Preschool Exam

causes of speech sounds disorders

• functional (no known cause)

• organic (developmental or acquired)

examples of organic SSD

• motor/neurological (execution and planning)

• structural (cleft palate)

• sensory/perceptual (hearing loss)

areas of target for functional

articulation and phonology

differential diagnosis of SSD

• articulation disorder

• phonological disorder

• consistent “atypical” phonological disorder

• inconsistent phonological disorder

• childhood apraxia of speech

what is articulation disorder?

• substitution and distortion of the same sounds in isolation and in all phonetic contexts (e.g., lateral lisp)

• traditional approach is better

what is phonological disorder?

• presence of speech error patterns that are typical of younger children (stopping, cluster reduction…)

• language based with focus on speech sounds and phonological contrast (pairs) interventions are helpful

what is consistent “atypical” phonological disorders?

• consistent use of one or more unusual non-developmental error patterns (backing, ICD)

• impaired abilities to organize knowledge about the phonological system —> deficits in phonological representation & internal organization

• phonological contrast is the best approach

what is inconsistent phonological disorder?

• multiple phonemic error forms for the same lexical item while having NO oromotor difficulties

• unpredictable variations

• lack of stable phonological system due to deficit in phonological planning

• perform better in imitation than spontaneous speech

• intervention: core vocabulary to establish consistency and accuracy followed by phonological contrasts

what is CAS?

• speech characterized by inconsistency, oromotor signs, (e.g., groping, difficulty sequencing articulation movements), slow speech rate, disrupted prosody, short utterance length

• Inconsistent errors on consonants and vowels in repeated productions of syllables or words

• lengthened and disrupted coarticulatory transitions between sounds and syllables

• inappropriate prosody

• poorer performance in imitation than spontaneous production

non-standardized test to assess children

• language sample —> connected speech

• speech perception test

• phonetic inventory

• stimulability

• speech intelligibility and severity

• phonological awareness

speech perception test

ability to perceive the difference between the standard production of a sound and his/her own error production

• test by auditory discrimination and picture identification

stimulability test

requires the client to imitate the phonemes that were misarticulated during the assessment. For the sounds that were stimulable, higher probability of growth and better prognosis

intelligibility and severity assessment

can use a rating scale, provide estimates in familiar and unfamiliar contexts.

interventions for SSD

• traditional approach

• stimulability

• complexity approach

• speech intelligibility

what is the traditional approach for SSD?

• select targets according to developmental norms

• skills mastered chronologically earlier simpler than those acquired later

• cannot violate sequence of skill acquisition

what is the stimulability approach for SSD?

• targeting existing sounds to be produced accurately

• stimulable sounds treated before non-stimulable sounds

• visible sounds are easier than obscured sounds

what is the complexity approach for SSD?

• different targets that produce generalization

• treats sounds that contrast in more than 2 features, later developing, more marked, non-stimulable, and consistent error

• facilitate systematic wide change in phonology system

what is the speech intelligibility approach to SSD?

• choose sounds that affect speech intelligibility the most

Goal attacking strategies

• vertical

• horizontal/simultaneous/multiple sound approach

• cyclic approach

Vertical goal attacking strategy?

• one sound/word pair at a time

• may need to reach a certain criteria before moving on to the next target

• mild SSD

• good for children who cannot manage more than one sound at a time

• advantage: more focused, less demanding, better accuracy for production

• disadvantage: takes longer to improve speech intelligibility, can be over drilled

Horizontal goal attacking strategies

• more than one sound/word pair at a time

• mild to moderate SSD

• good for children who can handle more than one sound at a time

• advantage: more cost effective to improve speech intelligibility

• disadvantage: accuracy for production will be lower at the beginning due to divided targets

cyclical goal attacking strategies

• treatment is from 5-16 week

• regardless of progress, move to the next target sound for the same amount of time

• during each cycle, one or more phonological processes are targeted

• highly unintelligible children

• advantage: there is not mastery level, target patterns to stimulate emergence of a specific sound or pattern, not mastery of it

phonetic approach

• correct productions of an individual sound

• makeup words are allowed

• good for limited speech errors

• good for non-stimulable sounds

phonemic approach

• correct production through contrasting sounds

• only real words allowed

• good for children who use error patterns

• good for stimulable sounds

phonological contrast approaches

• minimal pairs

• maximal oppositions/pairs

• multiple oppositions

phonological contrast approach: minimal pairs

• utilized sets that differ by a phoneme (undesired & desired production)

• sounds have the least difference

• good for children with mild to moderate phonological disorders

• children need to learn the linguistics rules which they did not innately acquired

phonological contrast approach: maximal pairs

• The only difference is the selection of sound pair

• good for children with moderate to severe phonological disorders

• an “unknown” or a “known” phoneme are used as a comparison rather than an error pattern

• based on the idea that error sounds should be contrasted with VERY different

• greater generalization than minimal pairs

phonological contrast approach: multiple oppositions

• combine minimal pair and maximal opposition features

• good for children with severe to profound SSD

• contrast several targets simultaneously to the child’s error sound

• impose great semantic demands