SHS Exam 3 Lecture Cards

Articulation

the motor skills involved in producing sounds in order

Phonology

The rules and patterns of the sound systems of language

Articulatory Disorders

Difficulty with the physical production (placement of tongue, teeth, lips) of sounds

Struggle to produce phonemes

- Omission

- Substitution

Phonological Disorders

Difficulty with the brain's organization of sounds and the rules of speech

Predictable, rule-based error

Cluster reduction ("try" changed to "tie")

•Weak syllable deletion ("banana changed to"nana")

•Final consonant deletion ("dog" changed to"dah")

Causes of articulatory disorders

physical, neurological or developmental factors like hearing loss or stroke

Causes of phonological disorders

Genetic predisposition, developmental delays or neurological issues

Treating articulation disorders

Repeated focus on correct placement of lips, teeth and tongue gradually increasing length

- Articulation test: Goldman Fristoe Test of Articulation

Treating phonological disorders

Targets specific patterns to improve by improving auditory discrimination and phonological awareness

Phoneme

smallest unit of language that conveys meaning that is sequenced together to form words

Delay

Children with speech production patterns typical for a younger child

Disorder

Children whose speech is not like any normal child at any age

Functional speech disorders

- No known cause

- Include articulation and phonology

How is severity determined

Similar to intelligibility

- Number of sounds produced correctly

- Accuracy of production

- Ability to produce various sound sequences and types of words

Mild: few sounds in error, generally intelligible

Moderate: difficulty producing all sounds within a class, intelligible only to friends and family

Severe: unintelligible to most listeners, relies heavily on gestures, don't sequence sounds consistently

Assessment

Goal is to determine nature and severity of disorder/delay

- Speech samples: transcribe what the child says during conversation with others

- Hearing screening

- Oral-peripheral examination

Childhood language Disorder

Cognitive or linguistic difficulty that impairs language learning

Patterns of language impairment

Form: the structure of language

- Syntax, morphology, phonology,

Content: the meaning of language

- Semantics

Use: the social aspects of language

- Pragmatics

Impairments in language Form

•Infants/Toddlers (0 - 2)

•Low frequency of vocalization

•Lack of syllable productions in babbling

•Preschoolers (2 - 5)

•Immature or disordered phonology

•Grammatical morphology errors

•School-age children (5 - 18)

•Difficulties with complex sentences

•Poor narratives and expository texts

Impairments of Language Content

•Infants/Toddlers

•Understands few words in context

•Less than 50 words by age 2

•Preschoolers

•Restricted vocabulary size

•Reduced comprehension of basic concepts

•School-age

•Incoherent stories

•Difficulties with figurative language

Impairments of Language Use

- Infants/Toddlers- Lack of intentionality, restricted range of communicative functions

- Preschoolers- limited assertiveness and/or responsiveness, difficulty initiating and maintaining topics

Assessment of Language Disorders

Team approach, standardized testing, language samples, unbiased assessment

Intervention of Language Disorders

Clinician-centered approach

- Behavioral principles (stimulus, response, reward)

- Structured activities

Child-centered approaches

- Language facilitation through play

- Modeling, self-talk, parallel-talk

Hybrid approach

Language Stimulation

-Expansion: repeat the child's utterance and complete it

-Extension: add information to what has been said

-Recast: say the same meaning in a different form (statement becomes a question)

-Build-ups and breakdowns: expansion plus breaks utterance into component parts

Causes of Brain Damage

CVA aka stroke (embolus, thrombosis, hemorrhages), traumatic brain injury, growths (neoplasms), progressive deterioration (dementia)

CVA (cerebrovascular accident/stroke)

Loss of blood flow to the brain which leads to loss of brain function

- Hemorrhage (hemorrhagic stroke)

- Blockage (ischemic stroke)

- Transient ischemic attack (TIA)

Aphasia

Acquired language disorder caused by brain damage usually to the left hemisphere

- Causes naming problems, fluency problems, auditory comprehension problems, repetition, agrammatism

Types of Aphasia

Fluent vs nonfluent

Normal comprehension vs impaired

Normal repetition vs impaired

Assessment of Aphasia

Immediately following brain injury

Formal diagnostic testing

Functional communication assessment

Intervention of Aphasia

Restorative approaches

- Constraint-Induced Language Therapy: inhibits use of intact language skills and encourages use of impaired skills

Compensatory approaches

- PACE: facilitates use of multiple modalities

Group Intervention: practice and observation

More research intervention needed for bilingual speakers

Agrammatism

One of the usual symptoms of Broca's aphasia; a difficulty in comprehending or properly employing grammatical devices, such as verb endings and word order.

Circumlocution

an indirect way of expressing something

Contusions

closed-head injuries that involve damage to the cerebral circulatory system

Diffuse axonal injury

damage to nerve cells in the connecting fibers of the brain

Embolus

moving blood clot

Thrombosis

formation of a stationary blood clot

Jargon aphasia

fluent unintelligible words typical of Wernicke's aphasia

Literal paraphasia

(phonemic paraphasia) phonemes in the intended word are out of order

Verbal paraphasia

speech error with unintended substitution of one word for another, usually from the same category

AAC (Augmentative and Alternative Communication)

Area of clinical practice that aims to support

communication for people who require

adaptive support and assistance

• Augmentative: Supplementing communication

• Alternative: Replacement of natural speech and/or

writing

Aided vs Unaided symbols in AAC

Aided systems require external physical materials or technology (ex picture books)

Unaided systems rely solely on the user's body (ex ASL)

Who needs/benefits from AAC

Individuals with developmental or acquired neurological conditions that leads to severe communication impairment

ACC Technology Levels

High tech: speech generating devices and software programs

Low tech: buttons that speak words

No tech: symbol book

AAC Assessment

Motor: Methods that allows accurate and easy message selection

Cognitive: Awareness, world knowledge, memory

Language and Literacy: Receptive and expressive vocabulary

Symbol: Functional use of symbols, ability to point at and match symbols to objects

Sensory and Perceptual: Hearing and vision

AAC Intervention

Goal: Assist individuals in meeting communication needs and goals

Taxonomic grid display

a method of organizing vocabulary or symbols in ACC by grouping them based on categories like people, places, feelings etc.

Auditory selection set

an AAC strategy where words are presented verbally for a person to choose from by listening instead of using their vision