Week 3 & 4 Flashcards
What is speech?
the motor production of speech sounds using the respiratory and vocal production systems in conjunction with the articulators in order to form words and sentences
What does speech account for?
most communication challenges
By what age do most people master complex coordination activity?
8 to 10 y.o.
The largest percentage of children with speech challenges are…
boys aged 3 - 8 years old
What integrity is required for speech development?
structural and functional integrity (hearing, oral structures, etc.)
How do you master articulation re rules?
establish and learn rules regarding distinctive features or phonological rules
What else do you require to master articulation?
time for maturation and learning and an accepting environment and a model to imitate
What is a phoneme?
a mental representation of a speech sound
e.g., /p/, /i/, etc.
What is a phone?
an actual production of speech sounds in various linguistic environments
What are allophones?
sounds which are perceived by the speakers of a given language to represent the same phoneme
What is phonology?
a system and rules by which the speech sounds are organized in any given language
e.g., ngot is not English, therefore different phonology
At what age are infants sensitive to distinctions in languages?
8 to 9 months
At what age do infants lose the ability to perceive distinctive features not meaningful in language of exposure?
at about 10 months of age
What precludes perceptual development of phonemes?
developing prototypes or boundaries for each phoneme in our language
What precludes perceptual development of phonemes? re rules
develop ruels governing the acceptable phonemic combinations within own language
What is another name for consonants?
pulmonics
What are the bilabial consonants?
p, b, m,
What are labiodental consonants?
f, v,
What are interdental consonants?
t, d
What are alveolar consonants?
t, d, n, r, r, l
What are liquids?
l, r
What are velar?
k, g, nnn
What are glottal?
?
What are the front vowels?
i e E ae a
What are the central vowels?
upside e,
What are the back kvowels?
u, o, backwards c, small a
What are the types of speech production challenges?
Functional articulation difficulties Phonological difficulties Dyspraxias Dysarthrias Structural damage e.g., cleft palate, other trauma to articulators
What is the f type of speech production challenges?
functional articulation difficulties
e.g., lisp can be associated with brain and tongue trust (infantile swallow)
What is the p type of speech production challenges?
continue to hear all sounds and not be able to discriminate them past 10 months (Wernicke’s area)
What is the d1 type of speech production challenges?
cranial/nerve damage
What is oral dyspraxia?
NERVE damage in fibres associated with coordination problems of tongue mouth
- associated with eating problems
Apraxia of speech/verbal dyspraxia -
cranial nerve damage
Dysarthrias
muscle damages and problems with drooling if in muscles themselves, weakness or rigidity of muscles
What is the s tyep ope of speech production challenges?
structural damage
e.g., clef palate, other trauma to articulators (lost teeth, tied frenulum)
WITHOUT NERVE DAMAGE
What are phonological challenges?
difficulty with a mental reprsentation of the sound system, associated with misunderstanding of sounds
What are challenges with motor planning of speech movements?
verbal/apraxia of speech - Broca’s area damage (cortical damage)
What are examples of lower-level execution of speech production/articulation speech production problems?
dysarthrias - cranial nerve damage
strutural problems e.g. cleft palate
What connects Broca’s area with Wernicke’s area?
the arcuate fasciculus
Where is the Sylvian fissure?
divides the frontal cortex from the temporal lobe, close to Broca’s area
Where is the Rolandic fissure?
separates the frontal and parietal cortices, close to sense and motor use
What is Broca’s area associated with?
convolution (speech, expressive language, frontal lobe)
What is Wernicke’s area associated with?
hearing, auditory processing (temporal lobe)
What is the Perisylvian area?
the area in the parietal lobe associated with reading, writing, word retrieval and general integration
What area is associated with oral/verbal dyspraxias?
higher level subcortical areas, like Broca’s area
What is the most typical speech production problem?
oral/verbal dyspraxia (Broca’s area damage)
What area is associated with dysarthria?
subcortical areas like the basal ganglia and cerebellum, motor neurons to tongue, lips, soft palate and possibly subcortical areas damaged
What area is associated with phonological disorders?
Perisylvian area of the cortex
What speech production disorder is associated with trouble with articulators for eating, speaking &
dysarthrias
motor neurons from SUBCORTICAL areas
What defines the model of phonological development?
input (adult models)
phonemic representation, and
output (trying out speech)
What are underlying causes of phonological challenges?
- mid-ear problems
- inaccurate phoneme representations
ineffective organization of phonemes in larger phonological system
What is a symptom of difficulty developing expressive phonology?
intelligibility and/or speech production challenges
What is a symptom of difficulty developing phonological/phonemic awareness skills?
impacted sound-symbol relationships and reading
What is a symptom of phonological processing challenges?
difficulty recalling and repeating a sequence of phonemes/nonsense syllables or words
What is a symptom of difficulty with word learning and retrieval?
difficulty in recalling and formulating words in conversation
dysnomia - uses circumlocution due to items being on the ‘tip-of-the-tongue’, but not available
What are phonological processes of speech?
a set of rules used by people to simplify the sound system as they progress through speech development culminating in typical adult speech production (associated with speech issues if difficulties occur)
What is syllable simplification?
- final consonant deletions ca-t
- unstressed syllable deletions (ban-ana)
- cluster reduction (s-top)
What is assimilation?
repeating sounds in a word instead of saying the whole world, occurring regressively/backward (water = wa-wa) or progressively/forward (water=ta-ta)
What is substsitution?
stopping
fronting
gliding
glottalization
What is stopping?
creating a stop in a vowel that doesn’t have one
e.g., fish = pish
What is fronting?
using a consonant that is further in front of the mouth instead of the typical one
e.g., car = tar
What is gliding?
substituting a consonant for a more sonorant one
e.g., rabbit = wabbit
What is glottalization?
removing the hard t
e.g., water = wa?
What is reduced phonetic inventory?
not being able to produce a wide variety of sounds
What is phoneme collapse?
substituting phrases like “na na na” instead of actual words
What is a target-substitute relationship (“order to the disorder”)?
e.g., substitution
What is reduced intelligibility/jargon?
speech is slurred, difficult to understand, weird words used, etc.
What are phonological awareness skills associated with rhyming?
rhyme detection and production
What phonological awareness skills are associated with syllables?
- syllable counting syllable elision (say butterfly without the flu)
What are phonological awareness skills associated with words?
word counting
What are phonological awareness skills associated with sounds?
identification of initial or final sounds
sound elision (say sky without the s)
sound blending (what word is “c-a-t”?
analysis - say the sounds that make up cat
What is non-word syllable repetition helpful with?
highly predictive of receptive and expressive language challenges
What is non-word syllable repetition related to difficulties with?
word learning (fast-mapping) and word retrieval difficulties (learn once and quickly incorporate)
What is good to recall for non-word/syllable repetition?
recall of function words especially pronouns or other arbitrary labels
e.g. colours,
what are issues with pronouns associated with?
?
What does acting out as one describes things associated with?
likely with word retrieval problems
What are oral-motor speech challenges?
apraxia of speech/verbal dyspraxia
developmental dysarthria
acquired dysarthria
What aren’t oral-motor speech challenges?
phonological challenges
What is apraxia of speech/verbal dyspraxia?
impairment in motor programming and planning speech movements (coordination
What is developmental dysarthria?
disturbance in neuromuscular control of speech production present at birth (often associated with cleft palate)
What is acquired dysarthria?
disturbance in neuromuscular control of speech production acquired in some form of neurological insult e.g. CVA, trauma, meningtis, seizures
What area is typically damaged with dyspraxias?
cortical areas
What isn’t childhood apraxia of speech?
Down’s syndrome with low tone in jaw muscles
What is childhood apraxia of speech
not able to use structures to speak in the absence of obvious musculature disturbance
what is praxis?
a speech mechanism associated with speech sequence and coordination
What are struggle behaviours, inconsistent errors in sequencing speech sounds, normal orgal tone/no weakness in articulators, and minimal or no feeding problems associated with?
childhood apraxia of speech (inability to move articulators)
- does not include the deaf whose habits are consistent ;in their errors, with regards to their knowledge of phonology, and ththey generally don’t have feeding problems
What is childhood apraxia of speech also known as?
developmental verbal dyspraxia
What is thought to be caused by lesions in cortical or higher cerebral regions (lower third frontal convolution, motor projection fibres)?
childhood apraxia of speech/dyspraxia
What is the lower third frontal convolution?
Broca’s area, possible higher level subcortical areas, and motor projection fibres
What may be accompanied by dyspraxia in other parts o the body
limb dyspraxia
What is the most frustrating of all speech disorders?
childhood apraxia of speech
What speech challenge issue is associated with eating or swalllowing issues?
oral dyspraxia
(cannot produce voluntary movements of the articulators, although they may occur reflexively or when not focusing on producing that motor response)
What does the presence of oral dyspraxia mean about verbal dyspraxia?
that it will also be present
What is more severe: oral or verbal dyspraxia?
oral (includes feeding issues)
Can you have verbal apraxia without oral apraxia?
yes
What signifies verbal dyspraxia?
child can produce normal, voluntary movements of the articulators during NON-speech tasks
What is a.k.a. apraxia of speech?
oral apraxia
What signifies a disturbance of neuromuscular function (lowest common pathway) marked by disturbances in strenght, speed, steadainess, coordination, precision, tone, and range of movement of the speech musculature?
childhood dysarthrias
Can childhood dysarthrias be congenital/developmental or acquired?
yes
What are the 4 types of DEVELOPMENTAL dysarthrias?
Spasticity
Athetosis
Mixed
Ataxia
what is spasticity?
high muscle tone, or hyper-reflexia (can occur alongside HYPOnasality)
What is the opposite of spasticity?
low muscle tone or HYPOreflexia can occur alongside HYPERnasality
What is athetosis?
involuntary muscular movements, writhing motions of the body, tongue
What is hypertonic associated with?
issues with the basal ganglia as a part of athetosis (involuntary muscular movements, writing motions)
What is the mixed type of developmental dysarthria?
a combination of spasticity and athetosis (high muscle tone, HYPERreflexia, hypoNASALITY,
and involuntary muscular movements
What is ataxia?
poor balance and coordination associated with damage to the cerebellum
i.e. cerebral palsy
What are the types of ACQUIRED childhood dysarthria according to site of lesion?
Muscle LOWER MOTOR neurone UPPER MOTOR neurone basal ganglia/extrapyramidal system cerebellar
What muscle lesion is associated with acquired childhood dysarthria?
flaccid dysarthria - low muscle tone, or HYPOreflexive
What is lower motor neurone associated with in acquired childhood dysarthrias?
bulbar palsy
What upper motor neurone challenge is associated with acquired childhood sdysarthrias?
spastic dysarthria (too high muscle tone)
What lesion of the extrapyramidal system is associated with acquired childhood dysarthria?
basal ganglia - athetosis (involuntary muscular movements, writhing motions of the body, tongue), chorea (jerky irregular motions, particularly of the hips, shoulders and face), dystonia (repetitive muscular formations creating weird positions), and tremor (tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving oscillations or twitching movements of one or more body painvoluntary, somewhat rhythmic, muscle contraction and relaxation involving oscillations or twitching movements of one or more body parts.)rts.)
What is athetosis?
involuntary muscular movements, writhing motions of the body, tongue
What is chorea?
jerking motion especially of the shoulders, hips and face
What is dystonia?
repetitive muscular formations creating weird positions
What are tremors?
involuntary, somewhat rhythmic, muscle contraction and relaxation involving oscillations or twitching movements of one or more body parts.)
What issue is associated with a lesion in the cerebellum as associated with acquired childhood dysarthria?
ataxic dysarthria - a perceptually distinctive motor. speech disorder (MSD) associated with damage to. the cerebellar control circuit
What is the difference between dyspraxia/dysarthria and apraxia/anarthria?
the former is having difficulty with, whereas the latter is an absence of it
dyspraxia =
difficulty with motor planning
dysarthria =
difficulty with speech production
apraxia =
absence of motor planning
anarthria =
absence of speech production
If one has issues with word order, what disorder is it associated with?
dyspraxia
What is associated with isues of low muscle tone/flaccid?
dysarthria
what is associated with not crisp/low tone (or flaccid dysarthria)?
phonological problems
e.g., saying Pirates instead of pilates
What usually has only one or two sound substitutions?
residual articulation difficulties
What is often seen during primary school years, is usually quickly treated and is the “traditional” focus for SLPs?
residual articulation difficulties?
What disorder is associated with no obvious oral-motor or hearing impairment?
residual articulation difficulties
What is Fragile x syndrome associated with?
dysarthria
What is spasticity / quick response associated with?
dyspraxia
What is reduction associated with?
phonological problems
e.g., saying shuffing instead of shuffling
when assessing communication disorders, what is the first order of assessment?
sending person for a hearing test
Following a hearing test, what is the first type of assessment for a SLP?
asking whether the person has troubles eating
After asking about the patient’s case history, what does the SLP do next?
an informal observation
What typically follows an informal observation?
oral-motor examination
What does oral-motor examinations usually include?
DDK or didochokinesis (how quickly one can repeat a quick succession of rapid, alternating sounds called tokens)
What follows an orall-motor examination?
stimulability
What follows stimulability?
a formal, structured test
What follows a formal, structured test?
analysis of data - review of vider performance with developing norms
What follows an oral-motor examination?
stimulability
What is the traditional approach to SLP treatment?
remediation, training from isolation, one sound at a time
What is the contemporary approach to SLP treatment?
phonological rules are treated rather than individual phonemes in order for the patient to determine patterns
e.g., issues with fricatives?
What is associated with communication issues?
reduced cognitive, social, and/or psychological development
What principle of intervention affects intelligibility the most, is stimulable, is deelopmentally appropriate, is more complex, and impacts overall system-wide change?
targetting sounds or patterns, rather than individual phonemes
What is otitis media and how would is be associated with speech production delays?
an ear infection that would limit hearing intelligbility
What is Angelman’s syndrome and how would it be associated with speech production delays?
it is an infrequency/non-verbality condition that would limit practice in order to develop those habits
What are these conditions associated with?
- otitis media
- learning disabilities
- Down syndrome
- Global developmental delay
- cerebral palsy
- autism
- fragile x syndrome
- Angelman’s syndrome
- cleft palate
speech production delays
What cued speech program was developed by Deborah Hayden in the 1980s?
prompt
What is specific to cleft palate and speech production challenges
strictly a structural issue; the frenulum is often too tight, limiting vocal cavity manipulation, tongue movement, etc. similar to learning how to speak with braces
How often is a cleft palate?
1 in 500 to 750 births
What is the problem in embryological development of the face and mouth that is a merging of tissue of the face and the head?
cleft palate
What is more common in Hispanic and Asian populations?
cleft palate
What side does cleft palate typically occur on?
the left side
What structures are most often involved with cleft palate?
the palate and the lip
What speech problem is associated with cleft lip or cleft hard or soft palate without lip involvement?
hypernasality
Why does cleft palate require so many surgeries?
it needs to adjust over time due to the growing child - minimal tissue, etc. also need of bone grafting often
What is the mandiibular arch?
the jaw
What process is associated with a nose to hard palate cleft palate?
fronto-nasal pocess
IF the cleft goes further back, does it entail mroe or less issues?
more
What do ou call a cleft that is just the skin underneath the palate?
submucous cleft
What entails a submucous cleft with bifid uvula?
a not fused uvula (what closes the nasal cavity in order to determine nasality of speech
What type of team are these people associated with? - family - plastic surgeon - oral surgeon orthodontist prosthodontist speech-language pathologist audiologist psychologist/social worker
cleft palate team
What is the orthodontist involved with for cleft paaltes?
teeth reconstruction
What is the prosthodontist associated with the cleft palate team?
building appliances like retainers to cover the area affected until surgery, such as
What would an audiologist be looking for with a patient with a cleft palate?
ear infections
Why are psychologists and/or social workers crucial for patients with ac cleft palate?
they help with child’s potential bullyign, as well as dealing with parents’ support due to the grotesque appearance of the condition to minimize psychological effect that could negatively affect the child
Why are early surgeries crucial for those with a cleft palate?
they help encourage parent-child attachment due to the grotesque appearance of the condition
Why is lip repair 6 to 10 weeks after birth?
once the infant regains birth weight and increases superficial tissue
When do primary and secondary palate surgeries take place?
usually 12 to 18 months - around functional time for speaking
What other issues are found in ongoing re-evaluation of a child with a cleft palate as s/he grows?
snorting issues due to sibilants, etc.
What is VPI and what does it have to do with speech production difficulties of the cleft palate?
velopharyngeal incompetence - can’t close nasal cavity from mouth, with potential issues with different phonemes, resonance problems
What are dental anomalies, hearing problems (perhaps otitis media), as well as delayed development due to increased hospitalization visit, and less time with cohort associated with?
causes of speech production difficulties in cleft palate
What are issues with articulation patterns associated with consonants with those with a cleft palate?
difficulty using high pressure consonants such as plosives, affricates and fricatives
What ar ethe most common errors with cleft palate articulation patterns?
omission or distortion
What place of articulation tends to be avoided with a cleft palate?
the front of the mouth (labials, dental, etc. sounds)
What do some children tend to have delays in language with cleft palate?
vocabulary development and expressive language
What is a less common language delay in children with cleft palate?
etiology - hearing; extended period of unintelligible speech
What other problem is associated with cleft palate? feeding difficulties dental problems social acceptance hearing problems
attachment difficulties
Do children do well with a cleft palte?
yes, if they are in the first world with access to a specialized cleft palate team
What role does an sLP assessment also include?
phonological development
phonemeic awareness skills for reading
feeding
evaluating vp closure for speech
language skills
What is another special assessment tool (other than a nasometer/mirror to measure nasal air escape)?
videofluoroscopy -o video x-ray of speech determining how much skin is needed
Why is a mirror used in an SLP’s office
to determine whether the nasal cavity is effectively closed, if a mirror fogs
How many stages are of remediation?
4
How long is the first stage of remediation?
birth to 18 months (prelinguistic)
When does early speech and language development require remediation?
18 months to 3 years
When is the first corrective cycle of remediation?
3 to 5 years old
What occurs after the corrective cycle of remediation?
a second corrective stage and follow-up
What does remediation potentially depend upon?
surgeries needed for the child
What is an aim to achieve consistent ___ to ensure air flow through the mouth in remediation?
velopharyngeal competence
What is success at least partly determined by in remediation?
structural repairs/surgery
When is treatment associated with a better prognosis?
earlier treatment
What is critical for remediation?
parental/family support
What type of exercises must be used to adapt to a child in remediation?
not too strenuous tasks such as if trying to get them to such through a straw, then use thin beverages instead of thick ones initially
What must be intact for self-monitoring in remediation?
auditory system
What alternatives are these from?
surgery e.g., pharyngeal flap
prosthesis to close off space
alternative communication systems used e.g., sign languge, AAC
VPC
velopharyngeal competence/airflow through the mouth apart from nasal phonemes
What is AAC?
alternative and augmentative communication like Hawking’s computre
What was Dolloghan and Campbell interested in?
nonword repetition and child language impairment
Who wrote Phonological awareness: from research to practice
Gillon
What did Love write about?
childhood motor speech disability
What did Storkel & Morrisette write about?
The lexicon and phonology: Interactions in language acquisition
Who wrote Speech correction: principles and methods
Van Riper
