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COSD week 5 & 6 notes, Chapter 5

by: Maycie Tidwell

COSD week 5 & 6 notes, Chapter 5 COSD 10303

Maycie Tidwell
GPA 3.8

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These notes cover what was in chapter 5.
Survey of Communication Disorders
COSD, communication, disorders
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This 9 page Bundle was uploaded by Maycie Tidwell on Thursday February 25, 2016. The Bundle belongs to COSD 10303 at Texas Christian University taught by Watson in Spring 2016. Since its upload, it has received 41 views. For similar materials see Survey of Communication Disorders in Nursing and Health Sciences at Texas Christian University.

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Date Created: 02/25/16
COSD ch. 5 notes: Disorders of Articulation and Phonology Phonemes: speech sounds  26 letters for 41- 43 different speech sounds in English  Phonemes combine by following certain phonotactic rules. And this is very language specific. (letters represent different sounds)  IPA is what SLPs use (international phonetic alphabet) Consonants: Place, Manner, and Voicing Place: where is it being produced in the vocal tract Voicing: whether there is vibration or not Manner: how we produce a sound (descriptive) plosive or fricative -Distinctive Features: if the sound is anterior or not (+) or (-) Ex: “rr”= (-) Is it nasally or not (+) or (-) Ex: “mmm” = (+) ** you must know at least one example of a feature Vowels: tongue height, tongue being in front or back, tense or lax -Distinctive Features: Sonorant (+) or (-) Ex: “aa” (+) Classification of Consonants: Place Bilabial: 2 lips Labial dental: lips and teeth ex: “ff” Interdental: use your teeth Alveolar: use alveolar ridge “ll” or “ts” Palatal: use your palate Velar: in the back Glottal: ex: “hh” Voicing Voiced ex: “dg” Voiceless ex: “shh” Manner Stop ex: “g” Fricative ex: “sss” Affricate ex: “ch” Nasals Approximants: glides Liquids ex: “ll” Classification of Vowels by Tongue and Lip Position and Tension All English vowels are normally voiced and not nasal. Tongue position refers to part of tongue: front, center, back and height: high, mid, low. Lip position may be rounded or retracted. Vowels are tense or lax. Diphthongs are a combination of two vowels produced in close proximity and treated as a single phoneme. Ex: front and closed “bead” open “bat” Distinctive Feature Analysis All phonemes can theoretically be described based on the presence [+] or absence [-] of each of the distinctive features, such as nasal, anterior, distributed. Ex: “m” or “n” Speech Sound Development through the Life Span: Pre-speech Toddler speech Preschool speech School-age speech Pre-speech: Newborns: Reflexive and Vegetative Crying helps them to get a feeling a vocalization in their vocal folds 2 mo: cooing/going: non-distress sounds -sounds similar to back (velum) sounds “k” and “g” 3 mo: vocalizations in response to others 5-12 mo: progressively more complex --babbling stops “b” “p” “t” “d” nasal “m” “n” --reduplicated babbling ( the twin babies) strings of CV repetitions --echolalia (8-10 mo.) repeating or echoing --Jargon (saying random sounds really fast like they’re talking) --Phonetically consistent forms (PCFs) “ba” for “pacifier” ; “iggy” for “gimme” Toddler Speech: 12 mo: 1 recognizable word --words with CV structure are the easiest ex: “baba” “mama” “dada” “wawa” they may also omit final consonants (CVC becomes CV) --may contain various phonological processes when a child substitutes a stop for a fricative ex: “pat” for “fat” “pum” for “thumb” Preschool Speech: Most phonological processes disappear by age 4 -- Consonant blends may continue to be difficult E.g., spoon, street, draw, squirrel -- Generalizations regarding sound acquisition vowels are easier than consonants sounds first appear in initial position stops and nasals are acquired first many individual differences --order of sound mastery School-aged Speech: Should resemble adult speech. Multiple consonant blends are still hard to do. Morphophonemic contrasts. -change in pronunciation resulting from morphological changes. Phonology and Articulation: Phonology: study and knowledge of sounds of language and rules governing their production and combination. Articulation: actual production of these sounds Phonological impairments: disorders of conceptualization or language rules Classes of sounds & sound patterns Phonology disorder saying “tup” instead of “cup” Or saying “did” instead of “dig” Articulation impairments: disorders of production Substitutions, omissions, distortions, & additions Not being able to pronounce certain sounds such as “r” in “friends” or “l” in “life” Associated Disorders & Related Causes (phonology and articulation) Unknown cause: functional disorder Have studies “correlates” or “related factors” Two or more conditions occurring together but one does not necessarily cause the other Established Correlates: Hearing loss, ear infections, tooth misalignment/missing teeth, impaired oral motor skills, etc. etc. Developmental Impairment in Children: Delayed: articulation resembles that of much younger child Disordered: articulation is idiosyncratic Distinction often difficult. May be cute in childhood, viewed negatively in adulthood. Language Impairments: About 60% of children who are hard to understand have articulation + general language deficits. Some have learning disabilities They might use simpler and less grammatically correct speech. Intelligence normal, but special help needed. This might impair their reading/writing skills. Hearing Impairments: Affected by: Age of onset (developmental vs. acquired) The later the age of onset, the better chance they will be fine. Degree and type of earing loss History of otitis media is often a factor. Neuromuscular Disorders: Known cause: Motor speech disorder caused by neuromuscular deficits that result in weakness or paralysis and/or poor coordination of the speech musculature.  Spastic: Slow rate, imprecise articulation, harsh voice, hypernasality, prosodic abnormalities 75-85% of children with cerebral palsy have impaired speech. Later onset due to muscular dystrophy, stroke, tumor, degenerative disease, e.g. Parkinson’s disease. Articulation: imprecise; consistent errors. Apraxia of Speech: The planning of speech, nothing is wrong with the motor of the speech. Neurological cause: impairment in programming speech musculature Errors inconsistent, poor imitation, vowel + consonant misarticulations, groping when producing sounds on command, rate/rhythm and prosody abnormalities. Groping for words (word finding problems to plan out the rest of the sentence) Childhood Apraxia of Speech (CAS) Adults: damage to left side of brain from degenerative disease, tumor, stroke, other trauma. (damage to left side of brain wouldn’t affect speech) CAS and adult onset apraxia may be distinct disorders because of different etiology. Structural & Functional Abnormalities: Usually only gross abnormalities affect speech Cleft palate is detrimental to speech Hard palate Soft palate Language & Dialectal Variations: The SLP must: 1. Recognize cultural differences 2. Evaluate phonological competence in relevant language when possible 3. Select appropriate assessment tools 4. Use non-standard assessments often, with help of bilingual assistants 5. Describe phonological patterns 6. Diagnose phonological disorders that exist (ex: in Spanish they don’t ever say the “th” sound) -Characteristics of Articulation and Phonology: Impossible to describe all the variations in articulation and phonology that reflect non-English and dialectal differences. -Lifespan Issues: Therapy goal is to improve intelligibility and communicative effectiveness, not eliminate accent or dialect. **not a disorder, it is a difference!! ASSESSMENT Goals of phonological assessment parallel those for any communicative disorder.  Describe speech-sound inventory  Identify error patterns  Determine impact of errors on communicative effectiveness  Identify etiological factors  Plan treatment when appropriate  Make prognosis  Monitor change Case history, interview, oral peripheral exam, hearing screening Collect baseline data Description of Phonological Status: Include:  Speech sound inventory  Syllable and word structure: CV, CVC (make note of all sounds they can say)  Listing of phonemic errors: SODA  Phonological process analysis  Standardized tests  Evaluation of intelligibility  Percentage of intelligible words, syllables, or consonants. Prognostic Indicators: Lack of consistency, stimulability, error sound discrimination ability, external & internal Poorer Prognosis  Lack of consistency in errors  Lack of stimulability for correct production  Inability to discriminate error sound from the target sound  External (i.e., interpersonal)  Internal (i.e., intrapersonal) Intervention: Target Selection Major goal: increase intelligibility Consider:  Importance of possible targets to client  Frequency of targets within the language  Likelihood of success: Ease of mastery & stimulability (However, greater generalization to non-target phonemes occurs when targets are more difficult) Intervention Approaches: Bottom-Up Drill Progress from simple to more complex Target one sound at a time Speech assignments for generalization Traditional Motor Approach Four stages: 1. Ear Training (identification, location, stimulation, discrimination) 2. Production Training (isolation, syllables, words, phrases, sentences) 3. Stabilization (reinforcement and review) 4. Transfer or carry-over Sensory-Motor Approach 3 stages: 1. Production Training (isolation, syllables, words, phrases, sentences) 2. Stabilization (reinforcement and review) 3. Transfer or carry-over Intervention Approaches: Language-Based Instruction is implicit -Within language activities (ie. Reading a book) Has proven to generalize to conversational speech -Following drill-type therapy Intervention Approaches: Phonological-Based Multiple speech-sound errors or highly unintelligible Cycles Approach (just cycle through all words they have trouble with)  Minimal pair contrasts Multiple Oppositions Approach  Maximal contrasts (contrast “tink” with “sink” or “think”) “no you’re not tinking your thinking” Metaphon Approach  Metaphonological skills Intervention Approaches: Complexity Approach Training the more difficult sounds first sounds leads to generalization of easier, untrained sounds. More efficient May take more time initially Success depends on  Severity  Frustration level  Overall therapy goal Treatment of Neurologically Based Motor-Speech Disorders: Dynamic Temporal and Tactile Cueing  Intensive, motor-based, drill-type treatment for severe childhood AOS (say chair, char, chair, chair.)  Simultaneous production, imitation, delayed imitation, spontaneous production Lee Silverman Voice Treatment  Designed to increase loudness in adults with PD (parkinsons)  Effective with modifications for children with CP Computer Applications  Computer programs and games  In conjunction with direct therapy  Opportunity for daily practice  Can involve family members in treatment process Generalization & Maintenance: Correct productions should become habitual Self-monitoring is often introduced from the beginning. Follow-up after dismissal may be used to assess maintenance and provide "Booster treatment" if needed.


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