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Most articulation errors fall into one of what three categories?
An articulation disorder is a _____ disorder that affects the _____ level. It is just _____ based.
All vowels should be developed by age ___.
Sounds such as /p/, /m/, and /b/ are learned as early as ___ years.
/s/, /r/ and /l/ often are not completely mastered until ____
the early school years.
Children should make all of the sounds of English by ___ years of age.
The most common error sounds are _____.
/s/, /l/ and /r/
Most common cause of an articulation problem is the result of _____.
chronic otitis media
What are some structural and/or neurological issues that can cause and articulation problem?
- cleft palate
- dental abnormalities
- cerebral palsy
- mental retardation
- inner ear hearing loss
______ articulation problems - children who do not have problems with muscle function, structural abnormalities or deficiencies in perception.
What are some measurements of articulation?
- Oral-facial examination
- speech intelligibility
- speech-language sample
- speech rate
- standardized testing
______ refers to the "understandability" of a person's spoken output.
List two features of intelligibility.
- Match between the intention of the speaker and what was received by the listener
- Ability to use speech and language to communicate effectively in everyday situations
By 3 years of age a child's spontaneous speech should be at least ____% intelligible to unfamiliar adults.
By 4 years of age, a child's spontaneous speech should be ________.
intelligible to unfamiliar adults
Gordon-Brannan and Hodson found that any child above the age of 4 years with a speech intelligibility score of less than ___% (less than _____ of utterances understood by unfamiliar listeners should be considered a candidate for intervention.
________ requires listener to assign a number to each recorded stimulus - where 1=completely unintelligible, 9=completely intelligible.
________ requires an estimate (percentage) of parts of a sentence which are understood.
Direct magnitude estimation
When analyzing a speech-language sample, each utterance should be transcribed _____.
Speech rate can impact ____ and ____.
Speech rate norms are not as important as ________.
the individual's rate
What can you use to identify appropriate targets?
- Standardized assessment results
- - selection of speech sounds
- - age appropriateness
- speech-language sampling
- - effect on intelligibility
- - frequency of occurrence
What are some ways to select sound targets?
- Stimulable or non-stimulable sounds?
- Sounds that have greatest impact on intelligibility?
- Sounds that are the furthest behind? (norm-based)
What are three ways to attack the goals?
What is the vertical attack strategy?
Work on one target sound at a time until the child masters it, then move on to the next target sound.
What is the horizontal attack strategy also called _____?
- a multiple sound or multi-phonemic approach
- Work on several target sounds all at the same time. As each sound is mastered, add in another target sound.
What is the cyclical attack strategy also called ____?
- a "cycles" approach
- Work on each target sound by itself for a specific period of time. Regardless of progress, switch to next target sound for the same amount of time, then switch to the next target sound, etc. Check progress and start cycle again. Drop out any target sounds that have been mastered.
What is the five-step therapy sequence for articulation?
- 1. Production of the sound in isolation.
- 2. Production in nonsense syllables.
- 3. Production in words.
- 4. Production in structured phrases/sentences.
- 5. Production in spontaneous speech.
You will always try _____ first with production in isolation.
You will likely not use nonsense words with a(n) _____ client.
Familiar words vs. nonsense words:
Should be taken on a(n) __________ basis. Some kids have an easier time producing familiar words than nonsense words.
_________ is used to get the child to form a longer utterance.
Carrier phrases support production in _____.
Spontaneous speech goes from sentence to ____ to _____.
With articulation patients, if accuracy reaches at least ___% accuracy in spontaneous speech, child can be dismissed.
When you dismiss a patient for articulation, you want to have them come back in _____ to make sure everything is on track as predicted.
What are some common types of oral motor tasks?
- Repetition of mouth opening
- Puckering lips
- Tongue protrusion
- Biting the lower lip
The vast majority of legitimate research show ____ in speech sound production because of non-speech oral motor exercises.
An assumption of oral motor theory is that the same structures used for speech perform _____.
the same way for non-speech gestures
An assumption of oral motor theory is that oral motor exercises _________.
strengthen the articulators
An assumption of oral motor theory is that warming up the speech musculature at the beginning of therapy will facilitate speech goals in a session, and lay the foundations _______.
for speech by getting the muscles used to the movements they must perform
There is a lot of evidence against ____ theory.
Oral motor exercises establish a starting point for a group of _____.
related speech sounds
Oral motor exercises are key to modify ____ gestures to be more ____, and to incorporate their production into speech _____.
- as soon as possible
Three things to think about with phonology:
- the way sound is stored in the child's mind
- the way the sound is actually said by the child
- the rules or processes that map between the two above
A child that has been unable to pick out ________ might have difficulty with phonological development.
the relevant information from the speech around them
Phonological issues can contribute to issues with reading. This is not true of _____.
A child that needs help focusing on the ________ might have difficulty with phonological development.
features and/or phonemes that are missing from their system
A phonological disorder is a ___ disorder not a ____ disorder.
Minimal pairs is a form of _____.
Present a pair of words to the child that addresses _____ and enables to child to first discriminate, and later ___, the differences between _____.
- the incorrect sound pattern
- sound patterns
In phonological therapy, most phonemic approaches use ____.
minimal word pairs
In phonological therapy, you create a contrast to show the child ____.
how differences in sound create differences in meaning.
All children make ____ pronunciation "errors" when they are learning to talk like adults.
Phonological processes are typically gone by the time a child is ___, though there is ____.
Idiosyncratic processes are displayed in children with ____ and are not usually found in the speech of typically developing children.
______ are considered to be red flags because they are indicators of abnormal phonological development.
___ includes the lingustic elements that connect sounds and symbols with meaning.
Form includes ___, ___ and ____.
____ is the meaning of language.
Content includes ___.
___ is the area of language that deals with rules that govern use of language in social contexts.
Use includes ___.
Piaget's 4 stages:
From birth to age 2 is called the ____ and is Stage ___.
Piaget's 4 stages:
From age 2 to 7 is called the ____ and is Stage ___.
Piaget's 4 stages:
From age 7 to 11 is called the ___ and is Stage ___.
- Concrete Operational Stage
Piaget's 4 stages:
From 12 years and up is called the ____ and is Stage ___.
- Formal operational stage
A language disorder is the impairment or deviant development of ____ and/or use of a ______.
- spoken, written, and/or other symbol system
A language disorder may involve:
- the form of language (phonologic, morphologic, syntax)
- the content of language (semantics)
- the function of language in communication (pragmatics)
What are two underlying contributors to language development?
What are some limitations to Piaget's theory?
- The stage model depicts children's thinking as being more consistent than it is
- Infants and young children are more cognitively competent than Piaget recognized
Piaget's theory understates _____.
the contribution of the social world to cognitive development
Piaget's tasks are _____ biased. Schooling and literacy affect ____.
- rates of development
Ate age 2, ____ demonstrate normal language comprehension but use less than 50 words and no word combinations.
Between 50% and 75% of late bloomers outgrow the delay by age ___.
_____ of late bloomers demonstrate an expressive language delay that persists.
25% to 50%
What are some risk factors for the development of language disorders? (6)
- Pre-maturity with low birth weight
- maternal drug and alcohol abuse
- presence of genetic syndrome
- prolonged hospitalization due to physical disabilities and frequent illness
- neglect and abuse
What are some informal/alternative types of language assessment? (4)
- Language sample analysis
- Curriculum-based assessments
- Portfolio assessment
- Dynamic assessment
What are some formal/standardized types of language assessment? (3)
- Traditional standardized tests
- Utilize norms for comparison to peers
- Strict administration guidelines
People who clutter can't decide _____.
exactly what it is that they're trying to say
People who clutter might have the ___ in mind, but the actual ___ are not clearly formed in their minds.
_____ is a central factor in cluttering.
____ has excessive levels of "normal" speech disfluencies.
People who ____ have little or no apparent physical struggle in speaking.
People who ____ exhibit atypical articulation patterns.
People who ____ have reduced awareness.
Differences between cluttering and stuttering
- types of disfluencies
- organized (stutter) vs disorganized (clutter) output
- secondary behaviors (stutter)
At least _____ children in the US stutter.
_____ people will say they have stuttered in their life.
1 in 5
Stuttering can last _____.
The probability of stuttering onset ______.
decreases with age
There is an increased potential for misdiagnosis of stuttering in Bilingual Spanish English children because they produce _____ than monolinguals.
a significantly higher number of mazes
There is an increased potential for misdiagnosis of stuttering in Bilingual Spanish English children because there is a _____.
critical overlap between SLDs (stuttering-like disfluencies) and mazes. -Sound/syllable repetitions
There is no evidence to support the assumption that bilinguals are at a higher risk for _____. But instead there is a higher risk for ____.
When is stuttering most likely to occur?
Bidirectional communication: When two people are talking to each other or one person is talking to a group of people. Not likely when a person is alone talking to themselves.
Stuttering is __________ in nature.
People don't stutter when they ______.
sing, whisper, yell
What are some factors that can indicate a higher rate of stuttering recovery?
- Onset before age 3
- Measurable decrease in sound/syllable and word repetitions, and sound prolongations, overtime, observed relatively soon postonset
- no family history of stuttering or a family history of recovery
- no coexisting phonological problems
Probability of recovery from stuttering:
- highest from 6-36 months postonset
- majority of children recover within 12-24 months postonset
What is the speech easy device?
It is a completely in the canal device that repeats your speech with the effect of slowing speech rate.
What is the effect of the speech easy device?
It initially helps to slow speech rate, but eventually the novelty of it can wear off and it does not work.
Why does stuttering increase at the initiation of therapy?
- Increased awareness of moments
- - no real increase in stuttering
- - OR - leads to increase (temporary) in stuttering
Why is there increased activation in the right hemisphere of stutterers?
- Two arguments for this - the left is not enough for language development
- Emtional reaction to stuttering
Do people who stutter only stutter on specific sounds?
Research finds that the stronger a person's expectation to stutter on a certain word actually increases the likelihood of stuttering on that word.
What is the best approach for helping covert stutterers?
Having them use words they know they stutter on. Having them bring those words to the surface. Having them mimic stuttering.
Why do stutterers have such a difficult time saying their name?