SSDs - Classification, causes and co-occurrence

Question 1

A cognitive-linguistic difficulty with learning the phonological system of a language, characterised by pattern-based speech errors.
(McLeod & Baker, 2016, p.38)

Answer 1

Phonological impairment

an SSD

Question 2

SSD

Answer 2

Speech sound disorder

Question 3

A phonological assembly difficulty (i.e., difficulty selecting and sequencing phonemes for words) without accompanying oromotor difficulties (Dodd, 2013, 2014). Characterised by inconsistent productions of the same lexical item.
(McLeod & Baker, 2016, p. 38)

Answer 3

Inconsistent Speech Disorder

Question 4

A motor speech difficulty involving the physical production (i.e., articulation) of specific speech sounds. Characterised by speech sound errors typically only involving the DISTORTION of sibilants and/or rhotics
(McLeod & Baker, 2016, p. 38)

Answer 4

Articulation impairment

for rhoticised dialects like US English - not for Australian kids gliding - that is a phonological process

Question 5

A motor speech disorder involving difficulty planning and programming movement sequences, resulting in errors in speech sound production and prosody (ASHA, 2007).
(in McLeod & Baker, 2016, p. 38)

Answer 5

Childhood Apraxia of Speech (CAS)

Question 6

A motor speech disorder involving difficulty with the sensorimotor control processes involved in the production of speech, typically motor programming and execution.
(McLeod & Baker, 2016, p. 38)

Answer 6

Childhood dysarthria

Question 7

Impaired PHONOLOGICAL planning = ______
Vs
Impairment in planning and programming MOVEMENT SEQUENCES = ______

Answer 7

Inconsistent speech disorder
Vs
CAS

Question 8

Which of the 5 SSDs are Phonological problems?

Answer 8

1. Phonological impairment

2. Inconsistent speech disorder

Question 9

Which of the 5 SSDs are motor speech problems?

Answer 9

1. Articulation impairment
2. Childhood apraxia of speech (CAS)
3. Childhood dysarthria

Question 10

Components of language:

Answer 10

• Phonology (speech sounds, rules about how they combine to form words an how they are pronounced)
• Semantics (vocabulary)
• Morphology (grammar)
• syntax (sentence structure)

(McLeod & Baker, 2016, p. 40)

Question 11

Children with which SSD, have trouble learning the phonological system of their language?

Answer 11

*Phonological impairment

Question 12

A language disorder that affects the phonemic organisational level. The child has difficulty orginising their speech sounds into a system of sound contrasts.

(Bowen, 2009 in McLeod & Baker, 2016, p. 40)

Answer 12

*phonological disorder

[McLeod & Baker, 2016 use phonological Impairment as an overarching term to cover both phonological disorder and phonological delay].

Question 13

Children with this issue can have difficulty knowing what features, speech sounds, word shapes, and stress patterns are present in a language, how they are used, and how they mentally represent and organise that system.
(McLeod & Baker, 2016, p. 40)

Answer 13

Phonological disorder

[McLeod & Baker, 2016 use phonological Impairment as an overarching term to cover both phonological disorder and phonological delay].

Question 14

Phonological error patterns (phonological processes) are considered symptomatic of underspecified phonological representations of words in this problem categorised under the umbrella term ‘phonological impairment’.
(McLeod & Baker, 2016, p. 40)

Answer 14

Phonological disorder

[McLeod & Baker, 2016 use phonological Impairment as an overarching term to cover both phonological disorder and phonological delay].

Question 15

Phonological Delay

Answer 15

Systematic error patterns (e.g., final C deletion, cluster reduction etc) that are typical in the speech of younger children, but which should have been resolved, are still exhibited by a child.

[McLeod & Baker, 2016 use phonological Impairment as an overarching term to cover both phonological disorder and phonological delay].

Question 16

A child who exhibits phonological processes that don’t occur in younger children (who speak the same language) (e.g. initial C deletion, glottal insertion) has which problem, subsumed under the umbrella term ‘phonological impairment?’

Answer 16

Phonological disorder

[McLeod & Baker, 2016 use phonological Impairment as an overarching term to cover both phonological disorder and phonological delay].

Question 17

Phonological patterns that are common in young children speaking a particular language, may not be a feature of the language of young children who speak a different language. True or false?

Answer 17

True

Question 18

Children with this SSD have difficulty selecting and sequencing phonemes (i.e., in assembling a phonological template or plan for production of an utterance).
(McLeod & Baker, 2016, p. 41)

Answer 18

Inconsistent speech disorder

Question 19

What percentage of children with SSD are thought to have inconsistent speech disorder?
(Broomfield and Dodd, 2004b in McLeod & Baker, 2016, p. 41)

Answer 19

10%

Question 20

Children with this problem know usually know how to articulate a range of speech sounds, but they have difficulty with the assembly of phonemes that make up a word. They present with lexical inconsistency, but don’t have oromotor signs, like groping. During intervention, they need to learn how to phonologically plan words, rather than simply imitating them.

Answer 20

Inconsistent speech disorder

McLeod & Baker, 2016, p. 41

Question 21

Children with _____ ______ difficulties have trouble performing articulatory gestures necessary for speech production. They may have problems with the coordination and production of precise mouth movements, respiration, resonance, and/or phonation required for fluent and rapid speech.
(McLeod & Baker, 2016, p. 41)

Answer 21

Motor Speech

Question 22

The inconsistency assessment in which formal comprehensive articulation and phonology assessment battery (normed in Australia), can give a percentage inconsistency in the inconsistency assessment sub-test.

Answer 22

Diagnostic Evaluation of Articulation and Phonology (DEAP)

Dodd et al., 2002

Question 23

Motor speech difficulties may be simple or complex. An example of a simple motor speech difficulty is:

Answer 23

Articulation impairment (e.g., a lisp)

Question 24

Complex motor speech difficulties are called Motor Speech Disorders (MSD). They may include problems with one or more of the sensorimotor control processes needed to produce speech, inlcuding motor planning, motor programming, and execution that disrupt the respiratory, phonatory, resonatory, and/or articulatory systems used in speech production (Duffy 2013). Which 2 motor speech disorders are included as SSDs of childhood?

Answer 24

1. Childhood apraxia of speech (CAS)
2. Childhood dysarthria

(McLeod & Baker, 2016, p. 41)

Question 25

Principals of motor learning guide intervention for these SSDs:

Answer 25

1. Articulation impairment
2. CAS
3. Childhood dysarthria

Question 26

This motor speech difficulty typically only applies to speech errors limited to rhotics and/or sibilants. [typically distortions].
(McLeod & Baker, 2016, p. 42

Answer 26

Articulation impairment

for rhoticised dialects like US English - not for Australian kids gliding - that is a phonological process

Question 27

Typically, children with ____________ __________ don’t have concurrent difficulties with phonology. They have learned the phonological system and can make themselves understood. Instead they have a difficulty with the physical production of sibilants and/or rhotics.

Answer 27

Articulation impairment
(for rhoticised dialects like US English - not for Australian kids gliding - that is a phonological process).
(McLeod & Baker, 2016, p. 42)

Question 28

___ is a motor speech disorder involving planning and programming movement sequences.

Answer 28

CAS (childhood apraxia of speech)

Question 29

This motor speech disorder occurs in 1-2 children per thousand. (McLeod & Baker, 2016, p. 43)

Answer 29

CAS (childhood apraxia of speech)

Question 30

Children with this MSD have a) inconsistent errors on Cs and Vs in repeated productions of syllables or words, b) lengthened and disrupted coarticulatory transition between sounds and syllables, and c) innappropriate prosody, especially in the realisation of lexical or phrasal stress. (ASHA, 2007 in (McLeod & Baker, 2016, p. 44).

Answer 30

CAS (childhood apraxia of speech)

[Although CAS is an underlying motor speech disorder, ths may also impact phonological and linguistic processing]. (Maassen, 2002 in McLeod & Baker, 2016, p. 44).

Question 31

This is a disorder in the ability to control and execute speech movements, caused by neurological impairment.

Answer 31

Childhood dysarthria

Question 32

Types of childhood dysarthria

Answer 32

• flaccid
• spastic
• hyperkinetic
• hypokinetic
• ataxic
• mixed

Question 33

Some causes of childhood dysarthria:

Answer 33

It is cause by neurological impairment, so: cerebral palsy, TBI, a neurological condition (e.g., neurofibromatosis)….

Question 34

What are some features of speech shared by inconsistent speech disorder, CAS, and childhood dysarthria?

Answer 34

• Substitution and distortion errors

* error inconsistency

Question 35

How do we tell the differency between childhood dysarthria and CAS? (Clue: look at prosody and voice - just look at prosody for this card:)

Answer 35

Prosody
CAS - inappropriate phrasing, rate, sentential stress, lexical stress, emphatic stress
Childhood Dysarthria - inappropriate rate and sentential stress, BUT appropriate phrasing, lexical stress and emphatic stress

Question 36

How do we tell the differency between childhood dysarthria and CAS? (Clue: look at prosody and voice - just look at voice for this card:)

Answer 36

Voice
CAS - appropriate loudness, pitch, laryngeal quality, and resonance.
Childhood Dysarthria - inappropriate loudness (too soft), pitch (too low), laryngeal quality (harsh), and resonance (hypernasal).

Question 37

How to tell the difference between children with inconsistent speech disorder (as opposed to those with CAS or childhood dysarthria)?

(McLeod & Baker, 2016, p. 45)

Answer 37

1. Typically do not have problems with prosody, voice, and fluency. (Their problem is with phonological planning, not motor planning, motor programming, or execution).
2. Speech intelligibility of children with inconsistent speech disorder is better in imitated speech. Children with CAS are better in spontaneous contexts.

Question 38

There is a correlation between speech and language: language delayed toddlers show a higher percentage of phonological errors than those of the same age whose language is more advanced. True or false?

Answer 38

True
(McLeod & Baker, 2016, p. 57)

–> but is this because at the one-word stage there isn’t as much practice, as at the 2-4 word stage…?

Question 39

In a 1994 study of children with SSD, 50-70% also had expressive language problems, and 10-40% also had expressive and receptive language problems. True or false?

Answer 39

True

McLeod & Baker, 2016, p. 57

Question 40

Are children with SSD more likely to have difficulties with phonological awareness and literacy?

(McLeod & Baker, 2016, p. 57)

Answer 40

Yes. According to the critical age hypothesis, those who still have SSD at the age of beginning literacy instruction (~5yrs) are most at risk.
The difficulty might be explained by underlying phonological processing skills (esp. quality and accessitbility of phonological representations) may explain difficulties with phonological awareness and reading.

Question 41

Children with SSD and concomitant language impairment are at greater risk of having difficulties with phonological awareness, reading, and writing, than those who only have SSD. True or false?

Answer 41

True

McLeod & Baker, 2016, p. 57

Question 42

Children are more likely to have greater difficulties with phonological awareness if they have atypical or non-developmental speech errors. True or false?

Answer 42

True

McLeod & Baker, 2016, p. 57

Question 43

Children with SSD or unknown origin can have co-ocurring difficulties with oromotor functioning (e.g. oral apraxia/problems with oral volitional movement). True or false.

Answer 43

True. One study found 32% of 50 children with SSD had these issues.
(McLeod & Baker, 2016, p. 58)

Question 44

Up to 30-40% of children who stutter are reported to have co-occuring SSD. True or false?

Answer 44

True. But this has been disputed.

McLeod & Baker, 2016, pp. 58-9

Question 45

What are some of the known origins of SSDs?

McLeod & Baker, 2016, p. 52

Answer 45

• Genetic causes (e.g., cri du chat syndrome)
• Craniofacial anomalies (e.g., cleft palate)
• Cognitive/intellectual impairment (e.g., Down syndrome)
• Hearing loss
• Motor impairment (e.g., cerebral palsy)
• Autism spectrum disorders

Question 46

Children with SSD may have difficulty with which 4 things:

Picture of girl and world

Answer 46

• phonological representation and mental organisation of speech (MIND).
• Perception of speech (EARS)
• Motor production/articulation of speech (MOUTH)
• Intelligibility and acceptability of speech (ENVIRONMENT)

(McLeod & Baker, 2017).

Question 47

Articulation impairment

Answer 47

Residual motor errors. Later developing sounds /s, z, r/

Question 48

Phonological impairment

Answer 48

One or more phonological processes

Question 49

Inconsistent phonological disorder

Answer 49

Variable productions, highly unintelligible

Question 50

Childhood apraxia of speech (CAS)

Answer 50

Variable productions, vowel errors, small phonetic inventory, groping

Question 51

Dysarthria

Answer 51

May experience difficulties with:

articulation, phonation, respiration, and prosody

Question 52

What is the most common SSD?

Answer 52

Phonological impairment