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pediatric speech disorders Flashcards

1
Q

speech sounds errors with preserved phonemic contrasts, due to structural, neurological, or habitual placement of the articulators

A

articulation disorder

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2
Q

order of typical sound development

A

nasals, stops, glides, liquids, fricatives, affricates, clusters

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3
Q

sounds typically developed at 2-3 years

A

m n p h w b

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4
Q

sounds typically developed ages 2-4

A

k g j ng t d f

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5
Q

sounds developed from ages 3-7

A

l v sh th r s z ch dz

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6
Q

informal assessment for artic

A

screening
case history (1st noted, treatment, injuries/diseases, effects on academic performance, language spoken)
oral motor exam
motor speech exam
conversational speech samples (phonemic inventory, PCC)
hearing screening
stimulability

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7
Q

ways to test stimulability

A

in imitation
one or more phonetic environments
key words
phonetic placement/shaping
combo

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8
Q

formal artic assessment

A

GTFA (2-21)
Arizona Artic Phon Scale 4 (1;6-18;0)
Contextual Probes of Artic - Spanish CPAC-S
CAAP
Percentage of Consonants Correct

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9
Q

Formal assessments for phonology

A

KLPA
CAAP clinical assessment of artic and phonology
CTOPP comprehensive test of phono processing
Connected Speech Sample

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10
Q

Apraxia Formal Assessment

A

Kaufman Speech Praxis Test
Apraxia Profile for children
Motor Speech Exam (diados, hierarchy)

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11
Q

selecting targets for treatment considerations

A

stimulability
frequency of sound
ease
developmental appropriateness
visibility of sound
how much sound impacts intelligibility

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12
Q

van ripers approach (6)

A
  1. placement movement of articulators
  2. drill-like rep
  3. establishment
  4. perceptual training (contrast miming, minimal pairs)
  5. generalization
  6. maintenance
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13
Q

phonological approach (4)

A

target groups of sounds
establish phono contrasts
emp natural communication process
minimal pairs

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14
Q

Hodson’s Cycles Approach

A

intensive program for highly unintelligible children
target one or more phono pattern and move on

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15
Q

developmental approach

A

based on selection of early developing targets

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16
Q

complexity approach

A

target nonstimulable sounds

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17
Q

distinctive features approach

A

establish missing distinctive features
underlying patterns
minimal pairs

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18
Q

problematic phonological errors after 3 (6)

A

weak syllable deletion
final consonant deletion
velar fronting
assimilation
reduplication
prevocalic voicing

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19
Q

core behaviors of stuttering

A

monosyllabic whole word repetition
sound/ syllable repetition
sound prolongations
blocks

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20
Q

secondary behaviors

A

eye blinking
head nodding
foot tapping
looking up
avoidance

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21
Q

assessment for stuttering

A

case history
kiddycat 3-6
oases (7+)
SSI
informal (total dysfluency index, core feature index)

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22
Q

stuttering modification strategy

A

easy onset
voluntary stuttering
cancellation
pull out
prep set

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23
Q

fluency shaping

A

light artic contact
response contingencies
rate control
prolonged speech
delayed auditory feedback

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24
Q

characteristics of cas

A

limited vowel and consonant repertoire
sound omissions
vowel distortions
inconsistent errors
difficulty moving from one artic position to another
groping

25
Q

3 consensus features of CAS

A

inconsistent errors on vowels and consonants
lengthened coartic transitions
inappropriate prosody

26
Q

assessment for cas

A

case history
neuromusc status
structural/functional status
oral mech
motor speech exam
DDK
Utterance hierarchy
experiment with cueing strats
kaufman speech praxis test
verbal motor production assessment

27
Q

Treatment for CAS

A

Kaufman Speech Praxis Kit
dynamic temporal/tactile cueing
simultaneous production
imitating
pure/direct imitation
child repeats several targets
responsive production
spontaneous

28
Q

assessment tools for dysphagia

A

nomas- neonatal oral motor assessment
penetration aspiration scale
jaw rehab checklist
pre feeding skills checklist
checklist in swigert
from NICU to childhood checklist

29
Q

pediatric physiology (8 steps to swallow)

A
  1. presence of food stimulates sensory receptors activates swallowing
  2. grinding and shaping food into bolus
  3. bolus moved to posterior tongue
  4. bolus thrust into pharynx with swallow reflex closure of v-port
  5. larynx elevates and tucks beneath base of tongue
  6. epiglottis inverts
  7. bolus penetrates cricopharyngeal sphincter
  8. bolus goes into the esophagus
30
Q

FEES

A

FFNL is passed transanally into the hypopharynx
visualizes before and after swallow

31
Q

VFSS

A

primary imaging technique for detailed assessment of oral, pharyngeal, and upper esophageal phases of swallow

32
Q

neuromuscular dysphagia is secondary to (6)

A

cerebral palsy
down syndrome
seizure disorder
craniofacial disorders
tbi secondary to shaken baby
anoxia

33
Q

oral phase characteristics (8)

A

sensorimotor deficits
arrhythmic sucking
hypo/hypertonia
flat flaccid tongue
humped tongue
jaw excursions
jaw clenching
wide jaw exercise

34
Q

pharyngeal phase characteristics

A

absent/delayed swallow reflex
velo-pharyngeal incompetence
weak pharyngeal constriction
poor laryngeal elevation
aspiration/silent aspiration
laryngeal penetration
poor handling of secretions
crico-pharyngeal sphincter
weak cough reflex

35
Q

treatment for neuromuscular dysphagia (5)

A

positioning adaptations
environmental adaptations
food preparation
oral sensory motor therapy
pharyngeal treatment

36
Q

assessment for oral motor dysphagia

A
  1. obtain case history ( important to know gestational age, how long takes to feed, nipples used, thickeners?, how baby is fed, spit up, concerns, weight loss
  2. bedside swallow
  3. FEES or MBS
  4. ICD 10 code
  5. treatment plan and goaols
37
Q

treatment for sensory motor dysphagia (5)

A

rule out medical complications
determine caregiver goals
work with all team members to determine cognitive language nutritional and postural needs
appropriate feeding swallowing goals
educate caregivers on feeding/swallowing
monitor carryover

38
Q

how to determine readiness to feed

A

34 weeks gestational age or more when suckle develops

39
Q

environmental mods 9

A

support for alertness
avoid unnecessary stimulation
1 stimuli/time
calm environment
containment swaddling
monitor stress signs
non-nutritive facilitation
kangaroo mother care
parent focused treatment

40
Q

positioning mods

A

signs of stress and withdraw when necessary
upright 75-90 degree positioning
swaddled contained
chin tuck

41
Q

disorganized feeding disorder typically seen in…

A

prematurity
pulmonary disorders
congenital heart defects
young infants with reflux
anatomical abnormalities

42
Q

assessment for disorganized feeding disorder

A

determine gestational age
interview parents
conduct bedside swallow eval
fees and mbs
diagnos with ICD 10
develop goals and treatment

42
Q

interview questions to ask for disorganized feeding disorder

A

how long for baby to suck on breast or bottle
nipples used
thickener?
formula used
spit up

42
Q

treatment for disorganized feeding

A

rule out medical complications
determine caregiver feeding goals
work with team members to determine child’s cog, language, nutritional, and postural needs
determine appropriate swallowing and feeding goals
educate caregivers
monitor carryover

43
Q

oral motor intervention techniques

A

pacing
intra oral stimulation
cheek support

43
Q

modifications for disorganized feeding

A

environmental
positioning
oral motor intervention

44
Q

example of disorganized feeding goal

A

infant will swallow 2-3 ounces in under30 minutes with intra oral stimulation needed less than 50% of the time without signs of aspiration over a 5 day period

45
Q

sensory based feeding disorder

A

aversion to food or liquid to a varying degree on either a medical diagnosed or an extreme sensory integration issue

46
Q

oral phase characteristics of sensory-based feeding disorders

A

sulcus pocketing
jaw clenching spitting
tongue thrust
refusal to eat certain consistencies
crying or other refusal

47
Q

pharyngeal phase characteristics sensory based

A

aspiration signs because of gagging
delayed swallowed
reflux/vomitting
irregular breathing patterns

48
Q

oral phase characteristics sensory based

A

sulcus pocketing
jaw clenching
spitting
tongue thrust
refusal to eat certain consistencies
crying

49
Q

mild sensory issue

A

may have flavor, temp, or food items
nourishment by mouth

50
Q

moderate sensory issue

A

1-3 textures
weight gain concern
nutritional concerns due to limited intake of certain food

51
Q

severe issues

A

may have supplemental feeding tube
diet consists of 1-5 items
weight gain and nutritional status is a strong concern

52
Q

Goals for sensory feeding

A

increasing oral intake
accepting new food tastes
tolerating food explorations
increase self feeding

53
Q

hierarchy of sensory relationship with food

A

tolerates presence
smell
touch
play
taste
eat and swallow
increase quantity of preferred foods
increase quantity of nonpreferred foods

54
Q

term used to describe working with currently accepted tastes, textures, temperatures and building on those

A

chaining

55
Q

ending session

A

end on postitive note
review strategies and goals
home strategies
positive activity

comps (4 decks)

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