THAS 102 FINAL REVIEW Flashcards

Question

What are the deficits in adaptive behavior?

Answer 1

Major limitations in… - academic learning - personal independence - social responsibility

Answer 2

Bio: - genetic and chromosomal abnormalities (2 most common are DS and fragile x) - infection during pregnancy/delivery complications - brain disease (meningitis, encephalitis) Enviro: - TBI - lead poisoning - malnutrition

Answer 3

- delays in hitting milestones - infants with CD are less alert, have a weak sucking reflex and muscle tone - milestones like sitting, standing, walking, crawling, lang and communication skills are all significantly delayed

Answer 4

1) Trisomy 21 (95%) - extra chromosome on the 21st pairing 2) Translocation pattern (2-3%) 3) mosaicism (2%)

Answer 5

- heart malformation - intestinal problems - hearing loss and poor vision - smaller head; slanted eyes, small ears, flat nose bridge - hypotonia - teeth come in late - short fingers 75% have conductive hearing loss (earwax + mid ear infection, low tone affects Eustachian tube)

Answer 6

- high, narrow and arched palate - large adenoids affects nasal airflow which leads to mouth breathing - difficulty with tongue control - hypotonia = fine motor skill diff - when looking at mouth movement function, consider speed,strength and coordination

Answer 7

Reduced intelligibility due to - delayed onset of speech - vowel errors are common;alveolar sounds are more likely to be distorted - structural differences + inconsistent error patterns

Answer 8

- sig lang impairments - exp lang more advanced than rec - visual learning skills are strong Semantics: slower to develop, but vocab is a strength (very good at labeling objects) Syntax: more impaired, challenges in learning to understand and use passives and pronouns Pragmatics: strong ToM, may have issues with conversational behavior, differentiating facial emotions

Answer 9

Fluency - diff apparent in 30% of DS Voice - quality problems, hyper/hypo nasality (can be due to structural differences) possible cleft/submucous palate

Answer 10

Sensory: - intolerance to certain sights/smells/sounds/textures/temp/colours - clues there may be a sensory issue = gagging, inability to tell if they are full or hungry, lots of drool or messy eater Cognitive: - attention + verbal short term memory - reasoning + problem solving

Answer 11

- x-linked genetic disorder (males more affected than females) - results in cognitive, communicative, and behavior disorders - IQ tends to decrease with age - self injurious behavior, ADHD, anxiety and disciplinary problems are typical - many symptoms mirror autism, which may be based on sensory integration/processing issues - higher incidence of otitis media - due to long pinnas, extensive examination of hearing mechanism is encouraged - auditory-receptive memory and auditory processing skills are generally deficient

Answer 12

- elongated faces/ears, prominent Jaw, flat bridge of nose - hypotonicity and joint dysfunction - vision difficulties - heart malformation

Answer 13

Articulation : - associated with cognitive imapairment - delayed articulation dev is common - oral-motor diff - dyspraxia apparent Lang: - affected by attention and sensory issues - rec lang is a relative strength - delayed in onset (may never develop) - echolalia and preservation lang - anomia and weak lang sequencing, organization and syntax Pragmatics: - weak nonverbal pragmatic skills; often inappropriate - poor non verbal skills - girls have a higher language skills - dysfluencies

Answer 14

- dev secondary disabilities - dis range from mild intellectual + behavioral issues to profound - most with FASD do not look different, can be misdiagnosed (ie ADHD, learning disabilities, anxiety etc) - primary disabilities = dis a child is born with

Answer 15

1) disrupted school experience with can include suspension, drop out etc (60%) 2) mental health issues (95%) 3) trouble with the law ( 60%) 4) inappropriate sexual behavior (52%) 5) high risk of being neglected/abused 6) being confined/housed in various public institutions (55%) 7) problems with employment (70%) 8) problems with parenting

Answer 16

1) craniofacial abnormalities = widely spaced eyes, flat thin upper lip, flat midface (less than 10% have visible differences) 2) prenatal + postnatal growth deficiency (low birth weight, lose weight over time not due to nutrition, low weight to height ratio. 70% have severe feeding problems, often “failure to thrive”) 3) CNS dysfunction (structural brain abnormalities including the partial or complete agenesis of corpus collasum. Neurogenic signs aka impaired fine motor skills, poor hand eye coordination. Brain malformation)

Answer 17

LH - logic, facts and rules RH - sensory input + reactive

Answer 18

- may have normal to high IQ but very low adaptive capacity (AQ, aka the inability to predict consequences of actions, poor judgment skills. 2/3 kids have significant behavioral and emotional disturbances)

Answer 19

Artic: - poor feeding skills early in life which doesn’t allow for normal movement patterns necessary for pre speech motions to develop) - dyspraxia (affects movement and coordination) Lang: often present with greater expressive language than they have (aka cocktail speech) and has dif with syntax, semantics and Pragmatics Voice: - resonance problems common (many have clefting, VP insufficiency, and craniofacial anomalies) - hypernasality + nasal air emissions - may be hoarse

Answer 20

- ~1/160 children (more boys than girls, diff to diagnose, typically between 6-8 yrs) - normal cognitive ability, maybe some learning disabilities Speech: - unusual prosody, tone accents and intensity of speech Simple vocal tics: whistling,coughing Complex vocal tics: linguistically meaningful utterances Simple motor tics: eye blinking, shoulder shrugging Complex motor tics: clapping, kissing, hopping

Answer 21

- occurs 1/8000 - 1/25000 live births - defect in chromosome 15 - most common cause of genetic obesity (have polyphasia insatiable appetite) (60% have normal metabolism) - develops between 2-5 years

Answer 22

Cognitive: - IQ 40-105 (average is 70) - immature for age, displays incomplicance, diff with transitions, impulsivity and disinhibition Physical: - hypotonia - short stature, small hands/feet, tapering on fingers and toes, distinct facial features, narrow palatial arch, underdeveloped chin and inadequate velopharyngeal closure.

Answer 23

Oral -Motor: severely reduced, low tone affected feeding in infancy, flaccid dysarthria notes (due to damage to the lower motor neurons) Articulation: hypotonia and structural differences, speech onset can be delayed, mild to multiple articulation errors ( esp trouble lifting tongue to make alveolar phonemes) Lang: both rec and exp lang delay, affected by cognitive function, reduced morphological and phonological, dif with comparatives and superlatives Voice: hypotonia can result in excessive hypernasality and high pitched voice, nasal emissions and poor VP closure Fluency: above average # of dysfluencies

Answer 24

Articulation: ability to produce sound in sequence by moving the articulators Articulation delays: refers to the difficulty making motor movements to produce speech sounds that should be achieved by their age * most artic delays are considered functional (ie the cause of differences in speech development from normal developing kids simply cannot be determined)

Answer 25

Phonology: system of sounds/sound patterns within a language Phonological delays: refers to children applying phonological processing longer than necessary or applying atypical phonological patterns *most phonological delays are considered functional (ie the cause of differences in speech development from normal developing kids simply cannot be determined)

Answer 26

In order to be classified as functional rather than organic disorder, kids should have - normal physiological development - normal functioning oral mechanism - normal hearing - no neurological problems relevant to speech production

Answer 27

1) syllable simplification (FCD, CCR, ICD, USD, Diminutization aka adding ‘ee’ at the end of a word, Reduplication aka soother becomes soosoo 2) sound substitutions (stopping, fronting, gliding) 3) sound assimilations (making one sound similar to another to simplifying the word aka gog for dog, prevocalic voicing)

Answer 28

By 3 they should be done with : USD, FCD, VF, PPV After 3: CCR, Gliding, Stopping

Answer 29

1) chronological mismatch (advanced patterns co-occur with ‘early processes) 2) variable use of processes 3) use of atypical processes (use of atypical processes, backing, glottal replacement) 4) small phonetic repertoire/inventory 5) systematic sound preference (aka “phoneme collapse”; child subs ‘t’ for all fricatives 6) reduces intelligibility

Answer 30

1) central nervous system CNS (includes the brain and spinal cord) 2) peripheral nervous system PNS (all associated nerves and sense organs including cranial + spinal nerves)

Answer 31

The brain is the central processor for incoming sensory information, mutual reasoning and outgoing motor commands. The cells in certain regions perform different tasks such as processing sensory information, generating motor commands and nourishing + supporting the other nerve cells.

Answer 32

1) cerebrum (divided into left and right hemisphere, it controls muscle function and also speech control, thoughts, emotions, reading, writing and learning) 2) cerebellum (responsible for coordinating movement and balance also known as the “little brain” plays a vital role in language and attention and can assist people with vision and eye movement) 3) brain stem (includes midbrain, pons, medulla oblongata, regulates breathing/swallowing/automatic body activities

Answer 33

Cerebral cortex: expands brains surface area + # of nerve cells Gray Matter: where processing + regulating of info occurs in CNS, found in cortex + some subcortical structures + basal ganglia and spinal cord White Matter: myelinated neurons, specialize in transmitting info over relatively long distances within the body Ridges = called a gyrus Valley = called a sulcus (very deep sulcus is called a fissure) ** made up of two major divisions Cerebral hemispheres Basal ganglia (responsible for motor control, motor learning, executive function, behaviors and emotion)

Answer 34

Ischemic (85%) - blood clot the restricts blood flow to brain - buildup of plaque involved in most ischemic strokes (fatty materials, calcium and scar tissue) 1) thrombotic - blood clot directly in artery in brain 2) embolic - clot that travels to brain from somewhere else in brain Hemorrhagic (15%) - uncontrolled bleeding in brain; interrupts normal flood flow in brain - flooding in brain kills brain cells 1) subarachnoid hemorrhage - uncontrolled bleeding on the surface of the brain (between brain & skull) 2) intracerebral hemorrhage - an artery deep within brain ruptures

Answer 35

- can be caused by structural problems with blood vessels in brain Aneurysm: weakened area in blood vessel wall fills with blood and bulges, high BP or trauma can cause a rupture AVM (arteriovenous malformation): malformation of brains blood vessels usually present at birth; cause artery walls to be weak

Answer 36

- “mini stroke” - symptoms are similar to ischemic stroke, but go away within minutes or hours (less than 24 hours) - many people have a TIA without knowing it

Answer 37

1) left hemisphere 2) right hemisphere 3) cerebellar stroke (can cause abnormal reflexes of head + torso, coordination + balance problems, dizziness, nausea + vomitting 4) brain stem stroke (esp devastating, can result in paralysis on one or both sides of body aka “locked in syndrome” where you can only move eyes)

Answer 38

Aphasia - impaired lang retrieval, recognition and competency (30% of stroke survivors) Dysphasia - diff swallowing (55%) Dysarthria - diff speaking bc speech muscles are weak (40%) Apraxia - affects coordination of muscles used for speech (10%)

Answer 39

- left sided stroke “brain holding your words hostage” - most common cause is a cerebrovascular accident (CVA) Causes: - 85% stroke - 15% brain injury, tumors, neuro conditions Every client is different depending on 1) site of injury 2) severity of injury 3) uniqueness of injury

Answer 40

Non-fluent aphasia: verbal expression is agrammatic, lacking in prosody, slow and effortful - relative strength is comprehension - typically frontal lobe injury, often comes with gross motor deficits - Broca’s aphasia = main type of nonfluent aphasia Fluent Aphasia: - marked by fluent (though nonsensical) speech +impaired comprehension - typically injury in temporal parietal region, therefore no gross motor deficits

Answer 41

- output similar to Broca’s but excellent imitation - little to no initiation of spontaneous speech (or writing) - present with telegraphic speech, agrammatism +anomia (also agraphia) - relatively intact comprehension

Answer 42

- most severe - little to no exp or rec skills - results from damage to Broca’s and wernickes area - severe motor deficits (hemiplegia, severe dysarthria, apraxia, dysphagia)

Answer 43

- wernicke’s area - main type of fluent aphasia - fluent but often meaningless (jargon) - imapired comp (both written and verbal) - unaware that what they are producing is incorrect Characteristics - circumlocations (talking around a word that can’t be retrieved) - jargon (meaningless speech) - neologisms (made up words) - paraphasias (word sub that are found in some individuals with aphasia who may talk fluently + grammatically ‘ Phonetic paraphasias: sub or transportation of a sound (tofa for sofa) Semantic paraphasias : sub of one word for another - alexia - agraphia - anomia

Answer 44

- relatively fluent speech and good lang comp - main imapairment is inability to repeat words or phrases - some have spoken lang impairments, paraphasias (often phonemic) and anomia

Answer 45

Significant word finding diff with otherwise fluent and grammatical speech ; good comp (writing may be poor) Least severe aphasia

Answer 46

1) speech fluency (measured by length of utterances with 4 or more connected words indicating greater fluent speech ability) 2) syntax 3) naming (ability to use appropriate words + provide names when presented an object) 4) repetitions or imitative speech (ability to repeat back what is said 5) automatic speech 6) lang comp 7) reading and writing Factors: 1) age (younger ones have greater levels of recovery) 2) lesions size (larger lesions typically cause more deficits + more diff to completely recover 3) lesions location ( more tissue damage + damage to wernickes area produce more persistent aphasia) 4) severity and type (global aphasia has poorest prognosis)

Answer 47

Stroke, TBI, tumor, seizure, infection that damages right side of brain

Answer 48

-cognition and language (nonverbal) are affected - language skills such as word and sentence processing are relatively unaffected - there are lang issues but cognitive and perceptual issues are more typical Cognitive: - diff with memory (esp working mem), logic, reasoning, planning, sequencing, problem solving, inferencing, understanding sarcasm and humor, and ToM. Perceptual and attentional deficits: - neglect of left visual field (left side neglect) - diff with facial recognition (prosopagnosia),denial of deficits, reduced sustained attention and selective attention - trouble reading others emotions

Answer 49

1) primary damage ( ranging from large to small microscopic brain lesions caused by impact to the head) 2) secondary damage ( resulting from such factors as infection, oxygen deprivation, brain swelling (edema) which can lead to intracranial pressure) Secondary issues include:M cerebral edema, traumatic hemorrhage and seizures. (Open) Penetrating injuries: - results when the scalp, skull and meninges are penetrated (ie gunshot wound) - injuries tend to be relatively localized “focal” with regard to the size and the extend of the neurological damage Closed head injuries: - brain is jostled in skull yielding diffuse “nonfocal” neuro injuries - primary damage are result of mechanical forces involving direct contact and inertia (similar to whiplash)

Answer 50

Coup - injury at point of contact Contracoup - injury at the opposite point of contact

Answer 51

Organic speech disorders: Motor- (neurogenic) childhood apraxia of speech (CAS) and dysarthria Structural - cleft lip and palate, craniofacial abnormalities Perceptual/Sesnory: - otitis media (infection of the middle ear, the air filled space behind the eardrum that contains the tiny vibrating bones of the ear) - sensorineural hearing loss

Answer 52

Speech disorder characterized by sensorimotor difficulties in planning,positioning and sequencing movements for the volitional production of speech - children with DAS have more problems saying sounds syllables and words Causes: - no consistent explanation - runs in families, higher incidence in males - presumed to be a disorder of motor programming

Answer 53

- neuro motor disorder resulting from brain function abnormalities, non progressive - may result in weakness, paralysis, and in coordination Types: categorized based on muscle tone, motor systems involved (hemiplegia) Spastic CP: most common, caused by damage to the motor cortex Athetoid CP: damage to basal ganglia, slow + invol movements Ataxic CP: damage to cerebellum, disturbance in balance + coordination

Answer 54

1) verbal apraxia - affects the initiation + execution of the movement patterns particular to speech 2) oral apraxia - apraxia of the mouth; oral often but not always with verbal 3) limb apraxia - associated with voluntary movements of the arms and legs (clients might be unable to wave goodbye for example)

Answer 55

- sound sub, omissions, distortions, and addition all observed (most frequent sub and omission) - artic errors are more frequent on cons clusters - usually aware of errors

Answer 56

- group of neuromuscular impairments that may affect speech, range, direction, strength and timing of motor movement as a result of paralysis, weakness of discoordination of muscles - motor movement that were previously established may have been lost through that movement still exists - artic errors most commom

Answer 57

- depends on location of lesion in CNS or PNS Errors include Artic errors (imprecise artic) Resp issues (weakness in muscles) Laryngeal issues (weak adductors/abductors) Velopharyngeal issues (hyper/hyponasality) Prosody issues (rapid or slow speech)

Answer 58

1) * flaccid (hypotonia resulting in weakness or paralysis of affected muscles) 2) spastic (hypertonic males movement difficult, slow speech with jerky imprecise artic) 3) ataxic (irregular or slow rythym of speech and pauses of speech or excessively equal stress on every syllable) 4) hyperkinetic ( involuntary movements affected respiratory, phonatory, articulatory structures impacting speech) 5) hypo kinetic (decrease or lack of appropriate movement) 6) mixed (spastic - flaccid)