442 exam 3

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442 exam 3
2012-03-25 13:16:30
phonological articulation disorders

phonological and articulation disorders
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  1. Longitudinal studies
    • following the same people over a period of time
    • look at one child or a small group of kids over time
    • sample sizes have been so small that you can't really generalize a lot
  2. What shows interaction between phonological system and the language system as a whole?
    children with more complex sentence structures tended to be more difficult to understand
  3. Phonological regression (longitudinal)
    accurate productions are sometimes later replaced by inaccurate ones, as the child is mastering other concepts within the language system
  4. What three groups can the order of acquisition of the eight English fricatives be summarized in?
    • /f, s, esh/
    • /v, z/
    • /theta, eth, yogh/
  5. Can we specifiy an exact age in which certain sounds are in?
    • no
    • we use norms, but use them loosely
  6. If a child has later developing sounds in repertoire, but does not have earlier developing sounds, are they a candidate for therapy?
    • yes
    • also, if one or more sounds is outside of the norms (across studies), may be a candidate for therapy
  7. Common processes of typical supression
    • reduplication
    • final consonant deletion
    • unstressed/weak syllable deletion
    • cluster reduction
    • epenthesis
    • stopping of fricatives
    • fronting
    • gliding
    • assimilation processes
  8. Reduplication
    • very early process
    • usually during first 50 word stage
  9. Final consonant deletion
    • usually suppressed by age 3 at the latest
    • other studies showed even earlier (2;2 and 2;5)
  10. Unstressed/weak syllable deletion
    • one study says by age 4
    • another study says before age 3
  11. Cluster reduction
    • is a process that is suppressed relatively late
    • often seen in 5 year olds
    • sometimes seen as late as 8-9 years old (this is a small percentage of kids, however)
  12. Epenthesis
    • common in preschool children, on up to age 8
    • example: "pu-lease"
  13. Stopping of fricatives
    • no general rule
    • depends on the fricative
    • different ones have stopping suppressed at earlier ages than others
  14. Fronting
    • one study reported suppression by age 3.6
    • another indicated presence until age 5 (but this was a small percentage of kids, this would usually not be let go this long)
  15. Gliding
    extends beyond age 5
  16. Assimilation processes
    typically suppressed by age 3
  17. Processes disappearing by 3 years (stoel-gammon and dunn)
    • unstressed syllable deletion
    • final consonant deletion
    • consonant assimilation (assimilatory processes)
    • reduplication
    • fronting (velar fronting)
    • prevocalic voicing (voicing consonants that occur bfore a vowel, not normally seen)
  18. Processes persisting after 3 years
    • cluster reduction
    • epenthesis
    • gliding
    • vocalization (vowelization)
    • stopping
    • depalatization
    • final devoicing
  19. Segmental form development
    • several sounds have been determined to be "later developing sounds" according to cross sectional studies that have been completed (they are added to phonetic inventory later than other sounds)
    • many of these are mastered after kids begin school
  20. Issues that school age children must deal with
    • learning all of the morphological rules, and how that ties into phonology (morphophonology)
    • ex. when pluralization should be pronounced as an "s" and when it should be pronounced as "z"
    • ex. how we change pronunciation from "divide" to "division"
  21. How long do children continue to learn phonological aspects related to overall language?
    as late as 17 years
  22. School age children have to deal with learning to speak and read
    • this is a trend in our field- literacy and speech language correlations
    • seems to be a close relationship between early speech and emerging literacy (means a strong correlation between phonological development, at the segment level, and later reading achievement)
  23. Predictors for literacy
    perceptual processing of sounds is a strong predictor of later reading ability
  24. Metaphonological skills
    • ability to think about phonology
    • related to reading
  25. What is metaphonology?
    • child's conscious awareness of sounds within a language
    • child's ability to discern how many sounds are in a word or which sound consititutes the beginning of a word
    • ex. duncan spelling "this" as "dis" because that is how he pronounces it
  26. Are children with phonological problems at risk for developing later problems with learning to read?
  27. Prosodic feature development
    • children are still learning stress rules, etc., into teen years
    • ex. even some teens may have difficulty with differences between "she dressed, and fed the baby" and "she dressed and fed the baby"
  28. Asseessment includes:
    appraisal and diagnosis
  29. Appraisal
    the collection of data; gathering data; testing and interacting with client
  30. Diagnosis
    studying and interpretation of data; after you have finished doing the actual appraisal you diagnose
  31. Why is appraisal important?
    • the collection of too little data will not provide enough information for an adequate diagnosis
    • the collection of too much data wastes the clinician's and client's/family's time
  32. Basic parts of an appraisal
    • gathering a case history (send "history questionnaires")
    • the clinical interview (primarily get information from parents)
    • previous records (school, medical, etc)
    • the actual evaluation by the clinician
  33. Evaluation by the clinician
    comprehensive phonetic-phonemic evaluation
  34. 3 purposes of evaluation
    • determine the presence/absence of a phonetic disorder
    • gather information so that we can later determine
    • determine possible treatment goals if either of the 2 above disorders are present
  35. Evaluation includes:
    • articulation test(s)
    • stimulability measures
    • conversational speech assessment (spontaneous speech sample)
    • oral mechanism exam
    • hearing screening
    • other measures if needed
  36. Articulation/phonology tests
    • usually consist of naming pictures
    • child's productions are recorded and error patterns are analyzed
  37. Advantages of articulation/phonology tests
    • relatively easy to administer (need to transcribe; easier than other tests)
    • time expenditure is minimal (15 to 20 minutes most)
    • results tell us which sounds are incorrect in different positions
    • tests may provide standardized scores to compare results to (so we can compare to other children of similar age)
  38. Disadvantages of articulation/phonology tests
    • most look at productions in isolated words (may not be representative of productions in connected speech)
    • may not give enough info about the phonological system (sound production tasks, so they look at phonetic realizations)
    • do not test all sounds in all the contexts that occur in general american english (may not assess vowels, or consonant clusters; typically look at sounds most often in error)
    • sounds that are tested are usually not context controlled (words that contain the sounds may vary in length and complexity; the sounds before and after the tested consonants are different from word to word; tests do not test phonemes in every possible coarticulatory context, they merely take a sample)
    • examines a small part of a child's total articulatory behavior (at that time, on that particular day; only a glimpse; need to keep in mind if it is representative of how the child usually sounds)
  39. Factors when choosing an articulation and/or phonology test
    • appropriateness for the age or development level of the client (need to consider stimuli when assessing adolescent or adult clients; be sure pictures are not too child-like; if you want to use norms, may have difficulty because many tests don't provide norms for older kids)
    • ability to provide a standardized score (some tests aren't standardized)
    • analysis of sound errors (articulation vs. phonology tests)
    • test's inclusion of and adequate sample of the sounds relevant for the individual client (many tests sample frequently misarticulated sounds and/or common processes, but may not do this in a variety of contexts)
  40. How to transcribe articulation tests
    • two way scoring: binary; "right" or "wrong" (not desirable, doesn't give enough info, tells you it's wrong, but not what's wrong about it)
    • five way scoring: correct, deletion, substitution, distortion, addition (better than binary, but doesn't tell you everything you need to know)
    • phonetic transcription (the most desirable type of scoring; requires a "good ear"; requires good transcription skills; should use both broad and narrow transcription for most accurate results)
  41. Procedures to supplement articulation tests
    • if a word contains an error production (vowels or consonants), transcribe the entire word (not just the sound the stimulus item is targeting)
    • supplement the articulation test with additional utterances that address the noted problems of the client (tailor made list of stimulus items; commercially available)
    • sample and record spontaneous speech, and look at that data
    • determine stimulability
  42. Stimulability testing
    • clinician "stimulates" client to produce misarticulated sounds correctly
    • usually "watch me, listen, and do what i do", "do this with your tongue"
    • usually start with sounds in isolation
    • may then move to more difficult contexts
  43. How is stimulability testing used in therapy?
    • some use it as a predictor of which children might benefit from more therapy (children who were highly stimulable were correlated with more rapid therapeutic success)
    • some use it to assist with choosing treatment goals
  44. Prognostic indicator
    what's the prognosis for getting better?
  45. How is stimulability testing used to choose treatment goals?
    • may decide to use highly stimulable sounds as treatment goals
    • may also determine that the stimulable sounds are "on the verge" of being acquired, so may not work on them
  46. How do you do a spontaneous speech sample?
    • take a look at errors on single words from the structured test
    • consider these sounds when planning the spontaneous speech sample
    • provide opportunities to talk about things that would contain words that have those sounds in them
  47. Suggestions for procedures of spontaneous speech sample
    • provide objects or pictures that contain target sounds
    • plan the length of the sample (usually need 10-15 minutes, trying to elicit at least 100 different words)
    • plan diversity into the sample (differen talking situations- storytelling, picture description, describing the function of objects, playing with toys)
    • record the sample (audio and video)
    • "gloss" the sample when necessary (write down what child was trying to say so you know what it is later)
    • try to transcribe as much of the sample "on line" (writing down as it's happening) as you can (go back and fill in blanks with audio/video tape)
  48. Oral mechanism exam
    • an evaluation of the structure and function of the client's articulators
    • looking to see if there are problems with structures, muscle movement (strength, speed, coordination)
  49. Diadochokinesis
    rapid alternating movements
  50. Hearing screening
    • required as part of ASHA's guidelines
    • want to see if hearing may be a contributing factor
  51. Other testing
    • language testing (most often used of these three)
    • perceptual testing
    • cognitive testing
    • *these tests are optional
  52. Emerging phonology
    • in typically developing kids, this is during the toddler period (18 months to 2/2.5 years old)
    • for children with more severe disabilities, this may be at a later age
  53. Why are children referred for evaulations?
    • may have known risk factors:
    • premature/low birth weight
    • cleft palate
    • down syndrome
    • multiples
    • genetics/prenatal risks
    • acquired medical complications
  54. Characteristics of children lacking emerging phonology
    • small expressive vocabularies
    • reduced repertoire of consonants
    • reduced repertoire of syllable shapes
    • words are often unintelligible
  55. How to gather apprasial information for young kids
    • children are young; most likely will not sit and name pictures from a standard artic/phonology test
    • also may not have the vocabulary to name these pictures
    • so, need to get a sample of words that they are using
  56. How to get a word sample from little kids
    • family can provide a tape recording of spontaneous and elicited words from home
    • family can bring favorite objects from home that the child can name
    • family keeps a log of words and the way the are "pronounced"
  57. Independent analysis
    • takes only the child's productions into account
    • the productions are not compared to the adult norm
    • looking to see what is present, rather than looking to see how the productions are different from the adult model
  58. In an independent analysis, usually consider:
    • inventory of speech sounds
    • syllable shapes
    • stress patterns
    • constraints that the child possesses (ex. only uses a certain sound in the initial position of words)
  59. Phonetic
  60. Phonemic
  61. Signals of phonetic disorders
    • preservation of phonemic contrasts (ex. client has some variation between 2 sounds, even if not produced correctly, then each is functioning as a "phoneme")
    • if errors are consistent across words, etc., regardless of the position of the sound (ex. child doesn't produced the sound in any context, or the error is the same in any context)
  62. Signals of phonemic disorders
    • collapse of phonemic contrasts (2 or more phonemes are represented by the same sound production)
    • consistent use of a process that usually crosses more than one sound (ex. more than one fricative is replaced with a stop)
    • inconsisten proudctions (a phoneme is produced correctly in one context, but not in another)