speech disorders Flashcards
what does language include
what words mean How to make new words (friend-ly) Put words to make sentences word combos for the best situations both verbal and nonverbal
language vs speech
Language: set of rules
Speech: spoken language
how many muscles are in speech
100 orofacial, laryngeal, pharyngeal, and respiratory muscles
what is needed for articulation
Adjust shape and degree of constriction of mouth, pharynx and nasal cavities as sound and air rpessure pass through
what is articualtion
speech sound production
what are speech sound disorders
Developmental, phonological compensatory , and placement/phonetic articlation disorders
what are the common articulation errors
Substitutions
Omissions
Distortions
Obligatory vs active
what are phonemes
Speech sounds
what is involved in the place, manner. and voicing of phonemes
- Bilabials, Lingual-alveolar, velars
- stops, fricatives, sibilants, affricates
- oral vs nasal consonants
- liquids and glides
- voices vs voiceless sounds
what does a speech language pathologist do
Provides treatment of SSD by improving articulation of individual sounds or reduce erros in production of sounds
what is articualtion treatment do for SSD
Demonstrating how to produce a sound correctly
learning to recognize which sounds are correct or incorrect
practicing sounds in different words
what is Phonological process treatment do for SSD
teaching rules of speech to individuals to help them say worlds correctly
what does treatment of SSD emphasize
auditory discrimination traninng
does oral-motor therapy work for speech
not evidence backed
what is phonation
Sound waves created by vibration of vocal folds
what causes movment of the vocal folds
airflow from lungs and laryngeal muscle contraction
how does phonation occur
Vocal folds adduct
subglottal pressure builds and air flow forces folds apart
vibration begins
ends when breath or abduction occurs
how do kids and adults feel about voice disorders
negative attention and limited participation in activity
incidence rate of pediattric voice disorders
6-23%
what are pediattric voice disorders broadly defined as
Dysphonia
what are the common pediatric vocal pathologies
Infectious Anatomic Ongenital Inflammatory Neoplastic Neuroogic Iatrogenic - vocal nodules - vocal cord cysts - vocal cord paralysis - laryngeal webs - paradoxical vocal fold dysfunction
what is one fo the most common cuases of pediatric dysphonia
Vocal nodules (38-78% of pediatric dysphonia)
what are the symptoms of vocal nodules
Hoarseness breathiness rough and scratchy voice harshness Decreased pitch range throat/ear/neck pain losing voice
treatment for vocal nodules
Behavioral voice treatment (voice therapy)
how to treat vocal fold cysts
Surgical removal
voice therapy
how to treat a laryngeal web
Surgical resection (multiple)
what does voice therapy include
vocal hygein
Worksheets
reducing abusive behavor (yelling)
what makes voice therapy hard for kids
Need to self monitor
- harder with behavior, congitive, and attention limitations
what are the types of Motor speech disorders
Dysarthria
Childhood apraxia of speech
what is Dysarthria
Neurologic speach disorders resulting from abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movement
when does Dysarthria in children show
- Usually before able to speak if Congenital
- Acquired showed significat variation depending on age of onset
- usually after the acquisition of some speech language skills
why is Pediatric Dysarthria hard to diagnose
due to emerging language
characteristics of Dysarthria
difficult with spech and accuracy of artiulatory movements reduced loudness dysphonia hypernasality abnormal rate abnormal breaths bad feeding/swallowing problems, drools
symptoms of Athetoid (dyskinetic) Cerebral palsy from Dysarthria
slow rate, dyshythmia with in appropriate voice stages and reduced stress
- more atric errors
symptoms of Spactic Cerebral palsy from dysarthria
breathy voice monopitch monoloudness hypernaslity voice changes throughout utterence bettter speech intelligbility with fewer artic erros
how does Dysarthria in children with cerebral palsy manifest
involve all speech subsystems
decreased vowel space and reduced word intelligibility
what is childhood apraxia of speech
A neurological childhood speech sound disorder
- precisision and consistency of speech movements impaired in absence of neuromuscular deficity
what causes childhood apraxia of speech
known neuro impairment in association with complex neurobehavioral disorders of known and unknown origin
or
idopathathic
what does childhood apraxia of speech lead to
errors in speech sound production and prosody
what is the perceived quality of sound
Resonance
what generates resonance
vocal folds as vibrates through pharyngeal, oral ,and nasal cavities
what determines the degree of perceived nasality in speech
Balance of oral and nasal sound energy
what influences resonance
size/shape of oral caivty, nasal cavity, pharynx and tisues
- velopharyngeal closure
what is hypernasality usualy associated with
velopharyngeal insuffiency
what are the signs of hypernasality
perception of excessive nasality during vosels, glides (w and Y) and liquids (L, R)
what causes hyponasality
Nasal obstruction midface hypoplasia septal deviation choanal atresia adenoid hypertrophy
what are the signs of ypnasality
percetpion of denaslity/too little resonance during vowel and nasal consonants
what is a nasometer
acoustic objective instrument to measure oral and nasal sound energy
what does the velopharyngeal mechanism
Alters the general shape and resonant characteristic of vocal tracts
- connects/disconnects oral and nasal cavities
- speech
- nonspeech
how does the velopharyngeal work in normal speakers
moves up and back
lateral pharyngeal walls move medially
when does VP closure occur
swallowing and speech \
what controls the variation of Celopharyngeal closure depend
Specific demands of speech sounds and coarticulation
- oral vs nasal consonants
who inherently has disrupted VP colute
celf palate
can VP closure conclusions be made off nonspeach activites
No
where does the levator veli palatini originate
petrous temporal bone and eustacian tube
what forms the muscular sling
Levator veli palatini with palatal aponeurosis and other muscles
what is the importance of levator veli palatini
provide adequate veolpharyngeal closure for speech
what is done in nasopharyngoscopy
A small fiber optic is inserted into childs nares and advanced to see the celopharyngeal port durinspecific speech tasks
what are the instruments used to look at velopharyngeal closure
Nasopharyngoscopy
Videofluoroscopy
what is videofluoroscopy
uses Radiation to look at how the VP closes
what are the types of velopharyngeal inadequacy
Velopharyngeal insufficiency
Velopharyngeal mislearn
Velopharyngeal incompetency
is a VP insufficiency related to cleft palate
No
what are the causes of a VP insufficiency
Short Soft palate Post adenoidectomy Palatopharyngeal dysproportion 22q11.2 deletion syndrome Palatal resection due to cancer trauams
signs of submucous cleft palate
Bifid uvula
Midline division or diastasis of musculature of soft palate
notch in posterio hard palate
what are the types of VP incompetency
Dysarthria
Apraxia
what causes Congenital dysarthria
Cerebral palsy
Myotonic dystrophy
what causes acquired Dysarthria
TBI
CVA
Degenerative neuromuscular disease
what are the types of VP incompenecy from Apraxia
Childhood
Acquired
what is the articular profile of Cleft palate/VPD
reduced speech sounds Articulation erros Audible nasal air emission weak oral pressure Hypernasality
how does one often compensate for cleft palatate or VPI
glottal stops
Nasal fricative
what are clottal stops
adducting vocal folds abruptly to release a stop like consonant at the level of the larynx
what is a nasal fricative
substitution of nasal airflow for oral airflow on fricative sounds
can speach therapy treat hypernasality
No, need surgery or prosthetic
standard age of treatment for VPD
4 years old
what sounds tend to get fucked from dental occulusion
S, Z, then SH, CH, J
what does an anterior cross bite do to sounds
distort S, Z, SH, CH, J
reversed F and V
what does Overjet do to sounds
P,B,M like a F or V sound
what does excessive spacing do to sounds
Distort S an Z
when should you do dental therapy for speech problems
in schoolage children
what tends to happen to oclusion of a cleft patient
maxillary transverse collapse and crossbite on side of the cleft Class III common (class II more common` in COP
what is the orthognathic surgery
treat skeltal malocclusion and reverese overjet and improve facial form and function
what should be done if you need more than 1cm of advancement of the maxillary
Distraction osteogenesis (less use Leforte advancement
what is speach therapy not effective for
Hypernasality of VPD
why use a speach bulb
palate too short
why do a palatal lift
Soft palate sufficient in length, but lacks adequate movement
