Types of SSD and their descriptions

Question 1

Inconsistent speech disorder

Answer 1

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

Question 2

Articulation disorder / impairment

Answer 2

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

Question 3

CAS

Answer 3

Difficulty planning and programming movement sequences resulting in errors in speech sound production / impacting speech segments and prosody

Question 4

Childhood Dysarthria

Answer 4

Inability to control and execute speech movements

Question 5

Phonological disorder / impairment

Answer 5

Difficulty learning the phonological system of a language (the rules of how sounds are used in a language)

Question 6

Phonological Impairment: Delay vs. disorder

Answer 6

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)

Question 7

How do we determine if a child has an inconsistent speech disorder?

Answer 7

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)

Question 8

Approximately ___ of children with SSD have an inconsistent speech disorder

Answer 8

10%

Question 9

The focus of treatment for inconsistent speech disorder?

Answer 9

They can respond well to imitation but the focus of Tx should be to learn how to phonologically plan the word

Question 10

A phonological impairment describes a child’s speech in terms of

Answer 10

patterns or phonological processes

(cognitive-linguistic difficulty characterized by pattern-based errors)

Question 11

A child with a phonological impairment may have specfic difficulties with _________

Answer 11

Which features, speech sounds, word shapes, stress patterns are present in a language, their use, their mental representation, and the organization of that system

Question 12

An articulation impairment / disorder is a ________

Answer 12

Motor speech disorder

Question 13

Errors in the production of individual sounds and/or coordination of muscles movements in an Articulation disorder typically refer to ________

Answer 13

errors with sibilants and rhotics

Question 14

Articulation disorder: Residual articulation errors

Answer 14

Residual: errors that continue to occur beyond 9 years of age and into adulthood

Question 15

Articulation disorder: Developmental articulation errors

Answer 15

Developmental: errors that occur by the age of 8 years

Question 16

CAS is a reflection of a known…

Answer 16

neurological condition (CP), comorbid with a neurobehavioral condition (Fragile X syndrome), idiopathic

Question 17

Domains affected by CAS

Answer 17

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

Question 18

About ____ children per 1000 have CAS; about ____ of children with SSD have CAS

Answer 18

1-2; 5%

Question 19

Characteristics of CAS

Answer 19

• 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)

Question 20

Dysarthria is characterized by:

Answer 20

• 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

Question 21

Dysarthria is very rare, for example, Cerebral Palsy occurs in ______ per 1,000 and dysarthria occurs in _____ of those with CP

Answer 21

2; 35%

Question 22

Dysarthria is caused by:

Answer 22

neurological impairment (e.g., cerebral palsy, TBI)

Question 23

Types of Dysarthria:

Answer 23

Flaccid, spastic, hyperkinetic, hypokinetic, ataxic, mixed

Question 24

Speech Difference

Answer 24

Dialectal Difference; Not necessarily a disorder! Difference DOES NOT EQUAL a disorder

Question 25

Differential diagnosis (CAS)

Answer 25

• inappropriate prosody (phrasing, rate, stress)

- appropriate voice quality

Question 26

Differential diagnosis (Inconsistent Speech Disorder)

Answer 26

• typical prosody, voice, & speech rate
• Inconsistent errors
• Difficulty with phonological planning rather than motor planning/programming/execution

Question 27

Differential diagnosis (Dysarthria)

Answer 27

• Difficulty with prosody (slow rate) but appropriate phrasing & stress
• Poor voice quality (low volume, low pitch, harshness, hypernasality)

Question 28

Important Clinical Implications (Comorbidity)

Answer 28

• 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.)

Question 29

Important Clinical Implications (Comorbidity): Why do different disorders coexist?

Answer 29

• 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)

Question 30

High comorbidity w/ other disorders… ONLY ____% of children with SSD did _____ have another disorder

Answer 30

41; NOT

Question 31

Numbers can change depending on which disorders you start with… ____% of children with an articulation disorder stutter

Answer 31

1%

Question 32

Numbers can change depending on which disorders you start with… _____% of children with stuttering also had articulation disorders

Answer 32

22%