MIDTERM- CHAP 4 Flashcards
Factors Related to Speech Sound Disorders
Otitis media with effusion
Frequent episodes of middle ear disease in children, which are accompanied by a buildup of liquid in the middle ear space
The accumulating liquid blocks the transmission of sound, resulting in a mild to moderate hearing loss, which may then impact speech sound acquisition.
Three main aspects of motor skills examined:
rate, strength, and coordination
Diadochokinetic (DDK) Rate:
tasks measure the ability to rapidly repeat syllables to assess oral motor skills independent of phonological skills.
Common syllables used in DDK tasks include /pʌ/, /tʌ/, /kʌ/ and their sequences.
rates improve with age, with adult values reached by ages 9-10.
Oral Myofunctional Disorders (OMDs):
Include tongue thrusting, abnormal tongue-resting postures, unusual oral movements, finger sucking, lip insufficiencies, and structural deficiencies.
Tongue Thrusting:
frontal or lateral tongue movement during swallowing.
Often misunderstood as forceful; individuals do not exert more tongue force than non-thrusters.
All infants are initially tongue thrusters; this is a normal part of swallowing.
Tongue-thrust swallow:
Other terms like “reverse swallow,” “deviant swallow,” and “infantile swallow” should be avoided due to misleading implications.
Types of Tongue Thrusting:
Forward gesture of the tongue during the initiation phase of swallowing.
Tongue fronting during speech with the mandible open.
Tongue resting forward in the oral cavity with the mandible slightly open.
Two types of tongue thrusting:
Habitual: Occurs without structural abnormalities.
Obligatory: Arises due to factors like airway obstruction, necessitating adaptation during swallowing.
Tongue thrust can present in three ways:
1) the tongue has an anterior gesture at the initiation of a swallow,
2) the tongue unnecessarily moves between or against the front teeth during speech,
3) the tongue lays on or between the anterior teeth during rest. These presentations of tongue thrust may occur together or in isolation.
Children who have all three presentations of tongue thrust tend to have the most difficulty with speech sound production, dentition, and treatment.
Tongue Position vs. Tongue Thrust:
The resting posture of the tongue has a greater impact on dental and jaw position than tongue thrusting or speaking.
Transient Force:
Tongue thrusting exerts brief pressure on the anterior teeth, which is usually within normal ranges, and is not believed to cause malocclusions in the absence of an anterior resting tongue position.
Treatment issues
Pacifier use
1) may alter the resting tongue position, resulting in a tongue thrust;
2) may affect tooth emergence and alignment;
3) may reduce the amount of time that a child practices or uses speech;
4) may make parents or others less likely to engage in conversation.
Forward Resting Position
A forward resting tongue can impede normal teeth eruption, potentially leading to: Anterior open bite and Class II malocclusion.
Psychosocial factors: Age
Children’s articulatory and phonologic skills improve significantly until about age 9.
Skills continue to be refined until puberty and likely into adolescence
Psychosocial factors: gender
Research shows girls generally perform slightly better than boys in speech sound acquisition until about age 12.
girls acquire sounds earlier, with significant differences noted mainly before age 6.
males showing higher rates of SSDs than females.
Multiple studies consistently find a higher incidence of SSDs in males compared to females.
Specific sound errors (e.g., /r/ in boys, /s/ in girls) in older children with persistent speech issues.
