Comps SLP
1. Congenital vs. Acquired
Congenital: Conditions present from birth (e.g., cleft palate, Down syndrome).
Acquired: Conditions developed after birth (e.g., aphasia after a stroke, traumatic brain injury).
2. HIPAA Privacy vs. HIPAA Security
HIPAA Privacy: Protects the confidentiality of patient health information (e.g., not sharing patient details without consent).
HIPAA Security: Ensures that electronic health information is kept secure (e.g., using passwords, encryption).
3. Perlocutionary, Illocutionary, Locutionary (Child Language Development)
Perlocutionary: Infant’s actions are interpreted by caregivers (0-8 months). E.g., baby cries, parent interprets hunger.
Illocutionary: Intentional communication with gestures or sounds (9-12 months). E.g., baby points to toy they want.
Locutionary: Use of words to communicate (12+ months). E.g., baby says “milk” to request a drink.
4. Milieu Teaching
Definition: A naturalistic, conversation-based teaching method aimed at promoting language development in everyday settings.
Components: Environmental arrangement, responsive interaction, and conversation-based strategies (e.g., modeling, prompting).
5. Developmental, Organic vs. Nonorganic Disorders
Developmental: Delays or disorders in reaching milestones (e.g., developmental language disorder).
Organic: Result from physical abnormalities (e.g., cleft palate, hearing loss).
Nonorganic: No clear physical cause (e.g., functional voice disorders).
6. Neurogenic
Definition: Disorders caused by damage to the nervous system (e.g., aphasia, dysarthria, apraxia of speech).
7. Articulatory Inaccuracies vs. Speech Sound Disorders Inaccuracies
Articulatory Inaccuracies: Difficulty physically producing speech sounds (e.g., /s/ for /th/ in "thumb").
Speech Sound Disorders Inaccuracies: Broader category including phonological errors (e.g., fronting "cat" becomes "tat").
8. Types of Dysarthria
Flaccid: Weakness, breathy voice (e.g., damage to cranial nerves).
Spastic: Stiff, strained speech (e.g., bilateral upper motor neuron damage).
Ataxic: Coordination problems, slurred speech (e.g., cerebellar damage).
Hypokinetic: Monotone, fast speech (e.g., Parkinson’s disease).
Hyperkinetic: Involuntary movements, variable speech (e.g., Huntington’s disease).
Mixed: Combination of two or more dysarthrias (e.g., ALS).
9. Dynamic Assessment
Definition: An interactive approach to assessing a child’s potential to learn, focusing on the child’s response to teaching (e.g., test-teach-retest model).
10. AMRs (Alternating Motion Rates)
Definition: The speed and regularity of rapid alternating movements (e.g., "puh-tuh-kuh" for diagnosing motor speech disorders).
11. Developmental Norms
Definition: Expected age ranges for achieving developmental milestones (e.g., babbling by 6 months, first words by 12 months).
12. Standardized vs. Non-Standardized Assessments
Standardized: Formal tests with consistent procedures and scoring (e.g., CELF, GFTA).
Non-Standardized: Informal tests, flexible (e.g., language samples, observations).
13. Calculating MLUs (Mean Length of Utterance)
Formula: Total number of morphemes ÷ total number of utterances.
Example: If a child says 100 morphemes in 20 utterances, MLU = 100 ÷ 20 = 5.
14. Phases of Swallowing
Oral Preparatory: Chewing, mixing food with saliva.
Oral Transit: Tongue moves the bolus to the back of the mouth.
Pharyngeal: Bolus passes through the pharynx, the airway closes.
Esophageal: Bolus moves down the esophagus to the stomach.
15. Basic Phonological Processes
Examples: Fronting (e.g., "tat" for "cat"), stopping (e.g., "tun" for "sun"), gliding (e.g., "wabbit" for "rabbit").
16. Basic Audiology Information: Pure Tone and Tympanometry
Pure Tone: Testing hearing thresholds across frequencies.
Tympanometry: Measures middle ear function, checks for fluid or eardrum issues.
17. Aural Rehabilitation
Definition: Therapy aimed at improving communication for people with hearing loss (e.g., hearing aids, lip reading, speech therapy).
18. Types of Aphasia
Broca’s: Non-fluent, speech is effortful.
Wernicke’s: Fluent, but often nonsensical.
Global: Severe, affecting both comprehension and expression.
Anomic: Difficulty finding words.
19. IEP vs. 504 Plans
IEP (Individualized Education Program): Tailored education plan under IDEA for students with disabilities, includes specialized instruction.
504 Plan: Accommodations to ensure students with disabilities have equal access in school, but no specialized instruction.
20. Professional Issues (Licensure and Certification)
Licensure: State-regulated permission to practice (e.g., passing Praxis exam).
Certification: ASHA’s CCC-SLP certification after completing the CFY (Clinical Fellowship Year).
21. C-Units vs. T-Units
C-Units: Communication units; used in spontaneous speech analysis, includes incomplete sentences.
T-Units: Terminable units; used for written language, complete sentences only.
Example: "She went to the store, and then she went home" is 1 T-unit, but can be broken into 2 C-units.
22. Percent of Disfluent Speech
Formula: (Number of disfluent words ÷ total number of words) × 100.
Example: If 10 out of 100 words are disfluent, the percent of disfluent speech = (10 ÷ 100) × 100 = 10%.
Brown’s Stages of Language Development
Stage I (MLU: 1.0-2.0) – Approx. Age: 12-26 months
Characteristics: First use of two-word combinations, early semantic relations (e.g., "more juice," "daddy go").
Examples of Utterances: Subject + Verb, Subject + Object (e.g., "Mommy sock").
Stage II (MLU: 2.0-2.5) – Approx. Age: 27-30 months
Key Morphemes:
Present progressive (-ing) → "Mommy running."
In → "Toy in box."
On → "Book on table."
Plural (-s) → "Cats."
Characteristics: Early use of grammatical morphemes (e.g., adding -ing, using prepositions like "in" and "on").
Stage III (MLU: 2.5-3.0) – Approx. Age: 31-34 months
Key Morphemes:
Irregular past tense → "She went."
Possessive (-'s) → "Mommy's car."
Uncontractible copula (e.g., "This is mine").
Characteristics: Emergence of simple sentence forms (subject-verb-object), mastery of basic sentence structure (e.g., "Doggie is big").
Stage IV (MLU: 3.0-3.75) – Approx. Age: 35-40 months
Key Morphemes:
Articles (a, the) → "A dog," "The cat."
Regular past tense (-ed) → "He played."
Third person regular present tense (-s) → "She runs."
Characteristics: Use of embedded phrases and clauses, sentences becoming more complex with conjunctions.
Stage V (MLU: 3.75-4.5) – Approx. Age: 41-46 months
Key Morphemes:
Third person irregular → "She does."
Uncontractible auxiliary (e.g., "He is swimming").
Contractible copula → "She's happy."
Contractible auxiliary → "He's running."
Characteristics: Mastery of complex sentences and most grammatical structures. Children can ask questions using inversion ("Is she running?"), and use negation appropriately.
Stage V+ (MLU: 4.5+) – Approx. Age: 47+ months
Characteristics: Refinement of earlier skills, understanding of more subtle language rules, and advanced use of compound and complex sentences.
Morpheme Acquisition Order
Some of the morphemes learned during these stages are acquired in a typical order:
Present progressive (-ing)
Prepositions (in, on)
Plural (-s)
Irregular past tense
Possessive (-'s)
Articles (a, the)
Regular past tense (-ed)
Third person singular regular (-s)
Auxiliary verbs
Example of MLU Calculation:
To calculate MLU, divide the total number of morphemes by the number of utterances. For example:
Utterance 1: "I am running." (3 morphemes: I, am, running)
Utterance 2: "She eats cookies." (4 morphemes: She, eats, cookie + s)
Total morphemes = 3 + 4 = 7
Total utterances = 2
MLU = 7 ÷ 2 = 3.5
Language Development Milestones
Birth to 1 Year
0-3 months: Coos, turns head toward sounds.
4-6 months: Babbles (e.g., "ba-ba"), responds to sounds by looking.
7-9 months: Uses sounds and gestures to communicate (e.g., waving, pointing).
10-12 months: Says first words, understands simple commands (e.g., "no," "come here").
1 to 2 Years
12-18 months: Says 10-20 words, follows simple directions (e.g., "give me the ball").
18-24 months: Vocabulary grows to 50+ words, starts combining two words (e.g., "more milk").
2 to 3 Years
24-30 months: Uses 2-3 word sentences (e.g., "want cookie"), understands simple questions.
30-36 months: Vocabulary expands to 200-300 words, begins using simple prepositions (e.g., in, on), asks "what" and "where" questions.
3 to 4 Years
Uses 4-5 word sentences, answers "who," "what," "where," and "why" questions, can tell short stories, and understands concepts of "same" and "different."
4 to 5 Years
Can define familiar words, uses complex sentences with multiple clauses, understands time concepts (e.g., yesterday, tomorrow).
Other Areas to Focus On
Speech Sound Development Milestones
By Age 3: Mastery of /p, m, h, n, w/.
By Age 4: Mastery of /b, d, k, g, f, t/.
By Age 6: Mastery of /l, j, sh, ch, th/.
By Age 8: Mastery of /s, z, r, v/.
Phonological Processes Suppression
By Age 3: Final consonant deletion, reduplication.
By Age 4: Fronting, stopping (for most sounds).
By Age 5: Gliding, cluster reduction.
Development of Pragmatic Skills
By Age 3: Takes turns in conversation.
By Age 4: Understands and follows basic social rules (e.g., using polite forms like "please" and "thank you").
By Age 5: Can tell a story with a clear beginning, middle, and end.
Fluency Development
Typical disfluencies (e.g., repetitions of words) are normal in preschool years but may decrease after age 3-4. A high percentage of disfluency (5% or more) or tension in speech may be indicative of stuttering.
Motor Speech Disorders
Childhood Apraxia of Speech (CAS): Inconsistent errors, difficulty with longer or more complex words, groping for sounds.
Dysarthria: Slow, slurred, or quiet speech due to muscle weakness or incoordination.
Assessment Tools
Be familiar with common standardized assessments, such as the CELF-5 (Clinical Evaluation of Language Fundamentals), GFTA-3 (Goldman-Fristoe Test of Articulation), and PPVT-5 (Peabody Picture Vocabulary Test).
Dynamic Assessment: This is used to measure a child's potential to learn (e.g., test-teach-retest approach), particularly important in multicultural populations.
Intervention Strategies
Milieu Teaching: Embeds language teaching within natural contexts, uses techniques like modeling and prompting.
Expansion/Extension: When you expand on a child’s utterance (e.g., Child: "dog bark." Clinician: "Yes, the dog is barking!").
Multicultural Considerations
Bilingual Language Development: Children learning two languages may have different rates of vocabulary growth but usually develop both languages without confusion.
Dynamic Assessment is especially helpful with children from culturally and linguistically diverse backgrounds, as it focuses on learning potential rather than static knowledge.
Swallowing Development
Infant: Suckling, coordinated suck-swallow-breath pattern.
By 4-6 months: Transition to solid foods begins.
By 12 months: Can manage a wider variety of textures and begins self-feeding.
Audiology
Understand basics of hearing screening and assessment: Pure tone testing, tympanometry, Otoacoustic Emissions (OAEs), and Auditory Brainstem Response (ABR).
Aural Rehab: Refers to interventions that improve communication for people with hearing loss, including hearing aids, cochlear implants, lip reading, and auditory training.
Key Terms in Cognitive Development
Theory of Mind: The ability to understand that others have thoughts, beliefs, and perspectives different from one’s own.
Executive Function: Skills that involve planning, organizing, and managing time and space.
Regulatory Requirements
IEP (Individualized Education Program): For students who qualify for special education services under IDEA.
504 Plan: Provides accommodations for students with disabilities who do not qualify for an IEP.
Licensure & Certification: ASHA's CCC-SLP, state-specific licensure requirements, and continuing education.
1. Form
This domain relates to the structure and rules of language, including phonology, morphology, and syntax.
Phonology: The study of the sound system of a language and the rules for combining sounds into meaningful units.
Example: The difference in sounds between /b/ and /p/ in "bat" vs. "pat."
Morphology: The study of word formation and structure, specifically morphemes, the smallest units of meaning in a language.
Example: The plural morpheme (-s) in "cats," or the past tense morpheme (-ed) in "jumped."
Syntax: The rules for organizing words into sentences (grammar).
Example: "She is running" (correct syntax) vs. "Running she is" (incorrect syntax in English).
2. Content
This domain refers to the meaning of language, which is related to semantics—the system of rules governing word meanings and word combinations.
Semantics: The meaning of words, phrases, and sentences.
Example: Knowing that "apple" refers to a type of fruit or understanding that "hot" can refer to temperature or spiciness depending on context.
Vocabulary falls under this domain, including understanding concepts and categories.
Example: Understanding that "dog" and "cat" both fall under the category "animals."
3. Use
This domain involves the pragmatic aspects of language, which are the social rules governing language use in different contexts.
Pragmatics: The rules for using language appropriately in different social situations, including understanding and following conversational norms, turn-taking, topic maintenance, and non-verbal cues.
Example: Knowing how to greet someone appropriately in a formal situation vs. an informal one, or recognizing when it’s your turn to speak during a conversation.
Three domains of language
Form: How language is structured (phonology, morphology, syntax).
Content: What language means (semantics, vocabulary).
Use: How language is used in social contexts (pragmatics).
Types of attention
1. Sustained Attention (Vigilance)
Definition: The ability to maintain focus and concentration over an extended period of time on a single task or stimulus.
Example: Reading a book or listening to a lecture without losing focus for a long time.
2. Selective Attention
Definition: The ability to focus on one specific stimulus or task while ignoring distractions.
Example: Having a conversation at a noisy party and filtering out the background noise to focus on what the person is saying.
3. Alternating Attention
Definition: The ability to switch focus between two different tasks that require different cognitive demands.
Example: A person switching between writing an email and answering a phone call.
4. Divided Attention
Definition: The ability to focus on two or more tasks simultaneously (also known as "multitasking").
Example: Cooking while talking on the phone, or driving while listening to a podcast and paying attention to the road.
5. Focused Attention
Definition: The most basic level of attention, where an individual responds to specific visual, auditory, or tactile stimuli.
Example: Immediately reacting when someone calls your name or quickly noticing a loud noise in the environment.
Types of Memory
Memory can be categorized into several types, each serving distinct functions:
1. Sensory Memory
Definition: The brief retention of sensory information (visual, auditory, etc.) for a very short duration (usually milliseconds to a few seconds).
Example: Remembering a flash of light after it has disappeared or retaining a sound for a moment after it has stopped.
2. Short-Term Memory (Working Memory)
Definition: The ability to hold a small amount of information in an active state for a limited time (typically 15-30 seconds).
Example: Remembering a phone number long enough to dial it or keeping track of information while following a recipe.
3. Long-Term Memory
Definition: The ability to store information over extended periods (from days to years) and retrieve it when needed.
Subtypes:
Explicit (Declarative) Memory: Involves conscious recall of facts and events.
Example: Remembering your birthday or the capital of a country.
Implicit (Non-declarative) Memory: Involves skills and actions that can be performed without conscious awareness.
Example: Riding a bicycle or typing on a keyboard.
4. Episodic Memory
Definition: A type of explicit memory that involves recollection of specific events or experiences, including contextual details such as time and place.
Example: Remembering your last birthday party.
5. Semantic Memory
Definition: A type of explicit memory that involves general knowledge and facts about the world, concepts, and language.
Example: Knowing that Paris is the capital of France or understanding the meaning of a word.
Nervous System
Brain: Key areas involved in speech and language include:
Broca's Area: Located in the left frontal lobe; responsible for speech production and language processing.
Wernicke's Area: Located in the left temporal lobe; involved in language comprehension.
Cricothyroid Muscle: Adjusts vocal fold tension for pitch control.
Cranial Nerves: Key nerves for speech and swallowing include CN V (Trigeminal), CN VII (Facial), CN IX (Glossopharyngeal), CN X (Vagus), CN XI (Accessory), and CN XII (Hypoglossal).
Vocal Fold Movement: Abduction (opening) and adduction (closing) are essential for breathing and phonation.
Epiglottis: Protects the airway during swallowing by preventing food from entering the trachea.
Abduction: The opening of the vocal folds, allowing air to pass through the glottis (the space between the vocal folds). This occurs during breathing and when producing voiceless sounds.
Adduction: The closing of the vocal folds, which is necessary for sound production during phonation. This action is primarily controlled by the lateral cricoarytenoid and interarytenoid muscles.
2. Cranial Nerves Important for Speech and Swallowing
Here are six key cranial nerves that play critical roles in speech and swallowing:
1. Trigeminal Nerve (CN V)
Function: Provides sensory information from the face and motor functions for chewing (mastication).
Relevance to SLP: Controls the muscles of mastication, and sensory input is essential for oral and facial sensation during speech and eating.
2. Facial Nerve (CN VII)
Function: Controls the muscles of facial expression and provides taste sensations from the anterior two-thirds of the tongue.
Relevance to SLP: Important for articulating sounds that require lip movement (e.g., "p," "b," "m") and contributing to emotional expression in communication.
3. Glossopharyngeal Nerve (CN IX)
Function: Provides sensory innervation to the posterior one-third of the tongue, the pharynx, and the tonsils. It also innervates the stylopharyngeus muscle, which helps with swallowing.
Relevance to SLP: Plays a role in the gag reflex and the initiation of swallowing; dysfunction can lead to swallowing difficulties.
4. Vagus Nerve (CN X)
Function: Has extensive innervation; it controls muscles in the larynx, pharynx, and soft palate, and carries sensory information from the larynx and thoracic organs.
Relevance to SLP: Critical for vocal fold adduction and abduction, which are essential for sound production. It also helps coordinate the swallowing reflex.
5. Accessory Nerve (CN XI)
Function: Primarily controls neck and shoulder muscles (sternocleidomastoid and trapezius).
Relevance to SLP: While not directly involved in speech, it aids in postural stability, which can influence breath support during speech.
6. Hypoglossal Nerve (CN XII)
Function: Controls all intrinsic and most extrinsic muscles of the tongue.
Relevance to SLP: Essential for articulation, swallowing, and manipulating food in the oral cavity.