midterm Flashcards
sensitivity
ability of the assessment to accurately identify children who HAVE speech sound difficulties
specificity
ability of assessment to accurately identify children who do NOT have speech sound difficulties
norm-referenced
Compare performance against normative samples to determine whether child is typical or delayed.
Criterion-referenced
Measures ability to produce a target skill
Does not compare to performance of other children
The most important articulator in the production of speech
tongue
What is the primary purpose of the tongue in speech?
changes the shape of the oral cavity
Restricts or stops airflow to produce the majority of our consonants and vowels
Ankyloglossia
aka “tongue tie”
an abnormally short, thickened, or tight lingual frenulum
~ 4–10% of population
Macroglossia
Large tongue
Can be associated with speech difficulties
Associated with individuals with Down syndrome
Bifid tongue
Tongue with 2 points
Feature of oro-facial digital syndrome, Mohr’s syndrome, & Klippel-Feil syndrome
Speech is typically intelligible, but may have distorted s, z
Glossectomy
Tongue is surgically removed (often as a result of cancer)
Speech can be intelligible through the use of compensatory strategies
cleft lip
Unilateral vs. bilateral
Complete vs. incomplete
Can be associated with cleft palate
Mandible
Supports many speech sounds by supporting the movement of the lower lip and tongue
Important in the earliest phases of speech
Occlusion
Alignment of teeth in the upper and lower jaws
Class I malocclusion
Bite is relatively correct
teeth, however, are crowded, crooked, or rotated
Class II malocclusion
“overjet” or “overbite”
Class III malocclusion
underbite
hard palate
roof of mouth
closer to teeth
Cleft palate
Can be hard and or soft palate
Difficulties with feeding and speech
Consonants that require “pressure build-up” may be impacted
Submucous cleft
“hidden” cleft palate
Tissue covers the cleft
Can have difficulties with speech sounds similar to overt cleft palate
can cause hyper-nasal speech
raised soft palate is necessary for what sounds
non-nasals
Soft Palate Cleft
hypernasality
nasal emissions
not good velopharyngeal
bifid uvula
uvula split in half
typically not associated with speech difficulties
Pharynx
Connects and extends from the nasal cavity to the esophagus
Destination for the velum during velopharyngeal closure
To produce oral consonants & vowels
Larynx
AKA vocal folds
Site of the production of voicing
prevents food/fluid from getting in lungs
vocalization
motor planning
providing instructions to the ARTICULATORS on which to activate and when
Motor programming
Specifies which MUSCLES will be used to carry out the motor plan
Motor execution
Physical production of programmed movements
Phonological planning
Selecting and sequencing the right combination of phonemes
~ 0 – 1 Year: Perception
Babies only a few days old can perceive differences in phonemes
Reflexive vocalizations (_ to _ months)
vegetative sounds (cry, cough, burp, laugh), sustained crying/fussing, grunt like sounds
Control of phonation (_ to _ months):
vowel-like sounds and consonant-like segments (raspberries, clicks, isolated consonant)
Expansion (_ to _ months):
isolated vowels, 2 vowels in a row, vowel glide, squeals, marginal babbling (lack regular syllable timing)
Basic canonical syllables (_ to _ months):
5 to 10 mo
single consonant-vowel syllable, canonical babbling, consonant-vowel combination followed by consonant (CV-C) and disyllables (CVCV)
Advanced forms (_ to _ months):
complex syllables (VC, CCV, CCVC), jargon, diphthongs.
PCC ~__% at 2;0
70%
development ~ 1 – 2 Years
First 50 words (up to ~ 18 months):
Small phonetic repertoire [anterior stops, nasals, glides, neutral vowels (low, non-rounded)]
/p, b, d, t, m, n, w/
Most consonants in syllable-initial position
Final consonants omitted or followed by a vowel
Simple syllable structures (CV, VC, CVC, CVCV)
Tend to simplify words
Reduplication, final consonant deletion, cluster reduction
2-year-olds are intelligible at least __% (more often with their parents)
50
age of acquisition
the age at which a certain percentage (often 75% or 90%) of children have acquired a phoneme in initial, medial, and final position in single words.
sounds acquired by age 2 (7)
p, b, d, m, n, h, w
sounds acquired by 3 (6)
t, k, g, ng, f, y
sounds acquired by 4 (7)
v, s, z, sh, ch, j, l
sounds acquired by 5 (3)
th (voiced), zh, r
sounds acquired by 6 (1)
th (voiceless)
Age of Acquisition – Consonant Clusters
May start ~ 2 years of age
PCC = 29.5% (mean)
By 3;0
range of word-initial clusters predominantly containing /l/, /w/ or /s/.
Common word-final clusters contained nasals (e.g., [-nd, -nt])
By 4;0
Near 90% PCC
By 5;0
Near 95% PCC
discreet individual vowels (in monosyllabic words) are generally mastered by age ___
3
Vowels in context (e.g., stressed and unstressed vowels in polysyllables) take at least __ years to master
6
three broad categories of phonological processes
Syllable structure processes
Substitution processes
Assimilatory processes
Syllable structure processes (3)
the repetition, deletion, or reduction of an entire syllable,
the deletion or reduction of consonants in a syllable, or
a change to the order of the sounds within a syllable.
Structural processes (5) that simplify syllables
Weak Syllable Deletion (WSD)
Cluster Reduction (CR)
Epenthesis
Final Consonant Deletion (FCD)
Reduplication
epenthesis
When a sound is added between two consonants, typically the “uh” sound
substitution processes (6)
Stopping
Fronting
Backing
Deaffrication
Gliding
Vocalization (vowelization)
stopping
affects fricatives and affricates
fronting
Consonants get moved to a position more anterior in the mouth especially velars, and some palatals
place change only
backing
Place of articulation of a consonant gets moved further back in the mouth
replacing a non-velar/non-glottal with a velar/glottal sound
Deaffrication
removing the stop portion of an affricate, making it a fricative
ex. tʃ to ʃ
gliding
Substitution of a glide [j] or [w] in place of a liquid /r/ or /l/
Vocalization
when /l/, /er/ or /3r/ is replaced by a more neutral vowel
Assimilatory Processes
A change in phoneme production due to a phonetic environment
It can be labial, velar, nasal and/or voicing assimilation
That is: A substitution occurs because of the influence of the _______ of articulation of a sound that occurs elsewhere in a word
PLACE
“consonant harmony
the assimilated consonant becomes the same as the influencing sound
Example: man /mæm/ take /keik/
context sensitive voicing (2)
can be ‘prevocalic voicing’ or ‘word final devoicing’
Prevocalic voicing
Consonant preceding a vowel is voiced (initial consonant typically):
/kæp/ [gæp] /pæd/ - [bæd]
Word final devoicing
last voiced consonant is devoiced:
/bed/ – [bet] /web/ – [wep]
the cause of articulation and phonological speech sound disorders in most children is _________
unknown
two categories of SSD’s
motor speech
phonology
two phonology SSD’s
phonological impairment
inconsistent speech disorder
three motor speech SSD’s
articulation disorder
childhood dysarthria
CAS
Phonological Impairment
Motorically able to produce the sound but cant
A cognitive-linguistic difficulty with learning the phonological system of a language
- characterized by pattern-based speech errors.
Phonological Disorders
“Atypical” patterns
Deaffrication
Initial Consonant Deletion
Backing
Denasalization
Palatalization
Lisping
Nasalization
Phonological Delay
“Typical” patterns
Cluster Reduction
Gliding
Stopping
Fronting
Weak Syllable Deletion
Assimilation
Final Consonant Deletion
inconsistent speech disorder
Impaired phonological planning (i.e., difficulty selecting and sequencing phonemes for words) without accompanying oro-motor difficulties.
characterized by inconsistent productions of the same word.
articulation impairment
A motor speech difficulty involving the physical production (articulation) of specific speech sounds
Most often r- and s- like sounds
/ɹ, ɝ, ɚ/ and /s, z ʃ, ʒ/
Could be functional or organic
Organic = known etiology
Functional = no known cause
SODA Analysis stands for
substitution
omission
distortion
addition
CAS
Impairment in planning and programming movement sequences impacting speech segments and prosody.
childhood dysarthria
Weakness, slowness, or incoordination of speech movements impacting speech systems including respiration, phonations, resonance, and articulation.
Components of Children’s Speech Assessments (6)
- case history
- intelligibility
- speech production
- speech perception
- oral structure/function & hearing
- other
intelligibility assessments (3)
PCC
% intelligibility
rating scales
how to assess single words elicitation (artic vs phonology vs both)
artic - Arizona-3 and GFTA-3
phonology - HAPP-3
both - CAAP and DEAP
how to assess Connected speech elicitation (4)
Conversations during play
Narrative retell
Picture description
Sentence repetition
What is the minimum size of an adequate sample?
100 WORDS
Stimulability assessment determines what
CAN THE CHILD PRODUCE AN ERROR SOUND WHEN CONTEXT IS SIMPLIFIED
how to test stimulability
List consonants that are absent from child’s inventory
Provide auditory and visual models, as well as instructions regarding PMV if necessary
Start at lowest linguistic level
Stick to a single position (e.g., initial only) OR do each level in each position of relevance (initial, final, &/or medial)
Do 3 trials at each level
which standardized test measures inconsistency
DEAP
“My child’s speech sounds slurry. Some sounds are hard to say, and people find it hard to understand him. The weakness in his mouth also makes it difficult for him to chew and swallow.”
dysarthria
“Some people find my child difficult to understand. He is having difficulty putting the ends on words and saying sounds like ‘c,’ ‘k,’ ‘g’” (i.e., patterns of errors
phonological impairment
“My child is having difficulty saying the sounds ‘s’ and ‘r.’ He has a lisp.”
artic error
“My child is hard to understand. Every time he says the same word he pronounces it differently.”
inconsistent speech
“My child is very difficult to understand. He has difficulty moving his tongue within his mouth when I tell him to do so.”
CAS
Independent Analyses (2)
Phonetic inventory
Syllable shapes (e.g., CV, VC, CVC, etc.)
Relational Analyses (5)
Provide a description of the child’s errors in relation to the adult target
Focus on errors in the sample
Examples of relational analyses
SODA (substitution, omission, distortion, addition)
PMV (place-manner-voice)
Phonological Analysis (rule-based)
Phoneme collapse analysis
Percentage of consonants correct (PCC)
suspected phonological impairment - what assessments and analyses
ASSESSMENTS
Comprehensive single-word speech sample from a standardized phonology test.
Connected speech assessment: targeting specific areas of difficulty (e.g., consonant clusters, fricatives, affricates, liquids).
Informal probes of patterns of errors (e.g., fronting, stopping, cluster reduction).
Speech perception ability (e.g., percent correctly identified target sounds given an array of correct, incorrect, and other sounds).
ANALYSES
Independent phonological analysis:
Phonetic inventory
Syllable shapes
Relational phonological analyses:
PCC
PMV
Phonological Process Analysis
Phoneme collapse analysis
suspected inconsistent speech disorder - what assessments and analyses
ASSESSMENTS
Inconsistency assessment (e.g., subtest on DEAP)
Assessment of the same words in imitated and spontaneous speech contexts
Stimulability testing of any consonants not present
ANALYSES
Independent phonological analysis:
Phonetic inventory
Syllable shapes
Relational phonological analyses:
Calculate percent inconsistency to determine whether the child’s repeated productions of single words show ≥ 40% variability
suspected artic impairment - what assessments and analyses
ASSESSMENTS
Single-word standardized articulation assessment: which consonants/any phonotactic constraints?
Informal probes of consonants in error
Connected speech assessment (consider impact on intelligibility)
ANALYSES
SODA analysis
if suspected CAS - what assessments and analyses
ASSESSMENTS
Comprehensive single-word assessment
Informal assessment of words of increasing length (e.g., but, butter, butterfly).
Assessment of the words in imitated vs. spontaneous speech
Connected speech assessment (attention to intelligibility and prosody)
Stimulability testing
Oral structure and function
ANALYSES
Independent phonological analysis:
Phonetic inventory
Syllable shapes
Stress patterns
Relational phonological analyses:
PCC
measures of accuracy of prosody
phonological process analysis
if suspected childhood dysarthria - what assessments and analyses
ASSESSMENTS
Single-word sample from a standardized test.
Informal probe of specific speech sounds in error.
Intelligibility test
Connected speech assessment (take note of respiration, phonation, prosody, voice, intelligibility, and acceptability.
Stimulability testing
Oral structure & Function
ANALYSES
Independent phonological analysis:
Phonetic inventory
Syllable shapes
Stress patterns
Relational phonological analyses:
PCC
measures of accuracy of prosody
Speech intelligibility
phoneme collapse
When a child uses a single consonant sound in place of other consonant sounds
