Types of SSD and their descriptions Flashcards
Inconsistent speech disorder
Difficulty selecting and sequencing phonemes (i.e., assembling and sequencing a plan for motor execution/speech production)
Presents as a lexical inconsistency (i.e., unpredictable pronunciations of the same word)
Children usually know how to articulate several sounds
Articulation disorder / impairment
Difficulty with the production of individual sounds (e.g., distortions or substitutions)
AND
The difficulty of coordination and production of precise mouth movements, respiration, phonation, and/or resonance
Difficulty with the production (particularly phonetic placement) of specific speech sounds
CAS
Difficulty planning and programming movement sequences resulting in errors in speech sound production / impacting speech segments and prosody
Childhood Dysarthria
Inability to control and execute speech movements
Phonological disorder / impairment
Difficulty learning the phonological system of a language (the rules of how sounds are used in a language)
Phonological Impairment: Delay vs. disorder
Delay: error patterns that are typical in young speakers (e.g., cluster reduction)
Disorder: error patterns that are not typical in young speakers (e.g., backing)
How do we determine if a child has an inconsistent speech disorder?
A child has an inconsistent speech disorder if 40% or more of 25 multisyllabic words (i.e., 10 words) are produced variably during three separate productions (Dodd et al., 2002)
Approximately ___ of children with SSD have an inconsistent speech disorder
10%
The focus of treatment for inconsistent speech disorder?
They can respond well to imitation but the focus of Tx should be to learn how to phonologically plan the word
A phonological impairment describes a child’s speech in terms of
patterns or phonological processes
(cognitive-linguistic difficulty characterized by pattern-based errors)
A child with a phonological impairment may have specfic difficulties with _________
Which features, speech sounds, word shapes, stress patterns are present in a language, their use, their mental representation, and the organization of that system
An articulation impairment / disorder is a ________
Motor speech disorder
Errors in the production of individual sounds and/or coordination of muscles movements in an Articulation disorder typically refer to ________
errors with sibilants and rhotics
Articulation disorder: Residual articulation errors
Residual: errors that continue to occur beyond 9 years of age and into adulthood
Articulation disorder: Developmental articulation errors
Developmental: errors that occur by the age of 8 years
CAS is a reflection of a known…
neurological condition (CP), comorbid with a neurobehavioral condition (Fragile X syndrome), idiopathic
Domains affected by CAS
Domains that can be affected in CAS (any or all):
- Nonspeech motor behaviors (e.g., smile-kiss mvmt)
- Motor speech behaviors (e.g., syllable repetition, DDK)
- Speech sounds and structures (e.g., words and syllable shapes)
- Prosody (e.g., prolonged sounds, pauses between sounds/words)
- Language (e.g., receptive/expressive)
- Metalinguistic/phonemic awareness (e.g., rhyming)
- Literacy
About ____ children per 1000 have CAS; about ____ of children with SSD have CAS
1-2; 5%
Characteristics of CAS
- Limited vowel and consonant repertoire
- Distortion errors in vowels
- Lengthened and disturbed co-articulatory transitions between sounds and syllables
- Groping
- Use of simple syllable shapes
- Inappropriate prosody (stress, segmentation)
Dysarthria is characterized by:
- Weakness, slowness, incoordination of the musculature used to produce speech impacting speech systems including: respiration, phonation, articulation, resonance.
- Shallow, irregular breathing
- Low pitched, harsh voice, hypernasality, poor articulation
Dysarthria is very rare, for example, Cerebral Palsy occurs in ______ per 1,000 and dysarthria occurs in _____ of those with CP
2; 35%
Dysarthria is caused by:
neurological impairment (e.g., cerebral palsy, TBI)
Types of Dysarthria:
Flaccid, spastic, hyperkinetic, hypokinetic, ataxic, mixed
Speech Difference
Dialectal Difference; Not necessarily a disorder! Difference DOES NOT EQUAL a disorder
Differential diagnosis (CAS)
- inappropriate prosody (phrasing, rate, stress)
- appropriate voice quality
Differential diagnosis (Inconsistent Speech Disorder)
- typical prosody, voice, & speech rate
- Inconsistent errors
- Difficulty with phonological planning rather than motor planning/programming/execution
Differential diagnosis (Dysarthria)
- Difficulty with prosody (slow rate) but appropriate phrasing & stress
- Poor voice quality (low volume, low pitch, harshness, hypernasality)
Important Clinical Implications (Comorbidity)
- better identify the nature of the problem (e.g., problems with plurals)
- understand the relationship between the 2 disorders (e.g., unintelligible speech & voice disorder, which came first?)
- treatment decisions (order of treatment, treat both simultaneously, etc.)
Important Clinical Implications (Comorbidity): Why do different disorders coexist?
- Some disorders can lead to other disorders by nature (unintelligible speech & LD) LD = Learning Disability?
- Communication is a complex process and to be seamless, a # of components need to be at use at the same time (maturity)
- Different aspects of language interact (morphology and sound development)
High comorbidity w/ other disorders… ONLY ____% of children with SSD did _____ have another disorder
41; NOT
Numbers can change depending on which disorders you start with… ____% of children with an articulation disorder stutter
1%
Numbers can change depending on which disorders you start with… _____% of children with stuttering also had articulation disorders
22%
