speech sound development/Language disorders Flashcards
Sound by 3 yrs old
peanut butter donuts mean no hungry women
sounds by age 4
to kiss guys for yogurt stinks
sounds by age 5
voodoo zoos show llamas chasing jaguars
sounds after age 5
the rs (th voiced and voiceless and r)
morphology
the study of word structure
morpheme
smallest unit of a language
semantics
the study of the meaning in language
overextension vs underextension
overextension is all round items are balls
under extension is only an Oreo is a cookie
quick incidental learning or fast mapping
child’s ability to learn a new word on the basis of just a few exposure to it.
pragmatics
the study of rules that govern the use of language in social situations
Functions of language
labeling: naming something
protesting: objecting to something
commenting: describing or identifying objects
deficiencies exhibited with children with language disorders
limited amount of language
deficient grammar
inadequate or inappropriate social communication
deficient nonverbal communication skills
deficient literacy skills
cognitive deficits
specific language impairment (SLI)
a language disorder in a child who is otherwise typically developing
Characteristics of children with SLI-specific
language
impairment
-often have arctic and phonological problems
-use less complex syllable structures
-overextend/underextend
-have marked morphological problems
-shorter utterances (decreased MLU)
-telegraphic speech
intellectual diabilty
term now preferred to mental retardation. disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. Speech generally believed to be delayed rather than deviant. They follow the same developmental milestones but slower.
autism spectrum disorders
persistent deficits in social communication and social interaction across multiple contexts
Cerebral Palsy (definition and types of CP)
ia disorder where the immature nervous system is affected. A group of sx associated with brain injury in children. occurs due to prenatal, perinatal, or postnatal brain injury. Can manifest paralysis of various body parts.
ataxic CP: disturbed balance, awkward gait, uncoordinated movements (cerebellar damage)
athetoid CP: slow, writhing, involuntary movements (basal ganglia, motor pathways damage)
spastic SP: increased spasticity as well as stiff, abrupt, jerky, slow movements
Types of paralysis
hemiplegia: one side of the body
paraplegia: only the legs and lower trunk are paralyzed
monoplegia: only one limb of a part thereof is paralyzed
diplegia: either the two legs or the two arms are paralyzed
quadriplegia: all four limbs are paralyzed
type token ratio
represents the variety of different words the child uses expressively
discrete trial procedure
shows card
asks questions
immediately models the correct response for he child and asks for imitation
gives praise or corrective feedback
records response
moves onto next trial
expansion
expands the Childs telegraphic speech (doggy bark to yes, the doggy is barking)
extension
the clinician comments on the child’s utterances and adds new and relevant info. (child says play ball and SLP says, yes you are playing with a big, red, plastic ball that bounces)
focused stimulation
usually done during play activity. The SLP repeats the model target (look, here are two pigs, I see two pigs)
The slp does not correct the incorrect responses but does model correct production (e.g., if the kid says I see two duck swimming, the SLP says yes, two ducks are swimming in the pond)
milieu teaching
kid pointing to ball
SLP says what do you want and waits
If child says nothing then model it
praises child then hands over desired object when child elaborates (spontaneously or imitatively)
joint book reading
child participates actively in reading a book. SLP asked questions or when child is familiar with story asks them to fill in information at times.
narrative skills training
working on having the child learn parts of a narrative using tools such as picture cars, books or even videos)
parallel talk
SLP describes what the child is doing during play activities.
recasting
recasting childs productions into longer of syntactically different forms.
self talk
clinician describes her own activity as she plays with the child
articulation approach to therapy
acquisition of individual phonemes and emphasizes speech motor control
phonological approach to therapy
underlying knowledge of the rules of the sound system of language. sound patterns and processes.
Behavioral Theory
based on conditioning and learning. develops speech through interactions with caregiver
natural phonology theory
proposes that natural phonological processes are innate processes that simplify the adult target word. believe that phonological processes are innate or acquired early in life. Suppress processes that do not happen naturally in the language they are exposed to. No evidence to support this.
Prelinguistic devlopment stages
phonation stage (birth-1 month): speech-like sounds are rare. Most sounds are reflexive
cooing stage (2-4 months): most productions are similar to /u/
expansion stage (4-6 months): playing sounds like growls, squeels, yells, raspberries
reduplicated babbling (6-8 months): produces strings of CV syllabes (mama)
nonreduplicated babbling (8mo-1yr): adult like syllabes in CV sequences but varierty of consonants/vowels appear in single vocalization
What age is a child a candidate for intervention if they are unintelligile to listener
3 years old
intelligibility % guidelines for ages
2: 60-70%
3: 75-80%
4: 90-100%
vocalization
a vowel is substituted for a syllabic consonant–usually a liquid (bado instad of bottle or noodoo instead of noodle)
gliding
a liquid consonant is produced as a glide (wamp for lamp)
velar fronting
an alveolar or dental replaces a velar (ti for ki or dout for gout)
stopping
a fricative or affricate is replaced by a stop (tu for shoe or dis for this)
depalitization
substitutes an alveolar affricate for a palatal affricate (wats for watch)or substitutes an alveolar fricative for a palatal fricative (wis for wish, sip for ship)
affrication
affricate is produced in the place of a fricative or stop (chun for sun, chu for shoe)
deaffrication
a fricative replaces an affricate (sip for chip, sieze for cheese)
backing
a posteriorly placed consonant is produced instand of anteriorly placed consonant (gan for dan)
reduplication
child repeats a pattern (wawa for water or baba for bottle)
regressive assimilation
earlier occurring sound influences a later occurring sound (kick for kiss, bup for but)
voicing assimilation
devoicing: pik for pig
voicing: bad for pad
substitution patterns
group of phonological patterns in which on sound is substituted for another
vocalization, gliding, fronting, stopping, depalatization, affrication, deaffrication, backing)
assimilation patterns
sounds are changed by the influence of the neighboring sounds
reduplication, regressive assimilation, progressive assimilation, and voicing assimilation
syllable structure patterns
affect the structure of the entire syllables not just certain sounds
weak syllable deletion: omission of unstressed syllables
final consonant delation: final consonant ommitted
epenthesis: schwa vowel is inserted between the consonants in an initial cluster (bulack for black)
diminutization: addition of /i/ to targe form (dagi for dag, egi for egg)
metathesis: production of sounds in a word in reversed order (peek for keep)
functional vs organic
functional means an organic or physical cause was not found. Organic is when a physical cause is the explanation.
artic error: substitutions
incorrect sound is produced in place of correct sound
omissions or deletions
required sounds omitted in words
labializations
sounds are produced with excessive lip rounding
nasalization
oral sounds (like g) are produced with inappropriate nasal resonance
pharyngeal fricative
fricative such as h are produced in the pharyngeal area
devoicing
voiced sounds are produced with limited vocal fold vibrations or without vibration (dak for dag)
frontal and lateral lisps
frontal: tongue tip too far forward (s and z)
lateral: airflow inappropriately over the sides of the tongue with s and z
stridency deletion
strident sounds are ommitted (ma for mash, tap for stop)
prevocalic, intervocalic, postvocalic errors
errors occur with reference to consonant position in syllables (gag for dag would involve prevocalic error)
Child dysarthria (definition and general treatment)
speech-motor disorder caused by peripheral or central nervous system damage. Causes paralysis, weakness, or incoordination of speech muscles. In children it can be caused by CP, TBI, degenerative disease, tumor, or CVA.
Treatment is very repetitive and structured. Involves increasing muscle tone and strenth, increasing ROM and treating other parameters (breathing). Drills, etc.
childhood apraxia of speech
caused by central nervous system damage. No weakness or paralysis of the muscles. it is a motor programming disorder. Diffisult to program the precise movement necessary for smoothly articulated speech.
slow, effortful speech
unusual errors of articulation
groping and silent posturing and of the articulators.
inconsistency in sound productions
Tratment involves extensive drills, imitation, decreased rate of speech. Hierarchical in nature (from CV and VC to more complex). Practice small set of functional words. Treatment should be intensive. Home practice and self monitoring.
Assessment of speech sound disorders
-screening
-case history
-orofacial exam
-Hearing screening
-conversational speech sample (50-100 utterances)
-Evoked speech samples (imitation, naming, sentence completion)
-stimulability assessment: ability to imitate the clinician’s model when given auditory and verbal cues
-standardized assessment
Scoring and analysis of assessment data
independent analysis: described without reference to adult models
relational analysis: more commonly used. Child’s speech is compared to the adult model (e.g., “the child produced a w/r substitution)
-use IPA
-note how consistently the errors are produced (e.g., 70%)
-analyze standardized testing
-List phonological patterns the child uses and percentage they are used
-Use published guidelines to decide whether the phono patter should have disappeared by the child’s age
-calculate intelligibility
-calculate severity by percentage of consonants correct (PCC)
PCC (percentage of consonants correct)
total number of consonants produced correctly
_________________________________
total number of consonants produced
> 85%: mild
65-85%: mild-moderate
50-65%: mod to severe
<50%: severe
Phonological patterns that should disappear by age 3
-reduplication
-weak/unstressed syllable deletion
-consonant assimilation
-prevocalic voicing
-fronting of velars
-final consonant deletion
-diminutization
phonological patterns that persist after age 3
-final consonant devoicing
-consonant cluster reduction
-stopping
-epenthesis
-gliding
-depalatization
-vocalization
motor based vs linguist approaches to treatment (when to use each)
motor: best for children with several sounds in error
linguistic: best for highly unintelligible children with multiple sound errors.
General considerations for treatment with SSDs
multimodal approach: auditory, visual, and kinesthetic cues
-goal is effective communication so activies are meaningful to child’s communication or daily environment
-early intervention is a high priority
-involve caregivers in therapy
-always take cultural and linguistic backgrounds into account. Distinguish the dif between a difference and a disorder. a child has a disorder only when his/her speech patterns in primary language or in English differ from those of peer with similar backgrounds
developmental vs complexity approach
developmental: treatment focuses on earlier sounds first…follows general speech sound acquisition.
complexity: recommends targeting sounds that are not stimulable, always incorrect, and develop later. Theory is they will learn the harder sound and this will aid them in gaining earlier sounds as well.
-may take longer
-must take into account child’s ability to handle frustration
Van Ripers Traditional Approach (motor approaches)
is the foundation for motor approaches to artic therapy. Focused on auditory discrimination/perceptual training, phonetic placement, and drill like repetition and practice. View artic errors as resulting from motor difficulties.
Successful with children who have only a few phonemes in error and are not highly unintelligible.
Linguistic approaches to treatment
assume that the child has a rule governed system with specific patterns but this system differs from the adult system in the community. Geared towards modifying this child’s system to be like the adult standard.
SLP attempts to remediate underlying patters or rules instead of discrete phonemes (e.g, stridency deletion). Most linguistic programs use minimal pairs for treatment with the goal to show the child that sound production affects meaning.
Minimal Pair Contrast Theory
SLP uses a pair of words that only differ by one feature–the feature the SLP is trying to help the child with. One contains the correct production and one has the incorrect production the child is making. (boat/bow, bee, bead).
Maximal Contrast Therapy
selected word pairs contain the maximum number of phonemic contrasts. All three features (place, manner, voicing) may be involved. (mack/shack, me/she)
phonological pattern approach
A child’s errors are grouped and described as phonological patterns (consonant cluster deletion) as opposed to discrete sounds (johnny makes w/r substitutions). Cycles approach is widely used phonological pattern approach.
Hodson and Padens Cycles Approach
designed to treat children with multiple misarticulation and highly unintelligible speech. Error patterns are targeted for remediation based on stimulability, intelligibility, and percentage of occurrence (40% or greater). Patterns not drilled to mastery. A cycle runs 5-16 weeks. Each sound receives 1 hr of treatment before the SLP proceeds to the next sound.
review of previous session’s target words
auditory bombardment (listening to target words that are amplified)
activities involving new target words
play break
more activies
repeated auditory bombardment
dismissal
*family is also given home practice
core vocabulary approach
70 core vocab words that are selected with help of parents and teachers. 8 weeks of therapy. Designed for inconsistent errors on the same words in the absence of CAS (apraxia).
Phonological Awareness Treatment
Treatment activities are designed to increase children’s awareness of sound structure of language. Activities like sound blending, rhyming, alliteration, etc. Draw kid’s attention to the printed word when targeting speech sounds. Use books and reading tasks.
browns stage 1`
12-26 months
~50 words in vocob
basic phrases with communicative intent (“more juice)
Browns stage 2
27-30 months
ing
in/on
plural s
Browns stage 3
31-34 months
irregular past tense (me drew)
possessive s (in house, on book)
uncontractible copula (my kids)
Browns stage 4
35-40
articles a/the (a drink)
regular past tense (she shopped)
third person regular present tense (he runs)
Browns Stage 5
41-46+
third person irregular (doggy does tricks)
uncontractible auxilliary (he was jumping)
contractible copula (she’s happy)
contractible auxilliary (she’s dancing)
MLU 12-26 mo
1.0-2.0
MLU 27-30
2.0-2.5
MLU 31-34 MO
2.5-3.0
MLU 35-40 MO
3.0-3.75
MLU 41-46 MO
3.75-4.5
MLU 47 MO +
4.5 +
Terms for age related:
hearing loss
vision loss
voice changes
swallow changes
presbycusis
presbyopia
presbyphonia
presyphagia
