Speech disorders chapter 5 FINAL - developmental speech disorders

what is a phoneme?

* smallest unit of language that conveys meaning
* Minimal pair contrasts
* Cat vs bat
* Phonemes are sequenced together to form words

Where do phonemes occur in words?

* syllables - CV, VC, CVC
* Consonants - initial, medial, final positions

Phonology

* Knowledge of the language convention or rules for combining sounds

Articulation

* The motor skills involved in producing sounds in sequence
* 8 years of age - nearly all children know and correctly produce the sounds of their language

Delay vs disorder

delay

* children with speech production patterns that are typical for children who are younger

Disorder

* Children whose speech is unlike children at any age who are developing normally

Phonological Disorder

* phonological processes
* Cluster reduction
* Weak syllable deletion
* Final consonant deletion

Articulation disorder

* Omission
* Substitution

Severity is related to…

* number of sounds produced correctly
* Accuracy of production
* Ability to produce sounds in different word positions
* Ability to produce sound sequences
* Ability to produce various types of words

It is closely linked to intelligibility of speech

Severity - Mild

* produce a few sound errors
* Usually involves a few of the “late 8” sounds
* Sh, th, s, z, l, r, d3 (garage)
* Generally intelligible to most speakers
* Mild speech sound disorder

Severity - Moderate

Difficulty producing all the sounds within a single class

* Velars - \[k, g, ng\]
* Final consonant deletion
* Incorrect use of sounds in certain word positions (“pod” instead of “pot”)
* Cluster reduction (“bu” for “blue”)

Intelligible to friends and family members, but not to unfamiliar listeners

Good prognosis but longer treatment

Severity - Severe

* Unintelligible to most listeners
* More than six sounds in error in all positions of words
* Do not sequence sounds consistently
* Unintelligible to most listeners
* May rely heavily on gestures to communicate

Severity examples

Bilingualism

* Bilinguals - phoneme differences in two or more languages


* Language differences in sound production

NOT a speech disorder

Dialects

vowel and consonant differences

* shicken - chicken
* Ten - tin

Etiology of Speech disorders

* functional speech disorders
* Perceptual etiology
* Structural etiology
* Motor etiology

Functional Speech Disorders

Cause cannot be determined

* Behavioral description takes place over search for cause

Perceptual Etiology

Hearing impairments

* Otitis media
* Sensorineural loss

Structural Etiology

cleft and lip palate (prenatal)

Motor etiology

* Dysarthria - Neuromuscular impairment
* Apraxia - neurological damage

Assessment

**Goal**: determine __nature__ and __severity__ of disorder/delay

* Describe production and compare speech patterns to others the same age
* Speech samples
* Articulation tests
* Note presence of behaviors
* Assess contributing factors
* Hearing screening
* Oral peripheral examination

Treatment - Articulation based approaches

Articulation-based approaches

* Teaching the motor movements necessary for speech
* Repetitive motor practice with feedback, done at various levels:
* Phoneme 
* Syllables (initial position, final position), 
* words (initial, final, medial)
* Phrases
* Sentences

Treatment - phonological approaches

Contrast therapy – show pictures representing word pairs that differ on one dimension 

* (+/- nasality)
* toe-no
* pot-not
* see-me



* Final consonant deletion
* No-note
* See-seat
* Me-meat

Intervention setting - Infants (birth - 3 yrs)

Early intervention programs in the home

Intervention settings - Preschools and school aged children ( 3 - 17 yrs)

\

* Intervention programs in schools


* Private practice settings
* Rehabilitation Centers or Hospitals

Intervention settings - adults

* Private practice settings
* Rehab centers or hospitals