Speech Sound Disorders Handout

AGENDA

  • Assigned Readings:

    • Child Speech Sound Disorders

    • Apraxia Therapy Cueing Targets

    • Speech Graphics’ Simone Articulation System

  • Assigned Videos:

    • 2 (not specified)

  • Quiz 1

OBJECTIVES

  • Explain how speech sounds are classified.

  • Outline the sequence of typical speech sound acquisition across the lifespan.

  • Discuss types of children’s speech sound disorders, associated disorders, and related causes.

  • Describe the goals and procedures in speech sound assessment.

  • Describe approaches and techniques for treatment of articulatory and phonological disorders, including supportive evidence.

SPEECH ARTICULATORS

  • Various structures involved in producing speech sounds.

UNDERSTANDING SPEECH SOUNDS

  • Written: 26 letters

  • Spoken: 43 phonemes

  • Phonemic Symbols: Representation of speech sounds.

  • Categories of Speech Sounds:

    • Consonants

    • Vowels

CLASSIFICATION OF SPEECH SOUNDS

  • PLACE:

    • Bilabial, Labiodental, Interdental, Alveolar, Palatal, Velar, Glottal

  • MANNER:

    • Stops, Fricatives, Affricates, Glides, Liquids

  • VOICE:

    • Voiced (vibration of vocal folds) and Voiceless (no vibration)

VOWELS

  • Produced by vocal fold vibrations.

  • Factors influencing vowels include:

    • Tongue elevation

    • Height

    • Location in mouth

    • Mouth shape

  • Diphthongs Examples:

    • /ɑɪ/ = sigh

    • /ɑʊ/ = now

    • /ɔɪ/ = boy

SPEECH SOUND ACQUISITION

Newborn Stage

  • Produce reflexive and vegetative sounds.

  • Non-crying vocalizations are essential for speech development.

Infants (2-6 months)

  • Produce back consonants and middle/back vowels.

  • Vocalize to respond to others.

  • Imitate tone and pitch.

  • Longer and prolonged sound sequences emerge.

  • Bilabial sounds by 6 months.

Infants (6-7 months)

  • Reduplicated babbling begins.

  • Range of consonants increases.

  • Babbling starts resembling adult speech.

Infants (8-12 months)

  • Begin imitating sounds and use gestures.

  • Variegated babbling and jargon develop.

  • Phonetically consistent forms (e.g., "ba" for bottle).

Toddlers

  • First recognizable words emerge.

  • Phonological patterns include:

    • Final consonant deletion

    • Syllable reduction

    • Substitution (e.g., Fronting or Backing)

    • Consonant blend reduction

    • Assimilation

Preschool

  • Phonological patterns typically disappear by age 4.

  • Some difficulties with consonant clusters, which emerge by age 4.

  • Initial speech sounds: stops, nasals, glides.

  • Later speech sounds: fricatives, affricates, liquids.

School Age

  • Phonological system begins resembling adults.

  • Most speech sounds acquired by this stage.

  • Consonant clusters are usually mastered by age 8.

PHONOLOGICAL PROCESSES VS ARTICULATION

  • Phonological patterns vs articulation patterns of speech sound production.

  • Open Syllables: CV, CVCV

  • Closed Syllables: VC, CVC

POSSIBLE CAUSES OF SPEECH SOUND DISORDERS

  • Family history

  • Otitis media

  • Hearing loss

  • Neurological disorders

  • Sensory deficits

  • Genetic syndromes

  • Perceptual difficulties

  • Structural abnormalities

  • Unknown causes

LITERACY

  • Reading, Phonemic awareness, Discrimination between speech sounds, Decoding.

  • Writing and Spelling.

HEARING LOSS

  • Sensorineural: Impacts high-frequency sounds.

  • Conductive: Sounds appear muffled or quiet; can affect transmission.

ASSESSMENT AND INTERVENTION

Assessment Components

  • Case history, Interview, Hearing and vision screening, Oral mech exam, Standardized test, Communication sample.

Diagnosis

  • Differentiate between phonological disorders and articulation disorders.

Intervention Strategies

  • Goals and objectives for individual case management.

  • Speech sound targets across isolation, words, phrases, and sentences.

  • Emphasis on intelligibility, generalization, and maintenance of skills.

INTERVENTION APPROACHES

  • Bottom up, Language-based, Phonological complexity approaches.

  • Techniques:

    • Multiple oppositions (e.g., one-ton, fun, sun, run).

    • Minimal pairs (e.g., Key-tea).

    • Cueing strategies.

CHILDHOOD APRAXIA OF SPEECH

  • Difficulty with planning and programming speech sounds.

  • Characteristics include:

    • Inconsistent errors, choppy speech, lack of prosodic variation.

    • Limited consonant and vowel production.

  • Better performance with single words.

  • Typically diagnosed by age 3 or 4.

  • Typical cognitive and receptive skills may be present, but intelligibility is poor.

ASSESSMENT AND INTERVENTION FOR APRAXIA

  • Assessment includes: Apraxia test, articulation test.

  • Intervention focuses on word patterns like V, VC, CV, CVC, CVCV.

  • Strategies may include the use of AAC (Augmentative and Alternative Communication).

PROGNOSIS

  • Early detection plays a critical role.

  • Differentiating articulation and phonological disorders from apraxia.

  • Motor speech impairment and distortion of later developing speech sounds (/s, r, z, l/).

  • Importance of sound discrimination and stimulability.