Week 4 Fluency and Hearing Flashcards
Stuttering definition. 3 types of disfluencies.
An interruption in the flow of speaking characterized by specific types of disfluencies.
1) Repetition of sounds, syllables and monosyllabic words
2) Prolongation of consonants when it isn’t for emphasis
3) Blocks
What are secondary behaviors aka secondary characteristics.
Behaviors that are used to unsuccessfully are used to stop stutter. Theory is that they began as a way to stop the stutter but eventually stopped working.
Ex:
Body movements (head nodding, leg tapping , fist clenching)
Facial grimaces (eye blinking, jaw tightening)
Distracting sounds (throat clearing)
Is developmental disfluency something we should be worried about? What ages does this typically occur?
No, disfluency is a typical part of development. It typically emerges between 2 and 5 years old. If it persists longer than 6 months to a year there is a higher chance of it being a true stutter.
Who is more impacted by stuttering and is there a genetic component
-Higher occurrence in males. Yes there is a genetic component because it tends to run in families.
What are the phases of stuttering and why do they matter?
1) Transient. Unaware, unemotional, any word (2-6 years)
2) Chronic self image (I am a stutter) have more difficulty with content words (5-8)
3) Start to identify trouble sounds/words. Circumlocution, substitutions (starts to avoid trouble sounds/words) (8+)
4) Fearful anticipation, avoidance. Child avoids certain experiences or situations (8+)
These matter because its important to be aware of the cognitive load and stress that a stutter can have on a child and they ways it effects other parts of their life.
True stuttering vs. developmental stuttering
Developmental stuttering is typical and resolves on it own. Occurs between 2-5 years old. 80% of people grow out of it without any intervention or therapy. (Spontaneous recovery)
-May repeat whole phrases, use filler words, no physical tension, no emotional response, no secondary behaviors.
True stuttering persists.
-single sound repetition
-sound prolongations
-blocks
What are atypical types of stuttering
-Repeating sounds or syllables
-Sound prolongations
-Blocks (child appears to be trying to make a sound but cannot) and/or physical struggle when speaking
-secondary behaviors that go along with speaker difficulty
-Negative reaction or frustration to speaking
-Family history of stuttering
-Disfluencies last longer than 6 months
Risk factors that relate to stuttering
-Family History (genetics)
-Gender
-Brain morphology & Neural Physiology
- Underlying motor speech coordination problem.
Precipitating factors (triggers that lead to onset of stuttering)
- Age (Developmental stuttering 2-5)
- Stressful adult speech models
- Stressful speaking situations
- Stressful life events
- Self awareness/temperament. people being more anxious about when and what to say.
What do we look for ina stuttering assessment?
- 10 or more total disfluencies in 100 words.
- 3 or more stuttering-like disfluencies in 100 words in the areas of sound repetitions, prolongations and blocks.
- Physical escape behaviors (secondary behaviors)
-Verbal avoidance, such as word substitution.
Why are many treatments targeted at fluency seen as controversial?
Commercial approaches may promise results that are not always possible. Takes advantage of people who are willing to pay any money to stop stuttering.
What are the three sections of the ear?
Outer Ear
Middle Ear
Inner Ear
Outer Ear
-Pinna
-External Auditory Canal (ear canal)
Middle Ear
Tympanic Membrane (ear drum)
Auditory ossicles (Malleus, incus, stapes) Bones
Eustachian Tube
Inner Ear
Cochlea
Semicircular canals
What are the types of hearing loss
Conductive hearing loss
Sensorineural hearing loss
Mixed hearing loss
Conductive hearing loss. Causes and Characteristics.
Caused by damage to the outer or middle ear that leaves the inner ear and cochlea intact.
-Otitis Media-Ear infection
-Cerumen blockage- Ear wax blockage
-Foreign objects in the ear canal
-Malformations of the ear
Characteristics: Sound is not conducted properly through the outer or middle ear, resulting in attenuation (reduction of sound being heard) Muffled sounds.
Can be slight to moderate. Can be temporary.
Sensorineural Hearing loss. Causes and characteristics
Caused by damage to the cochlea or the auditory nerve that leave the outer and middle ear intact. Could be caused by Age, noise exposure, infection, congenital.
Reduction in loudness, speech perception and the ability to distinguish sound from background noise.
Typically treated with amplification or other types of intervention. Most common type of hearing loss.
Mixed hearing loss causes and characteristics
Caused by damage to both the conductive and sensorineural mechanisms.
Is hearing loss only acquired?
No it can be congenital
When do hearing screenings occur for kids?
-Infant screenings: done in hospital shortly after birth. Tests for reflexive responses of the ear.
- School aged children. Screened in school or in doctor check ups.
If a child fails a hearing screening what is the next course of actions?
-Have them screen again in two weeks. There are many reasons a child mild fail a screening the first time. (Ear infection, Sick, something in ear)
-If they fail again they may need to be referred for further audiological evaluations.
What is the impact of hearing loss?
-Children learn language through incidental learnings.
-Deaf and hard of hearing children miss out on incidental learning.
-need significant and extensive intervention to develop oral speech
What are the choices parents of a child who is deaf need to make about oral language?
How will the child communicate. Will they use assistive technology.
What are the advantages to early use of hearing aids or implantation of a cochlear implant?
Critical for speech and language development skills similar to their peers.
More likely to take advantage of auditory neuroplasticity and developmental synchrony. (inate ability to pick up sounds)
Children raised in a home with a fluent manual language (American sign language) will learn language effortlessly.
What are the language impacts for children with hearing loss?
-Receptive and expressive language delays
-speech and articulation delays
Semantics:
Abstract concepts
Phonology:
Hearing speech sounds
Resonance, tone
Morphology:
Some morphological features may be harder to hear ex plural –s
Pragmatics:
Difficulties with figurative language and sarcasm.
Is any kind of direct instruction needed for kids with hearing aids or cochlear implants?
Yes
What are classroom strategies to support kids with hearing loss?
Sound treated room- Sounds proof the room to limit outside noice.
Sound treated systems- PA system.
Personal FM systems- Assistive listening device. Student receives sound input directly to ear from a teachers mic.
