SLP praxis exam

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SLP praxis exam
2012-01-14 01:24:30
SLP praxis exam

SLP praxis exam
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  1. What is Aphasia?
    • an acquired neurologically based language disorder
    • can be fluent, nonfluent, or subcortical
  2. What are the characteristics of fluent aphasia?
    • relatively intact fluency but less meaningful speech
    • easily initiated, well articulated, good prosody and phrase length
  3. List 4 types of fluent aphasia
    • Wernicke's
    • Anomic
    • Conduction
    • Transcortical sensory
  4. Describe Wernicke's aphasia
    • posterior temporal gyrus in left hemisphere
    • rapid speech with normal prosody
    • severe word finding issues
    • paraphasia
    • extra syllables
    • neologisms
    • circumlocution
    • empty speech (this stuff, that thing)
    • poor auditory comprehension, repetition, writing
  5. Describe Anomic aphasia
    • posterior temporal gyrus in left hemi (same as Wernicke's)
    • word finding difficulty during fluent speech
    • verbal paraphasias
    • use of vague, nonspecific words
    • good auditory comprehension
    • most language functions (except for naming) unimpaired
  6. Describe Conduction aphasia
    • Arculate fasciculus - which carries info from wernicke's to broca's
    • impaired repetition
    • paraphasias
    • word finding issues
    • empty speech due to omitted content words
    • normal auditory comprehension
  7. Describe Transcortical sensory aphasia
    • temporoparietal region
    • paraphasic and empty speech
    • severe naming problems
    • good repetition but poor comprehension
    • echolalia of grammatically incorrect forms, nonsense syllables
    • can repeat phrases started by clinician - good automatic speech
  8. What are the characteristics of nonfluent aphasia?
    limited, agrammatic, effortful, halting, and slow speech with impaired prosody
  9. List 4 types of nonfluent aphasia
    • Broca's
    • Transcortical motor
    • Mixed
    • Global
  10. Describe Broca's aphasia
    • posterior, inferior frontal gyrus of left hemi
    • nonfluent, effortful, slow uneven speech
    • limited word output
    • short phrases
    • misarticulation or distorted sounds
    • agrammatic or telegraphic speech
    • poor reading and poor comprehension of read material
  11. Describe transcortial motor aphasia
    • anterior superior frontal lobe left hemi below broca's
    • speechlessness
    • perseveration of repetition
    • absent or reduced spontanous speech
    • intact repetition skill (specific to TMA)
    • nonfluent, paraphasic, agrammatic, telegraphic speech
    • good comprehension
    • impaired writing
  12. Describe Mixed aphasia
    • watershed area or arterial border
    • limited spontaneous speech
    • automatic unintentional conversation
    • severe echolalia (parrotlike repetition)
    • neologisms
    • severely impaired auditory comprehension, reading, writing
  13. Describe Global aphasia
    • Massive damage in middle cerebral artery
    • severe deficits in all areas
    • expression limited to a few words, exclamations, and serial utterances
    • perseveration
  14. What is subcortical aphasia?
    • lesion in area surrounding basal ganglia and thalamus
    • damage to basal ganglia: fluent speech with pauses and hesitations, intact repetition and auditory comprehension, articulation problems
    • damage to thalamus: hemiplegia, intial mutism, severe naming problems, good auditory comprehension
  15. What are Literal paraphasia?
    (Phonemic) - transposing sounds in a word such as tevelision for television
  16. What are verbal paraphasias?
    (Semantic) - incorrect word such as saying knife for fork
  17. What is an Embolism?
    artery abruptly occluded by traveling material (more frequent)
  18. What is a thrombosis?
    artery slowly occluded by collection of material
  19. What is an aneurysm?
    pouch formed by a weakened artery wall - leaking can be easier to repair, but ruptured is not
  20. What is an infarct?
    a loss of blood supply
  21. What is a TIA?
    a transient ischemic attack - mini stroke, change in blood supply to a particular area of the brain resulting in brief neurological dysfunction
  22. What are two different kinds of strokes?
    • ischemic: blocked or interrupted blood supply to the brain caused by thombosis (slow collection of material) or embolism (traveling clot)
    • hemorrhagic: bleeding in the brain due to ruptured blood vessel
  23. Describe information about strokes.
    • 750,000 new cases of strokes a year
    • 50% of those who survive have aphasia
    • 2/3 stroke patients over 65 years
    • Blacks have a higher incidence
  24. What is the function of CN I?
    • Olfactory
    • smell
  25. What is the function of CN II?
    • Optic
    • vision
  26. What is the function of CN III?
    • Oculomotor
    • eye movement
  27. What is the function of CN IV?
    • Trochlear
    • eye movement
  28. What is the function of CN V?
    • Trigeminal
    • mastication, facial sensation
  29. What is the function of CN VI?
    • Adbucens
    • eye movement
  30. What is the function of CN VII?
    • Facial
    • facial movement and sensation
  31. What is the function of CN VIII?
    • Auditory
    • hearing and balance
  32. What is the function of CN IX?
    • Glossopharyngeal
    • tongue/pharynx movement and sensation
  33. What is the function of CN X?
    • Vagus
    • heart, blood vessels, movement larynx/pharynx
  34. What is the function of CN XI?
    • Spinal accessory
    • neck muscles
  35. What is the function of CN XII?
    • Hypoglossal
    • tongue muscles
  36. What are the different types of acquired communication disorders?
    • Motor speech - 41%
    • Aphasia - 19%
    • Other Cognitive - 11%
    • Anatomic deficiency - 8%
    • Voice - 8%
    • Idiopathic - 8%
    • Psychogenic - 4%
    • Other - 1%
  37. Describe flaccid dysarthria
    • Lower motor neurons
    • weakness
  38. Describe spastic dysarthria
    • Bilateral upper motor neurons
    • spasticity
  39. Describe ataxic dysarthria
    • Cerebellum
    • incoordination
  40. Describe hypokinetic dysarthria
    • Basal ganglia
    • rigidity or reduced range of movement
    • Parkinson's, Alzheimer's, Pick's
  41. Describe hyperkinetic dysarthria
    • Basal ganglia
    • abnormal movements
    • Huntington's
  42. Describe unilateral upper motor neuron dysarthria
    • Unilateral upper motor neurons
    • weakness, incoordination, spasticity
  43. What is a motor speech disorder?
    A speech disorder resulting from neurological impairment affecting the motor planning, programming, neuromuscular control, or execution of speech - they include the dysarthrias and apraxia of speech
  44. What is dysarthria?
    A disturbance in muscle control over the speech mechanism due to damage of the central/peripheral nervous system
  45. What is apraxia of speech?
    Impaired capacity to plan or program speech - NOT muscle weakness
  46. What are the subsystems assessed with motor speech disorders?
    • phonation
    • resonation
    • articulation
    • prosody
    • respiration
  47. What is right hemisphere dysfunction as it related to the manifestation of speech and language?
    For most people the right hemi is the non dominant hemi for speech and language. They typically have both communication and cognitive deficits which can be addressed in S/L therapy.
  48. What are some deficits that can be seen in right hemi dysfunction?
    • Left neglect
    • inattention
    • denial
    • executive function difficulty
    • inability to integrate information
    • literal/figurative meanings
    • flat affect
    • impulsivity
    • disorientation to time and direction
  49. What is dysphagia?
    The interruption in eating pleasure or in the maintenance of nutrition and/or hydration - the inability to transfer the bolus from the mouth to the stomach
  50. What are some common etiologies of dysphagia?
    • Stroke
    • head injury
    • cervical spinal cord injury
    • progressive neurological disease
    • head/neck cancer and/or radiation
  51. What are the primary concerns of dysphagia?
    • aspiration
    • dehydration
    • malnutrician
    • quality of life
  52. What is aspiration?
    the entry of food/liquid into the airway below the vocal folds
  53. What is penetration?
    food/liquid enters the laryngeal vestibule at the level of the true vocal cords
  54. What are the 4 stages of swallowing?
    • oral preparatory stage
    • oral transit stage
    • pharyngeal stage
    • esophageal stage
  55. What are the 6 stages of the pharyngeal swallow?
    • prompt trigger of the pharyngeal swallow
    • velar elevation/velopharyngeal closure
    • base of tongue retraction
    • epiglottic retroflection
    • laryngeal elevation
    • cricopharyngeal opening
  56. What are some compensatory strategies for dysphagia?
    • chin tuck
    • head rotation
    • head tilt
    • side-lying
    • multiple swallows
    • alternate solids and liquids
    • effortful swallow
    • cough/clear throat
    • modify bolus size
    • modify food consistency (last option)
  57. What are the 2 components of the respiratory system?
    • UPPER nose
    • Nasal cavity
    • pharynx
    • LOWER larynx
    • trachea
    • bronchi
    • lungs
  58. What the components of the Gastro-intestinal tract?
    • mouth
    • esophagus
    • stomach
    • pancreas
    • liver
    • small intestine
    • large intestine
  59. What is respiration?
    Breathing - supplies the energy needed for speech
  60. What is phonation?
    involves voicing and the structures and processes that create voice
  61. What is resonation?
    the processes by which the voice or laryngeal tone is modified by various supralaryngeal cavities and structures
  62. What is articulation?
    the process of making speech sounds
  63. What structures support the process of inhalation, exhalation, and speaking?
    • lungs
    • bronchi
    • trachea
    • spinal column
    • sternum
    • rib cage
  64. What are the key laryngeal structures from superior to inferior positioning?
    • hyoid bone
    • epiglottis
    • thyroid cartilage
    • cuneiform
    • arytenoid cartilage (pyramid)
    • corniculate (tip of arytenoids)
    • cricoid cartilage (top tracheal ring)
    • trachea
  65. What is the myoelastic-aerodynamic theory?
    the vocal folds vibrate because of the forces and pressure of air and the elasticity of the vocal folds
  66. What is the Bernoulli effect?
    sucking motion of the vocal folds towards one another - caused by the increased speed of air passing between the VF
  67. What are the 3 sections of the pharyngeal cavity?
    • laryngopharynx
    • oropharynx
    • nasopharynx
  68. What cranial nerves are involved in articulation?
    • CN V: trigeminal
    • CN VII: facial
    • CN X: vagus
    • CN XI: spinal accessory
    • CN XII: hypoglossal
  69. What are neurons?
    central building blocks of the nervous system - they include the cell body, dendrites, and an axon
  70. What are the structures of the brainstem?
    • Midbrain: CN III, CN IV (eye mvmt)
    • Pons: CN V, CN VII (speech production)
    • Medulla: CN VIII-XII
  71. What is the reticular activating system?
    • structure in the midbrain, brainstem, and upper portion of the spinal cord
    • execution of motor activity
    • attention and consciousness
    • sleep-wake cycles
  72. What are the functions of the basal ganglia?
    • regulate and modify cordically initiated motor movements - including speech
    • damage here can lead to: hypo, hyperkinetic dysarthria, unusual body postures, uncontrolled movement, lead to involuntary movements
  73. What speech and language structure is located in the frontal lobe?
    • primary motor cortex
    • motor strip
    • Broca's area
  74. What speech and language structure is located in the temporal lobe?
    • primary auditory cortex
    • Wernicke's area
  75. What is phonetics?
    the study of speech sounds
  76. What are the 7 manners of articulation?
    • nasals - /m, n, ng/
    • stops - /p, b, t, d, k, g/
    • fricatives - /f, v, th, s, z, j, sh, h/
    • affricates - "j" "ch"
    • liquids - /l, r/
    • glides - /w, j/
    • laterals - /l/
  77. What are the places of articulation?
    • bilabial
    • labiodental
    • linguadental
    • lingua-alveolar
    • linguapalatal
    • linguavelar
    • glottal
  78. What are suprasegmentals?
    • add meaning, variety and color to running speech
    • they include: stress, length, rate, pitch, intensity, juncture
  79. What is amplitude?
    the strength or magnitude of a sound signal - the greater the amplitude the louder the sound signal
  80. What is frequency?
    rate of vibratory motion measured in cycles per second (Hz) - 1 cycle per second is 1 Hz
  81. What is an octave?
    an indication of the interval between two frequencies
  82. What is sound?
    sound is the result of a vibration or disturbance in the molecules of a medium (solid, liquid, air) that is potentially audible
  83. What are acoustics?
    the study of the physical properties of sound
  84. What is linguistics?
    the study of language
  85. What are the subfields of linguistics?
    • morphology
    • syntax
    • semantics
    • pragmatics
    • phonology
  86. What is morphology?
    The study of word structure
  87. What is syntax?
    the arrangement of words to form meaningful sentences
  88. What is semantics?
    the study of the meaning of language
  89. What is pragmatics?
    the use of language in a social context
  90. What is the behaviorist theory of language development?
    • Skinner
    • verbal behavior as a form of social behavior
  91. What is the nativist theory of language development?
    • Chomsky
    • children are born with language acquisition device
  92. What is the cognitive theory of language development?
    • language acquisition made possible by general intellectual process
    • knowledge of mental processes
  93. What factors are associated with language problems in children?
    • children with specific language impairments (language-learning disabilities)
    • children with language problems associated with other clinical conditions (intellectual, autism, HL, TBI, CP)
    • children with language difficulties related to a combination of factors (poverty, neglect, abuse, alcohol, ADD)
  94. Why do children with SLI have issues with morphological features of language?
    • Perceptual problems: children do not perceive morphological features as well as they do other features because they are produced with less intensity
    • Syntactic problems: the syntactic complexity involved in sentence comprehension and production may have a negative effect on morphology
  95. What pragmatic skills do children with SLI have difficulty with?
    • topic initiation
    • turn taking
    • topic maintenance
    • appropriate conversation repair
    • discourse and narrative skills
    • staying relevant during conversation
  96. What is an intellectual disability?
    formally called mental retardation, this is significant limitations both in intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical adaptive skills
  97. What is Autism?
    • impaired social interactions, disturbed communication, stereotypic patterns of behavior, interests, and activities
    • because of wide variation in the symptom complex of autism, it is described as a spectrum disorder
    • most experts support genetic or neurophysiological theories of autism
  98. What are the (2) subgroups of brain-injured children?
    • those who sustain injury due to head trauma
    • those who have cerebral palsy
  99. What are the main causes of TBI in children?
    • vehicular accident
    • sports-related accident
    • falls
    • physical abuse
    • assults
    • gunshot wounds
  100. What is cerebral palsy?
    • disorder of early childhood in which the immature nervous system is affected
    • not a disease
    • group of symptoms associated with brain injury in still-developing children
  101. What are the types of cerebral palsy?
    • ataxic: disturbed balance, awkward gait, uncoordiated movement (cerebellar damage)
    • athetoid: slow, writhing, involuntary movement (indirect pathway, basal ganglia damage)
    • spastic: increased spasticity, tone, rigidity of muscles, stiff, abrupt movements (motor cortex, direct motor pathway damage)
  102. What are patterns of interference/transfer from one language to another?
    an error in a student's second language that is directly produced as a result of influence from the first language
  103. What are the functions of the cuneiforms?
    cone-shaped cartilages that are located under the mucous membrane that covers aryepiglottic folds
  104. What is the role of the tensor palatini?
    muscle that opens the Eustachian tube during yawning and swallowing
  105. What is the response cost method?
    a token is given for each fluent production, and one is withdrawn for each disfluency
  106. Based on Spanish influences, what is NOT typical for a Spanish speaking, English language learner?
    v/f substitutions in medial position of words
  107. What muscle is primarily responsible for the vibration that produces sound in the vocal folds?
    internal thyroarytenoids
  108. What are the categories of cerebral palsy?
    • ataxic
    • athetoid
    • spastic
  109. What is auditory memory?
    child's ability to mentally sort speech stimulu or remember what he has heard
  110. What is an octave?
    an indication of the interval between two frequencies
  111. What is the social interactionist theory?
    the idea that the structure of language may have arisen from language's social communication function in human relations
  112. When is -ed mastered in typical developing children?
    24-26 months
  113. Describe Blom-Singer's prosthetic device that is used with laryngectomy patients.
    shut the air from the trachea to the esophagus so that the patient can speak on pulmonary air that enters the esophagus
  114. What is a jitter?
    variation in vocal frequency, or frequency perturbation
  115. What is a submucous/occult cleft?
    surface tissue of the soft or hard palate fuse but the underlying muscle or bone tissues do not
  116. Which is a pattern in English you would NOT expect to find in a student who speaks Korean?
    substitution of t/k such as "tea/key"
  117. Describe neurogenic stuttering?
    disfluencies on function words and in imitated speech, lack of adaptation minimal or no effect of masking noise
  118. At what age should typically developing children be able to understand agent-action relationships?
    3-4 years
  119. At what pecent disfluency in speech rate would you diagnose a disorder in fluency?
    5% of the words spoken
  120. What is McDonald's sensory approach?
    articulation therapy approach which emphasizes both the syllables as the basic unit of speech and the concept of phonetic environment
  121. What does the ~ mark mean when placed above a phoneme?
    non-nasal had become nasalized
  122. Descibe Von Langenbeck surgical method?
    surgical method of a cleft palate repair that involves raising two bipedicled flaps of mucuperiosteum, bringing them together and attaching them to close the cleft
  123. What is a stroboscopy?
    procedure that uses a pulsing light to permit the optical illusion of slow-motion viewing of the vocal folds
  124. What cranial nerve is primarily responsible for innervating the larynx?
  125. In the scientific method, what is the inductive method?
    this is the experiment first and explain later approach
  126. How would you distinguish Asperger's versus Autism?
    lower IQ and language skills in Autism and the reverse with Asperger's
  127. Describe fast-mapping?
    the ability to learn a new word on the basis of just a few exposures to it
  128. According to Halliday, what are 4 of the 7 functions of communicative intent that develop between 9 and 18 months?
    • heuristic
    • imaginative
    • interactional
    • personal
  129. What is a thrombus?
    stationary blodd clot that blocks the flow of blood
  130. Which is NOT predictable based on a student's first language of Mandarin?
    confusion of /r/ and /l/
  131. What did Brutten and Shoemaker hypothesize?
    that stuttering is caused by classically conditioned negative emotions
  132. What did Piaget state?
    concrete operations state that the child employs logical causality
  133. What properties affect sound transmition?
    mass and elasticity
  134. Repetition skills are better preserved in which aphasia?
    Transcortical motor aphasia
  135. Describe basic interpersonal communication skills - BICS.
    are developed to a level commensurate that of native English speakers for those developing English as a second language in 2 years
  136. What does the cricothyroid do?
    raises pitch of voice by lengthening and tensing the vocal folds
  137. What pattern is NOT typical for a Spanish-speaking student in terms of predictable productions based on Spanish influence?
    ch/f substitutions
  138. What articulation difference is NOT commonly observed among Asian speakers of English as a second language?
    t/k substitutions such as "tin/kin"
  139. What is concurrent validity?
    researchers developing a new test of language acquisition correlated the scores of children studied with the score on an established test of known validity
  140. What is signal-to-noise ratio?
    in social situations such as parties, people don't speak loudly enough and noise creates a problem for him in hearing what people are saying
  141. Describe ex-post facto research.
    a type of research in which independent variables have occurred in the past and the investigator tries to find potential causes of the dependent variables
  142. Sensitivity to sound of the normal ear of a young adult is limited to what frequencies?
    20 Hz - 20,000 Hz
  143. What is split-half reliability?
    in developing a test with 100 items, a test developer correlated responses to the first 50 items with responses to the last 50 items
  144. What is coarticulation?
    the influence of one phoneme upon another in production and perception, wherein two different articulators move simultaneously to produce two different speech sounds
  145. Describe the positive features of conduction aphasia.
    • fluent aphasia
    • good syntax, prosody, articulation
  146. Describe an indirect laryngoscopy.
    specialist uses a bright light source and a small, round 21-25 mm mirror angled on a long slender handle to list the velum and press gently against the patient's posterior pharyngeal wall and the mirror is maneuvered to view the laryngeal structures during quiet respiration and while the patient is producing /i/
  147. What is an example for telegraphic speech in a child?
    a child saying "dog bark" instead of "the dog is barking"
  148. What is juncture?
    • vocal punctuation - such as pausing and intonation
    • "What did you eat?" vs "What, did you eat?"
    • "night rate" vs "nitrate"
    • "I scream" vs "ice cream"
  149. What is adequate construct validity?
    test scores are consistent with theoretical concepts or expectations
  150. What does a visi-pitch measure?
    frequency range, optimal pitch, and habitual pitch
  151. What is a myringoplasty?
    surgery used to repair the tympanic membrane after it has been ruptured
  152. What is otosclerosis?
    a spongy growth that starts on the footplate of the stapes and causes it to become rigid
  153. According to Brown, what is the last morpheme to be acquired by a typical child?
    contractible auxiliary
  154. What is otitis media?
    • also known as middle ear effusion
    • infection in the middle ear associated with upper-respiratory infections and eustachian tube dysfunction
  155. What is external otitis?
    • bacteria or viral infection of the skin of the external auditory canal
    • causes conductive loss
  156. What is a myringotomy?
    surgical procedure in which small incisions are made in the tympanic membrane to relieve pressure caused by chronic otitis media
  157. What is stenosis?
    birth defect resulting in extremely narrow external auditory canal
  158. What is aural atresia?
    birth defect in which extrenal ear canal is completely closed
  159. What is Carhart's notch?
    • frequently found in patient's with otosclerosis
    • specific loss at 2,000 Hz as indicated by bone-conduction testing
  160. What is content validity?
    when a test measures what it is supposed to measure because the scores are progressively higher across age groups
  161. What muscles contribute to velopharyngeal closure?
    • palatoglossus
    • tensor veli palatini
    • levator veli palatini
  162. Stuttering is preschool children tends to occur somewhat more frequently on which words?
    function words more than content words
  163. What is the muscle that's used to create the /th/ sound?
    genioglossus muscle
  164. Define cohesion.
    ordering and organizing utterances in a message so that they build logically on one another
  165. What is vital capacity?
    the volume of air that a person can exhale after a maximal inhalation
  166. What is a leukoplakia?
    • benign growth of thick, whitish patches on the surface membrane mucosa
    • leads to soft, hoarse, low pitched, and breathy voice
  167. What is the fluency shaping method?
    teaching a client to use normal prosodic features of speech for those who stutter
  168. What is the adaptation effect?
    when the frequency of stuttering decreases from a first to subsequent reading
  169. What is a granuloma?
    unilateral localized inflammatory vascular lesion that developed on the vocal process of the arytenoid cartilage
  170. What are Halliday's 7 functions of communication intent?
    • imaginative
    • heuristic
    • regulatory
    • personal
    • informative
    • instrumental
    • interactional
  171. What is dysarthria?
    speech disorder associated with muscle weakness or paralysis
  172. What are the characteristics of Broca's aphasia?
    nonfluent, effortful, agrammatic, and slow speech
  173. What is reduplication?
    when a child repeats a pattern such as (wawa/water)
  174. What is a papilloma?
    a pink or white wart-like growth that can be found anywhere in the airway and can make a person's voice hoarse, breathy, and low pitched
  175. At what age does the concrete operations stage of cognitive development occur according to Piaget?
    7-11 years
  176. What is the discrete trial procedure?
    recording the correct and incorrect responses on each attempt you ask the child to make
  177. What is PL 94-142?
    children and youth with disabilities from age 3-21 years are guaranteed free and appropriate publich education (FAPE) in the least restrictive environment including special education and related services
  178. What is alternate-form reliability?
    administering two versions of a test (Form A and Form B) to selected children
  179. What is electromyography?
    a procedure that studies the pattern of electrical activity of the vocal folds by inserting electrodes into the patient's peripheral layngreal muscles to measure laryngeal function
  180. Which are the 2 muscles in the middle ear that dampen vibrations of the tympanic membrane and ossicular chain?
    • tensor tympani
    • stapedius muscle
  181. What is holophrastic speech?
    one word is used to communicate a variety of meaning
  182. What is the lingual frenum?
    the structure at the inferior portion of the tongue that connects the tongue with the mandible
  183. Apraxia of speech is commonly associated with lesions in which area?
  184. Which muscle adducts the vocal folds?
    transverse arytenoids
  185. What are some limitations of standardize testing?
    • inadequate national sampling in the normative process
    • inadequate response sampling
    • contrived test situations that don't represent naturalistic communications
    • limited participation of families assessment
    • general inappropriateness for ethnoculturally diverse children
  186. Where is the primary motor cortex in the frontal lobe located?
    precentral gyrus
  187. What is rarefaction?
    when vibrating objects return to equilibrium and air molecules become thinner
  188. What is a type-token ratio?
    represents the variety of different words the child uses expressively
  189. What is the TTR for a child between 3-8 years?
    1:2 or .5
  190. What are some factors involving an established risk of developing language disorders?
    • mostly biological or disease related
    • congenital malformation, genetic syndrome, neurological disorders, chronic illness, infections
  191. What are some conditions that place children at risk for developing language disorders?
    • environmental or genetic factors
    • serious pre, peri, post natal complications, behavioral disorders, low parental education, substance abuse, unstable living condition
  192. What are some characteristics of children with language problems?
    • difficulty in comprehending spoken language
    • slow/delayed onset of language
    • limited language output or expressive language
    • problematic syntactic skills
    • problematic pragmatic skills
    • problematic learning of grammatical morphemes
  193. What are different types of intervention techniques available?
    • one one one intervention
    • small group intervention
    • whole classroom intervention (in which the child is worked with as part of his/her class in the classroom setting)
    • indirect intervention (in which the clinician sets the goals and a peer, parent, teacher's aide, interpreter)
  194. What are some basic behavioral techniques that are used in a comprehensive language treatment program?
    • instructions
    • modeling
    • prompting
    • shaping
    • manual guidance
    • fading
    • immediate, response-contingent feedback
  195. What is expansion?
    • expanding a child's telegraphic or incomplete speech into a more grammatically complete utterance
    • if the child says "doggy bark" the clinician can say "yes, the doggy is barking"
  196. What is telegraphic speech?
    • preserving the meaning of the utterance while omitting the smaller grammatical elements
    • saying "cat eat food" for "The cat is eating the food"
  197. What is extension?
    the clinician commenting on a child's utterance by adding new and relevant information
  198. What is the milieu teaching?
    teaching functional communication skills through the use of typical, everyday verbal interactions that arise naturally
  199. What are the parameters used to classify consonants?
    • place
    • voicing
    • manner
  200. What are some finding on speech sound acquisition?
    • vowels are acquired first
    • nasals mastered between 3-4
    • stops mastered between 3-4.5
    • glides /j, w/ mastered between 2-4
    • fricatives/affricates mastered 3-6, but /f/ usually first around age 3
    • liquids /r, l/ mastered late around 3-7
    • consonant clusters are last
  201. What is vocalization?
    • substitution
    • a vowel is subbed for a consonant
    • saying "bado" for "bottle"
  202. What is gliding?
    • substitution
    • a liquid is produced as a glide
    • saying "wing" for "ring"
  203. What is velar fronting?
    • substitution
    • an alveolar or dental replaces a velar
    • saying "tea" for "key"
  204. What is stopping?
    • substitution
    • fricative or affricate is replaced by a stop
    • saying "to" for "shoe"
  205. What is depalatization?
    • substitution
    • child subs an alveolar affricate for a palatal affricate
    • saying "wats" for "watch"
  206. What is affrication?
    • substitution
    • affricate is produced in place of a fricative or stop
    • saying "chun" for "sun"
  207. What is deaffrication?
    • substitution
    • fricative replaces an affricate
    • saying "sip" for "chip"
  208. What is backing?
    • substitution
    • posteriorly placed consonant is produced instead of anteriorly
    • saying "boak" for "boat"
  209. What is assimilation?
    • sounds are changed by the influence of neighboring sounds
    • reduplication, regressive, progressive, voicing
  210. What are possible syllable structure processes that can affect words?
    • unstressed syllable deletion
    • final consonant deletion
    • epenthesis (adding schwa)
    • consonant cluster reduction
    • diminutization (adding /i/)
    • metathesis (reversing sounds in word)
  211. What is ankyloglossia?
    being tongue-tied
  212. What is a malocclusion?
    deviation in the shape or structure - in this case it usually refers to a dental malocclusion
  213. What is class I malocclusion?
    arches are properly aligned but individual teeth are misaligned
  214. What is class II malocclusion?
    overbite - maxilla is protruded
  215. What is class III malocclusion?
    underbite - mandible is protruded
  216. What is an orofacial myofunctional disorder OMD?
    any anatomical or physiological characteristics of the orofacial structures that interfere with normal speech, physical development
  217. What are some characteristics of childhood apraxia of speech?
    • slow, effortful speech
    • prolongation of speech sounds
    • repetition of sounds and syllables
    • difficulty with consonant clusters
    • omissions and substitutions
    • voicing errors
    • groping and silent posturing
  218. How many utterances are in an optimal speech sample?
  219. What is stimulability?
    refer's to a child's ability to imitate the clinician's model
  220. Describe Van Riper's traditional approach.
    • auditory discrimination/perceptual training
    • phonetic placement
    • drill-like repetition and practice
  221. Describe McDonald's Sensory-motor approach.
    • based on the assumption that the syllable, not the isolated phoneme, is the basic unit of speech production
    • coarticulation is important in this approach
    • helpful for children with oral-motor coordination difficulties
  222. Describe the Hodson and Paden Cycles approach.
    • phonological pattern approach designed to treat children with multiple misarticulations and highly unintelligible speech patterns - 4O% or greater
    • clinician introduces correct patterns, gives the child limited practice with them, and returns to them at a later date
  223. What is phonological awareness?
    explicit awareness of the sound structure of a language, or attention to the internal structure of words
  224. What are some characteristics of English as Foreign Language learners?
    • 25-3O% refere themselves for other conditions involving fluency, voice, and possibly dyspraxia
    • impact of the first language on English is so great that their English intelligibility is reduced
  225. What are different types of fluency disorders?
    • stuttering
    • cluttering
    • neurogenic stuttering
    • psychogenic stuttering
  226. What are different types of secondary behaviors?
    • muscular tension
    • breathing abnormalities
    • negative emotions
    • avoidance behaviors
  227. What are the 3 definitions of stuttering?
    • 1. anticipating trouble in speaking situations
    • 2. what a person does to avoid stuttering
    • 3. social role conflict
  228. List the different types of dysfluencies?
    • repetition
    • sound prolongation
    • silent prolongation
    • interjection
    • pauses
    • broken words
    • incomplete sentences
    • revisions
  229. What percentage of speech needs to be dysfluent to be judged as "dysfluent" or "stuttered"?
  230. More statistics on stuttering.
    • 5% of population has instance of stuttering
    • 1% of US population
    • generally begins between 3-6 years
    • onset of stuttering after 12 yrs is rare
    • onset in adults is rare, usually occurs after neurogenic incidence
    • 3:1, male to female
  231. What is concordance?
    the occurance of the same medical conditions in both members of a twin pair
  232. What is spontaneous recovery?
    disappearance without professional help
  233. What abnormal motor behaviors may be associated with stuttering?
    • excessive motor effort
    • various facial grimaces
    • various hand/foot movements
    • rapid eye blinking
    • rapid opening/closing of mouth
    • tongue clicking
  234. In what instances/loci is stuttering most likely to occur in adults and school-age children?
    • consonants over vowels
    • first sound/syllable of a word
    • first word/phrase in sentence
    • longer words
    • less frequently used words
    • content words over function words for adults
    • function words over content words for kids
    • this can be due to the fact that adults usually start with content words and kids start with function words - this further strengthens the idea that position of words rather than the actual class of words affects stuttering
  235. What is the adaptation effect?
    frequency of stuttering is reduced when a short passage is repeatedly read aloud
  236. What is the consistency effect?
    • the occurance of stuttering on the same word or loci when a passage is read aloud repeatedly
    • 65% of stuttering may be consistent
  237. What is the adjacency effect?
    occurance of new stuttering that occur on word surrounding previously stuttered words
  238. What is the audience size effect?
    the frequency of stuttering increases with an increase in audience size
  239. What are the main theories of stuttering?
    • environmental
    • genetic
    • neurophysiological
  240. What is the fluent stuttering method?
    the focus is not on normal fluency, but on making stuttering more fluent
  241. What is the fluency shaping method?
    establish normal fluency by teaching various skills of fluency (appropriate management of airflow to produce and sustain fluent speech, slower rate of speech, and gentle onset of phonation)
  242. What is neurogenic stuttering?
    stuttering with documented neuropathology such as cerebral vascular disorders causing strokes and head trauma, extrapyramidal diseases (Parkinson's), drug toxicity
  243. What is cluttering?
    • disorder of fluency that often coexists with stuttering
    • speaking highly disfluently, rapid, unclear, and disorganized manner that is jerky and monotonous
  244. What is the glottis?
    the opening between abducted vocal folds
  245. What is the primary CN involved in laryngeal function?
    • CNX - vagus nerve
    • superior and recurrent laryngeal nerve branches that innervate larynx
  246. What can happen with damage to the recurrent laryngeal nerve?
    • it supplies all sensory information below the vocal folds
    • if damaged, patient may experience difficulty adducting the vocal folds
  247. What is the cricoid cartilage?
    • uppermost tracheal ring
    • completely surrounds the trachea
  248. What are the arytenoid cartilages?
    • supraposterior surface of the cricoid cartilage on either side
    • pyramid shaped
    • vocal process are the most anterior angel
  249. What is the average fundamental frequency for men? Women?
    • 125 Hz (men)
    • 225 Hz (women)
  250. What is presbyphonia?
    an age related voice disorder characterized by perceptual changes in quality, range, loudness, and pitch in the older voice
  251. What are the 3 sets of vocal folds?
    • aryepiglottic folds
    • ventricular folds (false)
    • true vocal folds
  252. What are 3 important characteristics of the voice?
    • pitch
    • volume
    • quality
  253. What is pitch?
    the perceptual correlation of frequency
  254. What is volume?
    perceptual correlation of intensity or loudness
  255. What is fundamental frequency?
    a person's habitual pitch
  256. What is amplitude perturbation or shimmer?
    cycle-to-cycle variation of vocal intensity
  257. What is quality?
    • the perceptual correlation of complexity
    • can be measured by hoarseness, harshness, strain-strangled, or breathiness
  258. What is glottal fry?
    • heard when vocal folds vibrate very slowly
    • sound occurs in slow but discrete bursts and is extremely low pitch
    • crackly
  259. What is diplophonia?
    • two distinct pitches during phonation
    • "double voice"
  260. What is stridency?
    voice sounds shrill, unpleasant, and somewhat high pitched
  261. What is an indirect laryngoscopy?
    bright light source and small mirror to lift the velum and press gently against the patient's posterior pharyngeal wall during phonation of /i/
  262. What is a direct laryngoscopy?
    • performed by surgeon under general anesthesia
    • can observe direct microscopic view of the larynx but no phonation so vocal function can't be observed
    • valuable tool for biopsy
  263. What is a flexible fiber-optic laryngoscopy?
    thin, flexible tube containing lens and light source passed through patient's nasal cavity, over velum, to view larynx
  264. What is an endoscopy?
    • flexible (nasally) and rigid (orally) where patient can do variety of things
    • can study laryngeal anatomy and physiology in detail
    • endoscopy can be attached to a camera (videoendoscopy) or a stroboscopic (flashing) light source can be used
  265. What are two ways vocal fold patterns can be measured?
    • electroglottography (EGG): noninvansive indirect measure
    • electromyography (EMG): invasive direct measure
  266. What is resonance?
    the modification of sound by the structures through which the sound passes
  267. What are the voice disorders of resonance?
    • hypernasality: excessive nasality
    • hyponasality: denasality
    • assimilative: nasal consonant carries over to adjacent vowels
    • cul-de-sac: backward retraction of tongue, often seen in the deaf population
  268. What is metathesis?
    spread of cancer to other regions
  269. What is a laryngectomy?
    • removal of the larynx due to cancer
    • patient may need radiation or chemotherapy
  270. Describe types of alaryngeal speech.
    • VF are gone after laryngectomy so normal voicing is not possible
    • may need stoma or opening in lower part of neck connecting to trachea
    • vocalization types: external device, esophageal speech, surgical modification
  271. What is a granuloma?
    • localized, inflammatory, vascular lesion composed of granular tissue is a firm, rounded sac
    • frequently develop on vocal process of arytenoid cartilage
    • caused by vocal abuse, injury, intubation, GERD
  272. What is a hemangioma?
    • soft, pliable, filled with blood
    • occur in posterior glottal area
    • caused by intubation or hyperacidity
  273. What is leukoplakia?
    • benign growths of thick whitish patches on the surface membrane of the mucosa
    • caused by tissue irritation from alcohol, smoking, vocal abuse
  274. What is hyperkeratosis?
    • rough, pinkish lesion occurring in the oral cavity, larynx, or pharynx
    • caused by tissue irritation
  275. What is laryngeomalacia?
    soft, floppy laryngeal cartilages - usually the epiglottis is affected
  276. What is subglottal stenosis?
    narrowing of the subglottic space which can be acquired or congenital
  277. What is a papilloma?
    • wart-like growths caused by the human papilloma virus
    • pink, white, or both found anywhere in the airway
  278. What is ankylosis?
    A stiffening of the joint
  279. What is multiple sclerosis (MS)?
    progressive and diffuse demyelination of white matter - impaired prosody, pitch, and loudness
  280. What is myasthenia gravis?
    a neuromuscular autoimmune disease producing fatigue and muscle weakness
  281. What is amyotrophic lateral sclerosis (ALS)?
    also known as Lou Gehrig's disease, is a progressive, fatal disease involving degeneration of the upper and lower motor neuron system
  282. What is parkinson's disease?
    • lack of dopamine in the substantia nigra of the basal ganglia
    • can sound breathy, low pitched, or monotonous
  283. What are vocal nodules?
    small nodes (fibrous) that develop on the vocal folds that develop over time as a result of prolonged vocal abuse behaviors
  284. What are polyps?
    masses that grow (fluid filled) on vocal folds due to vocal abuse
  285. What are contact ulcers?
    sores or craterlike areas of ulceration, granulated tissue that develop along glottal margin
  286. What is dementia?
    an acquired neurological syndrome that is usually accompanied by progressive deterioration in intellectual functioning, language, memory, emotion, behavior
  287. What is Huntington's disease?
    • subcortical
    • kills the brain cells that control movement
    • loss of neurons in the basal ganglia
  288. What is Parkinson's disease?
    • 35-55% of Parkinson's patients have dementia
    • brainstem deterioration
    • slow voluntary movements, muscle rigidity, masklike face
  289. What is Alzheimer's?
    • type of cortical demetia
    • intellectual and language deterioration precedes motos deficits
    • causes 50% of irreversible dementia
  290. What is Wernicke-Korsakoff syndrome?
    alcohol abuse related dementia
  291. What is right hemisphere syndrome?
    • group of characteristics related to perceptual and attentional deficits that also affect communication
    • visual/spatial perception, facial recognition, arousal, attention, orientation, emotional experience, musical harmony, prosody
  292. What is traumatic brain injury?
    • injury to the brain due to external force or physical trauma
    • caused by: falls, auto accidents, struck by an object, assults, alcohol/drug abuse
    • open and closed injuries
  293. What is alexia?
    loss of previously acquired reading skills
  294. What is agraphia?
    loss in previously acquired writing skills
  295. What is agnosia?
    impaired understanding of the meaning of a certain stimuli
  296. How long does it take CDL children to develop basic interpersonal communication skills (BICS) and cognitive-academic language proficiency (CALP)?
    • 2 years
    • 5-7 years
  297. What is construct validity?
    what theories were used in the test's creation
  298. What are some theories regarding stroke recovery in bilingual patients?
    • synergistic and differential recovery theory: L1 and L2 recover equally, most common
    • antagonistic recovery theory: one recovers at expense of other
    • successive recovery theory: one lang recovers after other lang is completely recovered
    • selective recovery theory: only one recovers
  299. What are the components of the outer ear?
    • auricle/pinna: part you can see
    • external auditory membrane: from pinna to tympanic membrane/eardrum
  300. What are the components of the middle ear?
    • tympanic membrane: vibrates in response to sound pressure
    • ossicular chain: malleus, incus, stapes
    • eustachian tude: opened by tensor veli palatini and levator veli palatini, connects middle ear to nasophaynx
  301. What are the major structures of the inner ear?
    • vestibular system: movement, balance, posture
    • cochlea: connects to auditory branch of acoustic nerve
  302. What are the degrees of hearing loss?
    • Up to 15 dB: normal
    • 16-40: mild
    • 41-55:moderate
    • 56-70: moderately severe
    • 71-90: severe
    • 90+: profound
  303. What is central auditory processing?
    the effectiveness and efficiently with which the central auditory nervous system utilizes auditory information
  304. What is retrocochlear pathology?
    damage to the nerve fibers along the ascending auditory pathways from external auditory canal to cortex
  305. What is acoustic immitance?
    transfer of acoustic energy
  306. What is tympanometry?
    acoustic immitance is measured with an electroacoustic instrument
  307. What are some ways that sound and speech can be amplified?
    • hearing aids
    • cochlear implant
    • tactile aids
    • assistive devices
  308. What is evidence-based practice in speech-language pathology?
    ensures that clients receive services that are known to be based on reliable and valid research and sound clinical judgment
  309. What are the standard components of any assessment?
    • case history
    • hearing screening
    • orofacial examination
    • interview
    • speech language sample
  310. What is validity?
    • if a test measures what it's supposed to measure
    • concurrent: degree a new test related to a test of established validity
    • construct: degree test scores are consistent with theories
    • content: degree of validity based on exam of all items
    • predictive: degree test can predict future performance
  311. What is consistency?
    degree to which a test can replicate what is measured
  312. What are different types of rating scales?
    • nominal: measures categorically without numerical relationship
    • ordinal: measures using a numerical relationship
  313. What is a functional assessment?
    evaluates day-to-day communication skills
  314. What is a dynamic assessment?
    assesses child's ability to learn when provided with instructions
  315. What is treatment?
    teaching, training, and any type of remedial or rehabilitation work
  316. What is reinforcement?
    selecting and strengthening behaviors arranging immediate consequences unders specific stimulus conditions
  317. What is booster treatment?
    • treatment offered any time after initial dismissal from services
    • important for maintenance
  318. What is the Hawthorne effect?
    the degree to which the participant's awareness of the participation in a study affects the outcome of the study
  319. List the reactions and emotions related to communication disorders.
    • shock and disbelief
    • denial
    • anger
    • grief
    • guilt
    • anxiety
  320. What is copralalia?
    • inappropriate use of swear words or obscene language
    • usually seen in Tourette syndrome
  321. Which muscles contribute to velopharyngeal closure through velar elevation?
    • palatoglossus
    • tensor veli palatini
    • levator veli palatini
  322. Which muscle is involved in making the /th/ sound?
  323. What is oscillation?
    the back and forth movement of air molecules because of a vibrating object
  324. What is McDonald's sensory-motor approach?
    an articulation therapy that emphasizes the syllable as the basic unit of speech production and heavily utilizes the concept of phonetic environment
  325. Which muscles adduct the vocal folds?
    • lateral cricoarytenoids
    • transverse arytenoids
  326. Damage to the recurrent laryngeal nerve would benefit from what vocal treatment?
    vocal fold adduction
  327. What is the hearing level?
    the lowest intensity that will stimulate the auditory system
  328. What is simple harmonic motion?
    back and forth movement of particles when the movement is symmetrical and periodic
  329. What is speechreading?
    deciphers speech by looking at the face of the speaker and using visual cues to understand what the speaker is saying
  330. What is the 3rd convolution of the left cerebral hemisphere?
  331. What is the correlation coeffecient?
    suggests the ways in which 2 variables are related to each other
  332. What is "delay" as a treatment procedure?
    the clinician waits for the child to initiate a response, prompts or models if there is no response, and gives the desired objects if no response after 3 months
  333. What is the direct stuttering reduction method?
    stuttering is directly reduced without teaching fluency skills