PEL 232 - Students with Communication Disorders

Social Communication Skill Screenings include

Norm reference assessments, observations, interviews , competencies, and hearing screenings

If a screening of a child with ADHD yields speech language concerns

Refer to a pediatric slp and comorbid conditions (I.e., family problems, psycho social difficulties,

regarding otitis media

Routine hearing screenings, refer to ENT or audiologist due to impact of social and emotional development changes

The main reason for a newborn hearing screening is

Identify babies with hearing losses that need more assessment. Or those with medical conditions that have later onsets and create plans to continue to monitor hearing.

If a newborn fails a screening

Refer immediately to audiologist and ideally identify hearing loss by 3 month

Permanent childhood hearing loss is the target of

Screening programs

hearing screening for new borns don't take into account

Minimal hearing loss, or difference across hearing frequencies

Speech sound screenings include

SLP designed tailored measures: Conversational speech samples,reading sentences or passages aloud, spoken and written language production and comprehension, hearing screening, oral motor function, orofacial exam for symmetry, such as ankyloglossia, malocclusion, or sub-mucous cleft palate

After speech sound screening an SLP

Should tell parents and teachers how to prevent speech impairment and encourage normal speech development

Screening for a spoken language disorder

Collect info from child's parents and teachers about the concerns regarding the child's language, language with family, and the language ability with each spoken language, hearing screening, standardized screening with specificity

Xerostomia

Dryness of the mouth caused by reduction of saliva

Cough or choke with thin liquids, pain or discomfort during swallow, intolerance to different consistencies

Signs of Dysphagia

Evaluation process in public school system

A referral is made; referral is made to a multidisciplinary team employed by the school district that has training in Dysphagia screening, identification and treatment. After referral, the school contacts parents to obtain informed consent for eval of eating, drink, and swallow. Explain process to them and collect information on students health. Interviews with teachers and observation count as screening.

Swallowing screenings done by

Cervical auscultation, laryngeal cough reflex, tartaric acid inhalation to test cough for laryngeal sensation, pulse oximetry,

The best way to test laryngeal function is via

Structural examination

Children's speech and language disorders are affected by

Genetic factors, and moreover that children with a history of speech and language problems are at risk for lower early reading performance. Histories of receptive, expressive, and articulation have the highest risk.

The main difference between American Sign Language and Signed exact English is

ASL has a grammar/syntax of its own

Decoding is

Learning to read by taking apart sounds in words and blending sounds together

Phonic decoding allows a student to say

Unfamiliar words

In stuttering etiologies, the following are

Generic or family history. Higher in twins. Higher in males.

Characteristics of a language impairment in children.

Understanding spoken language, word meanings, expressing thoughts with correct word order and sentence formulation. I.e., omission of s endings

In the language sample with Ryan the brother,

Is is a phonologic disorder (omission of r and substitution of r..w/r) A phono disorders shows that the speech sound is produced in some words but not in others.

FOXP2 and CNTNAP2

Cause complex speech and language disorder and differences in brain structure when disrupted.

CNTNAP2 disruption

Inability to imitate non words and isolated skills

FOXP2

Affects multiple abilities concurrently due to its regulating genes

Dyslexia

Included difficulty recognizing words with nonstandard spellings, sounding words out, perceive phonemes, syllables, and other discreet within connected speech, access mental vocab for rapid naming tasks

Children misarticulating certain sounds like a lisp on /s/ or /z/ have

An articulation disorder

Children misarticulating in specific contexts (I.e., at end of words or consonant clusters) have

Phonological based disorders

Children diagnosed with childhood apraxia of speech have

Incorrectly producing multiple speech sounds including vowels, unintelligible speech, and robotic prosody

Dyslexia and speech sound disorders share

Genetic risk factors

Language disorders with unknown origins are

Idiopathic or developmental

Mixed language disorders

Impact receptive and expressive language

Children will show receptive language disorders byb

4 years old

Brain injuries can cause mixed language disorders which can be misdiagnosed as

Developmental disorders

Intellectual disabilities

Seldom cause language disorders

Language delays

Develops speech and language in the summer manner as those with typically developed language, just at a later time.

Language disorder

Child develops some language skills but not others

Apraxia of speech is caused by

Difficulty with accurate and consistent motor production of speech, deficits in the brain to coordinate and control the movement or muscles used to control speech

The DSM includes

Classifications, definitions, codes for mental disorders, define developmental disabilities up to 18. Chronic and severe, that limit the functioning in major life activity areas.

Characteristics of ID

Delayed development of speech and language skills

Children with severe and moderate ID

Speak at later than normal ages, acquire smaller vocabulary, take longer to read and write. Never develop functional literacy skills read at lower levels than chronological age, no abstract concept understanding, simple sentence structure

Profound ID

Nonverbal, utter few words,

Aphasia and apraxia are cause by

Motor and executive impairments

Cerebral palsy

Impairs neurological control of muscular functions, includes speech muscles and body movements.

A common CP symptom is

Spasticity -muscle is rigid and lack of coordination and control

Spastic dysphonia

Spasticity of muscles impact speech sound production (more severe CP)

Mild CP

Slight limp, weakness, or difficulty with movements

Severe CP

Hemiplegia, quadriplegia, and paraplegia, or difficulty with phonation and movement/coordination of speech mechanisms

What is the conductive function of hearing mechanism?

Air medium, impedance testing, fluid medium

Children/adolescents with coexisting CP and ID can

Vocalize but be nonverbal

Muscular dystrophy

Particularly oculopharyngeal and myotonic can cause sever speech and swallowing disorders

Oculopharyngeal MD

Impairs muscles contractions of pharyngeal wall and laryngeal elevation. Causes oral weakness and swallow problems

Myotonic MD

Pharyngeal impacts such as control of cricopharyngeal and chewing muscles

Amyotrophic Lateral Sclerosis (ALS)

A progressive disease, causes motor neurons in brain, brain stem, and spinal cord to degenerate and die. Causes muscular atrophy, impair initiation and control of muscle movement.

Bulbar ALS

Affects motor neurons in brain stem, causing affects in speech and swallowing muscles

ALS early symptoms

Dysarthria causing impairment in normal loudness and clarity of speech, slurred speech, nasal speech, spastic causing difficulty pronouncing words, decreased control of breathing making longer sentences difficult

ALS eventually

Destroys patients ability to speak or vocalize. Respiration becomes weak, and they can't be loud enough for intelligibility

ALS causes

Fatigue, depleting patients of energy so they can't finish eating.

Huntington's disease is

Inherited and progresses brain cell degeneration, behavior, cognition, and motor control

Motor symptoms of Huntington's disease are

Impaired voluntary movement, chorea (spastic), involuntary movement such as writhing and jerking, dystonia, muscles contractions, impaired balance gait and posture

HD symptoms affecting voice and speech are

Dysarthria, weakness and incoordination in speech muscles causing slurred speech apraxia, program and sequence, speech rate control, coordinate voice with breath, breathy voice, overly loud or soft, horse, harsh tone

Huntington's disease can also cause

Dysphagia. Risk for aspiration pneumonia. Impulse eating and difficult with intake control, coordinate breathing and swallow, involuntary oral and pharyngeal muscle movements

In PD, cognition and language can cause difficulty with

Quick thinking, multi tasking, understand complex spoken sentences, word retrieval, formulate ideas timely.

PD patients in conversation can have difficulty with

Conversational pauses, behind in fast paced group discussions

PD symptoms

Flat/lack of facial vocal expression, reduce meaning that patients can communicate, ability to recognize emotions with facial expressions, impaired communicative gestural expressions, lower vocal volume, hoarse or breathy voice. Coordinate talking with walking. Can appear to stutter over others. Worse with comorbid hearing loss.

Congenital heart disease

Impaired developmental language skills

Hypoplastic left heart disease and transposition of great arteries/septal defects impairs

Speech production

Multiple sclerosis

Inflammatory degenerative disease of central nervous system and causes demyelination

Thenthe most common problem with MS is

Dysarthria

In MS, weakness and spastic muscles cause

Slurred speech, unclear and slow articulation, breathy or harsh voice, and mono pitch

MS can also cause

Breathing problems and ataxia (incoordination)

In MS weak respiratory muscles cause

Decrease in vital capacity, reduce vocal loudness,

Language symptoms in MS

Comprehension, naming, repetition, word fluency, and sentence construction

Main CAPD problems:

Auditory background in a noisy class.

auditory memory like retain a list, directions, study material immediately or after.

auditory discrimination in phonemes in words, interfere with reading writing or spelling or directions

auditory attention such as following direction and competing tasks

auditory cohesion such as math problems or riddles, inferences, discussions

/r/ and /s/ are phonemes that are notoriously hard for

Hearing impaired individuals to hear. /w/ and /t/ substitute

Deaf individuals can learn to develop speech through

Vibrations, feeling vocal cords. Have a harder time than those with residual hearing.

Those with down syndrome have different head and beck structures which lead to

Basal, sinus, upper respiratory, ear problems, velopharyngeal insufficiency

DS children display

Tongue protrusion, drool, mouth breathing, nasal congestion and drainage, snore, sleep apnea, otitis media

DS children may receive

Tonsillectomy adenoidectomies but canmcause hyper nasal and VPI

DS structural abnormalities are

Short soft palate and short high arched palates

Tonsillectomy treats

Sleep apnea and other obstructive symptoms

Adenoidectomy may cause

Chronic ear drainage, respiratory problems, VPI, and hypernasality

In acute AOM

Middle ear fluid is infected

In OME

Fluid is not infected

Chronic OME lasts

8 weeks

OME is prevalent with

DS, fragile X, turner syndrome, Williams, cleft palate cranky facial abnormalities, childcare, second hand smoke, OME family history and low income families

OME causes mild to mod conductive hearing loss an affects

Lang processing, speed, phonological, vocab, syntax, convo comp, and expression (incomplete phonics encoding or grammatical morphemes).

OME can disrupt

Auditory attention in noisy environments

Conductive hearing loss originates in

The outer and middle ear and prevents sound from reaching middle ear

Conductive hearing loss causes

Wax buildup, ear tumor, otosclerosis (sound conduction), eardrum perforation/scar, fluid, canal infections that are middle ear

Conductive hearing loss can be

Uniformly faint in sound. Speech is quiter, can hear through bone condition but lack in air.

Sensorineural hearing loss originates in

The inner ear when cochlear hair cells and inner ear nerves die. Caused by aging (presbycusis) starting with high frequency

Sensorineural causes

Loud noise exposure, injury, viral infection, measles, mumps, meningitis, stroke, diabetes, fever, ototixic meds, meinere's disease (vestibular system), neuroma, heritability

Sensorineural hearing loss can be heard but

Not understood through speech sound discrimination, speech is louder. No air or bone conduction problem

Dysarthria is caused by damage to

CNS or PNS

Spastic dysarthria

UMN damage; pyramidal tract

Hyperkinetic dysarthria

UMN; basal ganglia in extrapyramidal tract

Hypokinetic Dysarthria

UMN; substantia Nigra in extrapyramidal tract

Ataxic dysarthria

UMN; cerebellar

Flaccid Dysarthria

LMN; cranial nerve damage