Intro To CSD- Quiz 5

Overall what percentage of school-aged children are estimated to have speech delay’s or speech sound disorder’s?

Overall, 2.3% to 24.6% of school-aged children are estimated to have speech delay or speech sound disorder.

What is articulation?

The physical production of speech sounds using the articulators.

What is an articulation disorder?

Difficulty producing one or a few consonant sounds correctly.

When does speech sound development begin for those with articulation disorders, and what are the first 3 years especially critical for?

Begins around age 2, with continued fine-tuning through ages 5-7. The first 3 years are especially critical for acquiring foundational speech sounds.

What are the errors that children make while learning speech that are expected and are not speech sound disorders, they are also part of normal speech development?

Children make errors while learning speech. These developmental errors are expected and are not speech sound disorders. They are part of normal speech development and typically resolve without therapy.

What are the expected errors for articulation disorders?

Omissions: Leaving out sounds not yet mastered.

Substitutions: Replacing unfamiliar sounds with known ones.

What are the steps for the Diagnostic Test Battery for articulation disorders?

1. Case History.

2. Oral Peripheral Exam.

3. Hearing Screening.

4. Intelligibility Rating.

5. Standardized Articulation Test.

What does the case history include in the diagnostic test battery for articulation disorders?

Including primary speech concerns, birth details, developmental milestones, family history for speech/language problems/therapy, childhood medical or developmental disorders.

What does the oral peripheral exam check for in the diagnostic test battery for articulation disorders?

Check for abnormalities of articulator appearance and function.

What is the hearing screening used to rule out in the diagnostic test battery for articulation disorders?

To rule out the mispronunciations aren’t influenced by hearing loss.

How is the intelligibility rating measured in the diagnostic test battery for articulation disorders, and what is it useful for?

How well the child can be understood by unfamiliar listeners. Useful for understanding when errors become clinically significant.
General rule of thumb:
2 years: ~ 50% intelligible.
3 years: ~ 75% intelligible.
4 years: ~ 100% intelligible (to unfamiliar listeners).

What is the name of the standardized articulation test used in the diagnostic test battery for articulation disorders?

Goldman-Fristoe Test of Articulation 3.

What does the intelligibility rating measure in the diagnostic test battery for articulation disorders, and what is it useful for?

How well the child can be understood by unfamiliar listeners. Useful for understanding when errors become clinically significant.

General rule of thumb:

2 years: ~ 50% intelligible.

3 years: ~ 75% intelligible.

4 years: ~ 100% intelligible (to unfamiliar listeners).

What is the name of the standardized articulation test used in the diagnostic test battery for articulation disorders?

Goldman-Fristoe Test of Articulation 3.

How is the child’s speech evaluated in the standardized articulation test for the diagnostic test battery for articulation disorders?

Child’s speech is evaluated using a norm-referenced test.

For the standardized articulation test for the diagnostic test battery for articulation disorders, who are the child’s results compared to, and what is the normed data collected across and what patterns does it reflect?

The child’s results are compared to normed age-level peers:
These peers are typically developing children with no medical or developmental concerns.
Normed data is collected across age groups and reflects patterns of correct and incorrect sound production.

What are the two ways that the child’s results are interpreted during the standardized articulation test for the diagnostic test battery for articulation disorders?

1. When the child’s results are consistent with their peers, their speech sound development is considered normal.

2. When the child’s results deviate from their peers, the child may benefit from articulation therapy.

What are the developmental error patterns for an articulation disorder?

1. Substitutions.

2. Omissions.

3. Distortions.

4. Additions.

For the developmental error patterns in articulation disorders what are substitutions?

Example: /w/ for /r/, /t/ for /k/.

Common in early development.

If still present past age 5, especially for later-developing sounds like /r/, /s/, /z/, it may indicate a disorder.

For the developmental error patterns in articulation disorders what are omissions?

Example: “ca” for “cat.”

Expected in toddlers.

If still present past age 3.5-4, especially in final consonants, it’s a red flag.

For the developmental error patterns in articulation disorders what are distortions?

Example: lateral /s/ (air escapes over the sides of the tongue instead of down the center).

Often not part of typical development.

If present past age 6-7, especially for /s/, /z/, /r/, may require therapy.

For the developmental error patterns in articulation disorders what are additions?

Example “buhlue” for “blue.”

Least common in typical development.

If frequent or persistent past age 3.5, may suggest motor planning or phonological issues.

For articulation disorders how does the SLP develop a therapy plan?

The SLP develops a therapy plan centered on one of the speech sounds the child is misarticulating, the target sound.

What are the steps for therapy for articulation disorders?

1. Show the child correct tongue/lip placement using charts, modeling the way to produce the target, and guidance/coaching.

2. Isolation: Repetive practice where the child repeats the target in isolation, with guidance/coaching. Include motor exercises to improve the coordination and articulator movement.

3. Syllable Integration: Practices using the target within syllables.

4. Word Positioning: Practice the target in the initial and final positions of words.

5. Sentence Use: Incorporate the target word into full sentences. This can be challenging for the child due to cognitive processing demands.

6. Conversational Practice: The target word is practiced in short conversations. Activities might include telling a story about a picture, describing an activity they recently completed in school, talking about sports.

What are the therapy musts for an articulation disorder?

1. Prep the Child: Set clear goals (“We’re practicing /b/ today.”)

2. Incorrect Productions: Gently interrupt incorrect productions, model the correct sound, and have the child repeat.

3. Positive Reinforcement: Celebrate correct productions to build confidence.

4. Make Therapy Fun: Use games and interactive activities that keep the child engaged and motivated.

What is phonology?

Phonology is the study of sound patterns and rules within a language. It governs how phonemes are:

Organized into syllables and words.

Combined to form permissible sound sequences.

Structured to create grammatically correct sentences. 

What are the phonological rules?

1. Phoneme combinations: Allowed: /pre/. Not allowed: /zdI/.

2. Syllable structure (aka, word patterns or word shape), how consonants (C) and vowels (V) are used to form syllables and words: “Me” - CV. “Cat” - CVC. “Stop” - CCVC. “Banana”- CVCVCV.

3. Sentence-level organization: How words are sequenced to form grammatically correct utterances.

As children learn to speak, they often attempt word patterns that exceed their current motor or speech sound abilities. To succeed, they simplify these patterns using predictable strategies, what are these strategies called, and what are some examples of simplification?

As children learn to speak, they often attempt word patterns that exceed their current motor or speech sound abilities. To succeed, they simplify these patterns using predictable strategies called phonological processes.

Examples of Simplification:

“spoon” (CCVC) - “poon” (CVC).

“banana” (CVCVCV) - “nana” (CVCV).

What are the characteristics of phonological processes?

1. Developmentally expected at certain ages.

2. Systematic and rule-based.

3. Temporary, they typically resolve as speech skills mature.

4. Persistent simplification of word patterns beyond typical age range, may indicate a phonological disorder.

What are the categories of phonological processes?

The categories of phonological processes include assimilation, substitution, and syllable structure.

For phonological processes what is assimilation, and what are some examples?

The child uses a similar sounding consonant in place of the correct consonant. 

Examples: “nunny” for “bunny,” and “guck” for “duck,” and “bub for “bus.”

For phonological processes what is substitution, and what are some examples?

When one type of sound replaces another type.

Examples: “tar” for “car” and “toap” for “soap.”

For phonological processes what are the two types of substitution?

1. Fronting.

2. Stopping.

What is the fronting type of substitution in phonological processes?

The substitution of a sound produced in the back of the mouth for a sound produced in the front of the mouth, “tey” for “key.”

What is the stopping type of substitution in phonological processes?

A stop is replaced by a fricative or affricate, “toap” for “soap” and “tair” for “chair.”

For phonological processes what is syllable structure?

When syllables are added, omitted, or repeated.

For phonological processes what are the three types of syllable structures?

1. Final consonant deletion.

2. Reduplication.

3. Cluster Reduction.

What is the final consonant deletion type of syllable structures in phonological processes?

The deletion of a final consonant sound in a word, “cuh” for “cup” and “dah” for “dog.”

What is the reduplication type of syllable structures in phonological processes?

Repeating the same syllable, “wawa” for “water.”

What is the cluster reduction type of syllable structures in phonological processes?

Simplifying a consonant cluster by omitting one of the sounds, “poon” for “spoon” and “tuck” for “truck” and “boo” for “blue.”

What are the diagnostic test battery steps for phonological disorders?

1. Parent Interview.

2. Speech Sample Analysis.

3. Standardized Testing.

4. Hearing Screening.

5. Intelligibility Rating.

For the diagnostic test battery for phonological disorders what do the parent’s and specialist’s identify in the parent interview?

Identify primary concerns.

For the diagnostic test battery for phonological disorders what happens during the speech sample analysis?

Picture naming, word repetition, and conversation to identify phonological processes.

For the diagnostic test battery for phonological disorders what is the standardized test called and what is used for?

Khan-Lewis Phonological Analysis.

HAPP- Hodson Assessment of Phonological Patterns.

To identify type of phonological disorder by comparing the child’s phonological processes to those of normed age-level peers.

For the diagnostic test battery for phonological disorders what is the hearing screening used to rule out?

To rule out the sound errors aren’t influenced by hearing loss.

For the diagnostic test battery for phonological disorders what does the intelligibility rating measure?

How well the child can be understood by unfamiliar listeners.

General ranges:

2 years: ~ 50% intelligible.

3 years: ~ 75% intelligible.

4 years: ~ 100% intelligible (to unfamiliar listeners).

What is the root of phonological therapy and what can success of phonological therapy improve for the child?

The root of phonological therapy is to train the brain to overwrite the immature phonological processes with mature sound patterns. Success of therapy can improve the child’s reading and writing.

What are some phonological therapy techniques?

1. Phonological Awareness Activities.

2. Minimal Pairs Auditory Discrimination.

3. Auditory Bombardment.

4. Cycles Approach.

What are some phonological awareness activities for phonological therapy?

1. Rhyming.

2. Sound Pattern Discrimination.

3. Segmentation.

4. Blending.

5. Phonemic Awareness.

What is rhyming for the phonological awareness activities in phonological therapy?

Recognizing and generating rhyming words, cat/hat.

What is sound pattern discrimination for the phonological awareness activities in phonological therapy?

Identifying words that start with the same sound, “silly, snakes, silently.”

What is blending for the phonological awareness activities in phonological therapy?

Combining the parts of the sound into the word, “/c/ + /at/+ to “cat.”

What is phonemic awareness for the phonological awareness activities in phonological therapy?

Identifying, blending, segmenting, and manipulating individual sounds in words.

What is the minimal pairs auditory discrimination for phonological therapy techniques, and what does it help the child learn?

Contrast word pairs differing by one phoneme, “bat” vs “pat.” Helps the child learn how sound changes affect word meaning.

What is auditory bombardment for phonological therapy techniques?

Repeated exposure to correct sound patterns to overwrite the immature processes.

What does the cycles approach do for phonological therapy techniques, and its ideal for children with what?

Rotate through multiple phonological targets in structured cycles, with focus on one pattern at a time. Ideal for children with highly unintelligible speech.

What is fluency or stuttering?

Fluency, or stuttering, is a speech sound disorder characterized by the inability to speak easily and smoothly.

When does stuttering usually start?

Stuttering usually starts early in childhood. Very few adults acquire it.

Boys are how many times more likely to stutter than girls?

Boys are 2 to 3 times more likely to stutter than girls.

The number of boys who continue to stutter is how many times higher than girls?

The number of boys who continue to stutter is 3 to 4 times higher than girls.

What is the cause of stuttering?

The cause of stuttering is unknown. Proposed reasons include genetics, neurobiological differences in which the speech areas of the brain of stutters differs from someone with normal fluency, and anxiety.

What are the three characteristics of dysfluent speech?

1. Repetitions.

2. Prolongations.

3. Blocking.

For the characteristics of dysfluent speech what are repetitions?

Repeating syllables or words over and over.

For the characteristics of dysfluent speech what are prolongations?

When the sound or word continues to be produced for a longer than normal time.

For the characteristics of dysfluent speech what is blocking?

The inability to start speech.

What are the types of dysfluent speech?

1. Normal Nonfluencies.

2. Developmental Stuttering.

3. Confirmed Stuttering.

4. Neurogenic Stuttering.

For the types of dysfluent speech what are normal nonfluencies?

When speech contains a normal number of repetitions and prolongations. The person does not struggle to produce speech. The person is not concerned about their nonfluencies. The person shows little muscle tension.

For the types of dysfluent speech what is developmental stuttering?

Developmental stuttering is the most common form of stuttering. Developmental stuttering may also run in families. The child has fewer nonfluencies and repetitions compared to a confirmed stutterer. The child may show some muscle tension. The child may become aware and concerned about their problem. Young children might stutter during the years when they are developing their speech and language skills. The common age range when developmental stuttering occurs is 2 to 6 years.

For the types of dysfluent speech what is confirmed stuttering?

This is true stuttering. The person has many repetitions, abnormally long prolongations, and frequent blocks. The person is aware and concerned about their problem. The person shows muscle strain and tension.

For the types of dysfluent speech what can cause neurogenic stuttering, and what is the neurogenic stutter’s speech characterized by?

Stroke, traumatic brain injury (TBI), or other brain injuries or disorders can cause Neurogenic Stuttering. Those suffering head injury have been documented to stutter following the insult. The damaged CNS structures from the insult disrupt speech timing and interfere with the thought process needed to speak clearly and fluently. Studies have shown physical evidence of CNS and/or muscle dysfunction in these individuals. The brain has difficulty coordinating the different regions involved in speaking which leads to dysfluent speech. The Neurogenic stutterer’s speech is characterized by a slow rate, pausing, and/or repetition.

What are some ways that an SLP can help people who stutter, and what is the first step in developing a therapy plan for people who stutter?

While there is no cure for stuttering there are options that may help people who stutter. The SLP will devise an individualized plan to reduce the frequency and severity of the stutter, manage the anxiety associated with speaking, and develop coping and support mechanisms. The first step is to conduct a comprehensive evaluation to identify the specific characteristics of the person’s stutter, including the types of dysfluencies, situations that trigger stuttering, and its emotional impact. That information is used to develop the therapy plan.

What are some stuttering therapy techniques?

1. Teach the stutterer to “slow their rate of speech.” Over time, they can work up to a more natural speech pattern.

2. Use “breathing managing techniques” to improve speech breathing so they have enough breath to speak slowly and more clearly.

3. Use “desensitization techniques” to reduce their fear and anxiety related to speaking by exposing them to situations that trigger their stuttering.

4. Use “stuttering modification techniques” to help the stutterer modify their stutters by managing their physical tension.

5. You might try “cognitive behavioral therapy” to address the negative thoughts and beliefs associated with stuttering to reduce anxiety and build confidence in speaking situations.

6. Provide access to support groups. Stuttering support groups offer information that gives the stutterer the chance to gain new perspectives on fluency, to learn and share stresses associated with their stutter with other’s who stutter, and to increase confidence when speaking.

What are some key points for stuttering therapy?

1. Individualized Approach: Every person who stutters has unique needs, so treatment plans are tailored to the individual.

2. Early Intervention: Early intervention with an SLP can be particularly beneficial for children who stutter.

3. Long-Term Management: Stuttering therapy is often an ongoing process to maintain fluency gains and address challenges as they arise.