chapter 5 pt 2 Flashcards
organic etiology
known, medical origin
hearing impairments
genetic disorders
apraxia of speech
unknown origin
no medial origin
a disorder of function
hearing loss
organic etiology
speech perception / production factors w/ hearing loss
hearing sensitivity
speech recognition
hearing loss configuration
audiograms useful but don’t fully predict individual outcomes
age of onset & detection of hearing loss
early-onset, sever hearing loss affects phonology, syntax, & semantics, needing specialized instruction
cochlear implants offer improved speech outcomes but w/ individual variation
speech characteristics in hearing-impaired individuals
errors w/ phonemes articulatioin
slow speech rate
pauses
nonstandard inflection
resonance issues
do cochlear implants improved intelligibility
up to 90%
residual issues in suprasegmental aspects
down syndrome
cognitive impairment delayed acquisition
relative macroglossia
(small oral cavity, typical tongue)
reduced muscle tone, some drooling
frequent otitis media
abnormal speech patterns
beckwith-widemann syndrome
macroglossia
drooling
galactosemia
enzyme deficiency – trouble breaking down sugars (lactose) — surplus of galactose in the body
weaker muscle tone & issues controlling motor movement
often w/ apraxia of speech & dysarthia
not everyone has both
issue w/ planning (know what they want to say but trouble having clear speech) & motor speech disorder
language (reading & writing) also affected
fragile x syndrome
mutation in X chromosome - affects mostly boys
cognitive impairment
many present w/ autism
error patterns are expected, just delayed
motor speech disorders
group of heterogeneous neurological impairments
(heterogeneous - many parts of the brain involved)
affect planning, coordination, timing, & execution of movement patterns used for speech production
congenital or acquired
important areas of the brain important for speech production
primary motor cortex
upper motor neuron system
pyramidal & extrapyramidal tracts
basal ganglia, subcortical
cerebellum
cranial nerves
acquired neuro-motor problems
degenerative
stable
improving
developmental neuro-motor problems
usually stable or improving
occasionally degenerative
apraxia
inability to perform particular purposive actions as a result of brain damage
motor planning/programming
problems w/ articulation, rate, prosody
inconsistent errors
errors more w/ more linguistic complexity (1 vs 2 vs 3 syllables)
rote or automatic phrases may be produced normally
muscles themselves not impaired
dysarthria
Speech production deficits caused by problems with the nerves &/or muscles used for speech
basic speech neurophysiology
see cat
brain has desire to say cat
brain makes recipe to say cat
sends recipe to speech muscles
say cat
apraxia neurophysiology
issue w/ recipe making
speech comes out a little wrong
very frustrating because they may get it one time & then not the next
“I know what I want to say but I don’t know how to say it”
dysarthria neurophysiology
issue w/ recipe getting to speech muscles
no planning error but speech isn’t entirely clear
“I know what I want to say & I know how to say it but my brain has trouble sending it to my muscles”
childhood apraxia of speech characterized by problems w/
articulation - often errors are inconsistent
prosody - difficulty w/ prosody in phrases & words
rate - lengthened & disrupted transitions between syllables & sounds
problems become more evident as linguistic complexity increases
dysarthria
group of neuromuscular impairments affecting muscles movement for speech
what is impaired in dysarthria
respiration
phonation
resonance
articulation
dysarthria due to
weakness
spasticity
discoordination
involuntary movements
main problem - motor speech control
cerebral pasly
developmental neurogenic disorder
cerebral palsy cause
result of brain injury early in fetal or infant development
damage to primary motor cortex
tremor
rhythmic movement of a body part
tics
rapid patterned movements
not completely involuntary
can be suppressed briefly w/ effort
dystonia
slow hyperkinesia
may involve entire body, may be localized
chorea
rapid, unpredictable movements
sub types of dysarthria
flaccid
spastic
ataxic
hyperkinetic
hypokinetic
mixed
what does dysarthria sound like
no phonological processes
more deletion
slurred, unintelligible version of speech
flaccid
short phrases, imprecise consonants
weak muscle tone
v
flaccid voice quality
breathy
monopitch
reduced loudness
flaccid associated disorders
bulbar palsy
muscular dystrophy
facial never disorder (CN VII)
spastic
slow rate of speech, imprecise consonants
stiff, riding muscle tone
spastic voice quality
harsh
strained/strangled
monopitch
spastic associated disorders
pseudobulbar palsy
ataxic
incoordination & improper timing of muscle movements
ataxic voice quailty
harsh
excessive stress
hyperkinetic
increased movement
tics, tremors
hyperkinetic voice quality
harsh
monopitch
excessive loudness
hyperkinetic associated disorders
dystonia
Huntington’s chorea
hypokiinetic
decreased/restricted movement
hypokinetic voice quality
harsh/breathy
monopitch
reduced stress
trouble w/ breath support
hypokinetic associated disorders
parkinson’s disease
mixed
result from damage to multiple motor system
mixed voice quality
harsh, hypernasal, excess stress
mixed associated disorders
ALS
TBI
functional SSDs
unknown origin
phonological disorders
sound productioni problems w/out a clear organic etiology
linguistic disorder - manifested by the use of abnormal patterns in the spoken medium of language
child within normal limits on hearing, cognition, sensory-motor abilities, & social-emotional factors
3 yrs –> 4th grade intelligibilty
15% of 3 year olds have trouble being understood by their communication community
3-4% by 4th grade still having trouble
classification by possible etiology - Shriberg
- genetic - has a family member w/ current or history of SSD
- otitis media w/ effusion - early & frequent ear infectionss
- psychosocial - extremely fearful, aggressive, &/or withdrawn
- speech error - sibilants
- speech error - rhotic
motor speech involvement
1. apraxia
- dysarthria
- motor-speech NOS (not otherwise specified)
classification by psycholinguistic deficit
classifying speech sound difficulties based on underlying processing problems
phonological processing
classification by smpomatology
groups based on surface error patters
- articulation disorder
- phonological delay
- consistent phonological disorder
- inconsistent phonological disorder
why is classification of SSDs important
identifying subgroups of children will enable development of focused interventions
comorbidity
SSDs & language disorders
SSDs & stuttering
SSDs & voice disorders
SSDs & emotional / psychiatric disorders
correlation DOES NOT EQUAL causation
children w/ SSDs are more at risk for other disorders
