Section 1

Question 1

What is the diaphragm?

Answer 1

Forms the floor of the thorax and the roof of the abdomen. At rest, the diaphragm is dome shaped. It consists of a tough sheet of inelastic tissue at its centre (central tendon) and a sheet of muscle that rises as a broad rim from all around the lower portion of the inside of the rib cage and extends upwards to the edges of the central tendon.

Question 2

What is the abdominal wall?

Answer 2

Provides a casing for the lower half of the torso; consists of two large sheets of connective tissue and several large muscles.

Question 3

Name what controls respiration and differentiate tidal breathing, sustained tone, and speech.

Answer 3

The CNS and PNS control respiration.
Tidal breathing is the amount you typically breath in and out at rest (looks like a smooth wave). Sustained tone is what occurs when you are holding a sound, resulting in a sharp quick inhale with sustained exhale alone with phonation. Speech results in sharp quick inhales with extended bumpy exhales, sort of like a staircase.

Question 4

Define vital capacity and tidal volume.

Answer 4

VC: The maximum amount you can breathe in and out. Depending on the size of your rib cage, this is usually 3.5-5 litres of air.
TV: the amount you typically breathe in and out at rest.

Question 5

Define inspiratory and expiratory reserve volume.

Answer 5

IRV: the amount you can inspire if needed, beyond your end-inspiratory tidal volume.
ERV: the amount of air you can expire from your lunch after your end-expiratory lung volume in tidal breathing.

Question 6

Describe what happens on inspiration, including muscles involved.

Answer 6

1. External intercostals actively contract, pulling the ribcage upwards.
2. Diaphagm actively flattens to accommodate expansion of the lungs.
   Note that your abdominal muscles are always on during inspiration and exhalation.

Question 7

Describe what happens on exhalation, including muscles involved.

Answer 7

1. External intercostals passively recoil.
2. Diagphragm massively returns to rest position
3. Lungs passively recoil.
   For active exhalation, the internal intercostals may be involved as they pull the ribs downwards to squeeze out air from your ERV. The abdominal muscles may also engage.

Question 8

Describe breathing during speech.

Answer 8

Speech breathing has a short inspiration with a longer expiration with many fine adjustments made during the exhalation. We speak in the middle of our lung volume. Exhalation during speech is often an active process, requiring involvement from internal intercostals and abdominal muscles.

Question 9

What is included in the articulatory system?

Answer 9

Includes the lips, teeth, alveolar ridge, hard palate, soft palate, velum and nasal cavity, tongue, and jaw; these structures (articulators) are used to shape the source signal generated at the glottis in order to generate speech.

Articulators can be active, passive, or both (i.e velum is active when producing nasals, but passive when approximated by the tongue, as in /k/ production)

Question 10

What is included in the phonatory system?

Answer 10

Includes the larynx and vocal folds. In the source-filter model, the phonatory system is involved in generating the source signal from which speech is derived. The source signal will have its own fundamental frequency (f0) and will generate harmonics (multiples of the f0).

Question 11

What two conditions need be met for vocal folds to be set in motion?

Answer 11

Vocal folds sufficiently approximated.

There is sufficient subglottal pressure.

Question 12

How are vocal tract resonances created?

Answer 12

Vocal tract resonances will be created, corresponding to formant frequencies, which are properties of the filter.

F1 = Mostly determined by tongue height - vertical plane
F2 = Mostly determined by tongue “backness” - horizontal plane

Question 13

What is included in the resonatory system?

Answer 13

Also referred to as the vocal tract; includes the “throat” (area above and around the larynx), oral cavity, and nasal cavity. This is the area through which the source signal generated by the phonatory system travels and is filtered (in conjunction with the articulatory system) due, in part, to resonance frequencies and damping characteristics of the tract/system.

Question 14

What is the larynx?

Answer 14

The larynx, commonly called the voice box or glottis, is the passageway for air between the pharynx above and the trachea below.

It extends from the fourth to the sixth vertebral levels. It is formed by cartilages that are connected to each other by muscles and ligaments.

Question 15

Describe the skeletal framework of the larynx.

Answer 15

Hyoid bone: Considered “free-floating” (not attached to any other bone)
Thyroid cartilage: Anterior prominence/ notch = Adam’s apple. Largest component; provides protection to other laryngeal structures
Cricoid cartilage: Ring-like structure located above trachea. The cricoid is the only complete cartilaginous ring of the airway.
Arytenoid cartilages (2): Sit atop the cricoid cartilage
Corniculate cartilages (2): The corniculate and cuneiform cartilages have fibrous attachments to the arytenoids and are located on top of and anterior to the arytenoid cartilage, respectively. The true function of these structures is unknown, but they increase and stiffen the aryepiglottic fold and may therefore aid in prevention of aspiration during swallowing. 
Epiglottis: A single cartilage positioned behind hyoid bone and root of the tongue. Lingual surface attaches to hyoid bone; the lower part attaches to the inner part of the thyroid cartilage just below the thyroid notch.

Question 16

What is the pharynx?

Answer 16

The pharynx, commonly called the throat, is a passageway that extends from the base of the skull to the level of the sixth cervical vertebra.

Inferiorly, it opens into the larynx and esophagus. The pharynx is divided into three regions according to location: the nasopharynx,
the oropharynx, and the laryngopharynx (hypopharynx).

Question 17

Name the intrinsic laryngeal muscles, their action, and their effect.

Answer 17

Cricothyroid: (A) pulls thyroid forward and downward when contracting (stretching vocal ligament). (E) Increases vocal pitch.
Posterior cricoarytenoid muscle: (A) rocks arytenoid away from midline to open VF. (E) moves VF out of the airway, stopping sound via abduction of VF.
Lateral cricoarytenoid: 9A) rocks arytenoid towards midline and backwards to close VF. (E) Adducts VF into the airway; voicing posture.
Transverse arytenoid: (A) pulls arytenoid cartilages together. (E) adducts VF.
Oblique arytenoid: (A) pulls cartilages together in a tipping motion. (E) adducts VF.
Thyroarytenoid: (A) causes arytenoids to pull towards thyroid and towards the midline, relaxes and shortens VF (agnostic to criocothyroid). (E) Makes up VF.

Question 18

Name the extrinsic laryngeal muscles, their function, and their innervation.

Answer 18

Thyrohyoid: contraction decreases the distanced between the thyroid cartilage and the hyoid. (I) Cervical spinal nerves.
Sternothyroid: pulls the thyroid cartilage downwards and may enlarge the pharynx. (I) cervical spinal nerves.
Inferior pharyngeal constrictor: moves the sidewall of the lower pharynx inwards and decreases size of pharyngeal lumen. Stabilizes position of the laryngeal housing. (I) CN X (Vagus)

Question 19

Name the intrinsic muscles of the tongue and their function.

Answer 19

I & S longitudinal muscles: moves tip up and down, can shorten tongue.
Transverse: narrows and lengthens tongue
Vertical: flattens and depresses the tongue.

Question 20

What innervated the intrinsic tongue muscles?

Answer 20

CN XII (Hypoglossal)

Question 21

Name the extrinsic tongue muscles and their functions.

Answer 21

Genioglossus: forms bulk of the tongue, sticks tongue out, presses against teeth/alveolar ridge, pulls tongue tip back, troughs the tongue.
Styloglossus: pulls tongue up and back.
Hyoglossus: retracts and depresses, elevates hyoid.
Palatoglossus: pulls tongue back to groove the tongue.

Question 22

What muscles make up the vocal folds and cords?

Answer 22

Folds: exterior part made up of external and internal thyroarytenoid muscles and the vocal ligament
Vocal cord: interior thyroarytenoid and vocal ligament.

Question 23

Where do the vocal folds attach to?

Answer 23

Anterior: inner surface of the thyroid.
Posterior: Arytenoids.

Question 24

Name the five layers of the vocal folds.

Answer 24

Cover: (1) epithelium & (2) superficial lamina propria (SLP)
Transition: (3) intermediate lamina propria (ILP) & (4) deep lamina propria (DLP)
Body: (5) vocalist/thyroarytenoid.

Question 25

Describe the myoelstic aerodynamic theory.

Answer 25

Vocal folds move towards the midline Subglottal air pressure builds and blows VF apart Muscle recoil (elasticity) and Bernoulli Effect (increase in velocity decreases pressure between the VF and sucks them back together again) creates vibration

Question 26

Name and describe the parts that make up the outer ear.

Answer 26

Auricle (pinna): a flap of thin elastic cartilage covered by skin which is continuous with the cartilage of the external auditory meatus; role = sound localization and amplification Concha (the bowl at the entrance to the ear canal) - has a resonating frequency of 4.5 kHz and amplifies this frequency by 10-15 dB External Auditory Meatus aka EAM (Ear canal) Outer part of tympanic membrane (eardrum)

Question 27

Name and describe the parts that make up the middle ear.

Answer 27

Tympanic membrane: concave oval cone-like disc, that appears pearly gray in colour and translucent. The apex lies at the umbo which corresponds to the bottom end of the malleus handle Umbo - area of slightly rounded elevation where malleus attaches to TM (point of maximal convexity/greatest retraction) Ossicles: Malleus = largest and most lateral and attached to the eardrum and the incus Incus = middle bone Stapes = attaches to the oval window of the cochlea by ligament Stapedial muscle: attaches to the neck of the stapes; contracts bilaterally to loud sound and tenses the membrane in the oval window. This reduces some of the signal passed onto the cochlea (acts as a protective mechanism for loud, startling sounds) Tensor tympani: inserts into the manubrium of the malleus and contracts bilaterally to non-auditory stimulation ( i.e., touching the ear canal or introducing air into the ear canal) Eustachian tube: This mucous lined tube is about 25 mm long and provides communication of the middle ear cavity with the nasopharynx (above and behind the soft palate) and permits equalization on both sides of the TM. It’s usually closed → opens when a mismatch in air pressure is detected between the middle ear cavity and ear canal.

Question 28

What is the general function of the inner ear?

Answer 28

Overall function: transduction of mechanical energy to electrical. Cochlea (hearing) Vestibular system (balance)

Question 29

What functions do the outer and middle ear serve.

Answer 29

Transformation of sound into mechanical energy. Outer ear: Sound waves reach the outer ear and are localized and amplified by the pinna and EAM. Sound reaches the external part of the tympanic membrane at the end of the EAM. Middle ear: The eardrum is the first movable link in the chain of auditory events. Acoustic pressure waves, which hit the eardrum, cause it to vibrate, reproducing the same spectrum of sounds that enter the eardrum. Sound pressure changes at the TM cause it to move.

Question 30

Name and describe the functions and parts of the inner ear.

Answer 30

Fluid-filled series of canals called the “labyrinth”. The outer duct is called the bony (osseous) labyrinth (spaces/cavities) because walls are made from temporal bone. It is divided into three sections: the vestibule the semicircular canals the cochlea. Within the bony labyrinth is a membranous labyrinth. It is also divided into three parts: the semicircular ducts; two saclike structures, the saccule and utricle, located in the vestibule the cochlear duct ( the only part of the inner ear involved in hearing). The entire inner ear is bathed in a cushioning fluid, called the endolymph when it lies within the membranous labyrinth and the perilymph when it separates the bony and membranous labyrinths. The cochlea is a spiral chamber that resembles a shell of a snail (~ 35mm long tube). It is subdivided into 3 chambers (upper, middle and lower). The scala vestibuli is the superior duct that begins at the oval window and extends to the apex of the cochlea. The inferior duct, called the scala tympani, begins at the apex and ends at the round window. The organ of Corti, a sensory mechanism of hearing, is located in the scala media and rests on the basilar membrane. It is the site of sensory transduction, containing the sensory cells responsible for transducing mechanical motion into electrical (neuronal) activity, and nerve fibres which transmit the electrical activity to the brain where it is perceived as auditory signals. It is the beginning of tonotopic organization within the auditory system (the frequency of a sound is coded or mapped to a place on the basilar membrane) and each hair cell has a characteristic frequency. Two types of sensory cells: 1 row of inner hair (3500) cells lined up side by side along the length of the organ of Corti 3-5 rows of outer hair cells (12,000). The OHC have hairs (modified microvilli) that project into the tectorial membrane which form a W pattern Hair cells synapse with nerve fibres which form the cochlear nerve (branch of CNVIII)

Question 31

How does the cochlear work (physiology)?

Answer 31

The stapes pushes in the oval window which moves the fluid in the scala vestibuli (aka vestibular duct) and scala tympani (aka tympanic duct). The motion is referred to as a travelling wave. The wave travels the length of the cochlea, growing in strength until it reaches a place of maximum displacement. At this point, hair cells embedded in the tectorial membrane experience a shearing force and begin to bend This causes a release of a neurotransmitter from the base of the hair cells that stimulates the nerve ending of the cochlear branch of the VIII nerve, causing an action potential which travels up the auditory pathway. The direction of the travelling wave is from the base (high frequencies) to the apex Low tones cause a vibration of the basilar membrane in the apex where the membrane is the widest but the cochlea is the narrowest (i.e in the center)

Question 32

Describe the ascending auditory pathway.

Answer 32

Vestibulocochlear nerve (VIII CN) - enters brainstem where its fibres bifurcate to synapses in the ventral and dorsal cochlear nuclei (cranial nerve nuclei) Some fibres decussate (cross over) the midline and synapse in the superior olivary complex ( first site of binaural representation from ipsilateral and contralateral input from CN, Role: localization through information on time and intensity) on the opposite side. Information travels to the nucleus of the lateral lemniscus Inferior colliculus AKA IC (relay station). The two IC are connected by fibres to allow crossover from both sides of the brainstem From the IC, pathway travels ipsilaterally and contralaterally, then continues to the medial geniculate body (MGB) The MGB is located in the thalamus and is the last subcortical relay station for auditory impulses. It: maintains and directs auditory attention (dorsal MGB) tells the brain to pay attention to what is going on (medial MGB) integrates information about the source, location, frequency and intensity of sound (ventral MGB) After the MGB, the central auditory tract fans out into multiple small fibres (auditory radiations) which run from MGB to the auditory cortex

Question 33

Describe the primary auditory cortex.

Answer 33

Located in the temporal lobes on both sides of the cortex in an area called superior temporal gyrus (Heschl’s gyrus) The tonotopic organization continues in the cortex Information is finally processed at this level Loudness perception and pitch are controlled at the brainstem, but higher-level behaviours (understanding speech and processing complex signals) is at the auditory cortex Speech is primarily processed in the LEFT Auditory Cortex. This means speech information from the right AC (information from left cochlea) crosses to the left AC, via the corpus callosum to be processed by the brain.

Question 34

Discuss the basic embryology and development of the auditory system.

Answer 34

The outer, middle and inner ears develop from different embryological tissue, and therefore one can have an abnormality in one part of the ear and not the other (usually abnormalities of the outer and middle ear are seen in combination with a normal inner ear) Outer and middle ear development starts around 3 weeks gestation; the pinna develops between 5th and 18th-week gestation, the tympanic membrane is formed by 4 months gestation, and the middle ear ossicles (adult size at birth) are correctly positioned/ formed by the 8th month (This means that most babies can “hear” in utero by 8 months gestation) The eustachian tubes are more horizontal in babies/young children, which often results in poor drainage; this is the reason young children are so susceptible to ear infections (as are individuals with Down Syndrome) due to fluid build up The brainstem and auditory cortex are not mature at birth; Brainstem response is adult-like by 18-24 months Auditory cortex is ½ the thickness at birth; development continues until age 2-3 Undetected hearing loss stunts auditory cortex development

Question 35

What are neurons?

Answer 35

Cells specialized to transport information throughout the body. Consist of a cell body (soma) with one axon (projecting segment), and one or more dendrite(s) (receptor segments). Grey matter; primary found on the outside of the brain and in the middle of the spinal cord (for protection)

Question 36

What are glial cells?

Answer 36

Surround neurons and provide support for and insulation between them, which increases the speed at which impulses travel through the neural system. Support neuronal function by regulating the environment of the nervous system and providing protection against harmful agents. White matter; on the inside of the brain and the outside of the spinal cord.

Question 37

What is the diancephlon?

Answer 37

Refers to 4 structures together: Thalamus (Relay station for all sensory and motor tracts, except olfaction; seems to regulate cortical activity for alertness), Subthalamic nucleus (STN -Tiny nucleus that sits under the thalamus; part of basal ganglia circuits or motor and cognitive functions), Hypothalamus (Controls the autonomic nervous system - heart rate, digestion, respiration, stress response, blood pressure, temperature regulation, fluid balance in the body), and the Epithalamus (Contains the pineal gland which secretes melatonin - involved in sleep/wake cycles).

Question 38

Describe the limbic system.

Answer 38

The part of the brain involved in our behavioural and emotional responses, especially when it comes to behaviours we need for survival: feeding, reproduction and caring for our young, and fight or flight responses. Includes the hippocampus, the amygdala, and the hypothalamus.

Question 39

What is the amygdala?

Answer 39

A roughly almond-shaped mass of gray matter inside each cerebral hemisphere, involved with the experiencing of emotions and drives.

Question 40

Name the four different lobes of the brain and their main function

Answer 40

Frontal: Higher order reasoning, planning, organization, inhibitory control, focusing attention, executive functions, decision making, motor control (mainly motor functions and higher-level functions) Occipital: Vision Temporal: Auditory, comprehension of language, some parts of taste, memory Pariatal: Somatosensory (touch, pressure, etc.)

Question 41

Name the four primary cortex of the brain.

Answer 41

Primary motor Primary somatosensory Primary auditory Primary visual

Question 42

What is the function of the temporal gyri (Superior, middle and inferior)?

Answer 42

Processing eye movements, analysis of visual social information, semantic memory processing, language processes, visual perception, and integrating information from different senses

Question 43

Differentiate Broca's and wernicke's area.

Answer 43

Brocas: expressive language; Production of speech and written language. Wernickes: Receptive language; Language comprehension, creates plans for meaningful speech.

Question 44

What is the function of the prefrontal cortex?

Answer 44

Executive functions; Attention, planning, impulse control, making predictions, cognitive flexibility

Question 45

What are the functions of the association cortex?

Answer 45

Coordinates brain functions that require more than basic primary sensory or motor functions. Can include language, attention, memory, visuospatial functions, mathematical functions, social cognition, reasoning, problem-solving, personality, critical thinking. Main purpose = Appropriate use of muscles (QUALITY; planning, sequencing) in context

Question 46

Describe the 'what' pathway.

Answer 46

Runs from the primary occipital lobe in the occipital cortex to the temporal lobe. Supports object identification – Images will start in the visual cortex, then move to the association cortex

Question 47

Describe the 'where' pathway.

Answer 47

Runs from the primary occipital lobe in the occipital cortex to the parietal lobe. Supports navigating space and understanding where you are in space

Question 48

Describe the function of the brainstem.

Answer 48

Corridor for all major sensory, motor, cerebellar and cranial nerve pathways Location of cranial nerve nuclei Location of other nuclei with unique functions that do not exist in the spinal cord (ex. critical for consciousness, cerebellar circuits, muscle tone, cardiac functions, & respiratory functions)

Question 49

Describe the function of the medulla.

Answer 49

Transmits motor and sensory signals from the spinal cord to higher parts of the brain. Regulation of heartbeat, respiration, and hormone release

Question 50

Describe the function of the pons.

Answer 50

Relays information from the cerebral cortex to the cerebellum; motor and sensory function of face, head, & eyes; hearing & balance; salivation

Question 51

Describe the function of the midbrain.

Answer 51

Associated with vision, hearing, motor control, sleep and wakefulness, arousal (alertness), and temperature regulation

Question 52

Describe the function of the cerebellum.

Answer 52

Responsible for the smooth coordination of movement. | One of the “big three” responsible for the quality of movement.

Question 53

What is the function of the thalamus?

Answer 53

All sensory roads connecting the outside world to the cortex go through the thalamus (except smell). A relay for the pathway between the cerebellum and primary motor cortex,as well as between the basal ganglia and primary motor cortex. Also regulates cortical activity for alertness.

Question 54

What is the function of the hypothalamus?

Answer 54

Controls autonomic nervous system. Responsible for homeostatic functions including autonomic and neuroendocrine functions.

Question 55

What is the subthalamic nucleus?

Answer 55

Part of basal ganglia circuits for motor and cognitive functions

Question 56

What is the epithalamus?

Answer 56

Pineal gland secretes melatonin, epithalamus connects diencephalon to limbic system and cortex

Question 57

What is the function of the basal ganglia?

Answer 57

Made up of the caudate and putamen nuclei, the globus pallidus, the subthalamic nucleus, and the substantia nigra. Refines motor commands from the cortex by receiving and processing information from the cortex, then sending it back to the cortex through the thalamus. Involved in the initiation (and inhibition) of movement

Question 58

What is the function of the hippocampus.

Answer 58

Memory.

Question 59

What are upper motor neurons?

Answer 59

Nerve cells that have cell bodies in the cerebral cortex and axons which run to the brainstem and spinal cord to synapse with interneurons and lower motor neurons, which in turn signal muscles to contract or relax

Question 60

What are lower motor neurons?

Answer 60

Nerve cells that have cell bodies in the spinal cord or brainstem (CNS) and axons that go into the PNS to synapse with interneurons or muscles Final common pathway

Question 61

What is a neuromuscular junction?

Answer 61

A synapse formed by the contact between a motor neuron and a muscle fibre

Question 62

Describe a peripheral nerve.

Answer 62

Contains lower motor neurons but can also contain sensory nerves. There can be a peripheral nerve that is only sensory, a peripheral nerve that is only motor, or a peripheral nerve that is a combination of the two.

Question 63

Describe a motor unit.

Answer 63

Made up of a motor neuron and the muscle fibres innervated by that motor neuron’s axonal terminal

Question 64

What functions do spinal nerves serve?

Answer 64

Only carry motor and somatosensory information (don’t carry smell, taste, vision, hearing) Carry information between the spinal cord and the body All spinal nerves carry both sensory and motor information together

Question 65

What functions to cranial nerves serve?

Answer 65

In addition to what spinal nerves carry, cranial carry smell, taste, vision, hearing Carry information between the head & neck and the body Can carry sensory information, motor information, or both

Question 66

Name the 12 cranial nerves in order with their major function.

Answer 66

Olfactory - smell Optic - vision Oculomotor - eye movement, pupil size, accommodation Trochlear - Eye movement, looking down Trigeminal - sensation (TTPP in face), motor (muscles of mastication) Abducens - eye movement, looking temporally Facial - sensation (taste), motor (muscles of facial expression) Vestibulocochlear - Sensation (sound, balance) glossopharyngeal - sensation (taste), motor (muscles of pharynx) Vagus - motor (larynx, parasympathetic to viscera) Hypoglossal - motor (muscles of the tongue)

Question 67

What are the key concepts that characterize neural development?

Answer 67

Neural development is characterized by over-development followed by pruning Neurons are born biased for certain functions but uncommitted The ultimate function of cells depends on what other cells they connect with and what input they receive Nervous system develops on a use-it-or-lose-it basis - Developmental plasticity permits correction of “minor mistakes” - Reorganized cortex may end up being somewhat different from the typical pattern

Question 68

Define gastrulation, neurulation, and embryonic folding.

Answer 68

Gastrulation: The process by which the three germ layers of the trilaminar embryonic disc are formed (Ectoderm, mesoderm, endoderm) Neurulation: The beginning of the formation of the nervous system-- the process by which the neural plate forms into the neural tube Embryonic folding: Process by which the trilaminar disc creates a basic three-dimensional human body plan. See section 1.3 for more details.

Question 69

Name the three layers present after gastrulation and what they form.

Answer 69

Ectoderm: skin and nervous system. Mesoderm: bone, muscles, and connective tissue Endoderm: lining of organs such as gastrointestinal tract and airways

Question 70

What do the notochord and neural tube become?

Answer 70

Notochord: neucleus of the backbone | Neural tube: comes off ectoderm and forms CNS`

Question 71

How does the brain change after birth?

Answer 71

At birth there is over-proliferation of neurons After birth, there is over-proliferation of connections - Programmed cell death - Pruning of connections Second wave of synaptogenesis and pruning in the pre-adolescent years Within the first few months of life, ventricles continue to grow and myelin coated axons begin connecting.

Question 72

When does myelination occur?

Answer 72

Myelination and formation of connections continues well after birth. For example, there is dramatic growth of neural connections between birth and 24 months in Broca’s area (and other brain regions). Different motor, sensory, and cognitive systems “come online” at different points throughout life as the neurons in the associated areas become myelinated and transmit information more effectively. Although MOST areas become myelinated in early childhood, several areas do not become myelinated until adolescence or even adulthood.

Question 73

What are the key principles of neuroplasticity?

Answer 73

``` Use it or lose it Use it and improve it Repetition matters Time matters Intensity matters Specificity matters Salience matters Difficulty matters Transference Interference Age matters ```

Question 74

Describe the steps of responding "no" to a question.

Answer 74

In order to respond “no” to a question, the auditory cortex will first receive information. From the auditory cortex, the prefrontal cortex makes the decision to respond. Muscle actions are planned in the premotor and supplementary motor area, which is connected to Broca’s area (“broken tongue” – expression is impaired). Then, info is sent to basal ganglia to decide if and how to proceed with action. Muscle actions begin to be planned in the premotor area, then are sent to basal ganglia that decides whether to initiate movement based on previous experiences Info goes back to the thalamus, which directs info to the primary motor cortex, which sends info to the brainstem and spinal cord, as well as a copy being sent to the cerebellum (allows the cortex to make adjustments)

Question 75

Name the different types memory and name the associated brain structures.

Answer 75

Sensory memory: peripheral receptors Working: frontal lobes and anterior structures of the limbic system Long-term (declarative): association cortex, medial temporal lobe, hippocampal formation, adjacent cortex of parahippocampal gyrus, medialdiencephalic memory areas, thalamus, mammillary bodies, other diencephalic nuclei lining 3rd ventrical Long-term (non-declarative): subcortical structures and cerebellum

Question 76

Name the three types of declarative memory and their associated structures.

Answer 76

Episodic: temporal neocortex Lexical: angular gyrus Semantic: temporal parietal, frontal association cortex

Question 77

Name the three types of non-declaratice memory and their associated structures

Answer 77

Skills and habits: cerebellum, basal ganglia (debated) Emotional associations: interactions among the limbic system, prefrontal cortex, subcortical structures (debated) Conditioned reflexes: cerebellum (debated)

Question 78

Discuss the evidence for a localization view of the brain.

Answer 78

The structure of our brains—from the time the brain begins to develop, neurons grow outwards from the middle in columns (which also differentiate into layers); this supports the idea that one column does one distinct thing, while a different column does something else. Existence of primary cortices and a variety of cell types Connections and dendritic arborization patterns across brain regions Lesion-behaviour correlations (especially for basic sensorimotor functions; i.e. a lesion in Broca’s area affects fluent speech output)

Question 79

Discuss the evidence against a localization view of the brain.

Answer 79

How interconnected and interdependent the brain is—when completing many functions (ex. reading, having a conversation, etc.), areas all over the brain are affected, and it is currently impossible to determine what sections of the brain do what It’s oversimplified Doesn’t account for individual variability A lot of data comes from patients with lesions (i.e difference between brains with and without lesions - different organization) Doesn’t account for dynamic changes in the brain over time

Question 80

What is lateralization?

Answer 80

A special kind of localization; function is primarily controlled by one hemisphere relative to the other

Question 81

Using the lateralization view, what functions are associated with the left hemisphere?

Answer 81

``` Language & verbal ability Logic Sequential things Details Fast temporal processing: acoustic timing and integration of information over time ```

Question 82

Using the lateralization view, what functions are associated with the right hemisphere?

Answer 82

Spectral processing: acoustic pitch and integration of information over space Big picture (gestalt) Musical ability Emotion recognition Attention to extrapersonal space (paying attention to the space around you- this is why right hemisphere strokes lead to spatial neglect far more often than left hemisphere strokes)

Question 83

Name the different structural imaging types.

Answer 83

Angiography: blood vessels over time CT: structural images collected over time via multi-angle x-ray (show tissue density) MRI: structural images collected via exposure to magnetic field (reflects density of hydrogen ions) MRA: blood vessels at one moment in time

Question 84

Name the different functional imaging techniques

Answer 84

PET: radiation emitted by radioisotopes injected into artery, measures metabolism of glucose EEG: brain electrical activity via electrodes on the scalp or on brain

Question 85

Compare UMN and LMN damage based on strength, reflexes and the presence of atrophy and fasciculations.

Answer 85

Strength: reduced weakness (UMN), weakness (LMN) Reflexes: hyperreflexia, hyporeflexia Atrophy: N/A, present Fasciculations: N/A, present.

Question 86

Describe the four major events of embryologic development.

Answer 86

1) Formation of embryonic disc: Differentiation into endoderm, mesoderm, ectoderm (aka gastrulation) 2) Formation of the neural plate: Notochord (structure that derives from embryonic disc) secretes growth factors that induce development of ectoderm layer into the neural plate → folds in and edges fuse to become neural tube → develops into brain and spinal cord with hollowed-out center that will become central canal and ventricles. Neural plate is formed during gastrulation 3) Migration of neural crest cells to become cranial nerves: Neural crest cells originate in the ectoderm and the settle down in various parts of the body. Cranial neural crest that gives rise to the head, connective skeletal structures and nerves 4) Development and fusion of pharyngeal arches

Question 87

What do the different pharyngeal arches form into?

Answer 87

The first arch gives rise to the mandible The second arch gives rise to the hyoid The third arch gives rise to the stylopharyngeus The fourth arch gives rise to the cricothyroid and soft palate The fifth doesn’t really form in humans The sixth arch gives rise to the intrinsic muscles of the larynx (except for the cricothyroid)

Question 88

Discuss how cleft palate arises.

Answer 88

Cleft palate forms if facial ridges don’t fuse properly in embryological development from sides and top of head. Cleft palate can lead to a variety of issues, including feeding/swallowing and nasal air emissions impacting speech intelligibility.

Question 89

How does substance consumption impact embryological development?

Answer 89

Early in embryological development, there are many processes that could be impacted by consuming substances like alcohol and drugs. These may impact the development before a pregnant person even knows they are pregnant (e.g., FASD), which may in turn impact speech or language development.

Question 90

How does premature birth impact development?

Answer 90

Risks of a lack of folds in the brain; the brain cortex is not developed fully and prepared for birth. White matter is not fully developed in premature children.

Question 91

Define chromosome and gene.

Answer 91

Chromosome: a thread-like (x like) structure of nucleic acids and protein found in the nucleus of most living cells, carrying genetic information in the form of genes Gene: section of chromosomes that are the basic unit of heredity in all living things. Genes are chemical instructions, inherited from your parents, that determine proteins. Each gene is a segment of DNA that is the code for the production of particular proteins (function: to make the proteins)

Question 92

Why is gene regulation important in embryonic development?

Answer 92

The genes are important because they determine what proteins we have and the proteins determine who we are How the genes develop during embryonic development will govern who we are, what we look like, all of our features It is the “instruction manual” (and of course, there are also env. factors)

Question 93

Give an example of each different type of hereditary pattern.

Answer 93

Autosomal recessive: only problematic is homozygous (this isn't always true) Autosomal dominant: huntington's X-linked disorder: fragile X syndrome, colour blindness

Question 94

What are some examples of disorders linked to chromosomal mutations?

Answer 94

Down Syndrome, William’s Syndrome (deletion in a chromosome – a handful of genes are missing) – these are NOT inherited syndromes. They result from mutations

Question 95

Discuss the impact of fragile X syndrome on a child.

Answer 95

``` Delayed speech and language development Mild-moderate intellectual disability Anxiety, ADHD 33% also have ASD Fragile X is the most common cause of ASD ```

Question 96

Discuss the impact of Down's syndrome on a child.

Answer 96

``` Extra 21st chromosome Delayed speech and language development Mild-moderate intellectual disability Attention problems, OCD Increased risk of gastroesophageal reflux, celiac disease, hypothyroidism, vision and hearing problems, cancer of blood-forming cells, Alzheimer disease Ramifications for family members: - Not typically inherited - Risks increase with the mother’s age at conception ```

Question 97

Discuss the impact of william's syndrome on a child.

Answer 97

``` Part of chromosome 7 is deleted Mild-moderate intellectual disability Cardiovascular problems Large vocabularies Poor visual-spatial skills ADHD, Anxiety, phobias Ramifications for family members: - Not typically inherited ```

Question 98

What are some examples of non-syndrome congenital disorders? List their causes as well.

Answer 98

Hearing loss: Can be Recessive, Dominant, X-linked, Mitochondrial ASD: Fragile X, Tuberous Sclerosis Complex, Rett Syndrome, family history, genetics (involving one or more genes), parental age, low birthweight, fetal exposure to valproate Cleft Lip/Palate: Van der Woude syndrome, Velcardiofacial syndrome, Median facial dysplasia

Question 99

Discuss the feeding and swallowing related developmental changes a child undergoes from birth to 3 months.

Answer 99

Presence of sucking pads Relatively smaller and retracted mandible High and anterior position of hyoid and larynx Close approximation of tongue, cheeks, hard and soft palate Close approximation of uvula and epiglottis Rooting, suckling, tongue protrusion (tongue thrust), transverse tongue, phasic bite (open and close jaw when pressure put on gums) and santmyer reflexes (blow air on babys face, elicits reflexive swallow) are present Gag and swallowing reflex present.

Question 100

Discuss the feeding skills developed from birth to 3 months.

Answer 100

Obligatory nose breathers Suckling liquids by bottle or breast Pause-burst swallow pattern Brings hands and toys to the mouth Generally fed in a semi-reclined position Begins to recognize food source BOTTLE VS JAW: **see jaw movement to faciliate tongue movement, Lip seal looks different, bigger lip, less work for bottle, See social piece, looking up at mom when feeding. Lots of research about bonding

Question 101

Discuss the feeding and swallowing related developmental changes a child undergoes from 3 to 6 months.

Answer 101

Developmental Changes = increasing distance in oral cavity Sucking pads are absorbed Mandible grows downward and forward Hyoid and larynx shift downward Increasing distance between uvula and epiglottis Greater distances between oral and pharyngeal structures Integration of rooting and tongue protrusion reflexes Increased muscle control of the mandible Increased active mobility of the tongue, lips, and cheeks Improved timing, rhythm, and co-ordination of suckling, swallowing, and breathing

Question 102

Discuss the feeding skills developed from 3 to 6 months.

Answer 102

Some exploration of puree consistencies by spoon No active lip movement to assist with spoon feeding Suckling used for spoon feeding as well as bottle Sequences greater than 20 sucks Some spillage from lips Places hands on the bottle Recognizes and anticipates food

Question 103

Discuss the feeding and swallowing related developmental changes a child undergoes from 6 to 12 months.

Answer 103

Continued elongation of the aerodigestive tract Mandibular incisors erupt between 6-8 months Increase in saliva production Continued increases in motor control and co-ordination Integration of the transverse tongue, suckling, and phasic bite reflex Gag reflex becomes less sensitive

Question 104

Discuss the feeding skills developed from 6 to 12 months.

Answer 104

Gradual development of sucking (vs. suckling) Holds tongue and jaw stable position for spoon Fed purees more upright position Active lip movement to remove food from spoon Phasic bite-release pattern initially but develops into bite and stable hold Munching used if solids break off in mouth Tongue moves laterally ONLY if food placed on the side Child learns to swallow with tongue tip elevation Finger feeds dissolvable and soft solids Begins to hold spoon and cup Fed in upright position - highchair or feeder seat

Question 105

Discuss the feeding and swallowing related developmental changes a child undergoes from 12-24 months.

Answer 105

Continued elongation of aerodigestive tract Development of food preferences Integration of the santmyer reflex

Question 106

Discuss the feeding skills developed from 12-24 months.

Answer 106

Diagonal rotary chewing pattern Less spillage from the lips Tongue tip can elevate independently of the jaw Refines independent spoon feeding and cup drinking skills Food may fall off the spoon as child learns to spoon feed Begins to use a fork for solid foods

Question 107

What are the typical feeding milestones in infants?

Answer 107

Solid food introduction: 6 months Cup drinking introduction: 6-9 months Straw drinking: By first birthday (12 months) Munching: 6-9 months Self feeds with fingers: 8-10 months Self feeds with spoon or fork: 33-36 months (fully independent) Management of combination of textures: 18+ months. By 18-24 able to manage combination

Question 108

Describe the expressive and receptive language skills in the perlocutional stage

Answer 108

0-9 months Expressive: Smiles, cries, coos (functional communication interpreted as intent by adults) Receptive: Responds to sound; seems to recognize your voice

Question 109

Describe the expressive and receptive language skills in the Illocutionary stage.

Answer 109

9 months Expressive: Intended meaning - uses protowords (their own sound used consistently for a message) Protoimperative - affect others’ behaviours Protodeclarative - affect other’s attention Receptive: Looks when you point, turns head when you call name

Question 110

Describe the expressive and receptive language skills in the locutionary stage.

Answer 110

11-13 months Expressive: Literal meaning of words, first word milestone, unstable vocabulary for first 10 words Receptive: Starts to respond to simple commands like “come here” and “no”

Question 111

Describe the expressive and receptive skills seen in 1 year olds.

Answer 111

Expressive: 50% of words are nouns, 2-word combinations, have naming errors (18 months vocabulary explosion) Receptive: Points to pictures in a book when you name them

Question 112

Describe the expressive and receptive skills seen in 2 year olds.

Answer 112

Expressive: Has a word for almost everything, possessive /s/, Receptive: understands basic WH questions

Question 113

Describe the expressive and receptive skills seen in 3 year olds.

Answer 113

Expressive: Uses some plural words like toys, birds, and buses. Most people understand what your child says Receptive: Responds when you call from another room, understands words for colours/shapes/family members

Question 114

Describe the expressive and receptive skills seen in 4 year olds.

Answer 114

Expressive: Says all speech sounds in words, tells a short story, names letters and numbers Receptive: Understands sequence of events, follow multi-step instructions, hears and understands what is said at school

Question 115

Describe the expressive and receptive skills seen in 5 year olds.

Answer 115

Expressive: Increase in figurative language (jokes), increase in language development because of school Receptive: Improved language-based conversation and reasoning skills

Question 116

List the key concepts that characterize neurodevelopment.

Answer 116

1) Neural development is characterized by over-development followed by pruning - Initially, you have all of these connections at birth, then through your experience and through genetic coding, your brain gets pruned back and shaped to ones individual circumstances 2) Neurons are born biased for certain functions but uncommitted - There are neurons that are biased to be motor neurons, but if something goes wrong during development, they can be other things (because there is some flexibility/plasticity in the nervous system) 3) The ultimate function of neurons depends on what other cells they connect with and what input they receive - Through experience, certain neurons end up communicating with other neurons, and then they become part of that network 4) The nervous system develops on a use-it-or-lose-it-basis - Developmental plasticity permits correction of “minor mistakes” - Recognized cortex may end being somewhat different from the typical pattern

Question 117

Describe some of the neurological changes that occur in adolescence.

Answer 117

Cognitive development is primarily executive functioning - the brain is undergoing major transformation in early adolescence. Most concerns in development surround executive functioning, not necessarily language - demands for executive functioning increase as one ages. Needs in attention, language, memory, visuospatial functions, and social cognition increase. It is suggested that adolescence now ends around 25, as research suggests the ability to use working memory, reasoning, etc. is still developing into your 20s.

Question 118

How does language change in adolescence?

Answer 118

Adolescent individuals with typical language development primarily see advances in language for more intensive social interactions, with language at the literate end of the oral-literate continuum, and with abilities related to abstract and critical thinking, and executive functioning Acquire a larger vocabulary - includes increasing understanding of derivational morphology, the recognition of root words, prefixes, and suffixes that can change the part of speech and pronunciation of base words. Morphological awareness can compensate for some phonological deficiencies in adolescents with LLDs. Learn to elaborate and expand the meanings of known words (e.g., “cold” meaning temperature, or “cold” meaning affect) and to understand connections among words related in various ways, such as by derivation or by meaning, synonyms, or sound.

Question 119

Name the stages of literacy development, their relative grade levels, and some achievements you might see at each.

Answer 119

0) Pre-reading (pre-k) - Literacy socialization 1) Decoding (1-2) - phonological analysis, segmentation, and synthesis of single words. 2) Automaticity (2-4) - fluent reading. 3) Reading to learn (4-8) - more complex comprehension, increased rate. 4) Reading for ideas (8-12) - recognition of different view points, use of inferencing. 5) Critical reading (college) - synthesis of new knowledge, critical thinking.

Question 120

Name the stages of narrative development, their relative ages, and some achievements you might see at each.

Answer 120

1) heap stories (2-3 years) - labels and descriptions of events with no organized theme. 2) sequence stories (3) - labels of events around a theme but still mostly listed without plot. 3) primitive narratives (4-4.5) - satires with a core or central person, object, or event; 3 story grammar elements; initiating event, attempt, or action, consequence, no real ending. 4) chain narratives (4.5-5) - a plot with some evidence of cause and effect and temporal relationships and some consideration of motivation; 4 story grammar elements; ending does not necessarily follow logically. 5) True narratives (5-7) - all 5 story grammar elements; central theme, character, plot, motivations behind actions, logical and temporal ordered sequences of events.

Question 121

How does normal aging affect cognition?

Answer 121

Highly variable changes Cognitive changes only relate to the nervous system Anything that does decline is not severe enough to cause significant impairment like a dementing disorder Individuals keep learning until the end of life We do slow down psychologically for processing and reacting - reduced inhibition and slow speed due to perceptual deficits and cognitive capacity

Question 122

How does normal aging affect attention?

Answer 122

Decline in executive attention/selective attention Reduced ability to ignore concurrent distraction Reduced ability to delete information that’s no longer relevant

Question 123

How does normal aging affect learning/memory?

Answer 123

Slower learning speed Not all types of memory are equally vulnerable (episodic > working memory > semantic/lexical > Procedural) Mild cognitive impairment is common, debate if precursor to Alzheimer type dementia

Question 124

How does normal aging affect language?

Answer 124

Syntax and morphology intact, word knowledge still increasing Word finding may decline, language comprehension might be impacted if presented too quickly, but secondary to slower processing

Question 125

How does normal aging affect motor?

Answer 125

The main change is sarcopenia - the loss of skeletal muscle mass This causes weakness (and thinking speed slows a little)

Question 126

How does normal aging affect respiratory?

Answer 126

Smaller lung volumes and speaking with a greater proportion of vital capacity are associated with aging

Question 127

How does normal aging affect nervous?

Answer 127

The main changes are cognitive slowing and reduced inhibition Main theory of cognitive aging is that it represents reduced inhibition and slow speed, with contributions from perceptual deficits, domain-specific cognitive impairments and reduced cognitive capacity Slower at perceiving, processing and reacting to information (particularly when the situation requires rapid processing of complex information)

Question 128

How does normal aging affect sensory?

Answer 128

Presbyopia: loss of visual acuity, seen first at near distances (cause is unknown) Presbycusis: hair cell degeneration in the cochlea Presbyosmia, Presbystasis: along with presbycusis, might be caused by interaction of body compression at foramen and loss of nerve fibers Decreased somatosensory function, including tactile spatial acuity

Question 129

What doesn't change with aging?

Answer 129

IQ - crystallized intelligence, personality (inhibitory control changes are usually just exaggerations of personality)

Question 130

Define senescence.

Answer 130

Progressive deterioration of many bodily functions over time.

Question 131

What are the general principles of normal aging?

Answer 131

Overall, muscle mass decreases Thinking speed slows down Decreased somatosensory function, including tactile spatial acuity

Question 132

Discuss some fo the possible psychosocial effects of communication disorders on clients and their SO.

Answer 132

Decrease in participation in social situations (client) Feelings of loneliness/isolation, increased mental health challenges (both) Finding and keeping a job (client) Loss of relationships (both) Communication partners may feel burdened/unsupported and experience caregiver burnout. (sig. other)

Question 133

Discuss the psychosocial impacts of stroke.

Answer 133

Communication barriers may lead to reduced participation Reduced autonomy/ ability to express needs Accommodations for job/ keeping a job Fatigue may impact memory reserves which may impact conversation exchange Loss of self Limited insight or reasoning may put person in dangerous situation Increased functional dependency -> caregiver burnout Mobility limitations in the community Apathy leading to decreased participation

Question 134

Discuss the psychosocial impacts of laryngeal/head/lung cancer.

Answer 134

Loss of voice, appearance changes and functional limitations may disrupt self image and identity Limited mobilization due to equipment needs and environmental barriers (O2, suctioning, noise, light, immunocompromised) Anxiety/depression

Question 135

Discuss the psychosocial impacts of CP.

Answer 135

Hearing loss and/or vision problems leading to social exclusion/ lack of willingness to participate Delays in emotional and physical development may lead to not being able to pick up on social cues emotional tone/empathy leading to reduction in friendships/inclusion Attention and behavioral deficiencies Mental health implications from frustrations of communication challenges and social exclusion/isolation Self acceptance and acceptance from others Need for accommodations in the workplace

Question 136

What are some coping mechanisms that can be used by clients and families with communication disorders?

Answer 136

Use of mental health/counselling resources Attending support groups (Eg: Niagara aphasia Program) Facilitating a strong support system To avoid caregiver burnout → alternate role with other family members if possible Working with HCP to promote effective strategies to mobilize and communicate with individual Physical activity to help alleviate tensions, frustrations/ mental health challenges Journaling Taking breaks when necessary

Question 137

Describe motivational interviewing.

Answer 137

A collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. Involves: - Partnership: involves mutual respect, not imposing idea of trying to “fix” situation - Acceptance: See others’ perspective, acknowledge their right to make decisions and the ability to recognize the other person’s strength and effort - Compassion - Evocation

Question 138

What are the key principles to motivational interviewing?

Answer 138

Express empathy Develop discrepancy: guide the client to see the discrepancy between goals and current behaviour Roll with resistance: understand that this is a necessary part of the process. Support self-efficacy

Question 139

What are some vital skills to counselling in SLP practice?

Answer 139

Listening: non-judgemental and active. Empathizing What do I say: clarifying, disclosing, affirming.

Question 140

Define intersectionality.

Answer 140

Concerned with simultaneous intersections between aspects of social difference and identity and forms of systemic oppression at macro and micro levels

Question 141

Define microagreessions.

Answer 141

A comment or action that subtly and often unconsciously or unintentionally expresses a prejudice attitude toward a member of a marginalized group

Question 142

Define cultural competence, humility, and safety.

Answer 142

Cultural Competence: Skills you can learn that makes the care you provide more effective. Cultural Humility: Your ongoing commitment to self-evaluation and longer-term awareness of bias. Cultural safety: Outcome of effective learning and practices on part of individuals and organizations when people feel safe receiving health care.

Question 143

Describe the learning theory.

Answer 143

Behaviourism: operant conditioning principles, the learner is a blank slate and must be provided experience. New behaviours are acquired through associations of stimuli and responses. Eg: Drill/Rote work, repetitive practice, participation points, verbal reinforcement Cognitivism: Humans process stimuli they receive rather than just responding to it → they think about what’s happening. Changes in behaviour indicate what is going on in the learners’ head. Learner plays an active role. Eg: Linking concepts, real word examples, mnemonics, analogies, imagery, problem solving Constructivism: We all construct our own perspective of the world, based on individual experience. Learning based on how we individually interpret the world around us. Learning is unique for each person. Eg: Case studies, research projects, problem based learning, brainstorming

Question 144

Describe behaviour modification.

Answer 144

Behavior modification is defined as "the alteration of behavioral patterns through the use of such learning techniques as biofeedback and positive or negative reinforcement. Skinner noted that a reinforcer is a consequence that increases the likelihood of behavior to recur, while punishment is a consequence that decreases the chance. The indications for developing a behavior modification plan can be for any unwanted, maladaptive, or aberrant behavior. It can also be used to teach and reinforce new, desired behaviors. In clinical settings, the treatment team utilizes the concept of operant conditioning to reinforce prosocial behaviors through positive consequences as seen in token economy, shaping, differential reinforcement of desired behaviors, and extinguish the undesired behaviors through negative consequences like an overcorrection, response costs, time outs

Question 145

Describe the different brown's stages, providing age range in months, MLUm, MLU range, morphological structure, and a few examples.

Answer 145

1) 15-30 months, 1.75, 1.5-2.0, stage 1 sentence types, examples: nomination, negation, recurrence, possession, attribution, locative, agent-action, action-object, agent-object. 2) 28-36 months, 2.25, 2.0-2.5, will see present progressive (-ing), in, on, -s plurals. Examples include it going, in box, on tree, my cars. 3) 36-42 months, 2.75, 2.5-3.0, will see irregular past tense, -s possessives, uncontractible copula, examples include me fell down, doggie's bone, are they there? 4) 40-46 months, 3.50, 3.0-3.7, includes articles, regular past tense (-ed), third person regular present tense, examples include the/a book, she jumped, he swims.

Question 146

List some possible assessments used at the various stages of language development.

Answer 146

Perlocuationary: feeding assessment, hearing assessment, overall development, parent-child communication and relationship, vocal assessment Illocutionary: intentional communication? play observation, parent report instrument, can initiation be elicited? Locutionary: play assessment, relationship between use of words as labels and functional play, receptive language, communicative function assessment.

Question 147

Discuss the development of pragmatics from 3-5 years.

Answer 147

3-3.5 years: More flexibility in requesting, including the following: - Permission directives (can you…?) - Indirect requests (would you…?) - Direct requests decrease in frequency, as indirect requests increase - Narratives are “primitive”, with theme and some temporal organization 3.5-4 years: New functions emerge, include the following: Reporting on past events, Reasoning, Predicting, Expressing empathy, Creating imaginary roles and props, Maintaining interactions 4-5 years: Hints that do not mention the intention in the request (“those smell good”) emerge Ability to address specific requests for clarification increases Narratives are “chains” with some plot, but no high point or resolution

Question 148

Discuss the development of semantics from 3-5 years.

Answer 148

3-3.5: Semantic relations between adjacent and conjoined sentences include Additive, Temporal, Causal, and Contrastive Understanding of basic colour words Use and understanding of basic kinship terms 3.5-4: Use and understanding of “when” and “how” questions Understanding of words for basic shapes (circle, square, triangle) Use and understanding of basic size vocabulary (big, small) Use of conjunctions and and because to conjoin sentences 4-5: Knowledge of letter names and sounds emerges Knowledge of numbers and counting emerges Use of conjunctions when, so, because, and if

Question 149

Discuss the development of syntax from 3-5 years.

Answer 149

3-3.5: Brown’s Stage IV: Emergence of Embedded Sentences First complex sentence forms appear Auxiliary verbs are placed in questions and negatives Irregular past tense, articles (a, the), possessive (‘s) acquired ``` 3.5-4: Brown’s Stage IV to Early Stage V Early emerging complex sentence types, including the following: Full prepositional clauses Wh- clauses Simple infinitive Conjoined ``` 4-5: Brown’s Stage V Later developing morphemes acquired, including To be verbs, Regular past tense, Third person /s/ Past-tense auxiliaries used including Relative clauses (right branching), Infinitive clauses with different subjects, Gerund clauses, and Wh- infinitive clauses Basic sentence forms acquired

Question 150

What might be some red flags in content in children?

Answer 150

Poor vocabulary skills Inflexible word knowledge (challenges with figurative language) Trouble with verbs

Question 151

What might be some red flags in form in children?

Answer 151

Omission of morphosyntactic markers Difficulty forming wh-questions Difficulty understanding complex syntax

Question 152

What might be some red flags in use in children?

Answer 152

Immature pragmatics Weak Theory of Mind Trouble understanding emotion & non-verbal cues

Question 153

What are some phonological characteristics associated with a language-learning disability?

Answer 153

May have intelligible speech without obvious errors in speech production More likely to have a speech sound disorder than the general population (e.g., 25% of children with LLD have delayed speech) Reading outcomes are poorest for children with the most severe phonological disorders, however language skills were a better predictor of later reading difficulties Often have difficulty with speech perception, phonological memory, and phonological awareness. Need specific assessment tasks (see p421)

Question 154

What are some syntactic characteristics associated with a language-learning disability?

Answer 154

Deficits in comprehension and production of complex syntax are common in children with LLD They have difficulty understanding passive voice, negation or relative clauses High error rates and less complex sentences in written language (e.g., fewer prepositions and descriptive words), also more morphological errors in writing. Syntax and morphology errors decline by age 8 in oral speech, but are prevalent in writing. 50% of children with LLD had syntactic deficits

Question 155

What are some semantic characteristics associated with a language-learning disability?

Answer 155

“Children with LLD have small vocabularies that are restricted to high-frequency, short words” (p422) Limited vocabulary may reflect limited words acquired through readings Weak word knowledge (e.g., meaning, categorization). Retrieval difficulties were noted. Receptive difficulties with complex directions, figurative language and integrating information from a large discourse Hard time with reading to learn

Question 156

What are some pragmatic/social/emotional characteristics associated with a language-learning disability?

Answer 156

“Many children with LLD have limited verbal fluency (Oetting & Hadley, 2009). They don’t talk much, and what they say is brief and unelaborated” (as cited in Paul, Norbury, Gosse, p422) Many reported conversational challenges, e.g., not sensitive to the needs of listeners, difficulties with repair, miss responses to others initiations, language may be more hostile, less assertive, tactful and polite. “Conversational pragmatics may be the area of the most significant deficit in the oral language of some students with LLD” “Children with LLD have been shown to be less accepted by peers, have poorer social skills, and have higher levels of problem behaviors than children with typical school achievement” (Weiner, 2002, as cited in Paul Norbury, Gosse p426) May be withdrawn or join social groups with higher levels of problem behavior (boys especially have challenges with emotional regulation)

Question 157

What are some attention and activity characteristics associated with a language-learning disability?

Answer 157

“Many students who have learning problems also have behavioral and emotional difficulties that make it harder for them to take advantage of the instruction, both regular and special, that they receive” (426) Unclear whether the behavioral causes the learning disorder or the learning disorder causes the behavior or if a third factor affects both Many children with LLD also have attention deficit hyperactivity disorder (ADHD). Challenge with selective attention. “Children with attention disorders are easily distracted and have short attention spans, low frustration tolerance, inability to recognize the consequences of their actions or learn from mistakes, and difficulty organizing and completing tasks”

Question 158

What are the key language assessment criteria for children 3-5 years old?

Answer 158

Risk Factors Vocabulary recommendations are to formally test receptive language first, but to treat expressively (unless the are speech sound disorders or difficulty with word recall) Syntax and morphology Both need to be assessed expressively and receptively because children commonly produce sentence forms (e.g., agent-action-object) before they can understand those forms when nonlinguistic cues are removed Usually assessed by obtaining a speech sample Pragmatics, play and literacy

Question 159

Compare simultaneous vs. sequential language learners.

Answer 159

Simultaneous bilingualism (or multilangualism) is when a child acquires two (or many) languages simultaneously, for example when they are raised by parents speaking more than one language. Sequential is when the child acquires the second language(s) after having considerably learnt the first language, for example when the parental tongue is different from the main language of the community or education system.

Question 160

How does the quantity/quality of language input effect language development in bilingual children?

Answer 160

Most children exposed to two languages hear one of those languages more than they hear the other This feature of dual language input creates a common feature of bilingual children’s language skills—that they are more advanced in one language than the other There are several properties of child-directed speech that are positive predictors of children’s language development, including use of a diverse vocabulary, diverse syntactic structures, and decontextualized language use

Question 161

How is the rate of language development impacted by dual language input?

Answer 161

Children who hear and acquire two languages build linguistic knowledge at a rate comparable to or greater than is observed in children who hear and acquire only one language. But the language growth of bilingual children, like their language input, is divided between two languages. The result is that young bilingual children tend to lag behind monolingual children of the same age in vocabulary and grammatical development when measured in each language separately. Some evidence suggests that in grammatical development, bilingual children catch up to monolingual children in single language skills by the age of 9 or 10 The bilingual–monolingual difference in vocabulary size may be lifelong, because vocabulary development does not have a point at which it is complete.

Question 162

Define the catch-up period for bilingual children.

Answer 162

The size of the lag associated with bilingualism varies depending on the domain of language under consideration and age. Bilingual children’s phonological skills and higher-level narrative skills are often closer to monolingual levels than their vocabulary and grammar, and their receptive abilities may be stronger than their expressive abilities…. some evidence suggests bilingual children catch up to monolingual children by the age of 10 years

Question 163

Compare language difference and language delay.

Answer 163

Some common misidentifications during these phrases are Language Disorder and Specific Learning Disability. Be careful that the years refer to a 12-month period of constant and consistent exposure. Our academic calendars are typically nine months, so it may take more academic years to acquire conversational and academic language. There is a difference between the terms ‘delay’ and ‘disorder’. A delay means that a child is developing language in a typical manner, but is doing so more slowly than other children his or her age. A disorder means that a child is not developing language as one would expect, or abnormally

Question 164

What should you consider when determining a delay vs. a difference?

Answer 164

Phonology—Linguistic development in bilingual children can result in different patterns from those seen in monolingual children. This can include phonological patterns as the result of transfer or interference from another language. Recognizing dialectal variations and the influence of accent is an essential component of phonological assessment. Morphology—Grammatical structures are not constant across languages. Pronouns, verb conjugation and verb inflection structures, tense, etc. may not exist equally in each language spoken by a bilingual individual. Syntax—Due to the variability of syntactic structures across languages, underlying syntactic deficits will likely manifest differently across languages. Consider if the patterns observed are due an underlying deficit, which may manifest differently across languages, or due to a difference, such as transfer of a grammatical structure from one language to another. Semantics—Clients may learn specific words and/or categories of words in their home language and other words in the language used in academic environments.

Question 165

What forms might intervention take for language delays?

Answer 165

Indirect treatment and monitoring Provide activities for parents and caregivers to engage in with the child, such as book-sharing and parent-child interaction groups. Check in with the family periodically to monitor language development. Direct intervention, including techniques such as: Expansions—repeating the child’s utterance and adding grammatical and semantic detail. Recasts—changing the mode or voice of the child’s original utterance (for example, declarative to interrogative). Build-ups and breakdowns—the child’s utterance is expanded (built up) and then broken down into grammatical components (break down) and then built up again into its expanded form.

Question 166

What are the basic requirements for reading?

Answer 166

Word-level processing: see letters, convert letters into speech sounds (aka decode), map the speech sounds to the word meaning Higher-level processing:, Combine words to form sentences and understand syntax to obtain sentential meaning, link sentences and paragraphs and obtain global meaning representation for a given text

Question 167

Describe the dual route model.

Answer 167

This model describes two routes of reading and can be used to help determine where a breakdown is occurring and what parts of the brain are involved. The roots are indirect (lexical) and direct (non lexical) The man argument is whether or not we just use the indirect or both routes.

Question 168

Describe the indirect route of the dual route model.

Answer 168

Indirect route = Goes through meaning. converting letter units orthographic input lexicon semantic system phonological output lexicon phoneme system speech. Involves meaning (explaining how if you have background information, you have something to map the word onto which helps with this process of print to speech.) You cannot do non-word reading with this route The lexicon is a dictionary, when reading a familiar word you access this word from the lexicon and how it’s pronounced ​​should be able to use the phonological representation of the words they have acquired through experience with oral language to access the meanings of those words in their printed form.

Question 169

Describe the direct route of the dual route model.

Answer 169

Direct route = on the right-hand side of the dual route model, It goes from letter units to grapheme-phoneme rule system to phoneme system to speech. This indirect route can bypass meaning (e.g. child with ASD hyperlexic, can read well without comprehension You skip accessing the mental lexicon (dictionary) by using rules instead to sound out words, while not attaching previous knowledge of word meaning. You can “sound out words” (read non-words)

Question 170

What language comprehension skills are required for reading?

Answer 170

``` Background knowledge Vocabulary Language structures Verbal reasoning Literacy knowledge ```

Question 171

What word recognition skills are required for reading?

Answer 171

Phonological awareness Decoding Sight recognition

Question 172

What are most kids able to do by the end of SK in terms of writing?

Answer 172

``` show they understand that text is written left to right, words have spaces between them, and words have capital and lowercase letters print most letters of the alphabet print their own name, names of family members, and some short words (e.g., "cat" and "dad") use a variety of instruments to communicate, including crayons, markers, pencils and paper; computers or tablets; and chalkboards or whiteboards contribute words or sentences to a class story written down by the teacher write messages using a combination of pictures, symbols, and letters ```

Question 173

What are most kids able to do by the end of grade 1 in terms of writing?

Answer 173

use phonics to decode or spell basic words write simple but complete sentences correctly form the plural of single-syllable words use periods and capitals when writing correctly spell high frequency words that have been taught in the classroom (e.g., “and", "the", "as", "it") print recognizable letters leave spaces between words when writing

Question 174

What are most kids able to do by the end of grade 3 in terms of writing?

Answer 174

use correct subject-verb agreement when writing use nouns, verbs, adjectives and adverbs correctly use irregular plurals correctly such as deer, children use apostrophes in contractions, for example cannot = can't use exclamations use phonics (letter sounds) and spelling rules when spelling use different sources to check how to spell unfamiliar words divide words into syllables use prefixes, suffixes and compound words use titles and subheadings to organize writing print words clearly

Question 175

What must theories speech perception be able to account for?

Answer 175

There is inter-speaker and intra-speaker variability among signals that convey information about equivalent phonetic events The acoustic signal is continuous even though it is perceived as and represents a series of discrete units Speech signals contain cues transmitted very quickly and simultaneously Theories must also account for various perceptual phenomena, such as Categorical perception, Phonemic restoration, Episodic memory, and Various word recognition effects (e.g., frequency effects, priming)

Question 176

What are the main two theories of speech perception?

Answer 176

Auditory: listeners identify acoustic patterns or features by matching them to stored acoustic representations Evidence for: context effects, coarticulation Motor: listeners extract information about articulations from the acoustic signal (i.e., when perceiving speech, listeners access their own knowledge of how phonemes are articulated) Evidence for: categorical perception, duplex perception, and the McGurk effect

Question 177

Name the key concepts to speech perception.

Answer 177

Bottom-up vs. top-down Active vs. passive Autonomous vs. interactive

Question 178

Compare bottom-up vs. top down related to speech perception.

Answer 178

Bottom-up: perception is built from information in the physical signal Top-down: listeners use higher level sources of information to supplement the acoustic signal

Question 179

Compare active vs. passive speech perception.

Answer 179

Active (or controlled): cognitive/intellectual work is involved in perception Passive (or automatic): perception relies on passive responses (e.g., thresholds)

Question 180

Compare autonomous vs. interactive speech perception.

Answer 180

Autonomous: closed system of decision making (capsulated, modular) Interactive: decision-making process relies on various sources of information outside the perceptual processor

Question 181

What is categorical perception?

Answer 181

There are no clear boundaries between vowels when we look at the acoustic properties, however, we PERCEIVE separate categories. This may include voice onset time (difference between the start of voicing and release of plosive)

Question 182

What is duplex perception?

Answer 182

One ear receives the third formant transition which sounds like a nonspeech chirp. The other ear receives a base syllable. As a result, the listener hears both the completed syllable AND the nonspeech chirp at the same time (i.e., we hear both the separate info (chirp) and the result of the integrated info (full syllable)) In real life, we can separate overlapping acoustic info (speech, cars, AC, siren, etc.)

Question 183

What is multimodal perception?

Answer 183

We integrate auditory and visual information When the information is conflicting between the modalities, we integrate and “hear” something in between both individual stimuli

Question 184

What two conditions are required for the generation of a sound wave?

Answer 184

Vibratory disturbance and elastic medium (ex. air)When a vibrating object is placed in an elastic medium, an air pressure disturbance is created through a chain reaction. The crowding effect is called compression or condensation. The relatively wide particle spacing is called rarefaction. The pattern that is produced by a simple vibratory system is called a sine wave. The sound produced by a tuning fork comes quite close to a sinusoidal shape, as do the simple tones that are used in hearing tests. Much more common in both speech and music are more complex, nonsinusoidal patterns.

Question 185

What is pitch?

Answer 185

Pitch depends on the frequency – the higher the frequency, the faster the vibration and the higher the pitch while the lower the frequency, the slower the vibration and the lower the pitch.

Question 186

What is Resonance?

Answer 186

Resonance is the increased amplitude (or loudness) of vibrations of an object caused by a source of sound that has the same natural frequency as the object’s frequency. Resonance occurs when two interconnected objects share the same vibrational frequency. When one of the objects is vibrating, it forces the second object into vibrational motion. The result is a large vibration and a loud noise. An example would be hitting one tuning fork near another tuning fork with the same natural frequency. The second tuning fork would vibrate even though it was not struck with a mallet but reacts to the vibrating air particles from the first tuning fork. The sounds we, ourselves, make produce resonance in the air filling the hollows in the throat, mouth and nasal cavities.

Question 187

Define frequency.

Answer 187

the number of cycles completed in one second, the unit of measurement for frequency is hertz (Hz)

Question 188

Define amplitude.

Answer 188

magnitude of the displacement pattern

Question 189

What is psychophysics?

Answer 189

Psychophysics is a set of methods (and the results obtained using these methods) relating sensation to the physical characteristics of a stimulus (Gustav Fechner developed the basic psychophysical methods we use today).

Question 190

Relating to psychophysics, what is concept of threshold and reality of threshold?

Answer 190

Concept of threshold: The smallest stimulus that can be perceived Reality of threshold: The stimulus that produces an arbitrary, but defined, level of performance

Question 191

Name the psychophysical methods used to estimate thresholds.

Answer 191

Classical methods: method of constant stimuli, method of adjustment, method of limits Adaptive methods: staircase methods, parameter estimation by sequential testing (PEST), maximum-likelihood adaptive procedures (QUEST, MLP)

Question 192

Describe Method of constant stimuli and name some pros or cons.

Answer 192

# Choose stimuli of several values (included some you don’t think the person will be able to hear), present these stimuli multiple times, record the proportion of times they report hearing each one ``` Pros: Provides complete picture of sensitivity Easy to administer Cons: Have to know approx. threshold before starting A lot of trials and time are wasted ```

Question 193

Describe the method of limits and name some pros and cons.

Answer 193

Start with a level you think the listener will hear, if they hear that one, present a lower level. Continue until listener says they can’t hear the stimulus, repeat Pros: Efficient: get threshold in small number of trials Don’t need to know where the threshold is at the start Cons: Spurious thresholds may be obtained without evidence that the listener was really listening

Question 194

Describe the method of adjustment and name some pros and cons.

Answer 194

``` Give listener control of the stimulus level, instruct listener to adjust level until they can just not hear the stimulus, repeat. Pros: Easy Intuitively appealing Cons: Produces unreliable results ```

Question 195

Describe the staircase methods.

Answer 195

Variation of method of limits where the level is changed on a trial by trial basis according to the listener’s response Pros: Efficient Cons: Observer may easily become aware of process, which could lead to anticipation of the approach of threshold and changes in response

Question 196

Describe PEST.

Answer 196

Adjustments in the amount of change in the stimulus are based on information already gathered according to the observer’s performance. Pros: Faster and more accurate than conventional staircase procedures

Question 197

Describe QUEST, MLP

Answer 197

``` Variation of staircase method that uses prior knowledge about psychometric function. Requires computer system to compute probability of different functions based on responses. Pros: Efficient and accurate Cons: Complex to learn and understand ```

Question 198

What is the goal of psychoacoustics?

Answer 198

The goal of psychoacoustics is to establish relations between stimuli, defined in the physical domain, and the related hearing sensations.

Question 199

Describe Fechner's law.

Answer 199

Fechner’s Law: subjective sensation is proportional to the logarithm of the stimulus intensity Our subjective perception is structured in perceiving relations between values rather than absolute differences

Question 200

How can medication, surgery, and radiation/chemo impact auditory function?

Answer 200

Medication: Ototoxicity: damage to hair cells from medications that are toxic to ears/hearing1 Temporary damage: salicylate pain relievers (aspirin), quinine (treatment for malaria), loop diuretics Permanent damage: mycin family of drugs (used for ear infections) Surgery: Can help with conductive hearing loss due to otitis media, atresia, microtia, tympanic membrane perforation, otosclerosis. Cochlear implant surgery Radiation:Cisplatin chemo: can cause high frequency damage (which is a permanent hearing loss)

Question 201

How can cognitive function be impacted by medication or surgery?

Answer 201

Brain injuries can metabolize medications differently | Surgeries to remove tumors can affect cognitive function depending on tumor location

Question 202

How can medication impact the voice?

Answer 202

Allergic reaction to medication could cause swelling in laryngeal region Antihypertensives, antihistamines, diuretics may affect vocal quality Hydration is important - medication, caffeine, and alcohol can also affect hydration levels/have a drying affect Hormone therapies may be used as part of gender affirming voice and communication therapy

Question 203

How can surgery impact the voice?

Answer 203

Voice disorders can be caused by phono-surgery (leading to scarring), traumatic intubation, etc. Voice disorders may also be treated via surgeries (remove polyps, nodules) Laryngectomy is the removal of the larynx

Question 204

How can radiation and chemotherapy impact voice?

Answer 204

Radiation therapy can cause dryness/hoarseness (may not be permanent)

Question 205

How can medication impact general communication

Answer 205

Dosage timing of neuroactive medications may affect communication Sedatives may result in lethargy which may influence communication function Alcohol results in loss of brain mass/ matter and affects executive function Opioids affect verbal learning and executive functions

Question 206

How can surgery impact general communication?

Answer 206

Cleft lip and palate surgery can help with articulation, resonance, etc. Surgeries to remove tumors in the oral cavity can affect articulation. Brain surgeries may affect communication depending on location of surgery.

Question 207

How can radiation/chemo impact general communication?

Answer 207

Chemotherapy and radiation can cause a diffuse toxic-metabolic injury (an example of an Acquired Brain Injury)

Question 208

What is the scientific method?

Answer 208

All scientific disciplines are united by their use of the scientific method. The scientific method offers an objective methodology for scientific experimentation that results in unbiased interpretations of the world and refines knowledge. Across all scientific disciplines, the major precepts of the scientific method are verifiability, predictability, falsifiability, and fairness.

Question 209

Name and define the major precepts of the scientific method.

Answer 209

Verifiability means that an experiment must be replicable by another researcher Predictability in a scientific theory implies that the theory should enable us to make predictions about future events Falsifiability refers to whether a hypothesis can be disproved. For a hypothesis to be falsifiable, it must be logically possible to make an observation or do a physical experiment that would show that there is no support for the hypothesis. Fairness implies that all data must be considered when evaluating a hypothesis.

Question 210

Describe the general flow of the scientific method.

Answer 210

Make an observation Ask a question Form a hypothesis that answer the question Make a prediction based on the hypothesis Do an experiment to test the prediction Analyse the restyles Hypothesis is either correct or incorrect (if incorrect return to form a hypothesis as well as the next step) Report results

Question 211

What are the different levels of measurement?

Answer 211

Nominal: data can only be categorized - Examples: ethnicity, city of birth Ordinal: data can be categorized and ranked - Examples: likert-type questions, language ability (beginner, intermediate, fluent) Interval: data can be categorized, ranked, and evenly spaced - Examples: temperature in Fahrenheit or Celsius, personality inventories, test scores Ratio: data can be categorized, ranked, evenly spaced, and has a natural zero - Examples : height, age, temperature in Kelvin

Question 212

What are the three main types of descriptive statistics?

Answer 212

Distribution refers to the frequencies of different responses Measures of central tendency give you the average for each response Measures of variability show you the spread or dispersion of your dataset

Question 213

What are descriptive statistics?

Answer 213

Summarize the characteristics of a data set Describe the sample of participants in the study Organize, summarize, and simplify data May be shared as tables or graphs

Question 214

Define the following terms: mode, median, arithmetic mean, range, interquartile range, standard deviation, and variance.

Answer 214

Mode: a data set is the most frequently occurring value Median: the value that’s exactly in the middle of a data set when it is ordered Arithmetic mean: the sum of all values divided by the total number of values Range: the spread of your data from the lowest to the highest value in the distribution Interquartile range: tells you the spread of the middle half of your distribution Standard deviation: the average amount of variability in your dataset; how far each value lies from the mean Variance: calculated by taking the average of squared deviations from the mean

Question 215

What are inferential statistics?

Answer 215

Allow you to test a hypothesis or assess whether your data is generalizable to the broader population. Interval- or ratio-level data: parametric statistics (e.g., t-test, ANOVA, Pearson’s correlation) Nominal- or ordinal-level data: non-parametric statistics (e.g., Mann-Whitney, chi-square, Spearman’s correlation) - Also use non-parametric statistics if interval- or ratio-level data do not meet assumptions required by the parametric test

Question 216

What is the meaning of the p--value and it's statistical significance?

Answer 216

P stands for probability and tells us the chance that our finding occurred by chance alone When doing research, you are testing if the null hypothesis is true or not. A p-value of <0.05 means there is less than 5% chance that the null hypothesis is true. Statistically significant does NOT equal importance. Hypothesis testing is a type of statistics that determines the probability of a hypothesis being true or false. If hypothesis testing reveals that results were “statistically significant,” this means that there was support for the hypothesis and that the researchers can be reasonably confident that their result was not due to random chance. If the results are not statistically significant, this means that the researchers’ hypothesis was not supported.

Question 217

What are the two types of statistical error?

Answer 217

Type 1: false positive | Type 2: false negative

Question 218

What is a confidence interval?

Answer 218

A confidence interval is the range of scores around a single measurement in which we are confident that the true scores lies Generally, researchers will look at the 95% confidence interval (i.e., the range in which the true score will be found 95 times out of 100) As the same size increases, the confidence interval decreases (i.e., becomes more precise)

Question 219

Define effect size.

Answer 219

An effect size quantifies the size or magnitude of a finding in a research study It is one indicator of the importance or clinical meaningfulness of a finding. It is related to, but not the same as, statistical significance.

Question 220

What are some common effect sizes?

Answer 220

Cohen’s d: a metric that quantifies the difference between two groups by converting all scores to the same standard deviation units d = 0 (no difference) d = 0.25 (small ES) d = 0.50 (medium ES) d = 0.80 (large ES) R2: describes the amount of variance shared between two variables. It is based on the correlation or strength of relationship between two variables. It is simply the correlation squared and it is interpreted as a percentage. Odds ratio: describes the odds of an event or outcome occurring in one group with the odds of the same event or outcome occurring in a different group

Question 221

Compare the different commonly used research designs based on if there is a control comparison and experimental manipulation.

Answer 221

Y/Y: controlled trial, multiple baseline Y/N: cohort, case-control, cross-sectional N/Y: uncontrolled trial N/N: case report, case series.

Question 222

Name the different types of quantitative research designs.

Answer 222

Experimental Quasi-experimental Correlational Descriptive

Question 223

Describe the purpose and characteristics of experimental study designs.

Answer 223

Used to test causal relationships Involves manipulating an independent variable and measuring its effect on a dependent variable Subjects are randomly assigned to groups Usually conducted in a controlled environment (e.g. a lab)

Question 224

Describe the purpose and characteristics of quasi-experimental study designs.

Answer 224

Used to test causal relationships Similar to experimental design, but without random assignment Often involves comparing the outcomes of pre-existing groups Often conducted in a natural environment

Question 225

Describe the purpose and characteristics of correlational study designs.

Answer 225

Used to test whether (and how strongly) variables are related Variables are measured without influencing them

Question 226

Describe the purpose and characteristics of descriptive study designs.

Answer 226

Used to describe characteristics, averages, trends, etc | Variables are measured without influencing them

Question 227

Name the different types of qualitative research designs.

Answer 227

``` Case study Ethnography Grounded theory Phenomenology Narrative ```

Question 228

Describe the purpose and characteristics of case studies.

Answer 228

Detailed study of a specific subject (e.g. a place, event, organization, etc). Data can be collected using a variety of sources and methods. Focuses on gaining a holistic understanding of the case.

Question 229

Describe the purpose and characteristics of ethnography.

Answer 229

Detailed study of the culture of a specific community or group. Data is collected by extended immersion and close observation. Focuses on describing and interpreting beliefs, conventions, social dynamics, etc.

Question 230

Describe the purpose and characteristics of grounded theory.

Answer 230

Aims to develop a theory inductively by systematically analyzing qualitative data.

Question 231

Describe the purpose and characteristics of phenomenology.

Answer 231

Aims to understand a phenomenon or event by describing participants’ lived experiences.

Question 232

Describe the purpose and characteristics of narrative research.

Answer 232

Exploring the life of participants

Question 233

Name and describe the different grouping research design types.

Answer 233

Cohort: A type of longitudinal research that samples a cohort (a group of people with a shared characteristic) while doing a cross-section at specific time intervals Cross-sectional: Analyzes data either from a population, or from a representative sample, at a specified point in time Longitudinal: Involves repeated observations of the same variables over short or long periods of time Cross-sequential: Combines longitudinal and cross-sectional research design, aiming to compensate for some of the issues inherently present in the two aforementioned designs

Question 234

What are the 4 steps to critically evaluating research?

Answer 234

1. Determine your purpose for reading. Think about what you need to get out of the article. 2. Device a reading strategy 3. Read to get an overview and then read closely and actively engage with the text 4. Don’t waste time - very few articles are so important that every word needs to be read carefully

Question 235

Define reliability.

Answer 235

The reliability of an assessment tool is the extent to which it consistently and accurately measures performance.

Question 236

Name the different types of reliability and describe them.

Answer 236

Inter-rater: indicates how consistent test scores are likely to be if the test is scored by two or more raters Test-retest: indicates the repeatability of test scores with the passage of time Alternate or parallel form reliability: indicates how consistent test scores are likely to be if a person takes two or more forms of a test Internal consistency: indicates the extent to which items on a test measure the same thing

Question 237

Define validity.

Answer 237

The validity of an assessment tool is the extent by which it measures what it was designed to measure.

Question 238

Name and describe the different types of validity.

Answer 238

Face: Does it really measure what it says it is going to measure? Content: Is a test based on a theoretical model that is explicitly stated? Does the test address all the behaviors it should? Construct: Does the structure of the test support its stated purposes? Do test scores on this measure correlate with scores on other measures of similar constructs? Is the test measuring other constructs that confound test result interpretation? Criterion: Does it distinguish groups or other disorders? Concurrent Ecological: Does it have any relevance to life in that person’s individual context beyond therapy, including that individual’s culture? Predictive

Question 239

Compare internal and external validity.

Answer 239

Internal validity: “extent to which empirical evidence provides a true or accurate reflection of patients, procedures, and settings observed” External validity or generalizability: “extent to which the [empirical] evidence provides an accurate reflection of patients, procedures, and settings other than those observed”

Question 240

What are some factors that can affect internal validity?

Answer 240

Subjective bias: impact of a person’s beliefs, opinions, and expectations on the findings from a study Can be controlled via blinding/concealment and/or placebos Quality of measurement Validity: does it measure what it’s supposed to measure Reliability: does it give consistent results Research design Nuisance variables: any systematic factor that inadvertently interferes with drawing accurate conclusion from a study Statistical significance (external evidence only)

Question 241

What factors can affect external validity?

Answer 241

How representative the study conditions are of the clients, settings, clinicians, and procedures encountered in typical practice settings How accurately the procedures described in the study were actually implemented by the researchers - Fidelity: did treatment get carried out the way it was planned

Question 242

What is treatment efficacy and how is it achieved?

Answer 242

A treatment is said to be efficacious to the extent that it brings about desired outcomes under highly controlled conditions (e.g., optimal operational definition for selecting patients, delivering treatment, dosing treatment, indexing the effects of treatment, etc). Under these conditions, valid statistical inference warrants the general expectation that a particular treatment will bring about desired outcomes when administered in clinical practice. As a result, evidence of treatment efficacy establishes the potential of a particular treatment protocol for bringing about beneficial change when administered to members of a particular clinical population. Efficacy data result from carefully conducted measurements of a large sample of rigorously selected patients from a clearly defined clinical population. Most often, participants in this form of research are randomly assigned to a treatment condition or a no-treatment condition. For a treatment protocol to achieve status as efficacious, it must be convincingly demonstrated that the protocol is the exclusive agent bringing about beneficial change.