Speech Sound Disorders

What do we need to know in order to treat speech sound disorders?

Anatomy and physiology, developmental processes, phonetic transcription, and knowledge of how speech sounds interact with other aspects of language and literacy development

Who may have speech sound disorders?

People of all ages who have structural deficits (cleft palate/lip), phoonological deficits, acquired injuries, voice disorders, neurodegenerative disorders (parkinsons, ALS), and neuro muscular deficits (cerebral palsy)

Why do some children have difficulty with speech production?

Motor planning disorder, difficulty with multisyllabic words, difficulty with vowels, inconsistent productions of repeated words and sounds, and improper prosody (rhythm of speech)

What is the worlds most common type of communication disorder?

Speech sound disorders! They affect 10-15% of preschoolers

How can we help speech sound disorders?

Professional intervention. Nearly 4/5 of children do this!

T/F: Many preschoolers with speech sound disorders also have language difficulties, including developmental language disorder

True

T/F: Children with speech sound disorders are at a decreased risk for later academic difficulties

False

How does having a speech sound disorder affect qualitiy of life?

Children with speech sound disorders are at risk of being bullied, struggling with friendships, and enjoying school less

What does Speech Sound Disorder mean?

An umbrella term referring to any difficulty with perception of speech, motor production of speech, phonological representation of speech sounds/segments, and phonotactic rules

What might affect speech clarity (motor/neurological disorders)?

Dysarthria: Muscle weakness (common w/Cerebral Palsy)

Childhood Apraxia of Speech: motor planning issues

Part of genetic syndrome: Down syndrome

What might affect speech clarity (structural anomalies)?

Cleft lip/palate, velopharyngeal insufficiency, babbling, or phonetic inventories

When assessing a person, what do you first need to know about the speech difficullties?

If they are a result of: developmental difference, structural deficit, a sensory deficit (hearing loss), a motor/neurological condition, or cognitive/linguistic weakness

What are phonotactic rules?

Language-specific constraints governing allowed sound combinations and syllable structures

What is an example of a phonotactic rule in English?

Can’t begin a word with ‘ng’ sound

What is a closed syllable vs open syllable?

Open syllables end in a vowel while closed syllables end in a consonant

What is the difference between: difference, delay, and disorder

Difference = Dialectical variation

Delay = Develop skills in the typical sequence but at a slower rate

Disorder = non-sequential development of skills that is persistant

What is the phonotactic rules being followed in: aside, splints, and dough

aside - V.CVC (vowel can stand alone in a syllable)

splints - CCCVCCC (up to 3 consonants in a cluster)

dough - CV (open syllable, don’t care about spelling just sounds!)

Differential Diagnosis

A list of conditions that share the same symptoms to help make a final diagnosis

What is the goal of differential diagnosis?

To narrow down potential conditions, guide further testing, and to rule out certain issues

What is the difference between organic causes and functional causes of speech sound disorders?

Organic causes refer to identifiable structural causes such as cleft palate, cerebral palsy, and hearing loss. Functional causes refer to an unidentifiable cause which lead to issues with phonological representation

What questions help identify the cause of an SSD?

Asking about hearing health, birth history, and family medical history

What are barriers that families face when completing standard intake forms?

Long, complex language, unknown answers to questions — all these can lead to family just leaving and not dealing with problem

During oral mechanism exam, what are we looking for?

Symmetry, muscle strength/range of motion, soft palate/uvula movement, and diadochokinesis (DDK)

Why do we look at symmetry during the oral mech exam?

Used to identify potential neurological involvement or muscle weakness/atrophy

Why do we look at range of motion during the oral mech exam?

Used to evaluate the flexibility, coordination, and structural integrity of the lips, tongue, and jaw

Why do we look at soft palate movement during the oral mech exam?

To see if the velum is closing during speech (stops air from flowing into the nose)

Why do we look at DDK during the oral mech exam?

Used to assess the speed, accuracy, and coordination of the lips, tongue, and jaw. This can help us differentiate between speech disorders (such as apraxia) and structural issues by looking at the motor planning and rhythm or speech produced

What is the SODA analysis of speech sound disorders?

Substituions, omissions, distortions, additions

What are substitutions?

Swapping one sound for another

What are omissions?

Deleting a sound or syllable

What are distortions?

Changing some features of a sound in an atypical manner

What are additions?

Adding a sound

What are phonological processes?

Systematic sound changes or simplifications typically used to make speech easier. Often includes substitutions, omissions, deletions, and additions

Why do children use phonological processes?

To simplify complex adult speech into manageable patterns as their speech muscles and motor control develop

What is resonance?

The amplification and modification of sound produced by the vocal folds as it travels through the throat, mouth, and nasal cavity

What is hypernasality?

A speech resonance disorder characterized by excessive nasal cavity sound during oral speech production, making voices sound nasally. This occurs when the velopharyngeal mechanism fails to seal off the nose from the mouth

What is the difference between biphonation in horses and diplophonia in humans?

Biphonation in horses is a natural, healthy vocal mechanism producing both a high and low pitch at the same time. Diplophonia in humans is typically due to something like a polyp and is not the normal.

What does the international phonetic alphabet (IPA) represent?

Represents a standardized symbol-based system used to accurately represent the sounds of spoken language, mapping one symbol to one specific sound

Why is the international phonetic alphabet needed for SLPs?

Needed for SLPs to be able to accurately document, analyze, and treat speech sound disorders by providing a standardized symbol for every unique speech sound, independent of spelling