1
Q
Research Methodology
A
- suck suck swallow pattern
- localization to sound
- habituation (baby laying in crib crying)
- visually reinforced head turns
- cessation of crying (mom says “hey baby”…baby stops crying)
2
Q
Auditory Discrimination
A
- Newborns hear sounds in utero for 4 mons- since the 20th wk of gestation.
- 2 to 7 day old infants localize rattling noise
- 4 mons of age (can discriminate)
- Prefer human speech to other sounds
3
Q
Speech Perception (2 to 4 mons of age)
A
- hear in categories
- attend to juncture (when sound is continuous)
- place of articulation (fricitives > velars; alveolars)
- manner of articulation
- can discriminate stress changes
- respond well to motherese
4
Q
Speech Perception (5-12 mons of age)
A
- better disciminate /sa/ VS. /za/ at 6-8 mons
- can be taught to discriminate sounds up to 8 mons
- done less at 12 mons because of phonological bins
5
Q
How often do we work with infants before 12 mons of age?
A
- Early intervention is key
- More cases of preemies with feeding, swallowing and hearing problems
6
Q
Speech overlaid function
A
Focus on staying alive; not worrying about speech and language
7
Q
What questions might help to understand a child’s auditory/sound perceptions?
A
- Does your child stop crying when you talk?
- Does you child turn head to loud sounds?
- When you stop talking, do they fill in the silence?
8
Q
Infant sound productions
A
- short vocal tract
- short pharyngeal cavity
- anterior tongue placement
- high larynx
- close approx. of velopharynx touches epiglottis
9
Q
Oller’s Stage 1: Phonation
A
- 0 to 1 mon
- Reflexive vocalizations (crying,fussing for attention or hunger)
- Coughing,sneezing,burping
- Syllabic naslas (limited resonance)
- Non distress sounds
- little vocal play
10
Q
Oller’s Stage 2: Coo and Goo
A
- 2 to 3 mons
- Velar consonant-like sounds
- A sound similar to rounded vowel /u/
11
Q
Oller’s Stage 3: Exploration/Expansion
A
- 4 to 6 mons
- Better control of laryngeal pharynx and articulators
- Improved oral resonance of vowels
- Squeals, growls, friction noises
- Vocal Play
- Begin to see CV and VC (Consonant Vowel)
12
Q
Oller’s Stage 4: Canonical Babbling
A
- 7 to 9 mons
- Better oral and nasal resonation
- C1V1C1V1 and C1V1C1V2 (reduplication)
- Stops, nasals, glides
- Velar like sounds decrease (because they are starting to sit up)
- Bilabial and alveolar usage increases
13
Q
Oller’s Stage 5: Variegated Babbling
A
- 10 to 12 mons
- Non reduplicated babbling
- Vowel and consonants increase
- Intonation pattern matures
- Connected strings resembles adult speech
- Vowels are beginning to stabilize
14
Q
Important Predictors?
A
- No. of vocalizations was positively correlated to later normal lang. dev.
- Diversity of vocalizations was positively correlated to beginning of speech
15
Q
Transition Period?
A
- Begins with comprehension
- Protowords: not true words, but have meaning
- Ends in true words
- Can co-exist with true words
16
Q
Tranisition period issue?
A
- The words are the symbol of not the acquisition of vocab but the ability of the brain to program the articulation of the sound sequences.
- The physical readiness/dev. of the structures & their ability to handle the more complex programming
- linking of sounds patterns to physical agility, and the neural programming ability with meaning
17
Q
Protowords/Vocables
A
- Mostly CV syllable shapes
- Expression of affect
- To make a request
- To focus attention
18
Q
Protoword Characteristics?
A
- Stops> nasals> fricatives
- 50% are stops
- Labials>Alveolars>Velars
- 30 % are labials
- Holophrastic phrases begin
- Neurological & physical ability to string them together
19
Q
First Real/True Word
A
- 10 to 14 mons
- Consistently used
- In a particular context
- Resembles the adult word
20
Q
Sound system DVPMT
A
- 18 to 24 mons: 50 words; short phrases
- Phonetic productions increase stability
- Protowords & holophrastic phrases decrease as phrases increase
21
Q
Single Phoneme DVPMT
A
-Cross Sectional research studies
-Cross section of children in U.S.
(age,culture,socioeconomic level, parents ed. level, IQ)
-Exclude Ch with known hearing loss and lang. loss.
22
Q
Cross-Section Studies
A
- Group data
- Average data
- Error types not determined
- “Age of mastery”
- “Molly VS. Deborah”; first born,well-educated parents, talkative
- Molly= labials
- Deborah=Fricatives
23
Q
Templin (1957)
A
- 75% of Ch, correct in all 3 positions (initial, medial, final)
- 480 Ch.
- 3 to 8 yrs old
24
Q
Fudala & Reynolds (1986)
A
- 5,122 Ch from 4 western states
- 1:6 yrs to 13:11 yrs
- Intial & medial/final?
25
Sander (1972)
Range of Development
26
Longitudinal Studies
- Few number of Ch. individually
- Over a considerable amount of time
- Mostly agree with Cross-Section studies
27
Articulation DVPMT
- Consonants
- Vowels
- Consonant Clusters
28
Consonants
- Templin is the standard
| - Sanders gives a good range
29
Vowels
- Templin (1957): 3 yrs of age, 93% had vowels correct.
- Irwin & Wong (1983): 100 Ch in 5 age groups
* Vowels and dipthongs produced by 3 yrs of age
30
Clusters
- Templin (1957)
- Smit (1990)
- Should be correct by 8 yrs of age
31
Expected Error Patterns
- Nasals: denasalization
- Glides: deletion
- Stops: deaspiration, fronting of velars, and deletions
- Liquids: W/L, R; Deletions V/L, R; Deletion
- Labial and Dental Fricatives are stoppped
- Alveolar & palatal fricatives & affricates deletion
- Stopping
- Devoicing
- Stopping of /s/
- Consonant clusters are reduced by a consonant (2nd member of cluster deleted)
- Remaining consonant changed to a stop
- Cluster with /L/ and /R/ have phonemes simplified to glide /W/
32
Sound Class DVPMT
- Earliest developing (nasals, stops,glides)
| - Later developing (liquids, fricatives, affricates)
33
Distincitive Feature DVPMT
```
Order of development
1. Nasals
2. Bilabials & Alveolars
3. Voice
4. Diffuse (k,g, h, ing)
5. Stridency (hissy sounds)
6, Continuant (flow not stopped)
```
34
Hodson & Paden (1981)
-Speech sound production approximated the adult model between 4-5 yrs of age
35
Grunwell (1982)
- Processes decreased before 3 yrs
- Redup. and STP of /f,s/ should be gone before 3
- Some voicing patterns
- Most all decreased by 5 yrs
36
Dyson & Paden (1983)
- Studied 40 two yr olds from 2 to 2:7
- Order of freq was GL, CR, FR, STP, FCD
- At 2:7 FCD almost gone & STP & FR infrequent
37
Stoel-Gammon & Dunn (1985)
- Processes decreased by age 3
- WSD/USD
- FCD
- DIM
- VELAR FRONTING
- REDUP
- PREVOCALIC VOICING
38
After 3 yrs and before 5
- CR
- EPN
- GL
- VOC
- STP
- POSTVOCALIC DEVOICING
39
Intelligibility
- Expressed in % intelligible
- # words understood divided by total words spoken multiplied by 100
- Percent of which someone could be understood but not correct
40
Age of intelligibility
-19 to 24 mons (25 to 50 %)
- 2 to 3 yrs (50 to 75 %)
-4 to 5 yrs (75 to 90 %)
-5 + yrs (100 %)
-8 yrs (100 % correct)
Intial consonant are a huge factor for intelligilabilty
41
Structures (LIPS)
-Generally speaking mild to moderate deviations of structure & function of lips DO NOT cause a significant disturbance of speech
42
Fairbanks & Green (1950)
| LIPS
-Variations in structure & function WNLs shouldn’t affect speech
43
Bloomer & Hawk (1973)
| LIPS
Most learn to use compensatory strategies
44
Structures (TEETH)
- Maxillary-Mandibular Alignment
- No clear relationship to speech in the mild to moderate malocclusions
- “Missing teeth, though they may be associated with a higher frequency of misarticulations are neither sufficient nor necessary to cause articulation disorders.”
45
Tongue
-Size, shape, Mobility
(Little good research done in this area)
-Ankyloglossia = tongue tie
-Glossectomy (Remove a portion or most of the tongue; usually from cancer)
-Open bite
-Mobility requirements are for elevation, grooving and protrusion
46
Hard Palate
-Wide variations in height, length and width have resulted in little effect on speech
47
Cleft Palate
-Surgical repair is required for normal speech
48
Excision secondary to cancer
-Prosthetic management
49
Structures
- Velum/Soft Palate:
| - Closes/opens the port into the nasopharynx and nares
50
Velopharyngeal Insufficiency (VPI):
- Hypernasality/nasal resonance/nasal emission
- Weak production of pressure consonants
- Substitution of glottal stops for target phonemes
- Pharyngeal stops & fricatives are substituted
- Occasional velar fricatives
51
Neural Control of Structures
Speech Requirements:
1. Muscle strength
2. Speed
3. ROM or excursion(Range of motion)
4. Accuracy
5. Coordination of multiple sequenced movements
6. Motor steadiness
7. Muscle tone
8. Appropriate rhythm
52
DX Related to Neural Control
```
VPI:
-Innervation problems
Cerebral Palsy:
-Usually congenital
-Usually dysarthric
```
53
DX- Neural Control (Dysarthria)
- A CNS or PNS problem
- Often secondary to a stroke, TBI, cancers, ,etc.
- Results in weaknesses/paralysis to one or more systems
54
DX- Neural Control (Apraxia)
- A motor programming issue
- No weakness
- Characterized by: inconsistencies, groping, decreased initiation, and vowels are affected
55
Motor Skills
-Research has not shown that non-oral motor issues are related to oral/speech production issues
56
Diadochokinesis (DDK)/RAM
- Repetition of identical syllables
| - Improves with age
57
Rapid Sequenced Movements
- Repetition of changing syllables
| - A defining variable in apraxia
58
Sensation
-Other than hearing, there is no identifiable relationship
Diagnostic tests of import:
-Hearing thresholds
-Speech Discrimination scores
-Configuration of the hearing loss
*Speech range is considered to be between 500Hz and 2000 Hz.
59
Types of hearing loss
Conductive: usually losses resulting from ME problems
-Less severe
Sensorineural: inner ear and into the cerebrum
-More severe
Mixed
60
Speech Problems Associated With Hearing Problems?
- FCDs
- Imprecise vowels
- Varying resonance
- Inappropriate stress & intonation; variable
- Variable pitch & control
- Variable vocal quality
61
CSOM
- Decreased Speech discrimination scores
- Decreased Auditory discrimination
- Auditory Processing DX
62
Sensory Issues
- /r/ child
| - dysarthrias
63
Auditory Discrimination
```
Discrimination:
-Of other’s speech
-Of themselves
Locke (1980):
-70% of children with misartics could discriminate between the target and error productions
Summary: it’s not a strong variable
```
64
Oral Sensation
```
Oral form recognition:
-Not much evidence (limited & contradictory)
-Little clear clinical application
Two point sensory discrimination:
-Ditto
Sensory deprivation (anesthetization):
-Not sure of clinical application
-Adults: increase in misarticulations, esp. frics & affrics.
```
65
Language Skills
- Language is the umbrella; articulation is like the spines of the umbrella.
- Coexistence of lang dx and artic dx: in preschool up to 50% of the children have both.
- Can exist separately
66
Relationships to Language
- Several studies show that 40%-80% of children with phonological disorders have language involvement.
- Same for SLI children having phonological dx
- As severity of phonological dx increases, it is more likely to have a concomitant lang dx present.
- Whitehurst (1991) found that one or the other may resolve by school age.
67
Relationships to Lanague #2
- Panagos, et.al. (1979) : when syntactic complexity is combined with syllabic complexity, a greater inc in artic errors is likely.
- When you have both present and treat one, the one treated improves more(WHEW!)
- When both are present, the likelihood of reading problems increases
68
Personal Characteristics
```
Artic and phonology improve with:
-Age
-Femaleness
-Intelligence
Of little influence seems to be:
-Personality type
-Socioeconomic status of families
-Birth order
-Number of sibs
```
69
Familial Ties
Shriberg & Kwiatkowski (1994):
-Of 62 children with arti dx, 39% had a family member with an artic dx and another 17% had more than one family member.
Felsenfeld, et.al.(1995):
-Children whose parents had no hx of artic dx did better on artic tests than children whose parents DID have an artic dx.
*Most of this research has been replicated.
70
Tongue Thrust
* Reverse Swallow
* Red Flags:
- Tongue protrusion during open lip swallows
- Dec’d masseter mvmt during swallow
- Pursing of lips during swallow
- Lower carriage of tongue at rest than normal
* Correlation with speech disorders:
SPHP 126 Exam 3
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