midterm 2 Flashcards
3 components of language with their parts
- Content: Meaning (lexicon, vocabulary, semantics)
- Form: Structure (morphology, phonology, syntax)
- Use: Communication (pragmatics)
Phonemes
unit of sound conveying meaning (p, b)
phonotatics
rules for combing phonemes into syllables and words
plural s sounds
added to the end of voiced consonants (z), voiceless (s)
e.g. of bound morphemes
plural -s or passed tense -ed (changes meaning and sometimes word class as well)
Mean length utterance (MLU)
100 consecutive utterances (total number of morphemes/total number of utterances)
2 types of meaning
denotative, and connotative
3 language stages for infant/toddler
- pre intentional (1-8 months)
- prelinguistic (8-18 months)
- emerging language (18-36 months)
Preschool language development stage
developing language stage (between 2-3 and 5 years of age)
pre intentional language
reflexive, vegetative sounds, vowel like sounds dominate
2 types pre linguistic language
- gestures
2. vocalizations (babbling: reduplicated and non) and (jargon)
3 stages of emerging language
- first words
- two word combinations
- simple sentences
MLU for developing language
> 2 but <5
by 3 years most children (5 things)
- use subject-verb-object (SVO) sentences
- negatives
- interrogative (questions)
- use some basic grammatical markers
- may over regularize
school aged language focus on 2 things (with 4 other stages)
- semantics (new words)
- pragmatics (context)
- higher order meaning (e.g. connotative meaning - figurative meaning, idioms, metaphors, jokes)
- discourse (conversation, narratives, persuasive)
- metalinguistic awareness (helps them start to read)
- Literacy Development
Literacy Development
oral comprehension –> reading comprehension
oral production –> writing expression
phonological awareness –> letter sounds
language disorder: language skills below…
environmental and norm references expectations
3 facts about language disorders
- quite common
- heterogeneous (often additional problems)
- enduring (continued difficulties)
- -> better long term outcomes for initial speech impairments than language impairments
- -> more favourable prognoses for specific LD than those secondary to other deficits
3 groups that need help in the pre intentional stage
- identified at birth for being at risk (e.g. drug exposure, premature, low birth weight, genetic disorder)
- infants in infancy (first year) as high risk (hearing impairment, global delay, autism, neglect)
- older children functioning at pre-intentional stage
4 factors for those that need help in the pre linguistic stage
- low rate of communicating
- limited inventory of speech sounds
- limited range of functions/purposes
- difficulties with receptive language
Emerging language - who needs help (3 groups, and 4 risk factors)
- fewer than 50 words
- no two word combinations
- risk factors (family history, learning problems, low SES, high parental concern)
Late talkers - delayed expressive language with all 5 of the following
- no risk factors
- normal play
- normal nonverbal communication
- normal receptive language
- some speech by 30 months
2 groups who need help in developing language stage
- children with developmental language disorders (SLI, intellectual impairment)
- children with other disorders (ASD, TBI, hearing)
specifically language impairment problem with…
no explanation for this - accepted neurological and genetic factors
4 communication features of SLI
- shorter utterances
- limited vocabulary
- more grammatical errors (omissions unusual for age)
- risk for reading disability
School aged - 3 groups who needs help
- language based learning disability
- dyslexia (specific reading disability)
- language impairments associated with other specific disorders
language based learning disability (LLD)
emerges when in school (reading and writing, literacy problems), intelligence is otherwise normal or higher, not the result of vision, hearing, handicap, emotions, or cultural differences
LLD 3 academic underachievement (in more than one of…)
- receptive language (listening, reading)
- language processing (thinking, conceptualizing, integrating, problem solving)
- expressive language (talking, spelling, writing)
SLI/LLD impairments in some of all of 3 things
- oral language
- academics
- learner skills
SLI/LLD 5 oral language problems
- phonological awareness (aware of sounds)
- vocal and word finding (often ummm, hmmm, pausing)
- higher order language
- discourse/texts (narrative, expository, persuasive)
- pragmatic/social communication
SLI/LLD 4 academic language problems
- reading (decoding, comprehension)
- writing (encoding, spelling, mechanics. content)
- mathematics (word problems
- curriculum based language
SLI/LLD learner skills language problems
self monitoring, self advocacy, planning, organizing, independent work
dyslexia
deficit in decoding print (processing phonological features), despite adequate educational opportunity/exposure, used to be attributed to visual deficits (but was discredited),
3 features of dyslexia
- impaired phonological awareness
- difficulty decoding/encoding words (word sight exceeds sounding out)
- read/spell with slow rate, poor fluency, lack of automaticity
- -> have good reading comprehension (if able to decode)
- -> have good written language content, organization (if able to decipher poor spelling)
ASD
neuro-developemental disorder, multifactorial aetiology, with/without other intellectual and language impairments
ASD 2 core symptom clusters
- deficits in social communications and social interaction
2. restrictive, repetitive patterns of behaviours, interests or activities
ASD 3 typical early communication impairments
- reduced communciative intents
- fewer conventional gestures
- immediate or delayed echolalia
ASD strengths/weaknesses in those who are verbal
- strengths in form (phonology, morphology, syntax)
- weakness in semantics/pragmatics (pronoun reversal ‘you for themselves’, social problems, nonreciprocal communication, monotone, staccato)
ASD features in those who are verbal
- high functioning ASD or Asperger syndrome
- advanced intellectual ability
- impaired pragmatics
- active but off
- topic obsession
Intellectual Impairments
IQ below 70 (2 SD below mean), deficits in adaptive functioning (independence, social activities)
other terms for Intellectual Impairments
mental retardation, developmental disability, intellectual disability, cognitive disability
known causes of Intellectual Impairments
down syndrome, fragile X, Williams syndrome
4 common characteristics of Intellectual Impairments
- less diverse vocab
- shorter utterances
- omit grammatical morphemes
- language pragmatics less flexible
Weaknesses in specific syndrome of Intellectual Impairments
- Down syndrome –> form (morphology and syntax)
2. Fragile X –> use (pragmatics) - high co-occurance with fragile X and autism
areas of assessment for language disorders
decontextualized way (finding if they know the actual meaning) –> standardized tests
- receptive (in context - familiar situation, nonverbal cues)
- expressive (in context - spontaneous language sampling)
3 methods of assessment for language disorders
- standardized (norm referenced) tests (PLS-5, CELF-5)
- criterion referenced tests
- language sampling
criterion referenced tests for language disorders
informal tasks individualized to child that probe particular communicative skills in depth (specific to a skill)
language sampling for language disorders - spontaneous language is 4 things:
- recorded during natural interactions
- transcribed verbatim
- analyzed for target structures/uses
- compared to age related criterion
- -> younger the kid, the wider the range of normal
Child language intervention - 4 service delivery approaches
- modify environment
- compensation
- prevention/promotion
- remediation
Child language intervention - modify environment
reduce language/literacy demands (facilitative language techniques), add supports (nonverbal, frameworks, outlines)
Child language intervention - compensation
give child tools to function better with limitations
e.g. model compensatory strategy –> support practice –> withdraw support until child uses independently (e.g. oh i can’t think of that word, the first sound is sssss, or its soccer)
Child language intervention - prevention/promotion
prevent early, stimulate language, for children at risk, provide optimal environment parent training (e.g. it takes two to talk - hand program, temps child to communicate)
Child language intervention - remediation
improve childs language by teaching specific skills, traditional role of SLP, takes many forms
3 repudiation approaches for language disorders
- adult centered (clinician directed - structures behaviourist approach)
- child centered (indirect language stimulation during natural interactions)
- hybrid (environment to elect targets and provide naturalistic reinforcement)
allophones
variations in the same phoneme (caT vs Take)
international phonetic alphabet (IPA)
42 symbols (18 vowel and 24 consonants)
3 IPA consonant classification
- manner (how air is modified)
- place (greatest closure in the vocal tract)
- voice (vibrating of vocal cords or not)
6 manner of articulations
- stop (plosive)
- fricative
- affirmative
- nasal
- liquid (tongue shape)
- glide (sound like vowels - j (yellow) and w (white)
cognates
speech sounds that share the same manner and place of articulation but differ along voicing dimensions
vowels (features and 2 differentiation)
open vocal tract, vocal folds vibrate, differentiation determined by
- tongue position (place of articulation and height)
- lip position (rounded or unrounded)
speech development milestones
- reflexive, vegetative sounds (crying, lip smacking)
- vowel like and consonant like sounds
- front sounds dominate (raspberries)
- prosaic play (duration and pitch, yells, squeals)
- canonical babbling (reduplicated - mamma)
- prosody like speech
- nonredplicated/variegated balling
- jargon
by 18 months, 2 years, 3 years and 4 years
18 months –> 1-2 clear vowels and few consonants
2 years –> most vowels produced, 70% consonants, 50% intelligible words
3 years –> 80% intelligible, affirmatives, liquids
4 years –> 100% intelligible, even to stranger (some consonant errors)
speech sound disorder (SSD) - 2 types of impairments
problem with speech differ from age and cultural expectations
includes both
1. articulation and 2. phonological impairments
SSD articulation impairment
inability to articulate certain sounds, results in phonetic errors (sounds distorted or mispronounced but still the same phoneme)
SSD phonological impairment
rules that govern patterns, results in phonemic errors (different phoneme or sound omitted, resulting in change of meaning)
3 etiologies of SSD
- physical/structural problem
- motor or neurological problems (cerebral palsy/childhood apraxia)
- functional cause (majority of cases)
cerebral palsy
motor SSD –> motor deficit due to CNS damage or developmental problem - results in dysarthria (weakness, slowness, or uncoordinated motor speech movement)
childhood apraxia of speech (developmental apraxia of speech DAS)
neurological SSD --> impaired planning of motor speech, difficulties in programming, combining, sequencing speech movement features include 1. inconsistent speech errors 2. unusual speech errors 3. difficulty with volitional speech 5. grouping (making sounds into words)
SSD functional impairment
many have phonological impairments (rule based problem), childs errors help us understand what rules the child is simplifying and using
2 assessments of speech development
- single word tests
- gather an example of initial, medial and final position
- standardized, provide inventory of sounds (norms) - speech sample
- many examples of sounds - spontaneous conversation
- percent consonants correct (PCC)
- -> if one or two sound errors, likely phonetic/articulation problem
- -> if large number of incorrect sounds, look to see patterns and phonological processes
4 speech sounds error patterns
- substitutions (replace t for k - they instead of key)
- deletion (one or entire class) - can be syllable simplification (nana for banana)
- distortion (sound is altered, but still same phoneme) –> lateral or frontal lisp
- addition (addition of unstressed vowels - balue) - not as common as the other ones, except for consonant blends in young children)
3 phonological processes/patterns
- final consonant delation
- cluster reduction
- stopping of fricatives
4 other speech assessment considerations
- stimulability
- intelligibility
- oral facial assessment
- audiometric testing
stimulability speech assessment considerations
can child imitate sounds - if they can, more likely to change
intelligibility speech assessment considerations
how do errors impact ability to understand the child? (bigger when larger number of errors, and omission errors)
oral facial assessment speech assessment considerations
AKA oral peripheral mechanism examination (OPE)
- determine if structure and function of oral mechanisms are adequate to support speech
1. exam structure defects, tone, symmetry
2. examine function of structures for non speech and speech movements (diadochotkinesis)
diadochotkinesis
rapid, alternating syllable strings (paddock or buttercup)
audiometric testing - speech assessment considerations
hearing impairment can lead to articulation impairment (vowel errors, quit consonant sounds)
2 main speech therapy approaches - intervention for SSD
- articulation approach (for child unable tis ay individual sound)
- phonological approach (can say sound, but doesn’t understand the rule)
articulation approach - intervention for SSD
using sensory information, repetitive motor practice
A) visual tactile support (showing and feeling differences)
B) PROMPT
1. provide auditory, visual, and physical cues
2. try to improve automaticity
3. increase length/complexity of stimulus
4. learns outside therapy room
5. child monitors how well they are saying sound
phonological approach - intervention for SSD
teach rules, emphasis changing in meaning (contrastive approaches - rhyming, minimal pairs, cycles approach)
3 cultural considerations for speech
- dialect
- accent
- phonological interference
2 types of non-develoepmental stuttering
- neurogenic
2. psychogenic
stuttering onset
typically between 2-5 years of age (heritable)
stuttering decreases during 3 things
- novel speaking manner (singing, putting on an accent)
- while alone, speaking to animals or kids
- disruptions in auditory feedback
stuttering increases during 3 things
- anticipating stuttering
- having to say specific word
- talking on the phone
8 primary characteristic of stuttering
- part word repetition
- single syllable word repetition
- multi syllable word repetition
- prolongation (not on stop sounds)
- silent/tense pause (block)
- phrase repetition
- interjection (hum, uh, umm)
- revision or incomplete phrase
bodily movements in stuttering
- facial griminess
- head movements
- loss of eye contact
- bodily movements
psychological behaviours in stuttering
- avoidance (fillers, pretending to thing, avoiding situations and people, appearing shy)
- emotional responses before speaking
- emotional responses after stuttering
distinguishing normal non fluency and borderline stuttering
normal non fluency
- repetitions of: sentences, phrases, words
- interjections revisions, hesitations, no frustration
borderline stuttering
- repetitions of: syllables, individual sounds
- bursts of speech, body movements
what causes primary stuttering - constitutional factors
- genetic predisposition
- neurological dysfunction (cerebral organization - over activation of right, and under activation of left hemisphere) –> difficulty with auditory or proprioceptive feedback
what causes secondary stuttering
online some von onto develop secondary stuttering and become chronic
- speech stressors (developmental or environmental)
- susceptible to conditioned associations between primary and secondary stuttering (stimulus/response - e.g. if i blink i won’t stutter)
- sensitive or reactive temperament
neurogenic non-developemental stuttering
neurological damage or disease (strong, head injury, parkinson, MS), exposure to toxins
- -> equally disfluent across situations
- -> secondary behaviours and negative emotions less common
psychogenic non-developemental stuttering
may be intermittent
unusual or bizarre speech patterns
may respond quickly to treatment
cluttering
frequent whole word and phrase repetition, rapid rate, irregular rate, misarticulating (slurred or deleted phonemes, substitutions)
how is cluttering distinct from stuttering
part word repetitions are infrequent, secondary behaviours not usually present, often more fluent in situations where stutters are less
other characteristics of people who clutter
disorganized, poor attention and concentration, hyperactive/impulsive (ADHD), reception and expressive language difficulties, pragmatic language difficulties, poor handwriting
mild vs. severe stuttering
mild: easy reputations
severe: sound blocks, prolongations, body movements
treatment for early stuttering
uses indirect methods - changes in environment - reinforce fluent speech - family involved Lidcombe program: clinician mediated, parent implemented, behavioural treatment (standard of care for preschoolers and adapted for school aged), goal: no stuttering,
3 treatments for stuttering
- fluency shaping
- stuttering modification
- nontraditional treatment approaches
fluency shaping - treatments for stuttering
modify all aspects of behaviour (behaviour modification - relearning speech movements), learn new pattern (reduced rate, vowel prolongation, slow and smooth onset), potential for rapid, dramatic change
fluency shaping - treatments for stuttering –> problems
- abnormal artificial speaking pattern
- skills not easily transferred out of therapy
- attention to speaking pattern ongoing
stuttering modification - treatments for stuttering
addresses individual movements of stuttering
- stutter more fluently with less tension
- use light articulation contact
- reduce situational fears and negative associations - feel in control
stuttering modification - treatments for stuttering –> problems
- slower change
2. may still have moments of stuttering
non-traditional treatment - treatments for stuttering
- hypnotherapy
- drug therapy (dopamine blockers)
- electronic devices (resemble eating birds - delayed auditory feedback)
when does CL/P occur
1st trimester of pregnancy (embryonic period, 5-8 weeks)
CL/P according to sex
2: 1 males for cliff of lip with or without palate
2: 1 females for isolated cleft palate
vermillion
red part of lips
columella
between nostrils - short and misaligned in CL
most common CL
left unilateral (if bilateral, usually cleft palate also)
signs of sub mucous cleft palate
- bifid uvula
2. notch in hard palate
isolated cleft palate associated with
a broader genetic syndrome (Pierre Robin sequence, velocardiofacal syndrome)
known aetiologies of CL/P
- chromosomal/genetic disorder
- family history
- increased parental age
- teratogens in utero (nicotine, alcohol)
- maternal nutritional deficiencies
voice issues in CL/P
velopharyngeal closure (velopharyngeal insufficient VPI --> hyper nasal sounds) evaluated with mirror, listening device or nasometer
articulation issues in CL/P
due to VPI, no pressure with stops/fricatives
- nasal emissions (snorting/blowing sounds out of the noise
- compensatory articulation errors (glottal stop, pharyngeal fricatives)
5 treatments for CL/P
- surgery
- dental
- psychosocial
- hearing (myringotomy tubes)
- speech language therapy
2 surgery for CL/P
- pharyngeal flap: flap of skill off back of through, bring it forward and sow it to back of velum - smaller area to close
- pharyngoplasty: narrow all the skin, make tube around velum and pharyngal wall into small hole
dental treatment for CL/P
prosthodontics (obturator, speech bulb, palatal lift)
Speech language therapy for CL/P
<10%, focus on hyper nasal resonance, reduction of glottal stops,
- traditional articulation therapy,
- visual feedback via electropalatography –> gives feedback on tongue placement feedback on
