COMD 242 Exam 3

Speech sound disorders

• one of the most prevalent types of communication impairment among children

• evidence multiple errors in the articulation of specific sounds and sound patterns

• often unintelligible because they produce a number of sounds in error

• a speech sound disorder becomes evident during the developmental period for speech sound acquisition, from birth through 9 years of age

SSD definition

An impairment of an individual’s sound system that results in a significant problem with speech sound production, causing it to differ from age‐ and culturally based expectations. The onset of the disorder occurs prior to 9 years of age, and its cause may be known or unknown.  An SSD arises from an articulation impairment or phonological impairment.

Articulation impairment

• the inability to articulate particular speech sounds correctly

• it often includes distortions or other sound substitution errors that do not result in a phonemic or meaning difference

Phonological impairment

• involves the rules that govern sound patterns in a given language

• a person’s sound system may not permit the production of word-final consonants, particularly obstruents, which are consonants produced with obstruction in the vocal tract and include stops, fricatives, and affricates, resulting in homonymy, two words sounding the same but having two different meaning

Speech difference

refers to the differences in speech that arise from a dialect or foreign accent; speech variation is considered a normal aspect of language and is not considered a speech sound disorder

Coarticulation

refers to the way sounds overlap during articulation, causing articulatory characteristics of phonemes to vary according to context

Assimilation

refers to the way the features of one sound take on the feature of neighboring sounds

Dialect impairment

• a speech and language variation that is characteristic of a group of speakers from a particular region within a country

• African American English

Delay

children have difficulty developing and using sounds of their native language

Difference

they arise from a dialect or foreign accent; speech variation is considered a normal aspect of language and is not considered a speech sound disorder

Speech variation

• refers to differences in speech that arise from a dialect or foreign accent

• considered a normal aspect of language and not considered a speech sound disorder

Dialect

speech and language variation that is characteristic of a group of speakers from a particular region within a country

Foreign accent or language-influenced speech

speech in which characteristics are carried over from one language to another

Allophone

two variation of one phoneme

Phonemes

• to be considered a phoneme, a speech sound must be able to signal a contrast in meaning between two words of a language

• standard english uses about 40 phonemes to create thousands of words

• the IPA represents each phoneme used in the world’s languages, both vowels and consonants, as a specific symbol

Voice place manner

voiced vs voiceless are the vocal folds vibrating in the production of this phoneme

Place

• where in the vocal tract a sound is produced

• bilabial

• labiodental

• linguadental (interdental)

• alveolar

• palatal

• velar

• glottal

Manner

• stops

• fricatives

• affricates

• nasals

• liquids

• glides

Tongue height

the vertical dimension of the tongue movement: how high is the tongue when a vowel is produced? vowels are classified as high, mid, or low

Tongue advancement

the horizontal dimension of tongue movement: how far forward is the tongue when a vowel is produced? vowels are classified ad front, central, or back

Roundness

are the lips rounded when a vowel is produced? vowels are classified as rounded, neutral on lip-rounding, or unrounded

Tension

are the articulators tense or lax when the vowel is produced? tension distinguishes among vowels that are produced with the same tongue height and advancement. for example, [i, I] are both high, unrounded vowels; they are distinguished by tension in the [i] is lax All stressed vowels, such as [ʌ, ɝ], are tense vowels, whereas unstressed vowels [ə, ɚ] are lax.

Rounded vowels

all vowels characterized as back on the dimension of tongue advancement are rounded [u, ʊ, o, ɔ, ɑ].

Vowels neutral on lip-rounding

central vowels are neutral in terms of lip-rounding [ʌ, ə, ɚ, ɝ].

Unrounded vowels

all front vowels are unrounded  [i, I e, ɛ, æ].

SSD unknown

• termed functional (speech sound) disorder

• include articulatory and/or phonological difficulties

SSD known

includes structural deficit, sensory impairment, or neurological impairments that results in a motor speech disorder (apraxia, dysarthria)

Referral

• typically made by a parent, a pediatrician, or an early childhood educator

• for children under 2, risk factors of a possible speech delay may include the following

• suspected hearing loss or chronic ear infection

• known physical impairment, particularly of the oral-facial structures

• known mental or cognitive impairment

Screening

• a careful examination of the structures and functioning of the speech mechanism

• relatively short assessment of a child’s speech

• the initial screening may be an informal observation of the child talking with the clincian, parent, sibling, peer, or a formal screening test

• screening is short, about 5-10 minutes

• informal screening task might include asking “what is your favorite toy/game/movie?”

Case history

an interview with a child’s parents or primary caregivers will provide information useful for developing a broad understanding of the child’s speech, social, communicative, health, and education history

Oral mech

• carefully examine the structures and functioning of the speech mechanism

• appearance of the articulators, including the lips, teeth, tongue, hard palate, and soft palate for any deviations that may hinder speech production

Relational analysis

• describes the child’s sound errors in relation to the adult standard in a one-to-one comparison of child:adult production

• are typically best suited for use with children who have mild to moderate speech disorders because their sound system are more intact and they tend to make fewer unusual or idiosyncratic errors

Independent analysis

describes the sounds and syllable structures a child produces regardless of accuracy relative to the adult target. an independent analysis includes a description of the child’s phonetic inventory and phonotactic patterns

Diagnostic speech assessment is designed to achieve

• characterize a child’s general developmental background, including family characteristics

• characterize the status of auditory and oral structures and functions

• characterize current phonological and language performance

• characterize the nature and severity of the SSD

• determine the prognosis for phonological outcomes

• determine the course of information

Fluency disorder

a descriptive term used to characterize the flow of speech during communication

Disfluency

the speech behavior that disrupts the fluent forward of speech, such as pauses, interjections, and revisions

Characteristics of a fluency disorder

• disturbance in the normal fluency and timing patterns

• disturbance in social communication, academic performance, or occupational achievement as a result of the fluency disturbances

• primary: repetition, prolongation. & block

• secondary: results from a individual’s excessive mental and physical efforts to promote fluent speech and disrupt disfluency speech

Assisted recovery

occurring in conjunction with treatment

Spontaneous, unassisted, & self-managed recovery

• recovery that occurs without treatment

• given that many cases of stuttering do resolve, it seems reasonable to ask whether treatment should be given to a child who stutters, given that the likelihood of recovery is quite high

Stuttering-like disfluencies

• part-word repetitions

• single-syllable-word repetitions

• sound prolongations

• blocks

• broken words

Cluttering

• rapid or unusual rate of speech that results in disfluencies; frequent and unusual pauses, and blending of sounds in words

• rapid speech

• interjections

• phrase repetition

• incomplete word production

Core features

• part word repetitions (5/100 syllables vs 0.5/100)

• single syllable word repetition (3+/100 vs 1/100)

• sound prolongation

• block (observed in intermediate and advanced stuttering)

Predisposing factors

• “constitutional factors”

• makes a child more susceptible than other children to developing a fluency disorder

• family history

• gender

• differences in brain morphology and natural physiology

• motor-speech coordination

Developmental disorder

• stutter emerges in early childhood between ages 2 and 5

• typically only stutter for several months, or they may stutter for several years

• the longer the stuttering problems persists, the less likely it will resolve itself

Intermediate level

• children who have stutters for one or two years are considered to be at the intermediate level of stuttering

• blocks can be accompanied by physical tension, including tremors of the jaw or the neck- core feature of intermediate and advanced stuttering

Advanced level

• fluency disorders of adolescents and adults

• the core and secondary behaviors much like school-age children

• secondary behaviors are used more to avoid or escape the appearrance of prolongations or blocks

Gender

• boys are more likely to develop a fluency disorder than girls

• children: 3 boys to 1 girl

• adolescents and adults: 7 boys to 1 girl affected

• 77% if boys who stutter will recover and 87% of girls

Acquired fluency disorder

can result from various types of trauma, illness, or injury that affects the brain

Feeling and attitudes

those who stutter may feel fear, frustration, and embarrassment, both within and beyond direct communicative activities

Voice disorder

the complex dynamic production of vocal fold vibration that allows us to vocalize and verbalize

Adduction

the state in which the vocal folds are closed

Abduction

the state in which the vocal folds are open (at rest)

Resonance

actual vibration of the air within the pharyngeal column at which affects the quality of voice

Frequency

rate of vocal fold vibration, expressed as cycles per second or hertz

Pitch

psychological or perceptual equivalent of frequency

Intensity

physical measurement of sound pressure, reported id decibels

Loudness

perceptual correlate of intensity

Phonatory quality

how well the two vocal folds work during vibratory cycle

Dysphonia

the umbrella term used to refer to a voice that is disordered in some way

Aphonia

refers to the total loss or lack of voice

Other terms

breathy, hoarse, rough, jitter, diplophonic, pressed, ringing, flutter, creak

Hypofunction

describes vocal folds that are underfunctioning and have inadequate tension

hyperfunction

when vocal folds are overly tense and compress together too tighly

Dilphonia

means double pitch and describes a vocal quality in which the vocal folds produce two different pitches simultaneously