CSDI Exam 2

When are language disorders in adults acquired?

After language development

Why do language disorders in adults occur?

Strokes, traumatic brain injuries, or degenerative conditions

Which hemisphere are speech and language represented in?

The left hemisphere

Which lobe is language expression associated with?

The frontal lobe (Broca’s area)

Which lobes is language comprehension associated with?

The temporal and parietal lobes (Wernicke’s area)

What connects Broca’s and Wernicke’s area?

Fiber tracts

What are the key structures within the perisylvian region?

Broca/Wernicke area, Arcuate fasiculus, ventral stream, & other pathways

Aphasia

The partial or complete loss of speech & language due to brain damage

What is the most common cause of aphasia?

Stroke (location of blockage or hemorrhage)

Broca’s aphasia

Primarily expressive impairment

Wernicke’s aphasia

Primarily receptive impairment

Conduction aphasia

Expression and comprehension largely intact. Impaired repetition of words & sentences.

Anomic aphasia

Prominent word-finding difficulty

Global aphasia

Severe impairment of both expression & comprehension

Primary progressive aphasia

Associated with neurodegenerative disease (e.g., dementia)

What can classification of aphasia be influenced by?

Lesion location

What lobe lesions is Broca’s aphasia associated with?

Left frontal lobe lesions

What lobe lesions is Wernicke’s area assoicated with?

Posterior temporal & adjacent parietal lesions

What are the key characteristics of Broca’s aphasia?

• Nonfluent speech

• Hesitation

• Effortful speech production

• Anomia

• Agrammatism

• Good comprehension

What are the key characteristics of Wernicke’s aphasia?

• Fluent speech

• Difficulty comprehending language

• Hearing intact

• Lengthy speech with occasional articulation errors

• Content is vague

What area is damaged regarding conduction aphasia?

Arcuate fasiculus

Where may damage occur in anomic aphasia?

Anywhere within the perisylian region

What are key characteristics of anomic aphasia?

• Word finding difficulty, esp. nouns

• Patient describing the object and function

• Difficulty accessing the object’s name

Where may damage occur in global aphasia?

Most of the perisylvian speech & language region

What are the key characteristics of global aphasia?

• Severely impaired comprehension & expression

• Occasional prod. or comprehension of simple utterances

What are the key characteristics of Primary Progressive Aphasia (PPA)?

• Broca’s like expressive symptoms

• Prominent anomia

• Impaired sentence repetition & comprehension

What are the key characteristics of Adult Apraxia of Speech (AAS)?

• Frequent hesitations & articulatory groping

• Speech sound errors

• Greater difficulty with increased phonetic complexity

Anterior

The front of the cerebral hemispheres

Posterior

The back of the cerebral hemispheres

Traumatic Brain Injury (TBI)

Results from a blow, jolt, or penetrating injury to the head

Dementia

Degenerative neurological disease. Results from progressive, irreversible neuronal death

What are the common impairments of dementia?

• Memory & cognition

• Executive function

• Psychiatric health

Respiratory System

Power supply for speech

Larynx

Sound source for speech

Upper & nasal airways

Modify the laryngeal sound to produce different speech sounds

Chest wall

Structures outside the lungs that expand & compress them

Lung compression

Raises internal air pressure > air flows out (exhalation)

Lung expansion

Lowers internal air pressure > air flows in (inhalation)

What are the breathing types and capacity?

1. Rest (vegetative) breathing

2. Vital capacity (VC): max volume of air exhaled after a full inhalation

Speech breathing

Use of the respiratory system for speech

Vegetative (rest) breathing

• Symmetric airflow pattern

• Equal inhalation & exhalation volumes

• Similar airflow rates for inhalation/exhalation

Speech breathing characteristics

• Not symmetric

• Rapid inhalation

• Prolonged exhalation during phrase production

What is the larynx composed of?

• Cricoid cartilage (bottom)

• Hyoid bone (top)

• Vocal folds

Vocal folds

Paired bands of muscular & non-muscular tissue; vibrate to generate the sound source for speech

Phonotation

Sound produced by vocal fold vibrations

Fundamental Frequency (F0)

The number of full vocal fold cycles in one sec

What is voice described in terms of?

• Pitch

• Loudness

• Quality

Pitch

Physical correlate: F0

Loudness

Physical correlate: intensity

Quality

Physical correlate: complex mix of frequency & noise energy

Vocal tract

Airway from the vocal folds to the lips

Nasal tract

Airway from the upper throat to the nostrils

Velopharynx

Upper pharynx & soft palate; controls connection between the vocal tract & nasal tract

What does the velopharyngeal mechanism include?

The soft palate & surrounding pharyngeal walls

Velopharyngeal port (VP port)

Channel between the soft palate & the pharyngeal walls

What is the concept of coarticulation?

Movements for one sound are influenced by movements for adjacent & even non-adjacent sounds

Theory of Speech Acoustics

The sound wave that emerges from a speaker’s lips during speech reflects a combination of a source & filter

Source

The acoustic signal produced by vibrating vocal folds; the signal contains multiple frequencies

Filter

The vocal tract emphasizes some frequencies produced by the vibrating vocal folds and de-emphasizes others (emphasization depends on shape of vocal tract)

Spectograms

• x-axis: time

• y-axis: frequency

• Formants (dark bars): resonant frequencies

What does the vocal tract function as?

A resonating tube; shorter tubes have higher resonant frequencies

Speech Perception

How speech perception works, & what information is perceived, remain open questions

Motor Theory of Speech Perception

Speech perception is carried out by a special, dedicated brain mechanism that is species-specific to humans

Dedicated

This mechanism is used only for speech perception

Auditory Theory

Speech is processed using the same general auditory mechanisms, & perceptual learning rules applied to all otehr enviro sounds

Motor Theory

Humans perceive speech by recognizing the articulatory gestures (vocal tract movements) used to produce it, rather than analyzing the sound

Top-Down Processing

The listener actively searches for a word once acoustic analysis begins, allowing faster recognition

Bottom-Up Processing

Early acoustic analysis at the start of a word

Speech Intelligibility

The degree to which speech is understandable

Measurements of Speech Intelligibility

• Scaling Techniques

• Transcription

Phonetics

Sound component of language

International Phonetic Alphabet (IPA)

A perceptual listening-based system; represents the speech sounds of all languages

Articulatory Phonetics

Describes speech sounds based on observation of speech movements

Acoustic Phonetics

Describes speech sounds based on observation of their acoustic properties

Perceptual Phonetics

Describes speech sounds based on hearing & the use of the IPA

Vowel Quadrilateral

Tongue height (vertical) & tongue advancement (horizontal)

High vs. low vowels

Tongue height relative to the hard or soft palate

Front vs. back vowels

Tongue advancement in the oral cavity

Corner Vowels

Define the limits of tongue position within the vocal tract for vowel production

English “corner vowels”

• /i/ (highest, most front)

• /u/ (highest, most back)

• /æ/ (lowest, most front)

• /a/ (lowest, most back)

How are dipthongs formed?

By a change in vocal tract shape from one vowel-like position to another

Dipthongs

Single, independent phonemes rather than two vowels in sequence

How are consonants organized?

By place of articulation, manner of articulation, and voicing

Place of articulation

The location of the primary constriction in the vocal tact, such as bilabial (lips) or alveolar (tongue tip & alveolar ridge)

Manner of articulation

How the sound is produced, including stops (complete closure), fricatives (tight but incomplete closure), & nasals (oral closure with an open velopharyngeal port)

Voicing

Whether the vocal folds vibrate for sounds with the same place & manner of articulation

Broad Transcription

Focuses on phonemes that change word meaning

Narrow Transcription

Captures specific physical properties of actual speech sounds (phones & allophones)

Fricatives

Tight but incomplete closure

Nasals

Oral closure with an open velopharyngeal port

Which two dimensions are represented in the vowel quadrilateral?

Tongue height & tongue advancement

What is the primary purpose of the IPA?

To provide a universal system for representing speech sounds

According to the source-filter theory, what primarily distinguishes the vowels /a/ and /i/?

Differences in vocal tract shape and resonant frequencies

A speaker wants to emphasize a word and make it louder. Which physiological change is most important?

Increasing lung pressure

This sound requires an open velopharyngeal port

/m/

Which deficit most commonly persists after TBI recovery?

Pragmatics

Which of the following is NOT one of the DSM-5 domains of adaptive functioning?

Motor skills

Which language domain is considered a relative strength in children with Down syndrome?

Receptive vocabulary

Idiopathic SSDs

Disorders of the motor production of speech sounds and the linguistic aspects of speech production

Phonemes

Sound categories that change word meaning when substituted in the same position