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SLP comprehensive exam Flashcards

1
Q

what is a speech sound disorder?

A

an umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds or speech segments

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2
Q

what is an articulation disorder?

A

errors in production of individual speech sounds (e.g., distortions on /s/ or substitutions)

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3
Q

what is a phonological disorder?

A

predictable rule-based errors that affect more than one sound..pattern of errors (e.g., fronting, backing, stopping, FCD)

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4
Q

Age of acquisition: 2-3 years, 3-4 years, 4-5 years, 5-6 years, and 6-7 years

A

2-3 years: p, b, m, n, h, w
3-4 years: t, k, g, ng, f, y
4-5 years: v, s, z, sh, ch, j, l
5-6 years: voiced th, zh, r
6-7 years: voiceless th

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5
Q

signs and symptomsof articulation disorder

A

-omissions/deletions: sounds are omitted or deleted (e.g., “cu” for “cup”
-substitutions: one or more sounds are substituted, which may result in loss of phonemic contrast (e.g., “wabbit” for “rabbit”)
-additions: one or more extra sounds are added or inserted into a word (e.g., “buhlack” for “black”)
-distortions: sounds are altered or changed (e.g., a lateral /s/)
-syllable-level errors: weak syllables are deleted (e.g., “tephone” for “telephone”)

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6
Q

why is a phonological disorder a “language” disorder?

A

children with phonological impairment have difficulty learning the phonological system of their language. They have difficulty organizing their speech sounds into a system.

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7
Q

list all: STOPS

A

Bilabial: p (vl), b (v)
Alveolar: t (vl), d (v)
Velar: k (vl), g (v)

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8
Q

list all: FRICATIVES

A

Labiodental: f (vl), v (v)
Dental: th (vl), th (v)
Alveolar: s (vl), z (v)
Palatal: sh (vl), vis (v)
Glottal: h (vl)

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9
Q

list all: AFFRICATE

A

Palatal: ch (vl), d3 (v)

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10
Q

list all: NASAL

A

Bilabial: m (v)
Alveolar: n (v)
Velar: ng (v)

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11
Q

list all: LIQUIDS

A

Alveolar: l (voiced)
Palatal: r (voiced)

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12
Q

list all: GLIDES

A

Bilabial: w (v)
Palatal: y (v)

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13
Q

what is fronting?

A

sound made in the back of the mouth (velar) is replaced by a sound made in the front of the mouth (e.g., t/k, d/g)

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14
Q

what is stopping?

A

fricative and/or affricate is replaced with a stop sound (e.g., p/f, t/s, d/z, b/v)

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15
Q

what is gliding?

A

liquid /r/ or /l/ is replaced with a glide /w/ or /j/ (e.g., wabbit for rabbit)

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16
Q

what is deaffrication?

A

affricate is replaced with a fricative (e.g., ship for chip)

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17
Q

what is cluster reduction?

A

consonant cluster is simplified into a single consonant (e.g., top for stop; keen for clean)

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18
Q

what is weak syllable deletion?

A

unstressed or weak syllable in a word is deleted (e.g., nana for banana; tato for potato)

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19
Q

what is final consonant deletion?

A

deletion of the final consonant of a word (e.g., bu for bus or tree for treat; ca for cat)

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20
Q

most common follow-up questions related to communicative disorders?

A

1) when did you first notice the speech/language problem?
2) Has the problem changed since it was first noticed?
3) Have you seen a therapist before? If so, where?
4) Family history?
5) What languages are spoken in the home? What language do they speak most often?
6) What sounds do you notice difficulty with?
7) Percent of intelligibility to familiar/unfamiliar
8) Does speech affect social interactions, academic or work?
9) How is hearing?
10) What is your goal for therapy?

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21
Q

what are the 5 domains of language?

A

-phonology: the rules of speech sounds; how phonemes are used
-morphology: the rules of word structure; how morphemes are used
-syntax: the rules of sentence structure; grammar
-semantics: the rules related to the meaning of language
-pragmatics: the rules that occur within social situations

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22
Q

articulation/phonology assessments

A

-clinical assessment of articulation and phonology (CAAP-2); age 2;6 -11;1
-goldman-fristoe test of articulation (GFTA-4); age 2;0-21;11
-kahn-lewis phonological analysis (KLPA-3); age 2;0-21;11
-Arizona articulation and phonology scale; 18 mo-21;11
-diagnostic evaluation of articulation and phonology (DEAP); age 3;0-8;11

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23
Q

language assessments

A

-expressive one word vocabulary test (EOWPVT-4) age 2;0-70 (has spanish version)
-receptive one word vocabulary test (ROWPVT-4) age 2;0-70 (has spanish version)
-clinician eval of language fundamentals (CELF-5) age 5;0-21;11 (spanish version and scoring for AAE)
-clinical eval of language fundamentals preschool (CELFP-2) age 3;0-6;11 (spanish)
-comprehensive assessment of spoken language (CASL-2) age 3;21
-preschool language scales (PLS-5) age birth-7;11 (spanish version)
-DAYC-2

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24
Q

literacy/phonological awareness assessments

A

-woodcock-johnson IV (WJ IV) age 2-90
-comprehensive test of phonological processing (CTOPP-2) age 4;0-24;11

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25
Q

cultural assessment options

A

-non-word repetition tasks: student is asked to repeat non-words of increasing length and complexity
-dynamic assessment: test-teach-retest (It is a less-biased approach for determining when there is a language difference rather than a language disorder because of second-language influence)
-narrative assessment: client tells a story. narrative assessment looks at sequencing, working memory, grammar, vocabulary, and pragmatics/perspective taking
-parent report

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26
Q

Roseberry: age of language acquisition

A

12 months: first word
18 months: 50 words and begin combine words
24 months: 200-300 words
3 years: children will have expressive vocabularies of 900-1,000 words
5 years: by kindergarten, they should be using 2,100-2,200 words

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27
Q

late talker vs language disordered

A

children who have fewer than 50 expressive words or no word combinations at age 2 are at increased risk of long-term language concerns. Those children who do not catch up to their same-age peers by age 3 demonstrate a language delay that is likely to persist throughout the school years.

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28
Q

BICS vs CALP

A

Bics: Basic Interpersonal Communication Skills–conversational, social, everyday language; fluency takes 1-3 years, often includes a “silent period” for ELL
CALP: Cognitive Academic Language Proficiency–school, textbook, academic language; takes a minimum of 5 years to develop even an intermediate; fluency takes a whole lifetime to develop

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29
Q

Browns Morphemes

A

1.25-1.5 years (Brown stage 2): present progressive -ing, “in” and “on, regular plural -s
2.5-2.8 years (Brown stage 3): Irregular past tense, possessive ‘s, main verb “to be”
3-3.5 years (Brown stage 4): articles, regular past tense -ed, 3rd person regular, present tense
3.5-4+ years (Brown stage 5): 3rd person irregular, helping verbs, copula, auxiliary

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30
Q

What does speech consist of?

A

respiration, phonation, resonance, and articulation

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31
Q

What does language consist of?

A

form, content, and use

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32
Q

What is the pyramidal system?

A

tracts that originate in the cerebral cortex, carry fibers to the spinal cord and brain stem (voluntary control–body and face muscles)

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33
Q

What is the extrapyramidal system?

A

tracts that originate in the brainstem, carry fibers to the spinal cord (involuntary & automatic control–tone, balance, posture)

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34
Q

What do Upper motor neurons do?

A

transmit nerve impulses from brain to lower motor neurons

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35
Q

What do Lower motor neurons do?

A

transmit nerve impulses from UMN to muscles

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36
Q

What artery is most commonly associated with Broca’s and Wernicke’s aphasias?

A

Middle Cerebral Artery

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37
Q

What are the six cranial nerves most associated with speech?

A

V (5) Trigeminal
VII (7) Facial
XI (9) Glossopharyngeal
X (10) Vagus
XI (11) Accessory
XII (12) Hypoglossal

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38
Q

V Trigeminal

A

Motor: muscles of mastication, elevation of hyoid and larynx
Sensory: Face sensation, position of bolus in mouth/cheeks, and gum sensation

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39
Q

VII Facial

A

Motor: facial expression, seal of lips, tone/movement of cheeks, and elevation of hyoid
Sensory: taste sensation anterior 2/3 of tongue, face/oral cavity/soft palate sensation, stimulates salivary glands

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40
Q

IX Glossopharyngeal

A

Motor: stylopharyngeous muscle, larynx/pharynx elevation, pharyngeal constriction
Sensory: taste posterior 1/3 tongue, gag reflex

41
Q

X Vagus

A

Motor: intrinsic laryngeal muscles, VP closure and approximation, constriction of esophagus
Sensory: sensation of food residue in larynx, pharynx, and esophagus

42
Q

XI Accessory

A

Motor: sternocleidomastoid, head turning and shoulder shrug

43
Q

XII Hypoglossal

A

Motor: innervates all intrinsic/extrinsic muscles of the tongue except 1 extrinsic, tongue motion, bolus prep, removing particles, transporting bolus

44
Q

Between subject designs

A

performances of separate groups of subjects are measured and comparisons are then made between the two groups

45
Q

Within-subject designs

A

performances of same group is compared in different conditions and/or in different situations; sequencing effect may occur

46
Q

What are the three steps of Evidence Based Practice?

A

Use internal clinical evidence
Use external research evidence
Collaborate with patient preferences

47
Q

What is validity?

A

degree the assessment measures what it says it measures

48
Q

What is reliability?

A

consistency and stability of test within varying contexts

49
Q

What does a comprehensive assessment consist of?

A

1) case history
2) interview
3) oral-motor exam
4) hearing screening if necessary
5) standardized testing
6) non-standardized testing
7) family education/input for goals
8) collaboration with pt about goals
9) provide resources

50
Q

Artic and phonology assessment

A

1) case history
2) hearing screening
3) oral-motor exam
4) interview
5) formal assessment: popular are GFTA, CAAP, Kahn-Lewis (KLPA), Arizona-3
6) informal assessment: speech/language sample (or phonemic inventory), speech intelligibility, rate and prosody, number, type and consistency of errors, SODA (substitutions, omissions, distortions, additions), features (voice, place, manner), phonological processes present?, understand etiology

51
Q

Language and cognition assessment

A

1) case history
2) interview
3) hearing screening
4) oral-motor exam
5) formal assessment: receptive and expressive language assessment (CELF, CASL, SCATBI, PLS-5, DAYC, CLQT)
6) informal assessment: language samples, MLU, WPM, number, type, and consistency of errors, voice, intelligibility, nature of errors

52
Q

What is bone conduction?

A

Oscillator device is used to submit sound through the temporal bone on the skull

53
Q

What is air conduction?

A

Uses headphones to submit tones through the ear drums

54
Q

What symbols are for right ear BC and AC?

A

right=red
O=air
triangle=with masking
<=bone
[=with masking

55
Q

What symbols are for the left ear BC and AC?

A

left=blue
X=air
square=with masking
>=bone
]=with masking

56
Q

Normal hearing

A

Both BC and AC symbols are with 0-20 dB

57
Q

Sensorineural hearing loss

A

Both AC and BC are below 20 dB with

58
Q

Conductive hearing loss

A

BC symbols are within normal limits
AC symbols are below 20 dB

59
Q

Mixed hearing loss

A

Both BC and AC symbols are below 20 dB and there is a 15 dB difference between BC and AC

60
Q

What are the types of CVA?

A

Ischemic and Hemorrhagic

61
Q

What is an ischemic stroke?

A

CLOT–obstructs the blood flow to the brain
Thrombosis: stationary blood clot that develops in a narrow part of the blood vessel
Embolism: a blood clot that originally formed in another location then breaks loose and travels to occlude another vessel

62
Q

What is a hemorrhagic stroke?

A

Aneurysms–blood vessel ruptures and prevents blood flow to the brain

63
Q

What is a TIA?

A

Transient ischemic attack or mini stroke
symptoms usually last about 24 hours and resolve themselves
typically a warning sign to say you are at high risk

64
Q

What is aphasia?

A

Aphasia is an acquired neurogenic language disorder resulting from an injury to the brain, typically the left hemisphere, that affects the functioning of core elements of the language network. Aphasia involves varying degrees of impairment in four primary areas:
spoken language expression
written expression
spoken language comprehension
reading comprehension

65
Q

Where are Broca’s and Wernicke’s areas in the brain?

A

Broca’s area: fontal lobe (producing speech)
Wernicke’s: temporal lobe (understanding and processing speech)

66
Q

What is circumlocation?

A

talking around or describing a target word due to inability to retrieve the right word

67
Q

What are paraphasias?

A

speech errors divided by categories:
-phonemic: sound errors (dod/dog or sooshbruss for toothbrush)
-semantic: semantically related word is substituted (fork/spoon, uncle/aunt)

68
Q

What is perseveration?

A

word is used previously used repetitively, involuntarily and incorrectly for target

69
Q

What are verbal stereotypies?

A

nonpropositional utterance characterized by repetition of a syllable, word, or phrase
Neologistic types: “tono tono tono”
Real word types: oh boy oh boy

70
Q

What is agrammatism?

A

use of mostly substantive words (e.g. nouns)
short phrases, e.g. “telegraphic utterances”
functor words omitted;
selective impairment of ability to retrieve and use verbs as opposed to nouns.
typical of Broca’s aphasia

71
Q

What is paragrammatism?

A

grammatical errors (such as wrong tense markers)
misuse of pronouns among range of syntactical constructions
typical of fluent aphasia

72
Q

Non-fluent aphasias

A

Broca’s, Global and Transcortical Motor

73
Q

Non-fluent aphasia characteristics

A

decreased speech rate
decreased phrase length
decreased prosody
decreased initiation of speech
decrease speech output in general
increased effort

74
Q

Fluent aphasias

A

Wernicke’s, Transcortial Sensory, Conduction, and Anomia

75
Q

Fluent aphasia characteristics

A

auditory comprehension deficits
paraphasic speech with poor self-monitoring
effortless and melodic speech
good articulation
decreased use of real words, i.e., neologisms (jargon)
“empty speech”, i.e., verbal output devoid of semantic content
paragrammatism, e.g., morphological disturbances
ability to initiate verbal expression

76
Q

Describe Broca’s aphasia

A

-Speech is non-fluent
-Speech is effortful and imprecisely articulated.
-They use syntactically simplified sentences with more nouns without function words or morphemes (agrammatism – telegraphic-like).
-Prosodic disturbances (rate, intonation) in speech are common.
-Word finding ability is often proportional to speech fluency.
-Usually aware of deficits
-Auditory comprehension is good in simple contexts
-reading and writing are usually similar to verbal output

77
Q

Describe Global aphasia

A

is a severe, acquired impairment of communication that involves all language modalities
-Non-fluent speech with minimal speech output
-Impaired auditory comprehension and reading comprehension
-Impaired verbal repetition
-Severely impaired naming with common recurrent stereotypical utterances
-Over time, auditory comprehension will improve more than verbal expression
-Problem-solving and other cognitive skills are also generally impaired.
-It typically involves damage to frontal, temporal, and parietal lobes

78
Q

Describe Transcortical Motor aphasia

A

-The TMA patient has non-fluent verbal output
-Fairly good auditory comprehension
-Good confrontation naming ability
-Phonemic paraphasias are common
-Perseveration is typically
-Decreased precision of speech articulation
-Slower speech output
-Syntax is generally reduced
-Repetition of speech is usually spared
-Initially the patient may be mute (poor impulse to speak)
-Bradykinesia (slow movement) is common
-Deficits are most evident at the conversational level

79
Q

AOS associated with non-fluent aphasia

A

-Difficulty executing and coordinating neuromuscular motor sequences for speech articulation
-False starts and re-approaches
-Effortful groping with struggle
-Slowed rate of speech
-Pausing between syllables
-Inappropriate stress patterns
-Erratic speech sound substitutions on the same trials
-Articulatory omissions
-Spontaneous speech output is more difficult than involuntary productions
-Greater ease for counting and reciting rote information
-Attempts to self-correct

80
Q

Describe Wernicke’s aphasia

A

Fluent speech
Usually not aware of deficit
Poor auditory comprehension
Possible word deafness
Oral reading impairment
Reading comprehension impairment
Poor letter and word recognition
Spelling difficulties
Empty speech with paragrammatism
Neologistic output
Logorrhea (“press for speech”)

81
Q

Describe conduction aphasia

A

Good intonation
Good auditory comprehension
Difficulty with word finding
Paraphasic errors (more phonemic/literal type)
Hesitations in speech, but generally fluent
Good recognition of errors with attempts to self-correct
Use of complex syntactic structures in spontaneous speech
Marked difficulty with repetition (especially with multisyllabic words and longer sentences)

82
Q

Describe anomic aphasia

A

Word finding ability is low
Aware of difficulty–tries to self correct
Paraphasias (semantic)
Morphology, syntax, and auditory comprehension are usually WNL

83
Q

Describe transcortical sensory aphasia

A

The patient has fluent, well-articulated speech.
Auditory comprehension deficits may be severe.
There is difficulty applying meaning to what is heard.
Discourse tends to be “empty” and circumlocutionary.
There are neologisms and verbal paraphasias.
The patient can repeat what is said by relying on the phonological system.
Word finding (lexical retrieval) problems are common.
Many ready made expressions (stereotypical speech) and echolalia are used

84
Q

Flaccid dysarthria

A

Lower motor neuron lesion
WEAKNESS!!
hypernasality
nasal emission
slow and slurred DDK
tongue fasciculations
breathy, hoarse voice
imprecise consonants (tongue cannot move–weak)

85
Q

Spastic dysarthria

A

Bilateral upper motor neuron
tight/contracted
strained and strangled voice
hypernasality
common after TBI, CVA, CP

86
Q

Ataxic dysarthria

A

Damage to cerebellum
“drunken like speech”
slow, slurred speech
irregular, uncoordinated
distorted vowels
prolonged phonemes
ataxic gate

87
Q

Hypokinetic dysarthria

A

Basal ganglia (dopamine depletion)
Most associated with Parkinson’s
short rushes of speech
DDKs–fast and imprecise
flat pitch–monotone
reduced stress
Slow/reduced movements

88
Q

Hyperkinetic dysarthria

A

Basal ganglia (excess dopamine)
Most associated with Huntington’s
involuntary movements at rest and during speech
voice stoppages

89
Q

Unilateral Upper Motor Neuron

A

Unilateral UMN
unilateral facial weakness
harsh voice

90
Q

Second Language Acquisition

A

variables that affect second language acquisition are personality, anxiety level, and motivation. Learning styles and strategies used during second language acquisition is modeling, practice opportunities, avoidance and use of routines and formulas. Is the child modeling their parents? If so, then we can’t take on if “s/l disorder” environmentally based, such as an accent. Lack of practice can impact acquiring the L2. Child may avoid speaking L2 for fear of being laughed at. The child might use memorized phrases as a strategy to converse right away, such as whole words like “wutup.” Normal process during second language acquisition is interference, silent period and code switching.

91
Q

Interference

A

or transfer is the process in which a communicative behavior from the 1st language is carried over into the 2nd language.

92
Q

Language loss

A

is loss of skills in L1 as L2 gets proficient. Note: we are required by law to assist in both languages.

93
Q

Sequential bilingualism

A

is when L1 is learned at birth and then L2 is learned at a later time

94
Q

Simultaneous bilingualism

A

is when two languages are learned from birth. The child is exposed to two languages by age three.

95
Q

Explain the difference between disorder and difference

A

Differences in sentence structure, speech sound production, vocabulary, and pragmatic uses of language are to be expected when a child learns a new language. Unfortunately, children with language differences that result from limited experience in using a language are often misidentified as “language-learning disabled.” The student may not be learning because of lack of exposure to new experiences or to experiences that are not appropriate with what the school expects.

A disorder or a “language-learning disability” diagnosis is appropriate only for students with disabilities affecting their underlying ability to learn any language. Some indicator of LLD: compared to SIMILAR PEERS, learn slowly in L1 and L2, communication problems at home and/or with similar peers, problems in syntax, pragmatics & morphology, need for lots of prompting and repetition during instruction, and delayed language development milestones in L.1

96
Q

Explain IDEA and how it helps bilingual assessment.

A

IDEA was established in 1977 because too many minority students were being qualified for special education. IDEA states that procedures and material must not be discriminatory. Assessment instruments must measure a student’s ability in the area tested, not English proficiency (test the disorder and not the language). And it is critical to know what is normal in L1 for each student so the clinician can know if the issue is a difference or a disorder.
The IDEA has helped with bilingual assessment by preventing minority students from being labeled as LLD and entering into Special Ed.

97
Q

How do you do an assessment for a bilingual client?

A

Formal testing is not required. You can do a systematic observation through play, language samples, books, etc. Use nonstandardized tests to examine student’s communication skills in real-life context, and to avoid the cons of standardized tests, such as biases. Observe in many different settings, especially speech rooms and classrooms to see how they are getting along with other students. Use school records of student’s achievement and questionnaires with individuals who interact with the student regularly. While gathering information about the child’s case history, ask questions about expressive/receptive language and speech sounds in L1. Collect language samples in a variety of situations with a variety of conversational partners. Look for language shifts as in all language domains. Analyze both content and form; can the child communicate meaning? Ask someone from the student’s cultural background to evaluation the sample in L1. Assess narratives; can he/she create or re-tell a story. Is it organized, do they include major details and can they remember details if asked. Take cultural styles into account

98
Q
A

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