Semester 1 Week 9 Speech Difficulties Flashcards
neurology of speech
The production of speech requires integration of diverse information sources in order to generate the intricate pattern of muscle activation required for fluency. These sources include auditory, somatosensory (relating to sensory perception) and motor representations…in addition to linguistic information regarding the message to be conveyed. Accordingly, a large portion of the cerebral cortex, along with associated subcortical structures, is involved in even the simplest speech task
subcortical structures involved in speech
cerebellum, basal ganglia and brain stem
lobes of brain involved in speech
temporal, parietal and frontal
define articulation
physiological movements modifying airflow to produce speech sounds, using the vocal tract above the larynx.
define phonetics
branch of linguistics that focues on the production and classification of speech sounds. also includes the variation within phonenes (e.g. /s/ sounds different depending on what word it’s in)
define phonology
concerns the speech sound systems of languages: how meaning is contrasted and howphonemes may be legally sequenced to form words
define morphology
the study of the internal structure of words. How they can be analysed into word elements, e.g. stem, prefix, suffix
define perception in speech
More than just hearing, includes discrimination from environmental sound and perception of known phonemes from not known and phonetic variations.
define discrimination in speech
Discrimination happens at different levels: sound, syllable, word and from close phonological forms and within multisyllabic words.
what are typical phonemes for a 1 year old to say?
Initial: b, d, m, n, [w, h, t, k, g,]
Final: m, h [t, s]
what are typical phonological processes for a 1 year old?
all present
what is the typical intelligibility/syllable structure for a 1 year old
primarily mono-syllabic
what are typical phonemes for 1-2 year olds to say?
Initial/medial: p, b, t, d, m, n, w, [h, k, g, s]
Final: m, h, [n, t, k, s]
what are typical phonological processes for 1-2 year olds?
all except reduplication present
what is the typical intelligibility/syllable structure for 1-2 year olds?
Mono/polysyllabic
26-50% intelligible
what are typical phonemes for 2-3 year olds to say?
I, M and F: p, b, t, d, m, n, w, h [k, g, s, f]
what are typical phonological processes for 2-3 year olds?
WSD, FCD*, CR, Fronting, Stopping, fricative simplification, gliding
what is the typical intelligibility/syllable structure for 2-3 year olds?
Mono/polysyllabic
51-70%
what are typical phonemes for 3-4 year olds to say?
p, b, t, d, k, g, m, n, f, s, [ l, j, ʃ, tʃ, ŋ
Vowels (UK) 97.39% (vowel errors tend to be with diphthongs, if errors persist beyond age 3 then big red flag)
what are typical phonological processes for 3-4 year olds?
gliding
possible emergence of cosonant clusters
what is the typical intelligibility/syllable structure for 3-4 year olds?
3;0 = 71-80% (95.68% to parents)
Mono and polysyllabic
Syllable shapes
CV, CVC, CVCV, CVCVC (CCVC, CVCC)
what are typical phonemes for 3-5 year olds to say?
+ k, g, l, j, ŋ [ʃ, tʃ, ʒ, dʒ, v, z, ɹ, θ, ð
PCC 3;0 76.77% - 85.2%
PCC 5;0 = 88.36% - 93.4%
what are typical phonological processes for 3-5year olds?
Stopping /v, , θ, ð/ Fronting /ʃ, tʃ, ʒ,
dʒ/ but declining - Gliding, CR,
WSD
typical intelligibility for 3-5 year olds
3;5-4;0 82-97%
5;0 = 98% intelligible.
(4;0 93% to unfamiliar listeners)
typical phonemes for 5+ years
Almost all acquired
PCC at 7;11 = 90.99% in polysyllabic words
typical phonological processes for 5+ years
Gliding
Later stopping
Simplification of affricate and fricatives /v, , θ, ð/
typical intelligibility for 5+ years
100%
typical intelligibility for 5+ years
100%
Schriberg’s original early 8 phonemes
/p/, /b/, /m/, /d/, /n/, /h/, /w/, /j/
Schriberg’s original middle 8 phonemes
/t/, /k/, /g/, /ŋ/, /f/, /dʒ/, /tʃ/, /v/
Schriberg’s original late 8 phonemes
/l/, /s/, /ʃ/, /z/, /ɹ/, /ʒ/, /ð/,/θ/
updated early phonemes according to McLeod & Crowe research
/p/, /b/, /m/, /d/, /n/, /h/, /t/, /k/, /g/, /w/, /ŋ/, /f/, /j/
what are the age of early phonemes
2;0 - 3;11
updated early phonemes according to McLeod & Crowe research
/l/, /dʒ/, /tʃ/, /s/, /v/, /ʃ/, /z/
what are the age of middle phonemes
4;10 - 4;11
updated late phonemes according to McLeod & Crowe research
/ɹ/, /ʒ/, /ð/,/θ/
what age are late phonemes?
5;0-6;11
defintion of delay as used in research
Child demonstrating typical developmental processes but beyond the age at which that would usually be expected.
Typical patterns seen in fewer than 90% of peers.
defintion of disorder as used in research
Child demonstrating atypical patterns of development.
Disorder patterns seen in fewer than 10% of children of any age,
prevalence of speech sound disorder
3.5-5% of 4-year-olds are affected
long term impacts of SSD on learning and applying knowledge
Difficulty with recall/calculation;
Difficulty with Language and Literacy, Mathematical Thinking, and Approaches to Learning
long term impacts of SSD on general tasks amd demands
less independent
more frustration
long term impacts of SSD on communication
weak oral and written language skills
long term impacts of SSD on interpersonal interactions and relationships
withdrawl
social and behavioural problems
bullying
long term impacts of SSD on major life areas
Decreased school enjoyment & connection; Increased remedial assistance; occupational differences; harrassment
red flags for SSD (9)
- failure/late onset canonical babbling
- Otitis Media with Effusion (OME) especially between 12-18 months
- glottal replacement when not dialectal
- initial consonant deletion (typical in some langauges but not english)
- small phonetic inventory of consonants/vowels
- inventory constraints
- backing (only for monlingual speakers of english)
- vowel errors
- persisting FCD
what is the typical development for canonical babbling
Infants should be producing canonical babble , at least some of the time, before their first birthday.
what is meant by inventory constraints
Six missing consonants or six sounds in error, across three manner categories signal severe SSD, e.g. 2 stops, 2 fricatives, 2 glides.
when should FCD be resolved by
2;10- 3;3
what is the critical age hypothesis?
literacy acquisition is likely to be compromised if children are not intelligible by 5;6.
predictors of risk of SSD in early childhood (4)
❑ Weak sucking at 4 weeks
❑ Not often combining words at 24 months
❑ Limited use of word morphology at 38 months
❑ Being unintelligible to strangers at 38 months
predictors of risk of SSD at school age (3)
❑ Maternal report of difficulty reporting certain sounds and hearing impairment at age 7 years
❑ Tympanostomy tube insertion at any age up to 8 years
❑ History of coordination problems
child risk factors for SSD (3)
- being male
- having ongoing hearing problems and ear infections
- reactive tempreament
child protective factors for SSD (2)
- being breastfed (>9months)
- persistant temperament
parent protective factors for SSD (2)
- maternal wellbeing
- parent’s status at speaking languages other than English
is the presence of older siblings a protective or risk factor for SSD
can be both
definition of SSD
‘Difficulty with the perception, articulation/motor production, phonological organisation and representation of speech’
2 branches of SSD
- phonology
- motor speech
2 types of phonology SSD
- phonological impairment
- inconsistent speech disorder
what is a phonological impairment
A cognitive linguistic difficulty with learning the phonological system of a language, characterised by pattern based errors.
what is inconsistent speech disorder
A phonological assembly difficulty without accompanying oromotor difficulties, characterised by inconsistent production of the same lexical items.
3 types of motor speech related SSD
- articulation impairment
- childhood apraxia of speech
- childhood dysarthria
what is an articulation impairment
A motor speech difficulty involving the physical production of speech characterised by speech errors typically involving the distortion of sibilants or rhotics e.g./s/, /r/.
consitent when sounds are said in words and in isolation
what is childhood apraxia of speech
A motor speech disorder involving difficulty planning and programming movement sequences resulting in errors in speech sound production and prosody.
what is childhood dysarthria
A motor speech disorder involving difficulty with the sensorimotor control processes involved in speech production.
do we know what causes SSD?
no - very heterogenous, many genetic and environmental factors suggested but specific aetiology remians unknown
define articualtion
how sounds are physically produced (respiration, phonation, resonance)
define articualtion disorder
difficulties with motor processes that result in speech
what is phonology
- how sounds are put together to form words
- how sounds contrast and convery meaning
what is a phonological disorder?
difficulties with the system and patterns of phoneme usage
what are the 8 phonologcial processes?
- reduplication
- voicing (context sensitive voicing - CSV)
- final consonant deletion (FCD)
- fronting
- stopping
- weak syllable deletion (WSD)
- cluster reduction (CR)
- gliding
what is reduplication?
one syllable repeated for another e.g. /dudu/ for dummy
is reduplication structual or systemic?
structural
what are the 2 types of phonological process?
- structural
- systemic
what is a structural phonological process
has an impact on the structure of the word
what is a systemic phonological process
Result in one sound changing to another (substitution & assimilation)
what age is reduplication resolved by?
3;0
is CSV structural or systemic?
systemic
what is CSV?
A voiceless sound is replaced by a voice sound or alternate depending on the context e.g. /p/ to [b] e.g., [bat] for ‘pat’ or /g/ to [k] e.g. [bɪk] for ‘pig’.
what age is CSV typically resolved by?
2;6 -3;0
is FCD structural or systemic?
structural
what is FCD
omission of final consonant
what age is FCD typically resolved by?
3;3
is fronting structural or systemic?
systemic
what is fronting
A target sound is produced further forward in the mouth, e.g (velar) ‘cat’ is [tæt]- (palatal) ‘shoe’ is [su]
what age is fronting typically resolved by?
3;6 - 3;9
is stopping structural or systemic?
systemic
what is stopping?
A fricative or affricate changes in manner to a plosive e.g. ‘mouse’ to [maʊt]
what age is stopping typically resolved by?
3;0 - 5;0
is WSD structural or systemic
structural
is WSD structural or systemic
structural
what is WSD
Omission of the unstressed syllable e.g. [mateʊ] for ‘tomato’.
what age is WSD typically resolved by?
4;0
is CR structural or systemic?
structural
what is CR?
omission of a cluster element e.g. ‘spoon’ to /pun/
what age is CR typically resolved by?
4;0
is gliding structural or systemic?
systemic
what is gliding
Liquid consonants are replaced by the glides e.g. ‘run’ to [wʌn]
what age is gliding typically resolved by?
5;0
what are atypical patterns of error (5)
- The persistence of a process beyond expected age range
- Backing – in English
- Predominance of one sound .e.g /d/ or /g/
- Sound substitutions not following typical patterns e.g. /s/ for /f/ e.g. [srɔk] for ‘fork’
- The emergence of ‘later’ developing sounds before ‘earlier’ sounds.
what might articulation errors look like?
- Dental, palatal or lateral lisps
- Hyper/hypo-nasal speech
are lateral lips typical or atypical in english? why?
atypical - no lateral phonemes in english
are lateral lips typical or atypical in english? why?
atypical - no lateral phonemes in english
3 possible phyiscal reasons for articulatory disorders
- craniofacial abnormalities
- hearing loss
- dysarthria
How do we determine whether to intervene and decide on the appropriate intervention?
case history -> observation and informal assessment -> formal assessment -> hypothesis driven intervention -> resassessment
2 types of analysis we need to conduct
independent
relational
what is independent analysis
independent of the adult form
3 questions to consider in independent analysis
- What did they attempt, even in play sounds?
- What sounds are they using, irrespective of accuracy?
- What is in their Phonetic Inventory (PI)?
what is relational analysis
in relation or in comparison to the adult form/TD children
3 questions to consider in relational analysis
What sounds are omitted?
What sounds are changed and how?
What phonemes do they have Productive Phonological Knowledge PPK of?
what data do i need to collect? (8)
•Gather at least 50 words common in their vocabulary if you can.
•Note also any two word phrases or two syllable words.
•See if they can copy any sounds you observe are missing.
•Make observation regarding the tone, volume and prosody of their speech. How fluent is it?
•Connected speech samples may be required. – consider age and expressive language ability. Note; just because you cannot get the data does not mean it’s fine.
•Carry out an analysis of your data – What processes are present? Are there any distortions or omissions? What are the patterns of error, if any?
•Consider which could be articulation errors and which phonological in nature – why?
•Is there evidence that further analysis is required e.g. characteristics related to CAS or dysarthria, a child with complex needs or very limited output?
useful assessments (5)
DEAP (most useful)
STAP (not as recommended as DEAP but better than CLEAR)
CLEAR (doesnt give adequate info)
Goldman-Fristoe 2 - Measure articulation of consonant sounds
KLPA-2 (works with G-F 2 to give more comprehensive diagnosis of articulation and use of phonological processes)
