Speech Disorders Exam #1

Unstressed/Weak Syllable Reduction

"cation" for vacation

Final consonant deletion

"ca" for cat

Reduplication

"baba" for bottle

Cluster Reduction

"nake" for snake

Velar fronting

"dut" for duckk

Palatal fronting

"su" for shoe

Gliding/liquid simplification

"yight" for light

Stopping

"pan" for "fan"

Assimilation/consonant harmony

"goggie" for doggie

Backing

"gok" for dot

Deaffrication

"dump" for jump

Devoicing

"let" for led

Vowelization/vocalization

"apo" for apple

Epenthesis

"bulack" for black

Metathesis

"hotsel" for "hostel"

Phonological processing

The way children simplify adult speech in a predictable, rule-bound way

Articulation impairment definition

disorders of production in sounds and sound sequences - motor difficulty (typically distortions and substitutions)

Phonological Impairments definition

disorders of conceptualization or language rules - inadequate mental representation of the language sound system

Articulation disorders organic

cleft palate, apraxias, dysarthias, etc.

Articulation disorders functional

No known cause, eg. substituation "wabbit" for "rabbit" with no physical reason

Articulation disorder examples

interdental lisp, lateral lisp, derhotacized r

phonological disorders examples

substitution, cluster reduction, etc.

Speech DELAY

children with speech production patterns that are typical for children who are younger

Speech DISORDER

children with speech production patterns that are not typical of normally developing children

Phonetic level (speech sound disorder)

Articulation!! "form" of speech, trouble making specific speech sounds

phonological levels (speech sound disorder)

Phonology!! "rules" of speech, trouble organizing sound patterns in the brain

2 years

Sound acquisition: /p, b, m, n, d, t, h/

3 years

Sound acquisition: /k, g, w, ng, f, y/ all vowels

4 years

Sound acquisition /l, dje, ch, s, v, sh, z/

5 years

Sound acquisition: /r, voiced th, eh/

6 years

Sound acquisition: /voiceless th/, consonant blends

Speech Intelligibility

Clarity of speech understood by listeners

Phonological processes that should be dropped by 3yo

Reduplication, assimilation, final consonant deletion, weak syllable deletion, metathesis

Phonological processes that are dropped after 3yo (should be by 4/5yo)

cluster reduction, fronting, stopping, voicing/devoicing, gliding, epenthesis

Substitutions

Replace one sound with another: eg. "wed" for "red"

Ommisions

Leave a sound of syllable out: eg. "leep" for "sleep"

Distortions

Alter a sound (or it is unlcear): eg. producing /s/ with a whistle

Additions

Add an extra sound of syllable: eg. "bulue" for "blue"

Screening purpose

quickly identify if someone needs a true assessment (pass/fail)

False positive

Unnecessarily says a child has a disorder, child could have been tired, shy uncooperative, or there could've been another environmental factore

False negative

Incorrectly says a child is fine, test could have not covered the correct area, etc.

Common testing procedures (in order)

Case history, oral mech, hearing screening, speech sound assessment in single words and connected speech, perception testing, stimulibility, intelligibility, literacy testing, diagnosis

Oral mech

examine structure and function of the structures for speech

Hearing screening (what an SLP can do)

pure tone screening, tympanometry, otoscopic exam

Speech sound assesment

standardized tests - usually picture naming, more than one target sound per item, connected speech sample elicitation

Perception testing

child selects a picture in response to a spoken word, important to identify CAPD

Stimulability testing

how easily can a child modify their production of a phoneme, so that it is either accurate or closer to the target?

Intelligibility testing

measures consonant or phoneme, syllable, word, sentence levels

Diagnosis

Does a disorder exist? - below the 10th percentile, more than 1.5 SD below the mean, >6mo below the phonological acquisition norms?, intelligibility

Spontaneous speech samples

games, conversation, unstructured

Elicited speech samples

probes, lists, structured

Advantages to standardized test

formal test that you can compare across clients, normative data that you can compare to typical development, efficient

Disadvantages to standardized tests

expensive, single words out of context, consistency across examiners can be poor, normative sample not representative, typically doesn't test vowels, may only indicate more in-depth assessment

Phonetic placement

facilitate correct production via direct instruction - visual aids, instruct client in correct (placement, manner, voicing)

Moto-kinestetic

clinician places hands on child's articulators to direct movements

Sound approximation

Clinician evokes sounds that approximate the target, modifies other sounds to make target - 1) begin w/sound child can make, 2) provide small steps toward target, move

from what child can do toward what they previously could not do

Perceptual training

help child acquire stable perceptual representation for target phoneme/phonological structure

Cycles Approach

For kids with several PHONOLOGICAL processes (highly unintelligible speech), cycles through phonological patterns for a fixed time regardless of mastery

Traditional approach

Mild articulation errors (a few or specific distorted or missing sounds), follows a strict step-by-step process: isolation --> syllables --> words --> phrases --> sentences --> conversation

Minimal Pair approach

Mild/moderate phonological errors, use words that only differ by one phoneme or feature to highlight how mispronouncing a sound changes the meaning of a word (key v.s. tea, sore v.s. shore, pot v.s. spot)

Multiple phonemic approach

Multiple articulation errors, targets all errored sounds simultaneously in every session (establishment, transfer, maintenance)

Maximal oppositions approach

Uses pairs of words with a contrastive sound that is maximally distinct (mall v.s. call)

PPC equation (intelligibility)

(total number of correct phonemes produced/total number of phonemes produced) x 100

Mild intelligibility

>90%

Mild-moderate intelligibility

65-85%

Moderate-severe unintelligibility

50-60%

Severe unintelligibility