Intro Comm Dis order exam 2

Why is it important to know hearing screening results for children producing speech sound errors?

If hearing is disrupted by ear infections of limited due to a medical condition, childs speech production can be affected. They cannot clearly hear others or themselves. (also know if they have a history of chronic ear infections)

When assessing SSD, what two examinations should be completed with every student/client who can participate?

~ Oral mechanism examination

~ Motor speech examination

Oral mechanism examination

Assess structure and function of the oral mechanism

~shape, size, intactness of structures, strength, range of motion, coordination etc, during movement in non-speech activites

Motor speech examination

How all systems coordinate to produce syllables (pa pa, ta ta) and connected speech

What is the main approach for treating an articulation disorder?

Work with client to conecptualize, create, and produce the sound- a motor plan approach

motor plan approach

uses motor learning principles to help nonspeaking individuals or those with limited speech communicate independently

What is the main approach for treating a phonological disorder?

Teach child that the sounds they say change the meaning of their message-Use linguistic approach

linguistic approach

applies formal models of linguistics—such as phonology, morphology, syntax, semantics, and pragmatics—to analyze, diagnose, and treat speech and language impairments

Know the basic characteristics and language strengths/weaknesses generally associated with Down Syndrome

~Phonology and speech sound mastery is delayed

~Morphonology and synax are impaired

~Semantics = relative strength

~Pragmatics = relative weakness

Know the basic characteristics and language strengths/weaknesses generally associated with pediatric TBI

~Full language recovery is rare

~Semantics may be a relative strength

~Pragmatics- responding, turn-taking, topic maintenance-is a relative weakness

~Decoding and comprehending written language can be severely impacted

What are some key areas of difficulty in the form for children with DLD?

Phonological impairment, morphology and syntax errors (Deficits in one or more language domain)

What are some key areas of difficulty in the content for children with DLD?

Smaller vocabulary, encode fewer semantic features, need more trials to learn new words

What are some key areas of difficulty in the use for children with DLD?

Immature social communication, difficulty understanding and applying pragmatic rules (e.g. conversational rules)

Case history

Gathering information (from indiviual, caregivers records) Including current complaint, relevent family history, social context

Norm-referejced

Comparing clients performance to a sample of peers

Criterion-referenced

Comparing client’s performance to pre-determined expectations

Parent/teacher/self-report

Using rating scales or checklists to get a picture of clients communication across settings

Observational tools

Observing clients’ communication across different settings and using clinical expertise to gather information on language skills

How do norm-referenced and criterion-referenced assessments differ? NORM-REFERENCED

~Comparing a client’s performance to a sample of peers

~Conform to specific properties that make them valid comparison tools

~Need to be administered in a standardized fashion (any deviation from these procedures invalidates the score)

How do norm-referenced and criterion-referenced assessments differ? CRITERION-REFERENCED

~Compared skills to a certain predetermined expectation

~May or may not use standardized administration procedures

~Can be administered in a naturalistic environment

~Do NOT provide standard scores

~Helpful in determining communicative skills the client does or doesn’t have

Dr.Browns 5 key take aways (1)

~most stuttering is invisible, prolongations, blocks

Dr.Browns 5 key take aways (2)

its biological not behavioral

Dr.Browns 5 key take aways (3)

Variability is a feature of stuttering, not a message

Dr.Browns 5 key take aways (4)

Tne impact of stuttering rivals chronic illness

Dr.Browns 5 key take aways (5)

Good treatment addresses the whole iceberg

Dr.Browns 5 key take aways (Bonus)

CBT or cognitive behavioral therapy is often used in treatment

What is dementia?

~A progressive decline in memory and other cognitive areas that, when severe enough, interferes with daily living and independent functioning

~Behavioral problems may develop

What causes dementia?

Widespread degeneration of cells and/or chemical changes to the brain

What is the most common type of dementia?

Alzheimer’s Disease in the most common

(Umbrella term associated with many brain diseases)

What language, cognitive, and other changes can be seen in a persin living with dementia? (5)

1. Memory loss that disrupts daily life

2. Challenges in planning or solving problems

3. Difficulty completing familiar tasks

4. Confustion with time or place

5. Trouble understanding visual images and spatial relationships

What are the main causes of TBI?

~Falls (highest in children and elderly)

~Motor vehicle accidents (MVAs)

other accidents

What is TBI?

‘Traumatic Brain Injuries’

What are the effects of TBI on thinking, behavior, emotions, language, sensations, etc? FRONTAL LOBE

~Problem solving abilities/limitations

~Attention/concentration

~Speaking

What are the effects of TBI on thinking, behavior, emotions, language, sensations, etc? TEMPORAL LOBE

~Hearing

~Understanding language (receptive)

What are the effects of TBI on thinking, behavior, emotions, language, sensations, etc? PARIETAL LOBE

~Visual perception

~Reading/writing

What are the effects of TBI on thinking, behavior, emotions, language, sensations, etc? OCCIPITAL LOBE

~Vision

What does “BE FAST” stand for

BALANCE: loss of balance or coordination

EYES: changes in vision

FACE: drooping features on one side of face

ARMS: weakness in a limb (even legs)

SPEECH: difficulty speaking or understanding others

TIME: call 911 or emergency services right away

What is aphasia?

Acquired total or partial loss of the ability to use or understand language, usually caused by storke, brain disease, or injury

What types of communication does aphasia affect?

~Receptive-such as understanding speech or reading

~Expressive-such as speaking or writing

What are the characteristics of non-fluent aphasia ?

~Called broca’s aphasia (expressive language center is damaged, limiting production of speech)

~Hesitant speech

~Comprehenstion > production

~Telegraphic speech

Telegraphic speech

Single words and simple grammatical markers, articles etc

What are the characteristics of fluent aphasia?

~Called Wernicke’s apshasia- respective language is damaged

~Speech is smoothly flowing

~Mostly jargon pr “word salad”- has little to no meaning

~Poor language comprehension

~unaware that their own speech is not meaningful

What is PPA?

~Neurodegenerative disease (before 65 and slow progression)

~Frontotemporal disorder (can progress into frontotemporal dementia or remain isolated to language)

~Can affect the ability to understand and use words, understand sentences, repeat sentences, and use correct grammar (think combined impact of the frontal and temporal lobes on language)

What is dysphagia?

is difficulty swallowing

~moving/coordination muscles

~trouble with sensation

Types of dysphagia defined by location where the difficulty occurs

• oral

• pharyngeal

• esophageal

• oropharyngeal

• pharyngoesophageal

Why does dysphagia matter?

Can cause dehydration, malnutrition, weight loss and pneumonia

What are the two instrumental procedures that can be used to assess swallow function? (MBS)

~Modified barium swallow

• done with oral phase deficits present

• or esophageal complaints- person saying it feels like something is in their lower throat or swallowing is difficult

• must be healthy enought to go to readiology dept.

What are the two instrumental procedures that can be used to assess swallow function? (FEES)

~Fiberoptic endoscopic evaluation of swallowing

• mostly done when patient only has pharyngeal concerns- food sticking in upper throat or moving into nasal passages (coughing often involved)

• can be done when patient CANT go to x-ray

• may be done when patient notes voice changes/concerns

What are the compensatory strategies for addressing dysphagia?

Diet modifications, posture changes, swallowing behvaior changes, external manipulation

What are the rehabilitative strategies for addressing dysphagia?

Exercise-based treatment to regain skills lost. To be effective, this takes a patient who is motivated to complete this and has the stamina to do so. Sometimes exercise-based treatment is contraindicated

What is the difference between functional and organic voice disorders?

~Functional is the inefficient use of the vocal mechanism despite having normal anatomy (Misuse, abuse, or overuse

~Organic is the neurogenic and structural

Who diagnoses functional vs. organic voice disorders?

For voice disorders its doctors (otolaryngologists) make the medical diagnosis. SLPS assess, diagnose and treat the voice disorder to restore function,

Examples of functional voice disorders?

~Muscle tension dysphonia (when the wrong muscles try to help out the voice)

~Functional aphonia (someone with a normal larynx loses their voice completely, often preceded by illness; can be caused or exacerbated by stress)

Examples of organic voice disorders?

~Neurological (vocal fold paralysis due to damage to cranial nerve X, the vagus nerve)

~Structural (presbylarynx or vocal fold lesions, polyps, or cysts caused by chronic vocal abuse or misuse)

What is the role of the true versus false vocal folds in voicing?

~True: They are the main source of sound production. As air from the lungs passes through, they vibrate to create the basic tone of speech and singing.

~False: They do not vibrate during normal speech or clean singing. Instead, they act as a protective barrier and a valve to seal the airway during swallowing or heavy lifting.

what often happens in people experiencing muscle tension dysphonia?

Develop an overly tight, strained, or hoarse voice accompanied by throat pain, fatigue, and a feeling of tightness around the voice box

What is motor speech disorder generally?

~Speech disorder that results from neurological impairments

~Affect the planning, programming, control, or execution of speech

What are the two MSDs?

~Execution (dysarthria)

~Planning (Apraxia)

What part(s) of the nervous system is affected in dysarthria vs. apraxia?

What are some common causes of dysarthria in adults?

~Neurodegenerative diseases (parkinsons, amyotrophic lateral sclerosis, huntington’s disease)

~Tumors

~Strole

~Infections

~Trauma (TBI, surgical trauma)

~ETC.

What are the primary symptoms and the location of damage for the two types of dysarthria?

What are the primary cause of acquired apraxia of speech in adults?

Why does task complexity influence speech accuracy in apraxia?