Speech and Language Disorders: Pediatric SSD, Language Disorders, ASD, Cleft Lip/Palate, and Fluency

Comprehensive practice flashcards covering consonant and vowel classifications, speech and language development milestones, speech sound disorders, childhood language disorders, Autism Spectrum Disorder, cleft lip and palate, and fluency disorders.

What is the definition of a phoneme?

A phoneme is the smallest unit of sound in a language that conveys meaning, encompassing the consonant and vowel sounds that make up a language.

How many total symbols are in the International Phonetic Alphabet (IPA), and how are they divided between vowels and consonants?

There are $42$ IPA symbols in total, consisting of $18$ vowels and $24$ consonants.

What are the three dimensions along which consonant sounds are classified?

Consonants are classified along Place (where constriction occurs), Manner (how air is modified through the vocal tract), and Voicing (whether vocal folds vibrate).

What are cognates in speech sound classification?

Speech sounds that share the exact same manner and place of articulation, but differ along the voicing dimension (for example, $d + t$, and $f + v$).

Which three dimensions determine vowel differentiations?

Tongue elevation (height), tongue advancement, and lip position (rounded or unrounded).

Which vowel sounds are categorized as having HIGH tongue elevation?

The vowels categorized as high elevation are $i$, $ɪ$, $u$, and $ʊ$.

What speech sound milestones are expected of a typically developing child by $2\text{ years}$ of age?

Most vowels clearly produced, $9\text{--}10$ word-initial consonants present, clusters emerging, at least $70\%$ correct consonant articulation, and at least $50\%$ intelligibility to unfamiliar listeners.

What speech intelligibility and accuracy milestones are reached by $5\text{ years}$ of age?

Speech is $98\%+$ intelligible, the phonetic inventory is complete, greater than $90\%$ of consonants, clusters, and vowels are produced accurately, and all word shapes can be produced.

How does a phonemic (rule-based) impairment differ from a phonetic (motor-based) impairment?

A phonemic impairment involves rule-based patterns and a collapse of phonemic contrasts that alter meaning, whereas a phonetic impairment involves an inability or motor difficulty articulating specific sounds, resulting in distortions without changing the intended phoneme.

What are the four categories of speech sound error patterns?

Substitution errors, omission errors, distortion errors, and addition errors.

How does progression between levels differ between the Traditional Approach (vertical) and the Cycles Approach (horizontal)?

In the Traditional Approach, a child advances to the next level based on performance ($80\text{--}90\%$ accuracy), whereas in the Cycles Approach, progression from one cycle to the next occurs after a designated period of time.

Under the Cycles Approach, what percentage threshold determines whether a phonological pattern is monitored or treated?

Patterns occurring at less than or equal to $40\%$ are monitored, whereas patterns occurring at greater than $40\%$ are grouped into target patterns and treated.

What are the three overarching components of language and their specific subcomponents?

Form (morphology, syntax, and phonology), Content (semantics), and Use (pragmatics).

How is Mean Length of Utterance (MLU) calculated from a language sample?

$\text{MLU} = \frac{\text{Total number of morphemes}}{\text{Total number of utterances}}$, typically evaluated across $100$ consecutive spontaneous utterances.

What characterizes the pre-intentional stage of communication, and what is its age range?

Spanning birth to $8\text{ months}$, the infant anticipates no outcome of their behavior, producing reflexive and vegetative sounds, while adults treat these behaviors as meaningful communication.

What is jargon in child speech development?

Speech-like sentences emerging around $10\text{--}12\text{ months}$ that contain a variety of vowels and consonants with the inflection and prosody of the native language without conveying explicit lexical meaning.

What grammatical milestones are typically observed in children by $3\text{ years}$ of age?

Use of subject-verb-object (SVO) sentence structure, negative and interrogative sentences, use of basic grammatical morphemes, and occasional overgeneralization of grammatical rules (e.g., 'goed').

What three core criteria must be met to diagnose a language disorder according to DSM-5 standards?

The child must present with: (1) language problems/difficulties, (2) functional impacts on daily life, and (3) difficulties that are likely to persist.

How is a language disorder distinguished from a language difference?

A language disorder occurs when language skills fall below environmental and norm-referenced expectations, whereas a language difference is a rule-governed style that deviates from mainstream norms (such as natural reduced second-language competence in an immigrant).

What is the distinction between Developmental Language Disorder (DLD) and Language Disorder Associated with a Biomedical Condition (LDx)?

DLD is used for children with persistent language difficulties and no known causal condition, whereas LDx is used when the language disorder occurs alongside a diagnosed biomedical condition (such as Down syndrome, ASD, or brain injury).

What did the Ottawa study (Johnson et al., 1999) reveal about the long-term prognosis of speech versus language impairments?

It revealed high rates of stability over time, with better long-term outcomes for initial speech impairments than language impairments, and more favorable prognoses for specific language impairments than those secondary to other deficits.

What percentage of late-talking toddlers are 'late bloomers' who catch up to normal language development?

Approximately $75\%$ of late talkers are late bloomers who will catch up and develop normal language skills.

How does the Nativist theory contrast with the Behaviourist theory regarding the cause of atypical language in children?

The Nativist theory posits that atypical language stems from a biological defect in the innate language-learning mechanism (language acquisition device), whereas the Behaviourist theory posits a lack of reinforcement opportunities and stimulus-response connections.

What are the four service delivery approaches utilized in child language intervention?

Environmental modification, compensation, prevention and promotion, and remediation.

What is the recorded prevalence of autism in Canadian children aged $5\text{--}17\text{ years}$?

The prevalence is $1\text{ in }66$ children.

What are the three DSM-5 support levels defined for Autism Spectrum Disorder?

Level $1$: requiring support; Level $2$: requires substantial support; Level $3$: requires very substantial support.

Can Speech-Language Pathologists independently diagnose autism spectrum disorder?

No; SLPs cannot diagnose autism, but they can assess and support language and social communication development, identify red flags, and make referrals.

In verbal individuals with ASD, which component of language is typically a strength, and which is typically a persistent difficulty?

Language Form (phonology, morphology, syntax) is typically a strength, whereas Language Use (pragmatics) is typically a persistent difficulty.

What is the difference between immediate and delayed echolalia?

Immediate echolalia involves repeating a spoken phrase immediately after hearing it, whereas delayed echolalia involves repeating words or phrases after a time delay; both frequently serve communicative functions.

How does the Medical Model contrast with the Neurodiversity Paradigm regarding autism?

The Medical Model views autism as an internal deficit or disease to be cured or reduced, whereas the Neurodiversity Paradigm views autism as natural human biodiversity, seeing disability as a poor person-environment fit with the goal of supporting authentic living.

What is the incidence of cleft lip and palate in live births, and what proportion of cases involve both cleft lip and palate?

It occurs in $1/750$ live births, with combined cleft lip and palate accounting for $50\%$ of cases (isolated cleft lip is $25\%$ and isolated cleft palate is $25\%$).

What sex-based differences exist in the presentation of cleft lip and palate?

Males more commonly have cleft of the lip with or without cleft palate, whereas females have a higher incidence of isolated cleft palate.

What are two distinct anatomical signs indicative of a submucous cleft palate?

A bifid uvula and a notch in the posterior border of the hard palate.

At what gestational weeks do the lip and soft palate fuse during embryological development?

The lips fuse at approximately week $6$ (facial formation at $5\text{--}8\text{ weeks}$), and the soft palate fuses at week $12$ (palatal fusion at $8\text{--}12\text{ weeks}$).

What resonance impairment frequently results from an unrepaired or insufficient cleft palate, and what causes it?

Hypernasal speech (hypernasality), caused by velopharyngeal insufficiency (VPI) preventing the closure between the oral and nasal cavities during speech.

What is the standard surgical timeline for cleft lip repair versus cleft palate repair?

The cleft lip is typically repaired at $3\text{ months}$ (to support feeding), and the cleft palate is repaired at $9\text{--}15\text{ months}$ or $1\text{ year}$ (to support speech).

What percentage of children who develop stuttering recover spontaneously without formal treatment?

Approximately $75\%$ of children who stutter recover without any formal intervention.

What are the three primary overt speech disfluencies characteristic of stuttering?

Repetitions (of sounds, syllables, and single-syllable words), prolongations of consonants, and blocks (inaudible or silent fixations/tense pauses).

How does neurogenic stuttering differ from developmental stuttering in its onset and circumstances?

Neurogenic stuttering begins past early childhood following an identifiable neurological episode or trauma, whereas developmental stuttering has an onset between $2\text{--}5\text{ years}$ without a neurological episode and commonly features a genetic family history.

How do cluttering and stuttering differ in terms of speaking rate, awareness, and expressive language organization?

Cluttering presents with an irregular rate of $300+\text{ syllables/minute}$, a lack of speaker awareness/anxiety, and disorganized expressive language, whereas stuttering features a regular rate around $240\text{ syllables/minute}$, high speaker awareness/anxiety, and organized language.