exam 1 Flashcards
Personal qualities (attributes)
Encouraging
Emotionally Stable
Self-Aware
Patient
Sensitive to Others
Empathic
Communication disorder Specialists
Audiologist
Speech-Language-Pathologist
Speech, Language, & Hearing
Scientists
Professional Aides
what do audiologists do
Measure Hearing Ability
Identify, assess, manage, and prevent disorders of hearing
and balance
Evaluate and assist those with auditory processing disorders
(APD)
Select, fit, and dispense hearing aids and other amplification
devices
where do audiologist work
Educational Settings
Clinics and Hospitals
Government Agencies
Industry
Private Practice
audiologist credentials
Beginning in 2012: Doctorate
After formal training: additional clinical training
Pass National Exam
ASHA CCC-A
State Licensed
services provided by an SLP
Prevention, assessment, treatment and
counseling for disorders of speech (fluency,
(articulation, voice, resonance) and language.
Dysphagia
Aphasia/TBI/Alzheimer’s Disease
Establishing alternative and augmentative
communication systems
Aural Rehabilitation
Referral to other Professionals
Family Education and Counseling
Modify a regional or foreign dialect
where the services are provided
Schools
Hospitals
Clinics
Early Intervention
Rehabilitation Centers
Governmental agencies
Nursing Care Facilities
Research Laboratories
Private Practice
Colleges
American Speech Language hearing association (ASHA)
Credentialing organization
Standards for professional practice and ethical conduct
Publishes professional journals
Accreditation standards for colleges and universities
Certification for individuals practicing the professions
ASHA promotes scientific study, quality of services, high
ethical standards and advocacy for those with communication
disorders.
National Student Speech Language Hearing association (NSSLHA)
NSSLHA is the national organization for graduate and
undergraduate students interested in the study of normal &
disordered human communication. NSSLHA operates on the
national and local level.
Graduate and Undergraduate Students
Access to Professional Journals
SLP Credentials
Bachelor’s Degree- with prerequisite courses in Speech-Language
Pathology; and including one social science, one physical science, one
biological science, and one Math course
400 Supervised Clinical Experience Hours- received while in graduate
school
Master’s Degree- In Speech-Language Pathology
Clinical Fellowship Year (CFY)- paid work as an SLP for 9- 12 mos. after
you are awarded your Master’s degree- supervised under someone with
their ASHA certification
Passing Score on Praxis in Speech-Language-Pathology
License in State of Employment (note: NY state’s license requirements
are very similar to ASHA’s requirements. If you graduated from an ASHA
accredited university/ college, you will have met most of the references
ASHA CCC-SLP- when you have completed your CFY, you
apply both for your state licensure, as well as for your ASHA
certification. Once both are approved, you sign your name on
all speech-language reports as: “Signature”, M.A. (or M.S.),
CCC-SLP
◦ My signature reads as: Mary K. Boylan, M.A. CCCSLP
◦
Continuing Education Units (CEUs)- once you are
licensed/certified by the state and ASHA, you are required to
maintain your license by taking continuing education
workshops. Every 3 years you must have 30 hours of CEUs.
This is an important aspect of our profession as therapy
methods and diagnostic measures are constantly changing.
Working with Children
If you are interested in working with children, you may find
yourself working either directly or indirectly through the
Board of Ed. You might either work at a school that receives
its funding through the Dept. of Education, or you might work
for an agency (or privately) and have children whose speechlanguage services are paid for by the Dept. of Education. Most
cases of children age three and older receive their funding
this way.
If you want to work with children and their funding comes
from the Dept. of Education, you must have an additional
license (teaching license) to work with them.
TSSLD
Completion of a NYS Registered Program - Speech And
Language Disabilities- Master’s Degree
New York State Teacher Certification Exam - Liberal Arts &
Science Test (LAST)- Old Exam and the current exam is called
ACADEMIC LITERACY SKILLS TEST
New York State Teacher Certification Exam - Elementary
Assessment of Teaching Skills (ATS-W)- Old Exam and the
Current exam is called EDUCATING ALL STUDENTS TEST
New York State Teacher Certification Exam - Speech-Language
Pathology (PRAXIS II)- taken after completing graduate program
(see link under SLP licensure requirements in previous slide
Coursework in education
Speech, Language, Hearing scientis
Usually have a doctoral degree
Work in universities, governmental agencies, industry,
research centers, and clinics
Extend knowledge of human communication processes and
disorders.
Speech Scientist
Language Scientist
Hearing Scientist
Professional Aides
Titles Vary
-Paraprofessionals
-SLPAs
Audiology assistants
SLPAs may perform screenings, do clerical work, assist in
preparation of materials.
Audiology aides may perform screenings, calibrate
instruments, do clerical work.
Aides work ONLY with supervision.
Related Professions
Team Approach
Family Members
Speech-Language-Pathologists
Regular & Special Educators
Psychologist
Social Workers
Occupational and Physical Therapists
Doctors and other medical professionals
Music Therapists
Physicists
Engineers
Audiologists
Services Through Life Span
Infants and Toddlers
-Screening important: About 2% have some disability
-Hearing loss most prevalent
-Developmental Delays, physical problems
-Feeding Issues
-Early Intervention (EI) & Individualized Family Service Plan
(IFSP)
PreSchoolers
-Communication of services or identification of new children
-Committee of PreSchool Special Education (CPSE)
School-age
-Full range of communication/swallowing issues
-Communication disorders often impact education
Young adults/other individuals
-Traumatic brain injury-bike/motorcycle/car/accidents/falls
-Rehabilitative efforts
Over age 65:
-Stroke, dementia, neurological disorders
-Communication and swallowing abilities may be affected.
-25% may have hearing loss requiring assessment and treatment
-Strive to improve quality of life.
Evidence-Based Pratice
Clinical Decision Making
-Scientific Evidence
-Clinical Evidence
-Client Needs
Efficacy-ideal conditions
Effectiveness-average conditions
Efficiency-quick, effective methods bring about greatest
positive change.
Efficacy
Ideal Conditions
Effectiveness-
Average Conditions
Efficiency
quick, effective methods bring about greatest
positive change
ASHA Code of Ethics
The welfare of persons served by communication disorders
specialist is held paramount
Each professional must achieve and maintain the highest level
of professional competence
Professionals must promote understanding and provide
accurate information to the public
Professionals are responsible for assuring that ethical
standards are maintained
Select legistions
1973: Section 504 of the Vocational Rehabilitation Act (PL93-
112)
1975: Education of All Handicapped Children Act (PL94-142)
1990: Individuals with Disabilities Education Act (IDEA)
1990: Americans with Disabilities Act (ADA)
2004: Individuals with Disabilities Education Improvement Act
(IDEIA)
How many cranial nerves are involved in speech?
5 but 7 if you count swallowing
Early intervention
Services are provided from birth to 5 years old and then to 21
speech
Spoken language or verbal communication
System in which meanings are communicated through a pattern of movements generated by the speech mechanism and a measureable pattern of acoustic vibrations.
Requires very precise neuromuscular coordination.
Speech Inclides
Articulation
Prosody
Pitch
Intonation
Fluency-rhythm and rate of speech
what makes up the speech mechanism
RESPIRATORY SYSTEM
LARYNEGEAL SYSTEM
ARTICULATORY/RESONATING SYSTEM which includes the SUPRALARYNGEAL (Pharyngeal- oral-nasal cavities).
Language
Socially shared code or conventional system for representing concepts through arbitrary symbols and rule-governed combinations of those symbols.
Language is arbitrary, creative and learned.
Languages evolve.
Primary vehicle for communication
Can be spoken or manual (American Sign Language)
Generative system
Language is a generative system-it is a creative/productive tool.
-Finite set of rules and symbols allow us to produce and infinite number of novel utterances.
-Words can refer to more than one thing
-Things can be called more than one name
-Words can be combined in a variety of ways
rules of language
form: syntax, morphology and phonology
content : semantics
use: pragmatics
5 aspects of language
Phonology
-Distributional Rules
-Sequencing Rules
Morphology
-Free Morphemes
-Bound Morphemes
-Inflectional Morphemes
-Derivational Morphemes
Syntax
Semantics
Pragmatics
Form
Elements that connect sounds and symbols with meaning.
Rules that govern phonology, morphology and syntax
Phoneme
PHONEME-smallest linguistic unit of sound that signals a difference in meaning
(ie /m/at, /p/at, /b/at)
allophome
ALLOPHONE-a specific production of a phoneme belongs to the same sound family , and does not change the meaning of a word.
Phonemes are classified:
-Acoustic Properties, Articulatory Properties and Manner of Articulation
phonological processes
SYLLABLE STRUCTURE PROCESS
ASSIMILATION
BACKING
SYLLABLE STRUCTURE PROCESS
SYLLABLE STRUCTURE PROCESS: delete one or more phonemes in a consonant cluster-Cluster Reduction (ie top it for stop it) or Final Consonant Deletion (ie. “ba” for bat)
ASSIMILATION
ASSIMILATION-one sound has influenced the other (ie. “goggy” for doggy)
BACKING
BACKING-make a sound in the back of the mouth when it is suppose to be make in the front of the mouth. (ie. TOP –child will say COP) or FRONTING- where child will make a sound in the front of the mouth when it is suppose to be made in the back (ie COP-child will say TOP)
Morphology
Morphology is a set of rules that govern words
MORPHEME
MORPHEME-the smallest linguistic unit with meaning that can’t be broken down and still have meaning.
FREE MORPHEMES-
FREE MORPHEMES-when a morpheme stands by itself (ie. Car, boy).
BOUND MORPHEMES-
BOUND MORPHEMES-cannot stand alone and is always attached to a free morpheme
BOUND MORPHEMES can be attached by prefixes and suffixes
ie. Biggest (2 morphemes)-superlative morpheme means most
ie. Cooked (2 morphemes)- ed means past tense
Morphemes deal with numbers (ie. Cat/s)
ie. Joan’s (2 morphemes) –possessive morpheme
Derivational morphome
Includes both suffixes and prefixes
changes whole classes of words
creates a new meaning of the word
inflectional morpheme
morpheme that serves a purely grammatical function never creating a new word. only a different form of the same word (past tense, plural).
mean length of utterance
MLU-measure of language development based on average number of morphemes per utterance
4. Why the man sitting 5 morphemes
ADD NUMBER OF MORPHEMES AND DIVIDE BY THE NUMBER OF UTTERANCES
Syntax
Rules which govern the organization of sentences, word order and different types of sentences
Sentence Organization, which combinations are acceptable and which ones are not
(ie. “The boy hit the ball” vs. “Ball the hit boy the”)
Each sentence contains Noun Phrase and Verb Phrase.
Transformational Rules:
Transformational Rules: allows us to change basic sentences into a variety of sentence types
variety of sentence types
Declarative Sentence: THE GIRL HIT THE BOY.
Negative Sentence: THE GIRL DID NOT HIT THE BOY.
Passive Sentence: THE BOY WAS HIT BY THE GIRL.
Interrogative Sentence: DID THE GIRL HIT THE BOY
Compound Sentence: THE BOY CRIED AND THE GIRL WAS HAPPY
prescriptive grammar
A set of rules how a language should be spoken.
It refers to the notion that there is one way of speaking a language.
Dictates a particular standard of grammar.
Descriptive grammar
Description of actual patterns (syntactic system rules) used in speaking.
does not judge the appropriateness of grammar, but simply states the rules used to produce language.
world knowledge
Refers to an individual’s auto biographical and experiential understanding and memory of particular events reflecting cultural and personal interpretations
word knowledge
Verbal word and symbol definitions
Usually based on world knowledge
concept development
VALIDITY
STATUS
ACCESSIBILITY
linguistic competence
Knowledge of the rules for generating and understanding conventional linguistic forms- morphology, phonology etc.
comminicative competence
Degree of success when communicating, measured by appropriateness of the message
pragmatics
Social Rules of Language Knowledge of Social Appropriateness
*EYE CONTACT
*TURN TAKING
*TOPIC MAINTENANCE
*TOPIC INITIATION
*CONVERSATIONAL TURN-TAKING
Paralinguistic Information/ Suprasegmentals-
It’s not only the words you say, but how they are said that can convey a message. It can change the form and meaning of the message. Without paralinguistic information added to a message, we would sound robotic when we speak.
Nonlinguistic Information-
We utilize nonlinguistic cues, such as body language and facial expressions, which add to the “affect” that a person demonstrates
Metalinguistic Cues-
ability to think about language, talk about it, and analyze it- use this in humor, sarcasm
Intonation
Intonation- When we make a statement our intonation drops at the end of the sentence. When we ask a question, it rises. You can take the same exact words, and by changing the intonation at the end of the sentence, the meaning changes. Say
NON-VERBAL COMMUNICATION
Eye Contact
*Facial Expressions
*Gestures
*Hearing Acuity
*Kinesics
*Proxemics
*Chronemics
*Tactile
*Artifacts
Cultural identity
We are all members of a larger community that make up our cultural identity
*Speakers and Listeners who share a common language and culture have the capacity for “optimum” communication.
*Speakers and listeners must share competence in a common language if they are to communicate fully.
Toddler language development
Focus of language is on language function: serves pragmatic purpose.
*First words occur at approximately 12- months of age
*Early language development is characterized by single word utterances and by early multiword combinations
*Primarily nouns
*Multiword utterances are rule based
*First words fill the intentions previously served by gestures and or vocalizations
PRESCHOOL LANGUAGE development
By kindergarten has learned 90 percent of the syntax, morphology, and phonology that she will use as an adult
*New words are added to lexicon at the rate of two or three per day
Preschool language development
Developmental focus on language form
*Language form follows function
*Paralinguistic information incorporated into utterances.
*Syntactic complexity increasing.
School age development
Growth in all aspects of language
*Changes slower
*Emphasis on language shifts to written language
*Acquire derivational morphology
*Figurate language develops
*Increase in syntactic complexity
*Pragmatically-turn-taking for longer periods of time, topic changes less abrupt.
Newborn
Most is reflexive
*Most common sounds are cries and partial vowel sounds
*Cries become differentiated by the end of the first month
2-3 month
Cooing
*Produces back consonants and middle and back vowel sounds
4-6 months
Babbling- prolongedc periods of vocalization and strings of sounds
*Lip sounds p,b,w,m
6-10 months
Reduplicated babbling – repetitive syllable production
*More closely approximates mature speech
*Baba mama wawa
11-14 months
Phonetically consistent forms
*Variegated babbling
*Jargon speech
*First words
Communication impairment
ASHA: Disorders of speech (articulation, voice, fluency, resonance), orofacial, myofunctional patterns, language, swallowing, cognitive communication, hearing and balance.
*Reading, writing, and manual communication systems are included.
*Variations in communication are not impairments.
*Dialects: Differences that reflect regional, social, cultural, or ethnic identity.
Etiology
Means of classifying communication disorders.
*Etiology: Cause/Origin
*Time at which disorder occurs
Congenital
Congenital: Present at birth
Acquired
Acquired: Result of illness, accident, or environmental circumstances later in life.
Severity
Severity: Range from mild to profound
Language disorders examples
Disorders of Form (examples):
*-Phonology-not producing word endings
*-Morphology-incorrect use of past tense
*-Syntax-incorrect word order
*Disorders of Content (Semantics): (examples):
*-Limited vocabulary, difficulty understanding abstract language.
*Disorders of Use (Pragmatics): (examples):
*-Difficulty staying on topic, inappropriate responses, interrupting conversational partners
Dysarthria
Dysarthria-cause by paralysis, weakness, poor coordination
Apraxia
*-Apraxia-Neuromotor programming difficulties.
Disorders of fluency
Disorders of Fluency
*-Developmental disfluency: Young children
*Speech behaviors: hesitations, repetitions, prolongations, fillers
*Stuttering: when speech behaviors exceed or are different from the norm, accompanied by struggle or tension.
*Noticed around 6 years old.
*Causes are generally unknown.
Disorder of voice
Disorders of Voice
*Vocal abuse can result in hoarsness
*Disease, trauma, allergies, neuromuscular or endocrine disorders
Deafness
Deafness
*-Primary sensory input for communication is not auditory
*-Interventions: Total communication (sign, speech, speechreading) Assistive listening devices, cochlear implants, auditory training.
Hard of hearing
*Hard of Hearing
*-Depend primarily on audition for communication.
*-Temporary or Permanent
*-Categorized by severity, laterality, and type
*-Mild to severe
*-Bilateral or unilateral
*-Conductive, Sensorineural, or Mixed
*Auditory Processing Disorders (APD)
*-Normal hearing but difficulty understanding speech
Prevalence in USA
Most communication disorder are secondary to Other disabilities.
*Prevalence
*Number/percentage of people within a population who have a particular disorder at a given time. Examples
*-17% of Americans have a communication disorder.
*-11% have a hearing loss
*-6% have a speech, voice, or language disorder.
Conductive hearing loss
In the Middle and outer ear
Sensorineural hearing loss
In the inner ear
Mixed hearing loss
A mix of outer, middle and inner ear
Anatomy:
Anatomy: Study of structures of the body and relationship of the structures
Physiology:
Study of the functions of organisms and bodily structures
Three physiological subsystems are involved in speech production
Respiratory: Driving force for speech via positive air pressure beneath vocal folds
Laryngeal: Vocal fold vibrate at high speeds
Articulatory/resonatory: An acoustic filter that allows certain frequencies to pass while blocking others
The Respiratory System
Primary biological functions
Supply oxygen to the blood
Remove excess carbon dioxide
Also the generating source for speech production
Lungs:
Pair of air-filled elastic sacs that change in size and shape and allow us to breathe
Trachea:
Air moves into the lungs via the trachea and branches into bronchi
Structures of the Respiratory System
Pulmonary apparatus
Lungs: Pair of air-filled elastic sacs that change in size and shape and allow us to breathe
Trachea: Air moves into the lungs via the trachea and branches into bronchi
Pulmonary airways
Chest wall (thorax)
Rib cage
Abdominal wall
Abdominal content
Diaphragm
Muscles of the Respiratory System
Inspiratory muscles – generally above the diaphragm
Expiratory muscles – generally below the diaphragm
Muscles of Inspiration
Diaphragm
Principle muscle of inspiration
Dome-shaped structure composed of a thin, flat, nonelastic central tendon and broad rim of muscle fibers that radiate to the edges of the central tendon
Contracts during inspiration, pulling down and forward, increasing lung volume
Numerous thoracic and neck muscles also contribute
Muscles of Expiration
Most important muscles of expiration are located in the front and sides of the abdomen
Assist the diaphragm’s movement back to its relaxed, dome-shape
Other muscles may be used depending on body position, pathological state, and environmental conditions
Resting tidal breathing
Breathing to sustain life
Duration of inspiration and expiration is relatively equal
Inspiration
Diaphragm contracts, rib cage and lungs expand, lung volume increases and alveolar pressure drops
Causes air to rush in and equalize with atmospheric pressure
Expiration
Decrease in the size of the rib cage wall, compression of the lungs, increase in pressure in the lungs, air rushes out to achieve equilibrium with atmospheric pressure
Does not require active muscle contraction
A respiratory cycle is one inhalation and one exhalation
Speech breathing
Contraction of diaphragm leads to rapid, forceful inspirations
Inspirations are much shorter than expirations
The amount of air inspired is greater than during resting tidal breathing
Inspiratory and expiratory muscles are both activated during speech
Lifespan Issues of the Respiratory System
Resting tidal breathing rate decreases from birth to adulthood
More alveoli
Maximum lung capacity is reached in early adulthood
Constant until middle age
Respiratory function is affected by exercise, health, and smoking
Larynx
Air valve composed of cartilages, muscles, and other tissue
Main sound generator for speech
Sits on top of the trachea and opens into the pharynx
Appears to be suspended from the hyoid bone, the point of attachment for laryngeal and tongue muscles
The Laryngeal System
Primary biological function of the larynx
Prevent foreign objects from entering the trachea and lungs
Larynx can impound air for forceful expulsion of foreign objects threatening lower airways
Structures of the Laryngeal System
Thyroid cartilage
Largest laryngeal cartilage
Forms the front and sides of the laryngeal skeleton and protects the inner components of the larynx
Thyroid prominence
“Adam’s apple”; just below the thyroid notch
Vocal folds
Attached at the front near the midline of the thyroid cartilage and at the back to the arytenoid cartilages via the vocal ligament
Abduct during respiration and adduct during phonation
Glottis
The space between the vocal folds
Thyroarytenoid muscle
Bulk of each vocal fold
Contraction shortens and thickens the vocal folds
Cricoarytenoid muscle
Stiffens and lengthens the vocal folds, increases pitch
Lateral cricoarytenoid and arytenoid muscles
Contraction results in vocal fold adduction
Posterior cricoarytenoid muscle
Primary muscle of vocal fold abduction
Lifespan Issues of the Laryngeal System
Larynx is small and high in the neck in newborns
Reaches final position between 10 and 20 years of age
Laryngeal cartilages increase in size and become less pliable
Vocal folds increase in length differentially for males and females
29 mm for males; 21 mm for females
Female laryngeal cartilage never completely ossifies
Vocal folds atrophy and lose elasticity with age
Men notice increase in pitch with advancing age
Women experience decreased pitch with the contribution of hormone-related changes
The Articulatory/Resonating System
Composed of
Oral cavity
Nasal cavity
Pharyngeal cavity
Vocal tract is a resonant acoustic tube
Shapes sound energy produced by respiratory and laryngeal systems into speech sounds
Mandible articulates with the temporal bone by the
Mandible articulates with the temporal bone by the temporomandibular joint
Structures of the Articulatory/Resonating System
22 bones in the facial skeleton and cranium
Mandible articulates with the temporal bone by the temporomandibular joint
Teeth
Tongue
Teeth
Adults have 32 teeth within alveolar processes of the mandible and maxilla
Hard palate is composed of the horizontal bones of the maxilla
Tongue
Muscular hydrostat
Structural support through contraction of muscles and has a soft skeleton of connective tissue
Velum
Also called the soft palate
Located in the pharynx
Uvula: Termination of the velum
Velopharyngeal closure
Contact of the velum with the lateral and posterior pharyngeal walls
Velar elevation
Necessary to prevent air or food escaping through the nose
Necessary to build up air pressure for production of pressure sounds
Air that escapes through the nose during speech results in a nasal quality
Lifespan Issues of the Articulatory/Resonating System
Bones of the skull reach adult size by about age 8
Newborns have 45 separate skull bones that fuse into 22 at adulthood
Lower facial bones reach adult size at about 18 years
Dentition emerges at about 6 months and is complete around 3 years
Secondary dentition is complete around 18 years
A newborn’s tongue occupies most of the oral cavity
Tongue reaches adult size by about 16 years of age
By 2 months of age, infants can inconsistently close the velopharynx for syllable productions
Consistent between 6 mos and 3 yrs
Aging has minimal impact on velopharyngeal function for speech
Length and volume of oral cavity increases
Influences the overall resonant characteristics
Lowers the frequencies at which the vocal tract naturally resonates
Fundamental frequency
Fundamental frequency: Number of cycles of vocal fold vibration per second
Harmonics
Harmonics:
Whole number multiples of the fundamental frequency
The Speech Production Process
Begins with phonation
Air pressure builds up beneath adducted vocal folds (alveolar pressure)
Air pressure from below displaces the lower edges of each vocal fold laterally
Followed by lateral displacement of the upper edges
Elastic properties results in vocal folds colliding
Fundamental frequency: Number of cycles of vocal fold vibration per second
Harmonics: Whole number multiples of the fundamental frequency
Movement of the tongue, lips, and larynx change the shape of the vocal tract and modify sound
Anterior view of the vocal folds
Anterior view of the vocal folds during one cycle of vibration. Air from the lungs creates pressure beneath the vocal folds (1, 2, and 3). This pressure causes the vocal folds to separate (4). The natural elastic restoring forces of the vocal folds and the time delay with respect to the upper and lower portions of the vocal folds causes the vocal folds to begin to close (5 and 6). The vocal folds close the glottis to end the cycle, and the next cycle begins (7).
Early intervention
0-3 years old
CPSE 3-5 years old