Speech Sound Disorders and Related Topics

Speech Sound Disorders

  • Definition: Difficulty in producing or using speech sounds correctly.

  • Types:

    • Functional: No known cause (articulation/phonological disorders).

    • Organic: Known causes like structural (cleft palate), neurological (cerebral palsy), or hearing loss.

Phonological Processes

  • Definition: Patterns of sound errors to simplify speech.

  • Common Processes:

    • Final consonant deletion ("ca" for "cat")

    • Fronting ("tat" for "cat")

    • Cluster reduction ("poon" for "spoon")

  • Disappearance Age: Most processes should disappear by age 4.

Assessment & Intervention

  • Assessment Steps: Case history, oral mechanism exam, hearing screening, speech sample, standardized tests, analysis.

  • Intervention: Therapy or treatment plans for improving speech, language, or communication skills.

Motor Speech Disorders

  • Definition: Problems with motor planning or muscle control needed for speech.

  • Types:

    • Dysarthria: Caused by muscle weakness; entails slurred speech with good comprehension. Common causes: stroke, Parkinson's, ALS.

    • Apraxia: Difficulty planning speech movements; typically presents with inconsistent errors and groping for sounds. Typically caused by stroke or developmental issues.

Fluency

  • Definition: Smooth, effortless flow of speech.

  • Disfluency Types: Typical (e.g., interjections) and stutter-like (e.g., repetitions, blocks).

  • Developmental Stuttering: Begins in childhood; 80% natural recovery. Common theories: genetic, neurological, environmental.

  • Acquired Stuttering: Caused by brain injury or trauma.

  • Treatment Methods:

    • Direct: Teaching fluency strategies.

    • Indirect: Changing environment to reduce pressure.

Voice

  • Function of Voice: Reflects physical health, emotion, personality.

  • Vocal Folds Movement: Opens and closes like a wave.

  • Layers of Vocal Folds: Epithelium, 3 lamina propria layers, vocalis muscle.

  • Pitch: Frequency of vibration measured in Hertz (Hz); affected by vocal fold length.

  • Common Problems: Hoarseness, breathiness, strain, fatigue, loss of voice; stridor (noisy breathing) and aphonia (loss of voice).

Voice Disorders

  • Causes: Structural damage, neuromotor diseases, overuse.

  • Examples: Vocal nodules, polyps, tumors.

  • At-risk Professions: Teachers, singers, coaches, actors.

Swallowing & Dysphagia

  • Phases of Swallowing: Oral prep, oral transport, pharyngeal, esophageal.

  • Aspiration: Food/liquid enters the airway.

  • Dysphagia: Difficulty swallowing; linked to same muscles as speech.

  • Deglutition: Act of swallowing; common causes include neuromotor diseases or stroke.

Language Components

  • Components: Form, content, and use.

  • Phonology: Study of sound systems; smallest sound unit is a phoneme (e.g., /p/ in "pat").

  • Morphology: Structure of words; smallest unit of meaning is a morpheme (e.g., “cat”).

    • Free Morphemes: Stand alone (e.g., "dog").

    • Bound Morphemes: Attached (e.g., "-s").

  • Syntax: Sentence structure and grammar.

  • Semantics: Meaning behind words; semantic features describe word characteristics.

  • Pragmatics: Social use of language (e.g., taking conversational turns).