CD 277 Final

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CD 277 Final
2011-12-10 22:23:52

Flashcards for CD 277 final
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  1. How are consonants classified?
    Place, manner, and voicing
  2. How are vowels classified
    tongue height, tongue placement, tension
  3. articulation disorder
    difficulty with physiological movements of articulators, coordination of air support, timing of phonation
  4. phonology disorder
    child doesnt know which sounds are contrastive and which are not, kinds of positional constraints and sequential constraints placed on verious speech sounds
  5. Characterizations of articulation disorders
    substitutions, omissions, distortion, additions,
  6. Describ the error "Tar" for the word "car"
    • substitution
    • error is in PLACE
  7. Child says "tog" for dog
    • substitution
    • error in VOICING
  8. Child says "PISH" for fish
    • substitution
    • error in PLACE and MANNER
  9. Child says "ephant" for elephant
    Syllable deletion
  10. Child says "baftub" for bathtub
    • substitution
    • error in place
  11. Causes of Speech Disorders
    Structural, Genetic, Hearing Loss
  12. What is fluency
    • Describes the flow of speech in a conversation'
    • Relates to the ease and smoothness of speech
  13. Lower end of fluency continuum
    • -Trouble finding words
    • -Excessive pauses
    • -Repetition of phrases to make time to think
  14. Upper end of Fluency Continuum
    • -Politicians
    • -Being fluent and saying nothing
    • -Fluent speakers of foreign language
    • -Glib speakers (Robin Williams)
  15. What are disfluencies?
    • -Speech behaviors that disrupt flow of speech
    • -Pauses
    • -Interjections
    • -Revisions
  16. What is a fluency disorder?
    When speech contains a high rate of stoppages that disrupt flow of communication must be severe enough to impact social communication
  17. What is general awareness?
    • -Most people know what stuttering is
    • -Stuttering was the first disorder SLP's researched
    • -More research on stuttering than any other disorder
  18. What is stuttering?
    Disorder offluency characterized by certain types of disfluencies, excessive amounts of dysfluency in general, of excessive durations of dysfluencies
  19. What is Cluttering?
    Fluency problem that can affect intelligibility; it is characterized by breakdowns at the word or phrase level, poor cohension and coherence.
  20. Acceptable Disfluencies
    • Interjections
    • Revisions
  21. Stutter-Like Disfluencies
    • Repetitions
    • Prolongations
    • Silent Pauses
    • Broken Words
  22. Core vs Secondary Features
    • Core- repetitions, prolongations, blocks
    • Secondary- eye blinks, filler words, emotional reactions
  23. How many people stutter?
  24. Are boys or girls more affected by stuttering?
  25. When do most children start to stutter?
    age 2-5
  26. ___% of children that stutter eventually stop
  27. What are stuttering-like disfluencie?
    • -Occur on first few words of sentance
    • -Occurs on major cord content
    • -Predictability
  28. What is the amount of disfluency in a stutterer
  29. What are secondary features of stuttering?
    motor behavior, tightening muscles of speech aparattus,
  30. Impairment of speech
    slower speech, unnatural speech, disruption of speech by associated behaviors
  31. Disability
    interference with basic communication skills
  32. Handicap
    Not getting called on in class, not being selected for a play, being hung up on.
  33. What causes stuttering?
    • Developmental has no known cause.
    • Other- predisposing + precipitating
  34. Constitutional factors for stuttering
    • -Runs in the family
    • - Boys>Girls
    • -
  35. Precipitating factors for stuttering
    predisposing factors must be present but precipitating factors determine whether or not predisposing factor is manifested, temperment, and stressors
  36. What to collect during a speech sample for stuttering
    • -% of disfluencies per 100 words
    • - Rate of speech in syllables per minute
    • -Duration of blocks
    • - avoidance strategies
  37. Inter-examiner
    two different people see and hear the same thing
  38. Intra-Examiner
    the same person makes the same observation at a different point in time
  39. What are the 3 options for a beginning stutterer
    • -Wait, Watch, Re-evaluate
    • -Enroll in therapy but not necess stutter ther.
    • -Enroll in treatment with SLP
  40. Treatment for intermediate stutterer
    Enrol in therapy, ane make realistic expectations
  41. What are overall goals of stuttering treatment?
    • 1. speak normally without thinking about it
    • 2.. Control and manage the problem
  42. Teaching fluent stuttering, changing sttitudes and feelings about stutter, little emphasis on data collection and counting, speaking with less tension, gaining control.
    Stuttering Modification
  43. Spontaneous fluency is goal, little time spent on attitudes, big emphasis on data collection, any stuttering after treatment is considered failure
    Fluency Shaping
  44. What are fluency shaping techniques?
    • -Pause and talk
    • -Behavior Modification (punish disfluency)
    • -Computer aided home practice
  45. What type of hearing screening is done by one month of age?
  46. Hearing Identification by three months
    • Audiologic Evaluation
    • Follow-up to confirm Hearing Loss
  47. Early Intervention for hearing by six months
    Medical treatment, early services, and family support
  48. Over ___% of children are screened before they leave the hospital
  49. What are rick factors for late onset or progressive hearing loss?
    • -Family History of HL
    • -TORCH
    • -Bacterial Meningitis
  50. What does TORCH stand for?
    Toxoplasmosis, Other Agents, Rubella, Cytomegalovirus, Herpes
  51. What does ABR stand for?
    Auditory Brain Response Test
  52. What is an ABR
    Electrodiagnostic test that requires application of elctrodes to skin and presentation of click like sounds through earphones. Used to assess inner ear and auditory pathways
  53. What does OAE stand for
    Otoacoustic Emissions
  54. What does an OAE do?
    Acoustic energy produced by cochlea and measured by ear canal, may be awake but better is asleep, moderate sensitivity.
  55. What is the Soundfield Test?
    Sounds are presented through loud speakers, assesses hearinf eaither aided or unaided, important to behaviorally confirm heraing loss, some tests can be done 3-6 months.
  56. Battery of tests to assess immitance audiometry
    • tympanometry, acoustic reflex
    • (measure mobility of eardrum and how well muscles in ear contracts to loud sound)
  57. What are the four components of hearing aids
    microphone, amplifier, receiver, battery
  58. Amplification for Infants/Children
    -Electronic devices inside or behind ear, Do not restore hearing, Medical clearance needed from Physician
  59. What makes a child a candidate for Cochlear Implants?
    • -Severe-Profound SNHL
    • -12+ mo
    • -Lack of progress of auditory skill
  60. Benefits of hearing aid
    -Improved audibilidy, improved communication, reduced handicap, increased participation in activities
  61. Limitations of Hearing Aids
    Noise, Fast Speech, Takes time to adapt
  62. Overall satisfaction with hearing aids is __%
  63. CIC Hearing Aid
    In the ear, fits deep in canal
  64. ITC hearing aid
    in ear device, Small enough to fit almost entirely in canal (In The Canal)
  65. ITE Hearing Aid
    (In the ear) made to fit in external ear
  66. BTE Hearing Aid
    (behind the ear) fits snug behind the ear and is attacched to a custom earpiece
  67. Open fit hearing aid
    Ultra thin tubing is virtually invisible
  68. RIC Hearing Aid
    (Receiver-in-the-canal) the smallest BTE instruments
  69. Analog Curcuitry
    • -Amplify sound wave after converting to an electrical signal
    • -Less precise tuning
    • -Less expensive
  70. Digital Circuitry
    • -Amplify sound waves after they have been converted to a binary numerical code
    • -Precise Tuning
    • -More Expensive
  71. What is the average life of a hearing aid
    5-7 years
  72. What can cause a hearing aid to whistle?
    • wax
    • It may need to be adjusted
  73. Average cost of a hearing aid
  74. What does a cochlear implant do?
    Bypasses a nonfunctional inner ear and stimulates a nerve with electrical current
  75. What does microphone of cochlear implant do?
    pick up sound
  76. What does speech processor of cochlear implant do?
    selects and arranges sounds
  77. What does transmitter and receiver of cochlear implant do?
    receives signals and converts them into electric impulses
  78. What does the electrode of cochlear implant do?
    collects impulses from the stimulator and sends them to the brain.
  79. Cochelar Implant Vs Hearing Aid
    • -HA acoustically amplifies speech & relys on healthy inner hair cells
    • -CI convert speech info into electric signal, bypass hair cells, stimulate hearing nerve (8th cranial nerve)
  80. What is Aural Rehabilitation?
    Services designed to help individuals with HL realize their optimal potential. (can be in individual of group setting)
  81. What are the components of Aural Rehabilitation?
    HA operation, Assessment of self report, Psychological counseling, Communication strategies, Speechreading, assistive devices, auditory training
  82. New trednt in AT
    Reading disorders, mild dementia, cochlear implants/hearing aids, auditory processing disorders
  83. Risk Factors for Laryngel cancer
    -Tobacco, Alcohol, GERD (inflammation), Epstein-Barr, HPV
  84. Symptoms of Laryngeal cancer
    Hoarseness greater then 3 wks, lump in throat, persistent throat clearing, coughing, or sore throat, throat discomfort, difficulty breathing
  85. Medical Evaluation of Larynx
    Case history, indirect mirror laryngoscopy, flexible fiberoptic endoscopy, Biopsy, imaging studies
  86. What does TNM stand for?
    • T- tumpr size
    • N- lymph node metastasis
    • /m- presence of distand metastasis
  87. Treatment options for Larynx cancer
    Rediation, Chemo, Laryngeal surgery, combination, laryngectomy
  88. Respiration for laryngectomee
    air is no longer flitered, moisturized or warmed
  89. How are smell and taste affected after a laryngectomy?
    smell impaired since can not breath through nose, which also affects taste
  90. Speech Rehab after laryngectomy
    loss of sound generator, pulmonary source disconnected from oral cavity
  91. What is the most common artificial larynx?
    Electro layrnx. When held against skin of jaw, converts vibration into electronic sound
  92. Beck-type artificial larynges
    Electronic Artifical Larynges
  93. Oral Artifical Larynges
    Cooper-Rand or P.O. Vox
  94. Intra Oral Artificial Larynge
    Ultravoice custom built into upper denture
  95. Pneumatic Artificial Larynx
    Memacon and Tokyo artificial Larynges (rarely used in US)
  96. Advantages of Artificical Larynges
    Easy to learn, Equal in intelligibility to esophogeal, more easity discriminated in noise than esophogeal, can be easy changed to intraoral
  97. Disadvantages to Artificial Larynges
    Robotic, costly, requires one hand for use, Mechanical Breakdown, Difficult to vary pitch and intensity
  98. Esophogeal Speech
    patient transports air into esopagus, air is forced back past PE to include resonance
  99. Major method of air intake during esophogeal speech
    • inhalation
    • injection
  100. Esophogeal Speech Advantages
    No mechanical devices, both hands are free, more natural sounding
  101. Disadvantages to esophogeal speech
    takes 4-6 mo to learn, low sucess rate, phonation can be sustain for a short period, low intensity and pitch, limited pitch modulation
  102. Primary TEP
    TE fistula puncture created at time of Laryngectomy
  103. Secondary TEP
    TE fistula puncture created months after laryngectomy (less successful)
  104. Prosthesis
    inserted into trachea held by strap or collar
  105. Advantages of Voice Prothesis
    Long phnation sustainablity, more natural breathing action, easy to acquire and learn, hands free
  106. Disadvantages to Voice Prosthesis
    daily maintenance, semi-permanent, leakage, cost, requires additional surgery
  107. Motor unit
    aspects of movement that remain constant in different contexts
  108. Motor Learning
    practice or experience leads to permanent changes in capability for movement
  109. Motor Planning
    Process that defines and sequences articulatory goals prior to occurence
  110. Motor Programming
    Process responsible for establishing the flow of motor information across speech production muscles
  111. Motor Execution
    Process of activating relevant muscles during speech production
  112. Motor speech disorder may include
    neromuscular defect, motor control system defect, or both
  113. Motor speech disorders may have deficit in
    Motor planning/programming, Motor execution
  114. Causes of motor speech disorder
    Cogenital (Downs, Cerebral palsy), Acquired (CVA, TBI, Parkinsons)
  115. Phonatory System
    modulates airflow, controls vocal folds, used for prosody
  116. Respritory System
    Inhale/Exhale, Airflow required for speech
  117. Resonatory System
    Regulates airflow in oral/nasal cavitiy, nasality of speech, shape of VT impacts sound quality
  118. Articulatory system
    regulate articulation, controls oral muscles
  119. Apraxia
    • Disorder of motot planning
    • -inability to transform linguistic representation into appropriate movement of articulators
    • -Affects ARTICULATORY system
  120. Primary Scharacteristics of Apraxia
    Effortful slow speech, distortions of sounds, impaired prosody
  121. Secondary Characteristics of Apraxia
    groping articulatos, difficulty initiating speech, ex: hello is untomatic until on command
  122. Causes of Apraxia
    Neurobiological, Different lesion locations associated, may accompany aphasia
  123. Dysarthris
    Dirorder of execution may affect any or all systems
  124. Goal of dysarthria treatment
    learn of re-learn accurate speech production, retention, generalization
  125. To improve Resp. System impairments
    Posture changes, respiratory exercises, speak at onset of exhalation
  126. to improve phonatory system
    exercise to increase vocal fold closure, use of easy onset voicing, increase volume
  127. Improve impairments of resonatory system
    prosthetic device
  128. improve impairment of articulatory system
    oral motor exercise, sound production
  129. improving impairments in prosody
    rate control, stress training
  130. Why do SLP work with dysphagia?
    Speech is an overlaid function,
  131. Dysphagia involves at least __% of all practicing SLPs
  132. Deglutition
  133. Mastication
  134. Bolus
    round, soft, mass of food
  135. Implications of dysphagia
    Malnutrition, dehydration, poor wound healing, pulmonary complications, aspiration risk, poor oral care
  136. Voval folds must be (open/closed) when we swallow
    closed to protect the airway
  137. Vallecula
    space between tongue and eppiglottis
  138. pyriform sinuses
    located beside larynx and formed by shape of muscle attachments to pharyngeal walls
  139. Sepeartes pharynx from esophagus
    UES (upper esophogeal Segment)
  140. Two ways to Examine swallow
    • FEES (Fiberoptic Endoscopic Evaluation of the Swallow)
    • MBS (Modified Barium Swallow)
  141. 4 stages of the swallow
    Oral Prep Phase, Oral Phase, Pharyngeal Phase, Esophageal phase
  142. Oral Prep Phase
    Bolus formed, Variable and voluntary stage
  143. Oral Ohase
    Voluntary but not prolonged, lasts one second, breathing inhibited at beginning of stage, food moved to back of mouth
  144. Pharyngeal Phase
    Bolus moves from mouth down throat to esophagus, airway protection, reflex, 1 second
  145. Esophageal Phase
    INVOLUNTARY bolus is moved down esophagus, 3-20 secs,
  146. Component Parts of Voice Production
  147. Function of larynx
    Sphicteric Muscular Organ degined to protect airway. Speech is an overlaid function
  148. Membraneous sturcture that vibrates during phonation
    Vocal Fold Microstructure
  149. Causes of voice disorders
    Vocal abuse, surgical trauma, chrinic illness,
  150. Primary disorder etiologies for voice disorders
    cleft palate, velopharyngeal insufficiency, deafness, cerebral palsy, etc
  151. personal-related etiologies for voice disorders include
    environmental stress, psychological conversions, identity conflict,
  152. How do we diagnose voice disorders?
    Larygology evaluation, Voice pathology evaluation,
  153. Voice Pathology Evaluation of Voice Disorders includes:
    Patient interview, Voice assessment (CAPE-V, Equal appearing interval screen), Acoustic Voice Assessment, Laryngeal videostroboscopy
  154. Hygienic Voice Therapy
    discover behavioral causes of voice disorder and modifies to improve vocal condition (throat clearing, shouting, speaking loudly)
  155. Symptomatic voice therapy
    • modification of deviant vocal symptoms (breathiness, pitch, loudness, hard glottal attacks)
    • ex: tone focus, halthy shout
  156. Psychogenic Voice Therapy
    focus on emotional and psychological status of pt. that lead to voice disorder (muscle tention dysphonia, aphonia, falsetto)
  157. Physiologic voice therapy
    improve balnce among voice resp. system , muscle strength, (vocal function exercise, lee silverman voice therapy)
  158. Eclectic Voice Therapy
    Combination of any therpies
  159. which type of hearing loss is the cochlear implant used for
    sensorineural hearing loss
  160. what does the cochlear implant stimulate
    auditory nerve
  161. What four features characterize vowels
    height, frontness, roundness, tension
  162. what three features characterize consonants
    place, manner, voicing
  163. cause of phonological disorders
  164. sings of hearing loss
    ear pain, bleeding ear, sudden or progressive HL, unequal hearing by ears, HL after injury of loud sound, slow speech dvmt, balance disturbance
  165. speech behavior that disrupts the fluent flow of speech
  166. what is the hallmark of developmental stuttering
    part and single syllable word repetitions
  167. person tries to delay disfluency by talking around it
  168. predisposing factor
    constitutional factors that make an individual susceptible to fluency disorder (genetics, or overly sensitive temperment)
  169. precipitating factors
    developmental and environmental factors that can worsen stuttering such as age or stress
  170. fluency shaping vs stuttering modification
    FS tries to eliminate disfluency SM modifies stutter and decreases fear and anxiety
  171. Adduction
    when vocal folds are closed at midline
  172. Abduction
    when vocal folds are open, rested, so one can breathe
  173. What three things determine vocal folds?
    • Length (longer=lower F)
    • Mass (thick=lower F)
    • Tension (Greater=higher F)
  174. What is phonatory quality
    how well two vocal folds work during vibratory cycle
  175. spasmodic dysphonia
    strained, broken, breathy quality
  176. Dysphonia
    disordered voice
  177. Aphonia
    Lack of voice
  178. Hypofunction
    vocal folds that are under functioning
  179. Hyperfunction
    vocal folds that are pressed too tight and strained
  180. Diplophonia
    Vocal folds produce two pitches simultaneously
  181. in one min of speaking, vocal fold strike together over ________ times
  182. Contact ulcers
    inflamed ulcers around arytenoid cartilages
  183. Psychogenic disorder
    linked to emotional and psychological characteristics
  184. Mutational falsetto or puberphonia
    male with abnormally high voice