lecture 3: SSD classification systems Flashcards

1
Q

SSD is an umbrella term. explain what this means

A

includes linguistically-based difficulties (ie phonological) + production-related articulation disorders (ie phonetic)

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2
Q

T or F: SSD = heterogeneous group, differs in surface speech error patterns, severity, etiology and presence/absence of language impairment

A

true

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3
Q

T or F: speech components are easier to identify than language components

A

false (language easier, ex: receptive, expressive, syntax etc)

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4
Q

what are the two main SSD classification systems?

A
  1. clinical inferential (dodd) – psycholinguistic
  2. medical-etiological (shriberg)
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5
Q

dodd: psycholinguistic/cognitive components of speech exist. what are these 3 components?

A
  1. input processing
  2. internal representation
  3. output processing
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6
Q

dodd: what are the 5 classifications?

A
  1. delayed phonological
  2. consistent deviant phonological disorder
  3. inconsistent deviant phonological disorder
  4. articulation disorder
  5. structural anomaly (miscellaneous)
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7
Q

dodd: describe the delayed phonological classification (2) + examples

A
  • speech errors that occur in normal development should stop after a certain age – if error continues after cutoff, this is delayed phono disorder
  • errors can be categorized into patterns
  • examples: cluster reduction, stopping, fronting
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8
Q

dodd, delayed phono: T or F: if you are not using a standardized test, you should still follow the test’s age cutoffs for phono processes

A

F – add 6 months

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9
Q

dodd: describe the consistent deviant phono classification (3) + examples

A
  • use of ATYPICAL phono patterns
  • imapired ability to organize phono info, follow phono rules, poor phono memory (cognitive-linguistic difficulty)
  • errors are consistent
  • examples: initial consonant del, stressed syllable del, backing
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10
Q

T or F: “disorder” suggests use of atypical processes but the use of only one atypical process can still be considered “delay”

A

F – even one atypical process = “disorder”

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11
Q

a) if the soft palate is contracted, does this mean it is open or closed?
b) is the soft palate open or closed during denasalization?
c) is denasalization a typical process?

A

a) closed when contracted – aka non-nasal sounds are produced
b) closed – aka client is constantly contracting
c) denasalization = atypical process

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12
Q

examples of phonological awareness? (3)

A

ability to segment sounds/syllables, join phonemes, rhyme etc

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13
Q

dodd, consistent deviation phono disorder: T or F: consistency is only measured on atypical processes

A
  • F – measured on any processes
  • ex: if child always calls soap “toap” (fronting) we measure the consistency of this, even though fronting is not atypical
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14
Q

what are the 12 atypical errors?

A

1) stressed syllable deletion
2) initial consonant deletion
3) epenthesis (at 3+ years of age)
4) sound preference patterns (ex: /h/ overused)
5) backing
6) glottal replacement of oral consonant
7) spirantization (stops replaced by fricatives)
8) unusual cluster reductions (ie dropping easier sound)
9) glides substituted by stops
10) denasalization or nasalization
11) metathesis (swapping order of sounds in a word)
12) palatalization (alveolar sounds replaced by palatal sounds)

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15
Q

which atypical processes have the most severe impacts on intelligibility and should be targeted in therapy first? (4)

A

1) stressed syllable deletion
2) initial consonant deletion
3) epenthesis
4) sound preference patterns (ex: /h/ overused)

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16
Q

characteristics of atypical processes? (4)

A
  • less likely to be outgrown without ix
  • more resistant to ix
  • more likely to lead to residual errors
  • present in <10% of population
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17
Q

a sound change would be considered atypical only if it could not be accounted for by a _______.

A
  • typical sound change (ex: assimilation)
  • example: dinosaur → ginosaur = atypical but pudding → pugging = maybe not due to the /ŋ/
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18
Q

T or F: atypical in one language may be typical in another

A

true

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19
Q

what are the 3 theoretical explanations for speech errors during acquisition of phonology?

A

1) auditory-perceptual explanation
2) linguistic explanations (optimality theory)
3) motor explanation (EPG data)

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20
Q

describe the auditory-perceptual explanation for speech errors (2)

A
  • for sounds you cannot see being produced (ex: /k, g/), we rely on hearing
  • fluctuating hearing loss (ex: due to otitis media w effusion) = loss of perceptual cues and may lead to more posterior tongue placement (backing)
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21
Q

describe the linguistic explanations (optimality theory) for speech errors (2)

A
  • markedness hierarchy (dorsal>labial>coronal>glottal)
  • backing involves adding a marked feature (+dorsal) which is atypical
  • note: no standardized tests are based on this theory
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22
Q

describe the motor explanation (EPG data) for speech errors (2)

A
  • target = /d/ but /g/ is heard if back of tongue is released last
  • at artic level, d/g contrast is maintained, just not perceived
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23
Q

dodd: describe the inconsistent deviant phono disorder classification (3) + examples

A
  • variable productions of same items but within same context (unstable phono system)
  • phono awareness is intact (issue with phono planning, ie phoneme selection and sequencing)
  • at least one atypical process is used
  • examples: target = butterfly, child says “chutterdy,” “butterfly,” “sunnerny”
24
Q

what is the cut off for inconsistency on the DEAP test? screener?

A
  • test: >40% on 25 items
  • screener: >50% on 10 items
25
Q

why do inconsistency tests include a buffer activity?

A
  • bc hypothesis is that this is a working memory issue
  • buffer activity stresses working memory (ie fresh chance at the target word)
26
Q

dodd: describe articulation disorders (2) + examples

A
  • inability to produce perceptually acceptable version of sound bc incorrect motor program has been learned
  • phono and cognitive-linguistic systems are intact
  • examples: /r/, /s/, /l/, or lisp (ONLY THESE!!!)
27
Q

T or F: artic disorders are considered higher-level phonetic problem i.e. motoric basis

A

F – lower-level

28
Q

T or F: artic distortions may be observed in both typically developing (TD) children and children with SSDs

A

true

29
Q

dodd: describe structural anomaly based speech errors (3) + examples

A
  • atypical physiological/anatomical development exists
  • phono and cognitive-linguistic systems are intact
  • concept: fix structure = fix intelligibility
  • examples: cleft lip/palate, hearing impairment
30
Q

dodd: childhood apraxia of speech was added to this model. describe CAS (3) + examples

A
  • neurological childhood SSD
  • precision + consistency of speech is affected despite no neuromuscular deficits
  • planning + programming of speech is affected
  • examples: wrong or equal stress, syllable separation, inconsistent productions
31
Q

how does differential diagnosis (DDx) relate to CAS?

A
  • inconsistent productions are characteristic of CAS
  • need to differentiate between inconsistent deviant phono disorder and CAS to ensure proper ix
32
Q

how can apraxia be cured?

A

apraxia cannot be cured

33
Q

how would we DDx between inconsistent deviant phono disorder and CAS? (2)

A
  • inconsistency ax (ex: DEAP) – IDPD would have inconsistency, CAS may or may not
  • oro-motor ax – IDPD would not have issues, CAS would
34
Q

who would be better at imitation than spontaneous speech, a child with inconsistent phono disorder or CAS?

A
  • inconsistent phono disorder better at imitation (helps memory)
  • CAS better at spontaneous speech (more rehearsed)
35
Q

what are 2 hallmarks of CAS?

A

1) articulatory groping (searching)
2) supra-segmental issues (ex: rhythm, stress, intonation)

36
Q

T or F: inconsistent phono disorder also has supra-segmental issues

A

F – none

37
Q

dodd: which SSD is most of the SLP caseload? least?

A
  • most: delayed phonological
  • least: inconsistent phono disorder
38
Q

which SSD is easiest to fix?

A

delayed phonological

39
Q

why is “buy bobby a puppy” a good sentence to have children who you suspect have CAS say?

A
  • no complex articulation
  • problems here = red flag
40
Q

what are the 3 classifications according to shriberg’s model?

A
  1. speech delay
  2. speech errors
  3. motor speech disorder
41
Q

shriberg: what are the 3 causes of speech delay?

A
  1. genetics
  2. otitis media w effusion
  3. psychosocial factors

note: only applies if >6 months behind age norm

42
Q

shriberg: what does the speech errors category encompass?

A

artic (/r, s, l/)

note: only applies if >7 years of age

43
Q

shriberg: what does the motor speech disorder category encompass? (3)

A
  1. apraxia
  2. dysarthria
  3. not otherwise specified
44
Q

shriberg: what is recommended for treating speech errors and motor speech disorders? what is the problem with what he recommends?

A
  • acoustic measures (ex: formants, pause markers)
  • not feasible for clinical use (ie time-consuming, complex)
45
Q

shriberg: what is meant by distal vs proximal causes? what about clinical typology?

A
  • distal cause: highest level etiological causes (genes, environment)
  • proximal cause: speech processes
  • clinical typology: behaviours
46
Q

classify the following level of breakdown: auditory-perceptual encoding

A

delayed phono

47
Q

classify the following level of breakdown: cognitive-linguistic rule extraction / phono memory issue

A

consistent phono

48
Q

classify the following level of breakdown: phonological planning issues / unstable selection

A

inconsistent phono

49
Q

classify the following level of breakdown: transcoding

A

CAS and artic

50
Q

classify the following level of breakdown: neuromotor implementation

A

dysarthria and artic

51
Q

shriberg: which classification makes up most of the SLP caseload? least?

A
  • most: speech sound delay
  • least: CAS (2.4%) and dysarthria (3.4%)
  • motor delay = 12%
52
Q

describe the “speech skills on a continuum of development” approach (3)

A
  • SSDs = difference, not disorder
  • SSDs = a continuum that children progress thru
  • errors = compensations that aim to provide more stability
53
Q

if kids progress thru SSDs naturally over time, why is speech-therapy still important?

A

because during those years of struggle, other effects like bullying and undermined social/academic development may occur

54
Q

what is the importance of response to intervention?

A

if client is not improving after intervention, need to change approach

55
Q

T or F: majority of teachers (N=48 grade 2 teachers) associated moderately intelligible speech with less behaviour and social problems as well as with increased expectations of school performance

A

false – more behaviour/social problems + reduced expectations

56
Q

T or F: childhood SSDs have major effects in adulthood including reduced likelihood of pursuing post-secondary education and increased delinquency

A

true