Developmental Speech Disorders

Outline

-How children learn to produce sound

-Basics of English sound system

-How we classify sounds -Problems that occur

-How we evaluate and treat these disorders

What can Infants be taught prior to age 1 perception wise?

perceive sounds NOT in their native language

When do infants lose their non-native language perception ability?

after age 1 if not continually exposed

What happens in infants perception as early as 1-4 months?

they can be taught to recognize the differences between some consonants and some vowels

Normal Development

cooing

babbling

variegated babbling

first words

cooing

producing vowel sounds

babbling

repeating the same syllables over and over

Variegated babbling

repeating syllables with added intonation

first words

clear intent

0-3 months

vegetative noises, limited interaction

3-6 months

cooing, laughter

6-9 months

canonical babbling

9-12 months

variegated babbling/jargon

12 months

first word

18 months

~50 words

How do we learn about speech or language development?

longitudinal

cross-sectional

longitudinal

-small group studied over a period of time. More expensive and time consuming

cross-sectional

-large group studied simultaneously. Not suitable to study changes in individual kids

What do longitudinal and cross-sectional help come up with?

norms, or typical behaviors expected of children at a certain age.

-Sounds mastered by the majority of children by a certain age

What do vowels come before?

consonants

When are most vowels present?

at age 3

When are nasals acquired?

earliest, between 3-4 years of age (m, n, ng)

When are stops mastered?

between 3-4 ½ years of age

•/p/ often earliest

When are glides acquired?

(/w/ as in what, /j/ as in you), around 2-4 years of age

When are liquids acquired?

(/r/ and /l/) later mastered

•Liquids 3-5 years

When is the earliest fricative acquired?

/f/ fricative, around 3

When are other fricatives acquired?

others mastered between 3-6

When are consonant clusters acquired?

later than most other sounds

Phonological Process

Simplified production of an adult like model

Where do Phonological Process occur?

normal development

What happens if Phonological Process persists beyond that age?

constitute a delay and/or disorder

IPA

The sounds we produce are represented by the International Phonetic Alphabet (IPA)

Each letter stands for only 1 sound

English alphabet does not correlate to the sounds we produce.

Has different letters for the same sounds

Vowels

produced by opening the oral cavity

Consonants

produced by constricting the oral cavity

Place

where we make the sound

Manner

how we make the sound

Voicing

whether we use our vocal folds or not

Manner classification - stop

stopping the airflow

Manner classification - fricative

constricting the airflow with hissing sound

Manner classification - affricate

combo of stop and fricative (only 2)

Manner classification - glide

gradual change of shape

Manner classification - liquid

vowel like with least restriction of oral cavity

Manner classification - nasal

nasal

Place classification - bilabial

both lips

Place classification - labiodental

teeth and lips

Place classification - dental

tongue contacting teeth

Place classification - alveolar

Tongue behind the upper front teeth

Place classification - palatal

Tongue contacting hard palate

Place classification - velar

Back of tongue against the soft palate

Place classification - glottal

Open vocal folds

PLACE VOICE MANNER CHART (PVM)

Nose

ˈnoʊz

Thought

ˈθɔt

Cruise

ˈkruːz

Beach

ˈbiːtʃ ˌ

Margarita

mɑrgəˈriːtə

What does phonology emphasize?

the acquisition of the rules for combining sounds to produce words in a specific language

Phoneme

basic unit of a language’s phonology that can change meaning

Delay

producing words and sounds of speech like a younger child

•following developmentally normal pattern at slower rate

Disorder

speech production is not like children developing normally; diverges from normal/typical patterns of development

•May co-occur with other disorders

SPEECH SOUND DISORDERS

One of the most common communication disorder

Seen in children who are otherwise typically developing as well as children with other developmental and language delays/disorders

Etiology

•Usually functional

•Continued research to pinpoint cause

•May be related to otitis media

Child not developing sound system as expected

Not following norms

Impacts intelligibility-degree to which someone can understand your speech

As child ages, intelligibility expected to increase

Articulation

difficulty with speech sound production

Phonological

difficulty with phonological rules/patterns

ARTICULATION VS PHONOLOGICAL DISORDERS EXAMPLES

• No sounds in a particular class – no fricatives (s, v, sh)

• No first sound – “ake” for “cake”

• No clusters – “lick” for “click

Ways to Classify Disorders

Individual Errors

Patterns of Errors (Place Voice Manner)

Patterns of Features

Phonological Processes (final consonant deletion, fronting of back sounds)

The treatment you choose is based on how you classify the sound.

Deletions/omissions

•“an” for “pan”

Sound substitutions

•/ti/ for “key”, /wed/ for “red”

Distortions

sound produced in an “unfamiliar” manner •lateralized /s/

Limited set of sounds

No /f, s, z, l, r/

•“tish” for “fish”

•“tock” for “sock”

•“ion” for “lion”

Potential connections, but not a cause

• Can occur with intellectual disabilities

• More boys than girls

• More errors in those with lower SES

• Language may be delayed with those who have severe disorders

Not explained by: reduced motor skills, impaired oral structures, reduced auditory discrimination

Hearing loss-moderate to severe range

Difficult to produce speech as you can’t hear it and/or monitor your own production

Childhood apraxia of speech

● Can produce the movements necessary to make a sound but cannot produce in speech

● Possibly neurological

Goal

determine nature and severity of the developmental speech disorder/delay

• Determine cause, if possible

• Describe patterns

• Compare to age-appropriate skills

Special considerations

• Variations of English dialect impacting articulation

• Accent due to English as a second language

•Testing young children?

ASSESSMENT, CONT.

• May involve:

• Case history

• Speech sample

• Articulation tests (single words, intelligibility, analysis of errors)

• Oral-peripheral exam

• Hearing test/screening – rule out hearing loss

• Language test

All summarized in a report including strengths, weaknesses or areas for improvement, goals. This may go to parents, school (IEP), doctor, insurance company, etc

• Treat behavior

• Use information from assessment to plan goals, treatment techniques

• Treatment approach

•May depend on nature of disorder

•Must align with severity

•Research evidence of efficacy of treatment procedure

Articulation-based Treatment

• Focus on how articulators move to produce target sounds

• Errors seen as a motor problem

• Attention to manner and place of articulation

• Phonological Treatment

• Focus on groups of sounds with similar error patterns

• Goal is to help the child to internalize rules that generalize to other sounds within the pattern e.g final consonants

Establishment Principles for Treatment

Select your target/goals i.e what sounds or patterns will you work on?

–Choose your stimuli (materials. cueing, ways to teach)

Generalization Principles for Treatment

Teach the sound at initial level with transition along the linguistic hierarchy (sound, syllable, word, phrase, etc)

–Give feedback on performance (positive reinforcement, breaks)

-Move on to the next level in the linguistic hierarchy when completing at 75-90% accuracy (based on your goal)

Maintenance Principles for Treatment

Increasingly automatic production with self monitoring /self correction of errors

-Family training

SEVERE SPEECH DISORDER

• Note intent of vocalizations

• If not communicative, goal = intentional communication

• May incorporate alternative/augmentative communication device (AAC)

What makes up a large part of SLP practice?

Developmental speech disorders

Assessment is tuned to what?

age, severity, treatment approach

Overarching goal

increased intelligibility and increased complexity (words to sentences to conversation)

Involves a variety of what?

treatment approaches