatic: emphasize a point.

Question 92

What are some instrumental techniques for seeing speech?

Answer 92

Photography and video
Acoustic analysis: spectrogram, wave form
Ultrasound
Nasometry
MRI
Electropalatography
Speech video nasendoscopy
Electromagnetic articulography

Question 93

During what functions should oral structure be considered in children?

Answer 93

During speech,
Non-speech tasks
Feeding

Question 94

What is the auditory discrimination task?

Answer 94

Require children to discriminate between phonemes in isolation, syllables and words (can be real or nonsense)
Auditory Discrimination same/different task: designed for CAS, where kids judge if two words sounds the same or different (e.g., lost vs lots)
Note that children with CAS do well with real words (comparable to TD) but worse on nonsense words
ABX task: listener hears 3 syllables, first 2 syllables are different, while the 3rd is identical to one of the first 2. Child picks which one they hear.
Illegal vs Legal non-words: children listen to non-words comprising of phonotactically legal (plik) and illegal (pnik) syllable sequences –judge whether possible or impossible in the language they are learning.

Question 95

What is the lexical discrimination task?

Answer 95

Are designed to not only assess children’s abilities to detect differences between words but their ability to compare what they hear with their own stored representations of words.
Can be completed with or without pictures
A common example is contrastive minimal pairs
Children point to a picture of one of the word pairs
Words typically contain child’s error (e.g., ring vs. wing)
Additional examples on pg 268 (too much detail for here)

Question 96

What is the cycles approach?

Answer 96

Targets phonological pattern errors, designed for children with highly unintelligible speech with extensive omissions, some substitutions, and restricted use of consonants. Treatment is scheduled in cycles from 5-16 weeks in length, with one or more phonological patterns targeted. To facilitate efficient change in the child’s phonological systems, phonological patterns are targeted rather than individual phonemes.
Good: better engagement due to frequent switching, used to stimulate emergence not mastery, evidence for improved intelligibility
Bad: requires errorless learning, environment is a critical component, not appropriate for children that cannot sit and practice.
Ex. Therapy may target FCD for 6 weeks, and then switch to target stopping of fricatives for the next 6 weeks, and then cycled once all phonological processes are targeted

Question 97

What is the core vocabulary approach?

Answer 97

Focuses on whole word production, and used with children with inconsistent speech sound production.
Short list of target words is compiled and practiced in isolation, and then the child is free to play with toys as long as he/she will continue to converse with the therapist. If words come up in conversation, they are practiced with correct production.
Good: good for children resistant to traditional approaches or with limited attention, slow progress or only say a few words due to speech issues.
Bad: relies on words coming up naturally and ability to divide attention between word practice and play, lower repetition frequency.

Question 98

What is distinctive feature therapy?

Answer 98

Focuses on elements of phonemes that are lacking in a child’s repertoire. It uses minimal pairs that compare the phonetic elements/features of the target sound with those of its substitution or some other sound contrast.
Good: used for children with substitution, often see generalization to other sounds that share targeted feature
Bad: lack of updated evidence
Ex. Distinctive features missing from the child’s repertoire may include frication, nasality, voicing, and place of articulation

Question 99

What is metaphor therapy?

Answer 99

Designed to teach metaphonological awareness - awareness of the phonological structure of language. Focus is on sound properties that need to be contrasted.
Good: alerts to the properties of sounds, to show contrasts between sounds conveys meaning, and to facilitate knoledge of manipulating these features. Increases chance of contrastive sounds being understood.
Bad: assumes children with phonological disorders have failed to acquire rules of phonological system.
Ex. For problems with voicing, the concept of ‘noisy’ vs. ‘quiet’ is taught. Targets include processes that affect intelligibility, can be imitated, or are not seen in typically developing children of the same age.

Question 100

What is Speech Sound Perception Training?

Answer 100

Used to help a child acquire stable perceptual representation of the target phoneme or phonological structure. The goal is to ensure that the child is attending to the appropriate acoustic cues and weighting them accordingly to a language specific strategy. This approach includes auditory bombardment, sometimes in the context of a story, many varied target exemplars are presented to the child with amplification; and identification tasks.
Good: computer tech has allowed for increased variability in stimuli presentation, opportunities for child to judge speech production of others.
Bad: used in or before speech production training, not appropriate to administer in isolation, child must have accurate judgement abilities of self-production of sounds.
Ex. In an identification task, the child identified correct and incorrect versions of the target (ie. ‘rat’ vs. ‘wat’) as presented by the clinician.

Question 101

Compare individual vs. group therapy for SSD.

Answer 101

Group therapy can limit the number of doses in each intervention session - this reduces treatment intensity
It is a poor choice for SSD unless the session length and number of sessions is increased
In school environment, this may lead to frequent amounts of time outside of the classroom
Emphasis on individual sessions so that each child can focus on their individual target sounds and spend minimal time outside of the classroom
Children do not benefit from hearing other children produce their own target, they need to do so themselves
Small group activities work for phonological awareness targets such as blending and segmenting

Question 102

What are some considerations when choosing an intervention approach?

Answer 102

Role and preference of the family
Service setting
Frequency
Formate (individual, group, parent, tele practice)
Who is providing therapy
When is it appropriate to change goals
When is it appropriate to discharge

Question 103

What are the 5 steps to SSD intervention?

Answer 103

Senetory-perceptial (ear) training
Prepractice instruction: learning to articulate sound
Practice: isolation, nonsense syllables, words, sentences
Transfer and carryover
Maintenance