1
Q
What anatomical structures and features affect the acquisition and production of speech sounds?
A
moveable and immoveable articulators
2
Q
What are the moveable articulators?
A
- jaw
- lips
- tongue
- velum
- uvula
3
Q
What does the Jaw help facilitate?
A
resonance and articulation
4
Q
What are the immoveable articulators?
A
- hard palate
- alveolar ridge
- teeth
5
Q
What are lips important for the production of?
A
bilabials
6
Q
What is the most vital articulator for the production of the majority of English sounds?
A
tongue
7
Q
What is the progression of speech sound acquisition?
A
- reflexive to purposeful
- undifferentiated to differentiated
8
Q
How does speech develop from undifferentiated to differentiated?
A
- open to CV word structures
- variegated CV combination
- Closed CVC word structures
- connected speech
9
Q
Why are infants early productions restricted to phonemes produced primarily by the jaw?
A
because they rely on jaw movement due to limited control of lips and tongue
10
Q
what does the production of full range of English sounds (consonants & vowels) require?
A
lower lip and tongue movements independent of the underlying jaw
11
Q
What are the implications of structural deficits and poor oral motor control?
A
- constrained speech sound acquisition (infants and children)
- articulatory errors
- reduced intelligibility
- restricted verbal communication skills
12
Q
What type of speech errors would you expect with malocclusions?
A
- the implications vary per case
- some can develop compensatory strategies
- articulation disorders
13
Q
What type of speech errors would you expect with cleft lip and/or palate?
A
-surgery completed within first two years to close fissure without permanent effects on articulation
14
Q
What type of speech errors would you expect with ankyloglossia?
A
-limits tongue tip mobility so it compromises speech sound production
15
Q
What type of speech errors would you expect with a submucosa cleft?
A
?? can’t find this in my notes, but it’s on the study guide.. ?
16
Q
What type of speech errors would you expect with velopharyngeal insufficiency?
A
- nasal emission: air escapes through nasal cavity & unable to build intraoral pressure for the production of oral sounds
- glottal stop: stopping & sudden release of air within glottis for /p,b,t,d/
- pharyngeal stop: pharyngeal contact using base on tongue for /k/ and /g/
- velar fricatives: distorted /k,g/ for sibilants /s, z,ʃ, ʒ/
- mid dorsum palatal stop: /j/ for /t,d,k,g/
17
Q
What are the possible causes of poor oral motor and speech deficits?
A
-central and peripheral nervous system damage. (EX: brain injury, neurodegenerative disease, etc.)
- Affects on the neural muscles needed for speech production
(ex: Weakening, paralysis, difficulty with coordination)
18
Q
what are the etiological factors for Dysarthria?
A
- stroke
- brain injury
- neurodegenerative diseases
19
Q
what are the speech and neural characteristics of Dysarthria?
A
- slurred speech
- slow rate of speech
- breathiness & decreased volume
- abnormal intonation
- decrease control of oral secretions
- difficulty chewing and swallowing
20
Q
What are the etiological factors for Apraxia of speech?
A
- acquired: stroke or brain injury to the motor cortex
- developmental: without evidence of neurological damage
21
Q
What are the speech and neural characteristics of apraxia of speech?
A
- limited verbal output
- difficulty with volitional oral & speech movements
- automatic speech preserved
- inconsistent sound errors:omissions, deletions, substitutions, distortions
- self corrections
- groping and effortful speech productions
22
Q
What is the purpose of an oral motor exam?
A
- it’s a critical component to speech assessments
- measure structural and functional integrity of speech mechanism
23
Q
What do you assess in terms of FUNCTION during an oral motor exam?
A
- adequacy of system to produce non-speech and speech related movement
- imitation tasks
- swallowing or feeding
- Diadochokinetic rate (DDK)
24
Q
What do you observe during an oral motor exam in terms of structure? and what are the particular anatomical parts?
A
- clinical observation of size, shape, and adequacy of structure.
- teeth & occlusion
- hard and soft palate
- tongue
- face, nose, mouth
25
During an OME what do you observe in terms of structure of the lips?
- drooping
- drooling
- resting position
- scarring
26
During an OME what do you observe in terms of function of the lips?
- range of motion (ROM): smile vs. pucker
- pressurizing without losing air from nose
- DDk rate for /p^/
27
During an OME what do you observe in terms of structure of the tongue?
- size
- atrophy
- abnormal movements
- mobility: protrusion, elevation, lateralization, rotation*
28
During an OME what do you observe in terms of function of the tongue?
- strength
| - mobility: ROM, Ankyloglossia, DDK rate for /t^t^t^/
29
During an OME what do you observe in terms of structure of the hard palate?
- height and width
- color
- check for clefts, fistulas, fissures, or appliances
30
During an OME what do you observe in terms of function of the hard palate?
immobile structure: nothing to test here
31
When checking the structure of the hard palate, what can the palate being too high mean?
-too high may signify structural issues
32
Why do we check the color of the hard palate?
-blue tint at midline may indicate a submucosa cleft
33
During an OME what do you observe in terms of structure of the soft palate?
- condition of the uvula
- symmetry and length
- repaired cleft
34
During an OME what do you observe in terms of function of the soft palate?
- movement of velum during production of /ɑ/ either sustained or repeated
- listen for hypernasal or hyponasal speech during production of stop consonants
35
During an OME what do you observe in terms of structure of the teeth?
- overall condition
- missing/extra teeth
- occlusion pattern
36
In terms of feeding skills, what should a 6-9 month old be doing?
assist with feeding
37
In terms of feeding skills, what should a 9-12 month old be doing?
finger feeds
38
In terms of feeding skills, what should a 12-15 month old be doing?
holds cup and starts using spoon
39
In terms of feeding skills, what should a 15-18 month old be doing?
uses straw and uses spoon independently
40
In terms of feeding skills, what should a 18-24 month old be doing?
feeds self without assistance
41
In terms of feeding skills, what should a 2-3 year old be doing?
uses fork and spoon without spilling
42
In terms of feeding skills, by age 5, what should a child be doing?
-feed and drink independently
43
Is there a relationship between feeding skills and speech development?
YES!
44
What are the natural consequences of connected speech processes?
- adaptive changes to phonetic and phonological forms
| - complex articulatory demands
45
What are connected speech processes governed by?
- increased rate of speech
| - acoustic perception, learned cognitive or phonological rules
46
What is co-articulation?
- overlapping movements or dynamic coordination of articulators within vocal tract
- depends on the phonetic context
- the results are two articulators "co-produce" or share features
47
What is assimilation?
- adaptive articulatory changes
| - changes in manner, place, and voicing properties
48
What is progressive/perseverative assimilation? GIVE AN EXAMPLE!
- phoneme 1 → phoneme 2
- sound segment influences a FOLLOWING sound
-EX: /dʒʌmpɪn/ vs. /dʒʌmbɪn/
/aɪskrim/ vs. /aɪstrim/
49
What is regressive/anticipatory assimilation? GIVE AN EXAMPLE
- Phoneme 1 <-- Phoneme 2
- Sound Segment influences a PRECEDING sound
-ex: /hænkɚtʃɪf/ vs. /hæŋkɚtʃɪf/
/pʌmkɪn/ vs. /pʌŋkɪn/
50
What is Coalescence assimilation? GIVE AN EXAMPLE
-merging of two features of two segments into one
-EX: "what you want?"
"would you?"
"in case you need it"
"has your letter come?"
51
What is Elision Assimilation? GIVE AN EXAMPLE!
-omission of one or more sounds in a word or phrase
-EX: "We arrived the next day"
"George the sixth's throne"
"have we got any vegetables?"
"that's the least of my worries"
52
When breaking down spontaneous speech what is the level from lowest to highest you would segment it down to?
- Individual or discrete sounds
- individual words
- associate meaning to words
- combine meanings according to knowledge of grammatical rules of a language
53
What two directions can assimilation occur in?
- progressive
| - regressive
54
How do we Segment Speech?
-spontaneous speech must be "broken down" into smaller components
55
How do we transcribe connected speech samples?
- speech stream is printed on page as it sounds
- it is continuous: there are no marked boundaries between words, except for when we pause
- sequence of distinct vowels and consonants except when we pause
56
What are the expectations for speech intelligibility for a 19-24 month old?
25-50%
57
What are the expectations for speech intelligibility for a 2-3 year old?
50-75%
58
What are the expectations for speech intelligibility for a 4-5 year old?
75-90%
59
What are the expectations for speech intelligibility for 5+ years?
90-100%
60
What is the objective of intelligibility rating? (why is it important)
measure effectiveness of overall communication skills
61
how do we determine the percent of intelligibility?
%intelligibility= # of intelligible words x 100
----------------------------------- - # of intelligible + # of unintelligible (total)
62
What is a spontaneous speech sample?
- informal assessment procedure
| - minimum of 50-100 utterance sample
63
What are elicited samples?
-responses to target questions and imitated tasks
64
What are spontaneous samples?
unmediated responses
65
What is the point of a spontaneous speech sample?
- measure information not found in formal (standardized testing)
- show HOW a child's articulators are able to move from word to word with accuracy or error
- determine effects of speech errors noted on formal testing on overall communication skills
- more accurate representation of current communication skills
66
How are language and cultures related?
-cultural identities are created by the vocabulary and grammatical constructs used in his/her language
67
What is a dialect?
mutually intelligible forms of a language associated with a particular region, ethnicity, or social class
68
what is a bi-dialect?
- speak two dialects within same language
| ie: standard arabic & dialect of arabic
69
what is bilingualism?
speak two different languages
70
what is simultaneous bilingualism?
- L1 + L2
- learning two languages concurrently (from the beginning)
- undifferentiated phonological system @ first (becomes differentiated by age 2)
71
What is successive bilingualism?
- L1 THEN L2
- Learning one language and THEN another
- most likely able to maintain "dual" phonological system
72
What is Metathesis? GIVE AN EXAMPLE
Child alters the sound sequence in a word
| ex: pasghetti vs. spaghetti
73
what is dimunitization?
adds a vowel @ the end of a word?
| ex: ball becomes bally
74
What two phonological processes are especially common with children with developmental apraxia?
metathesis & dimunitization
75
What are the 3 types of phonological processes?
- Syllable structure simplification
- Substitution
- Assimilation
76
What is Syllable structure simplification?
Commonly reduces complexity of syllable structure of words
77
What is substitution?
one sound class replaces another
78
What is assimilation?
sounds take on qualities of those surrounding it
79
Which phonological processes fall under syllable structure simplification?
- unstressed syllable deletion or weak syllable deletion
- reduplication
- initial consonant deletion
- final consonant deletion
- epenthesis
- cluster reduction
80
What is unstressed syllable deletion or weak syllable deletion?
- weak/unstressed syllable omitted
[meto] for "tomato"
[ɛfənt] for “elephant”
81
What is reduplication?
- doubling of syllable
[bɑbɑ] for “bottle”
[mɑmɑ] for “mommy”
82
What is initial consonant deletion?
- Omission of first consonant in a word
[æt] for “bat”
[ɑg] for “dog”
83
What is a final consonant deletion?
- Omission of final consonant in a word.
[haʊ] for “house”
[mæ] for “match”
84
What is epenthesis?
- Adding an "unstressed" vowel (e.g., schwa)
[bəlu] for “blue”
[səpun] for “spoon”
85
what is cluster reduction?
- deletion/reduction of a cluster/blend (2 consonants together) partial vs. total
Partial: [tɔp] for “stop”; [dar] for “dark
Total: [æɡ] for “flag”; [pa] for “palm”, [da] for “dark”
86
Which phonological processes fall under substitution processes?
- Stopping
- deaffrication
- fronting
- backing
- depalatalization
- gliding
- vocalization
87
What is stopping?
- Stop for a fricative
[tup] for “soup”; [pʌn] for “sun”; [maʊt] for “mouse”
88
What is deaffrication?
- Stop or fricative for an affricate
[tɛr] for “chair”; [mæt] for “match”
89
what is fronting?
- Front for back or velar sound
[tæt] for “cat”; [bɪd] for “big”
90
What is backing?
- Velar for alveolar
[ɡɪɡ] for “dig”; [baɪk] for “bite”
91
What is depalatalization?
- Alveolar for palatal
- It no longer becomes a palatal sound
[tɛk] for “check”; [dun] for “June”; [mæts] for “match”
92
What is gliding?
- Glides /l, r/ for Liquids /w, j/
[wɪŋ] for “ring”; [jek] for “lake”
93
What is vocalization?
- Vowel for a syllablic liquid
- Syllablic liquid = /l, r/ takes on characteristic of syllable
[sɪmpo] for “simple”; [pepo] for “paper”
94
what are the assimilation processes?
- labial
- velar
- nasal
- alveolar
- prevocalic voicing
- postvocalic devoicing
95
what is labial assimilation? give an example
- bilabial for non-labial
| - [bæb] for /bæd/; [pɛb] for /pɛn/
96
what is velar assimilation? give an example
- velar for nonvelar
- [kɔg] for /kɔp/
- [kɪk] for /kɪt/
- [gok] for /got/
97
what is nasal assimilation? give an example
- nasal for non-nasal
- [mæm] for /mæp/
- [nɑŋ] for /lɑŋ/
- [non] for /noz/
98
what is alveolar assimilation? give an example
- alveolar for non-alveolar
- [tɑt] for /tɑp/
- [sut] for /sup/
- [lɛd] for /lɛg/
99
what is prevocalic voicing? give an example
- voiceless sound BEFORE vowel becomes voiced
- [dɛn] for /tɛn/
- [bap] for /pɑp/
- [zut] for /sut/
100
what is postvocalic devoicing?
- voiced sound AFTER vowel becomes unvoiced
- [pɪk] for /pɪg/
- [b^s] for /b^z]
- [sæt] for /sæg/
101
What is the definition of phonological processes?
Simplifications of the adult forms of words
102
At what age should phonological processes disappear?
Around age 5
103
What is an articulation disorder?
- Mild to moderate sound distortions
- Does not affect meaning of words
- Speech intelligibility preserved
- Errors based on physical properties of sound production (imprecise movement and placement of articulators)
104
When is an articulation disorder diagnosed?
WHEN errors persist beyond expected age range
105
What is a phonological disorder?
- Patterned sound production or sound class errors
- Affects meaning of words
- Can affect intelligibility depending on # of class sound errors
106
When is an phonological disorder diagnosed?
WHEN phonological process errors persist beyond expected age range (typically age five)
107
Why is it important to know the language characteristics of an individual’s primary language when conducting an speech and language assessment?
Because we may confuse them with being a language disorder, where in reality it may just be a difference due to the phonological properties of their native language.
108
What are the assessment regulations of culturally diverse students?
- should not be culturally or racially discriminatory
- the assessment/test must be provided in child's primary language
- parents are entitled to an interpreter
- goal of assessment: yield most accurate information on what child knows and can do academically, developmentally, and functionally
109
What is the definition of a speech sound disorder?
- classification of speech delays and impairments in children and adults
- it may be a primary or secondary disability
110
Why is it important to identify the severity rating among individuals diagnosed with a speech sound disorder?
...
111
What are the etiological factors we look at when diagnosing a speech sound disorder?
- perceptual (are they hearing the sounds?)
- phonetic (are they appropriately using their articulators to produce that sound?)
- phonological (looking @ this child's understanding of the sounds system within the language)
- motoric (how well the child is able to coordinate their structures to produce phrases, sentences, etc)
- structural (are oral motor structures intact?)
112
What are the three general speech sound disorder categories?
- phonological deficit
- articulation deficit
- motor speech deficit
113
What are 4 different types of qualitative ratings?
- mild
- moderate
- severe
- profound
114
What is the the therapy focus for perceptual sensory deficit?
speech and language development
115
In terms of speech sound disorders, what characteristics do you see in a phonological deficit?
- often unitelligible
| - involves multiple class sounds
116
In terms of speech sound disorders, what characteristics do you see in a articulation deficit?
- more phonetic based
- intelligible
- residual errors
117
In terms of speech sound disorders, what characteristics do you see in a motor-speech deficit?
- developmental--children
| - acquired--children/adults
118
What is the clinical presentation of a phonological deficit within the speech sound disorder category?
-multiple errors and highly unintelligible
119
What are the speech errors of a phonological deficit within the speech sound disorder category?
- simplification patterns of sound classes
| - persistent beyond age expectancy
120
What is the treatment focus of a phonological deficit within the speech sound disorder category?
- teach production of sound classes
- contrast productions using minimal pairs
- accompany language remediation
- teaching of minimal pairs
121
what are minimal pairs?
set of words that vary only by one phoneme
122
What can we use to develop discrimination skills with children who have a phonological deficit?
use contrastive function of phonemes
```
for example:
ICD-"mat" vs. "at" "bin" vs. "in"
FCD-"boat" vs. "bow"
Fronting-"cap" vs. "tap"
Backing-"top" vs. "cop"
Deaffrication-"chip" vs. "sip"
vowels-"tip" vs. "top"
```
123
What is the clinical presentation of an articulation deficit in the speech sound disorder category?
- a. residual errors and minimal intelligibility concerns
| - b. speech errors due to structural issues
124
What are the common speech errors of an articulation deficit in the speech sound disorder category?
- omissions, additions, substitutions
| - majority who have articulation disorders have substitution errors
125
What is the treatment focus of an articulation deficit in the speech sound disorder category?
-teach positioning/movement of articulators for production of target speech sounds
126
What neurological evidence is there for a DEVELOPMENTAL motor speech disorder?
- absence of brain injury
| - there is no evidence!
127
What is the clinical presentation of a developmental motor speech disorder?
-speech motor planning
128
What are the speech errors commonly made for somebody who has a developmental motor speech disorder?
- omissions
- substitutions
- vowel distortions
- inconsistencies in productions
129
In terms of developmental motor speech disorders, what specific speech errors are made with regards to omissions?
- Initial consonant deletion
- final consonant deletion
- deaffrication
- cluster reductions
- weak syllable deletions
130
What other phonological processes do children with developmental motor speech disorder experience?
- metathesis
| - dimunitization
131
In terms of developmental motor speech disorders, what specific speech errors are made with regards to substitutions?
fronting
backing
depalatalization
132
In terms of developmental motor speech disorders, what specific speech errors are made with regards to vowel distortions?
any vowel substitutions
reduplication of diphthongs
*very common in children with developmental apraxia of speech
133
In terms of developmental motor speech disorders, what specific speech errors are made with regards to inconsistent productions?
- variability in saying same sound
| * very common in children with developmental apraxia
134
What is the treatment focus for Developmental Motor Speech disorders?
-repetitive practice of varying syllable sequences of sounds the client already knows
135
What neurological evidence is present for people who have ACQUIRED speech motor disorder?
- presence of brain injury
| * most common is stroke!
136
What is the clinical presentation of somebody with acquired speech motor disorder?
- difficulty with one or more phases of speech production
| - speech motor planning
137
What two disorders fall under the category of speech motor disorder?
acquired apraxia of speech
dysarthria
138
What Speech errors occur for people who have acquired speech motor disorder?
- omissions
- substitutions
- vowel distortions
- inconsistencies in production
139
What is the treatment focus for people with acquire speech motor disorder?
- repetitive practice of automatic speech
- repetitive practice of production of varying syllables
(must conquer first one before able to do second one!)
140
Once we've established automatic speech in treatment with people with acquired speech motor disorder (apraxia), what do we work on?
-we move on to working on the varying syllable shapes so we try to get them to speak in multisyllabic words
141
Be able to discuss the consequences of a speech sound disorder on an individual’s ability to function or participate in the home, school, and community.
...
142
In a case history, what does the referral help the SLP with?
Identifying Concerns
143
In a case history, what does the Medical and Developmental history help the SLP with?
determine contributing or limiting factors
144
In a case history, what does the social and educational history help the SLP with?
obtain broad perspective on student's developmental profile
145
In a case history, what does the referral help the SLP with?
Identifying Concerns
146
In a case history, what does the Medical and Developmental history help the SLP with?
determine contributing or limiting factors
147
In a case history, what does the social and educational history help the SLP with?
obtain broad perspective on student's developmental profile
Spring '13-126 (Exam 2)
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