Phono Final Flashcards
What questions do we want to ask when doing an appraisal?
Why are we conducting the assessment?
What information should we collect?
How should we collect the information
What are the two parts of an assessment?
appraisal, diagnosis
What are screenings?
brief observation of speech sound production
what are formal screenings?
standardized, valid, reliable
What are informal screenings?
ask children to state name, age, address, etc; ask older children and adults to read a passage
what are the components of an assessment?
case history single-word speech sample stimulability testing spontaneous speech sample oral mech hearing screening language screening specific auditory perceptual testing cognitive appraisal
What are the ways to score a single-word speech sample?
two way - production is correct or incorrect
five way - determine whether Substitution, Omission, Distortion, or Addition
phonetic transcription - describe actual speech sound
How long does a spontaneous speech sample have to be?
3 minutes, or 200-250 words
When would you use specific auditory perceptual testing?
client demonstrates collapse of two or more phonemic contrasts into a single sound
How do we need to organize data for diagnosis?
document inventory and distribution of speech sounds
How do we know when a disorder is ARTICULATION
phoneme contrasts maintained, peripheral, motor-based problems
How do we know when a disorder is PHONOLOGY
loss of phonemic contrasts
What are the types of analysis of phonological error patterns?
place-manner-voice analysis (feature system)
phonological process analysis
assessing productive phonological knowledge
What are the general guidelines for intelligibility?
50% intelligible by 2 years
75% intelligible by 3 years
90% intelligible by 4 years
what are factors that influence intelligibility
loss of phonological contrasts
loss of contrasts in specific environments
degree of homonymy
differences between target and speaker’s production of target
frequency of error sound
consistency of error production
familiarity of listener with speaker’s speech
context in which communication occurs
what is the severity measure people use?
Percept of consonants correct (PCC)
Consistent errors are more indicative of _____
articulation disorders
What should you look at during a phonological assessment?
inventory of speech sounds
distribution of speech sounds
syllable shapes and constraints
What is a central goal of assessment?
understanding the child’s phonological system
What constitutes a severe phonological disorder?
6 (i’m guessing consistent) sound errors over 3 manner classes
What are the characteristics of a child with emerging phonology?
demonstrates small expressive vocabulary
reduced repetoire of consonants and syllable shapes
unintelligible
may have other language difficulties
may show specific delay/disorder in communication skills
may have been born with a devleopmental disorder
may exhibit an early acquired disorder secondary to disease or trauma
may belong to group of late talkers whose expressive language emerges slowly
What are some modifications to the case history you can use?
questionnaires
What are some modifications to single-word speech sound sampling you can use?
use toys and objects, ask caregivers to keep a log of words, encourage sound play and sound imitation
What are some modifications for spontaneous speech sound sampling?
ask caregiver to play with child
modifications for oral mech?
pretend to make fish or clown faces, have child look in your mouth first with flashlight
modifications for language screening?
use language sample
modifications for cognitive appraisal?
play behavior
We usually consider a child’s sound system to be:
unique self contained system; independent of adult sound system
how do you usually determine severity?
clinical judgement scales or percentages
What are frequent errors that lead to unintelligibility?
difficulty with liquids, stridents, clusters,
sometimes: deletion of entire sound classes
ERRORS OFTEN NOT CONSISTENT
How might you get a speech sample from a highly unintelligible child?
use scripts and structured activities (trip to mcdonald’s, telephone conversation), gloss utterances that may be difficult to understand later
What is progress monitoring (deep testing)
additional probes for error sounds… usually informal
What is the purpose of traditional articulation therapy?
learn how to position articulators to produce sound
What is the traditional artic approach?
perceptual training followed by extensive motor-speech production practice
What is the phonetic approach of traditional articulation therapy?
go according to developmental norms
Who is traditional therapy best for?
individuals with limited number of errors
What is the criteria for accuracy for traditional artic?
80-90% before moving onto the next level of treatment
What are the levels of treatment for traditional artic?
sensory-perceptual training
production training - sound establishment/acquistion
production training - sound stabilization
transfer and carryover
maintenance
What is the goal of sensory-perceptual training in traditional artic therapy?
client able to differentiate between their error sound productions and the correct production
Why is sensory-perceptual training important?
for self-monitoring; only needed if client has difficulty with perception
What are the levels of production training?
isolation, nonsense syllables, words, phrases, sentences, conversation
What are the steps for production training in isolation?
auditory stimulation - target sound is modeled
phonetic placement method - specific instruction on placement of articulators
sound modification method - establish target using phonetically similar sound client can produce
facilitating contexts - words in which target sound produced correctly
what are nonsense syllables good for?
determine if accuracy of production is established
What is the accuracy criterion for dismissal from traditional artic therapy?
50% correct production in spontaneous conversational speech
What is the general focus of phonological intervention?
focus on learning RULES of phonological system
What production level do you usually start at for artic and phono? (conversational, sentence level, etc)
isolation for artic; usually word-level for phono
What are the kinds of phonological therapy we learned about in class?
Minimal pair contrast therapy distinctive feature therapy maximal opposition approach multiple oppositions approach phonological processes therapy cycles approach metaphon therapy
What is minimal pair contrast therapy?
use pairs differing by one phoneme, establish contrasts not present in child’s phonological system, distinctive features
What are the two kinds of distinctive feature therapy?
minimal opposition and maximal opposition contrasts
What is minimal opposition contrasts?
least number of differences, unites production and perception
who is a candidate for minimal opposition contrasts?
child with consistent substitution processes and is stimulable
What are the steps of minimal opposition?
discussion of words, discrimination testing and training, production training, carryover training
What is the maximal opposition approach?
start with minimal pairs (differing by only one distinctive feature), but then move onto pairs that are more contrastive… differing in place, manner, and voicing
who is a candidate for the maximal opposition approach?
children with moderate to severe phonological disorders
what are good targets for the maximal opposition approach?
sounds not in child’s inventory, maximally different, sounds child cannot produce
you should not directly train perceptual contrast for which therapy approach?
maximal opposition
What is the multiple oppositions approach?
alternative to minimal pairs approach - directly addresses collapse of multiple phonemes, contrasts multiple sounds simultaneously
who is a candidate for multiple oppositions therapy?
severe phonological disorders
What are the benefits of multiple oppositions therapy?
shortens length of therapy, increases intelligibility, more efficient intervention
Which sounds should be chosen as targets for multiple oppositions therapy?
sounds with potential for greatest impact on phonological organizations
what is the goal of phonological processes therapy?
suppress phonological processes
Who is a candidate for phonological processes therapy?
young children with persistent use of phonological processes
What is CAS?
motor speech disorder (not weakness or paralysis) that affects production of sounds, syllables, and words
What is the difference between CAS and a phonological disorder?
we don’t really know/we have no current method to differentially diagnose
What does CAS look like in a very young child?
child does not babble or coo late emergence of first words very small sound inventory (including vowels) problems combing sounds feeding problems, possibly
what is the most common process found in children with CAS?
omission/substitution
What does CAS look like in an older child?
inconsistent sound errors; not the result of immaturity
sounds get worse with repeated productions
unusual errors not typically found in child with SSD
more errors with sound classes involving complex oral gestures
difficulty imitating speech
difficulty with longer words
more difficulty when anxious
super unintelligible
difficulties with nasality
difficulties identifying rhymes and syllables
What do we need to make sure we do in assessment with suspected CAS that we might not do with other SSDs?
thorough oral mech, with a DDK
CAS requires what kind of therapy?
frequent, intensive, 1 on 1
What are the two types of therapy for CAS that we talked about in class?
Kaufman approach
PROMPT
What is the kaufman approach?
drill drill drill! move from less to more complex syllable shapes
successive approximations toward favorite vocabulary
simplifying for success!
What does PROMPT stand for?
Prompts for restructuring oral muscular phonetic targets
What is prompt?
therapy approach where you use tactile cues to help manually guide patients through targeted productions
What are some prognostic indicators for CAS?
severity
history of progress with intervention
presence/severity of co-occuring symptons (language, cognitive, oral/limb apraxia)
access to services
What are the characteristics of acquired apraxia of speech?
slow speech sound distortions prolonged duration of sounds reduced prosody consistent errors within an utterance difficulties initiating speech groping
What is dysarthria?
neuromuscular speech disorder
What are the types of dysarthria?
spastic ataxic hypokinetic hyperkinetic flaccid mixed: simultaneous occurrence of characteristics of several types
What are the assessment/treatment areas for dysarthria?
respiration, phonation, resonation, articulation, prosody and rate
