Speech Sound Disorders and Orofacial Myofunctional Disorders Review

Comprehensive review vocabulary flashcards covering assessment, intervention principles, phonetic classification, and OMDs across five lecture sets.

Orofacial Myofunctional Disorders (OMDs)

Difficulties with speech sound perception, production, or physical habits involving the muscles of the mouth and face.

Certified Orofacial Myologist

A credentialed specialist on the multidisciplinary OMD assessment team who evaluates and treats myofunctional disorders.

Multidisciplinary OMD Team

A collaborative group assessing OMDs that includes an allergist, certified orofacial myologist, dentist, oral surgeon, orthodontist, otolaryngologist, physician, plastic surgeon, physical therapist, sleep apnea specialist, and speech-language pathologist.

Comprehensive OMD Assessment

A four-part evaluation consisting of a case history, comprehensive oral mechanism examination, swallowing evaluation, and speech sound evaluation.

OMD Case History

Gathering client background information including birth/developmental history, oral habits, prior intervention, respiratory habits, medical history (allergies, snoring, ear infections), dental/orthodontic history, feeding history, and speech/language history.

Typical Oral Resting Posture

A resting posture where lips are closed, breathing is nasal, teeth are slightly apart, and the tongue rests on the palate.

Tongue Thrust Resting Posture

An abnormal resting posture characterized by a forward posture of the tongue or tongue tip protruding through anterior teeth, often accompanied by lip incompetence or open bite.

Lip Incompetence

The inability to maintain a closed lip posture at rest without conscious effort.

Open Bite

A malocclusion where the anterior upper and lower teeth do not make contact when the mouth is closed.

OMD Swallowing Assessment

Observation of tongue and lip movements during a dry swallow (saliva), liquid sip, and snack to assess oral prep and oral phases of swallowing.

Anterior Bolus Loss

The unintentional escape of food or liquid from the front of the mouth during feeding or swallowing.

OMD Speech Sound Assessment

Evaluation of speech production focusing on lingual placement for $/t/$, $/d/$, $/n/$, and $/l/$, jaw deviations, bilabial strength, resonance changes, and articulation errors on sibilants.

Hanson & Mason (2003) Purpose

The goal of OMD treatment to create an oral environment in which normal processes of orofacial and dental growth/development can take place and be maintained.

Nasal Airway Establishment

The primary step in OMD therapy requiring resolution of airway interferences before a consistent closed-mouth posture can be established.

Adenotonsillectomy

Surgical removal of the adenoids and tonsils, often performed by an otolaryngologist to clear airway interferences in OMD clients.

Rapid Maxillary Expansion

An orthodontic procedure used to widen the upper jaw to help establish a proper nasal airway and palatal arch.

Nonnutritive Sucking

Sucking behaviors such as thumb sucking or pacifier use not associated with feeding, which increase the risk of malocclusion if prolonged.

AAPD Nonnutritive Sucking Recommendation

Guidelines from the American Academy of Pediatric Dentistry advising that nonnutritive sucking habits should stop by age 3.

Oral Resting Posture Remediation

Therapy aimed at creating, recapturing, or stabilizing a lips-together posture with the tongue placed on the alveolar ridge.

Pierce (2002)

Author of "Swallow Right: An exercise program to correct resting posture and swallowing patterns," a clinical resource for OMD therapy.

Appraisal

The first phase of speech assessment involving the collection of data from sources such as case histories, records, interviews, observations, and tests.

Diagnosis

The second phase of speech assessment where collected appraisal data is analyzed to identify and characterize a disorder.

Speech Sound Screening

A quick pass/fail procedure using limited speech sound sampling to identify individuals who warrant comprehensive testing.

Informal Screening

An examiner-designed screening tool lacking normative data or standardized scoring, often tailored to specific age groups using picture descriptions or word lists.

Formal Screening

A standardized screening tool with structured elicitation procedures, normative data, and cutoff scores.

Fluharty Preschool Speech and Language Screening Test – 2

A formal screening test for children ages 3–6 that uses 15 pictures to elicit 30 target sounds, yielding standard scores and percentiles.

Comprehensive Evaluation

A detailed assessment core including single-word sampling, conversational speech, hearing testing, an oral mechanism exam, and additional measures.

Single-Word Sampling

Elicitation of individual target words using pictures, commonly conducted as part of a standardized articulation or phonology test.

Goldman-Fristoe Test of Articulation – 3 (GFTA-3)

A standardized articulation test for ages 2:0 to 21:11 taking 5–15 minutes, providing standard scores and percentile ranks.

Arizona Articulation and Phonology Scale – 4

A standardized test for ages 1:6 to 21:11 taking 5–20 minutes that assesses articulation and includes phonological analysis.

Clinical Assessment of Articulation and Phonology – 2 (CAAP-2)

A standardized test for ages 2:6 to 11:11 taking 15–20 minutes, providing standard scores and an optional phonological process analysis.

Assessment Link between Phonology and Articulation-Revised

A standardized phonological test by Lowe (1996) for ages 3 to 8;11 evaluating initial and final word positions.

Bankson Bernthal Test of Phonology

A standardized phonological test by Bankson & Bernthal (1990) for ages 3 to 6 assessing initial and final word positions.

Diagnostic Evaluation of Articulation and Phonology (DEAP)

A standardized test by Dodd et al. (2006) for ages 3 to 8;11 containing subtests for sounds in words, phonological processes, and connected speech.

HAPP-3

The Hodson Assessment of Phonological Patterns (3rd ed., 2004) for preschool children, assessing phonological patterns and linking directly to the cycles approach.

Khan-Lewis Phonological Analysis (KLPA-2)

A phonological analysis for ages 2 to 21;11 that uses target words from the GFTA to analyze ten developmental phonological processes.

Conversational Speech Sampling

Collecting speech in connected, natural context to evaluate overall intelligibility, severity, and functional articulation accuracy.

Hearing Screening Threshold

Standard audiological screening protocol passing pure tones at $20\,\text{dB}$ HL for frequencies $500\,\text{Hz}$, $1000\,\text{Hz}$, $2000\,\text{Hz}$, and $4000\,\text{Hz}$.

Oral Mechanism Examination

An evaluation of the structure and function of the oral/facial speech mechanism, assessing symmetry, range of motion, strength, and coordination.

Diadochokinetic (DDK) Rates

Quantitative measurements assessing the speed, smooth movement, range of motion, and coordination of rapid alternating speech movements.

Sequential Motion Rates (SMRs)

A component of DDK testing evaluating rapid repetition of varied syllable sequences such as $/p\wedge t\wedge k\wedge/$ (10 times).

Alternating Motion Rates (AMRs)

A component of DDK testing evaluating rapid repetition of a single syllable such as $/p\wedge/$ (20 times).

Perception Tasks

Additional assessment measures testing a client's ability to auditorily discriminate between correct and incorrect speech productions for differential diagnosis.

Stimulability

Testing a client's ability to correctly produce a misarticulated sound when given direct models and cueing.

Intelligibility

A perceptual judgment made by a listener regarding how much of a speaker's conversational speech can be understood.

Coplan & Gleeson (1988) Norms

Intelligibility expectations to strangers: ~25% by age 1, ~50% by age 2, ~75% by age 3, and ~100% by age 4.

Gordon-Brennan & Hodson (2000) Criterion

Recommendation that children who are less than 66% intelligible to strangers by age 4 should receive intervention.

Open-Set Word Identification

A method for calculating intelligibility percentage by dividing the number of understood words by total spoken words multiplied by 100 in a speech sample.

Closed-Set Word Identification

Intelligibility assessment where a listener identifies words recorded by a client imitating a preset word list (e.g., Children's Speech Intelligibility Measure).

Intelligibility in Context Scale (ICS)

A free rating scale completed by parents/caregivers, translated into 60 languages, to rate a child's intelligibility across different communicative partners.

Percentage of Consonants Correct (PCC)

An objective metric calculated as total correct consonants divided by total intended consonants multiplied by 100 (Shriberg & Kwiatkowski, 1982).

PCC Severity Scale

Standardized severity categories: 85–100% (Mild), 65–85% (Mild/Moderate), 50–65% (Moderate/Severe), and <50% (Severe).

Place-Manner-Voicing (PMV) Analysis

A diagnostic procedure comparing phonetic features of target sounds with produced sounds to tabulate feature change occurrences.

Phonological Process Analysis

A diagnostic procedure identifying systematic pattern rules in error productions across syllable structures, substitutions, or assimilations.

Systematic Sound Preferences

An error pattern where a child uses one or two single sounds to replace an entire class or large group of phonemes.

Idiosyncratic Processes

Atypical phonological patterns that are not present in normal speech development at any age, such as backing or initial consonant deletion.

Eligibility Criteria

Organizational standards (such as 1.5 SDs below the mean in schools) used alongside academic impact and parent input to determine eligibility for speech services.

Long-Term Goal

An overarching intervention outcome describing the ultimate communicative performance a client is expected to achieve.

Short-Term Objective

Specific, measurable intermediate treatment goals designed to step toward achieving the long-term goal.

MUSTDO Criteria

A goal-writing framework used to ensure objectives are Measurable, Understandable, Special/Specific, Time-bound, Directional, and Observable.

Pull-Out Delivery Model

Service delivery where the clinician sees the client for speech therapy outside the classroom in a separate treatment room.

Inclusion (Push-In) Model

Service delivery where speech therapy is provided directly within the classroom setting during regular activities.

Drill

An intervention style where the clinician provides prompts for target responses repeatedly, followed immediately by corrective feedback.

Drill Play

An intervention style combining repetitive drill prompts with an antecedent motivating event, such as taking turns with a game spinner or dice.

Structured Play

An intervention style structurally similar to drill play, but designed completely as an embedded play activity.

Play

An intervention style where the child perceives the activity as pure play, but the clinician has structured targets into the play environment.

Shriberg & Kwiatkowski (1982b)

Researchers who defined four primary intervention styles: Drill, Drill Play, Structured Play, and Play.

Task Complexity Hierarchy

The progression of speech therapy target levels ranging from Isolation, Syllable, Word, Phrase, Sentence, to Conversation.

Isolation Level

The simplest task complexity level where a target speech sound is produced individually without neighboring sounds.

Syllable Level

The task complexity level where a target sound is paired with a vowel in consonant-vowel combinations.

Word Level

The task complexity level where a target sound is produced within single words in initial, medial, or final positions.

Phrase Level

The task complexity level where a target sound is produced within short two-to-three word phrases.

Sentence Level

The task complexity level where a target sound is embedded in complete structured sentences.

Conversational Level

The highest task complexity level where a target sound is produced accurately during spontaneous, unstructured speech.

Imitation

An implicit elicitation method where the clinician provides a direct model for the client to immediately repeat.

Phonetic Placement

An explicit elicitation method providing verbal, visual, or tactile instructions on how to position articulators to produce a target sound.

Successive Approximation

An elicitation method (shaping) where a client transforms a sound already in their repertoire into a new target sound.

Context Utilization

An elicitation approach identifying and leveraging phonetic environments (facilitating contexts) in which a target sound is produced correctly.

Facilitating Context

Specific phonetic environments, such as VCV contexts or specific consonant clusters, that make accurate sound production easier.

Verbal Cues

Spoken instructions or prompts provided by the clinician to help the client adjust their production.

Visual Cues

Nonverbal visual signals, mouth demonstrations, or gesture models provided to prompt correct placement.

Tactile Cues

Physical touch cues provided to the face or mouth to guide articulator positioning.

Gestural Cues

Hand gestures or body signals used by the clinician to prompt articulatory placement or sound qualities.

Knowledge of Performance

Feedback describing the specific motor or articulatory actions performed during the attempt (e.g., "Your tongue was up behind your teeth").

Knowledge of Results

Feedback informing the client strictly whether their target attempt was correct or incorrect (e.g., "That was correct").

Generalization

The transfer of learned speech skills to unlearned stimuli, people, settings, or conversational contexts without extra direct training (Stokes & Baer, 1977).

Hitchcock & McAllister Byun (2015) Challenge Benchmarks

Guidelines for practice accuracy:

Maintenance Phase

The final intervention stage where session frequency decreases while client self-monitoring increases before discharge.

Retention

The persistent and continued correct use of learned speech skills after therapy services have ended.

Discharge Readiness

The clinical determination that a client has met goals, demonstrated functional retention, and no longer needs skilled intervention.

Vowels

Speech sounds produced with a largely open vocal tract, capable of standing alone as meaningful utterances.

Consonants

Speech sounds produced through a specific point of constriction within the vocal tract, classified by place, manner, and voicing.

Prevocalic Consonant

A consonant that occurs before a vowel in a syllable (e.g., /s/ in "soap").

Postvocalic Consonant

A consonant that occurs after a vowel in a syllable (e.g., /p/ in "soap").

Intervocalic Consonant

A consonant occurring between two vowels in a word (e.g., /m/ in "camel").

Syllabic Consonant

A consonant that functions as the nucleus of a syllable in place of a vowel (e.g., /m/ in "prism").

Manner of Articulation

The type or degree of airflow constriction used in producing a consonant sound.

Place of Articulation

The anatomical location in the vocal tract where constriction or closure occurs.

Voicing

The presence or absence of vocal fold vibration during consonant production.

Stop

A consonant manner characterized by complete blockage of airflow followed by a sudden release.