Big Epic Praxis Study set,

What would a child whose utterance containing an embedded form say?

"The teacher who gave a lot of homework wasn't very popular"

example of recurrence

"more cookie"

Typical Development: 3-4 years - Acquired Grammatical Morphemes

* Passive voice, opposites, answer "what if" questions, modify speech to age of listener. * Acquisition of grammatical morphemes. - Articles ( A cookie) - Past-tense regular -ed - Regular third person -s - Irregular third person (does, has) - Uncontactable auxiliary (she was walking) - Contractable copula (He is nice) - Contractable auxiliary (mom is coming)

Typical Development: 2-3 years -Acquired grammatical morphemes

* Word combinations, 3-4 word sentences, express negation, wh-questions, plurals * Acquisition of grammatical morphemes for ages 2-3 years - Present progressive -ing - Prepositions "in" "on" - Regular plural inflections -s - Irregular past-tense verbs - Possessive -s -Uncontractable copula (Here I am)

The components of the vertebral column consist of:

- 7 cervical - 12 thoracic - lumbar - 5 sacral - 3-4 coccygeal (fused)

Single-subject designs

- Are useful in establishing treatment efficacy - The multiple-baseline design awards the disadvantage of treatment withdrawal - A disadvantage of single-subject designs is that they cannot efficiently predict the behavior of groups of individuals

Standardized assessment good for expressive language

- Clinical evaluation of language fundamentals- preschool - Preschool language scales

Characteristics of Spanish-influenced English Articulation:

- Dentalized /t/, /d/, /n/ - Devoiced final consonants - /b/ substitution for /v/ - /ch/ substitution for /sh/

Two characteristics that are primarily indicative of CAS

- Displaying inconsistencies in articulation performance - Speaking with a disrupted rate, rhythm, and stress of speech

Mylohyoid

- Elevates floor of oral cavity - Innervated by CN V trigeminal

Levator Velo Palatini

- Elevates palate - Innervated by CN x, XI vagus, accessory

Palatoglossus

- Elevates posterior tongue - Innervated by CN IX, X, XI glossopharyngus, vagus, accessory

Styloglossus

- Elevates posterior tongue - Innervated by CN XII hypoglossal

Characteristics of cluttering

- Excessive frequency of revisions - reduced intelligibility in conjunction with rapid rate - Misarticulation of multisyllabic words - Limited concern and awareness of communication difficulties

Typical Development: 1-2 years

- Holistic single-word phrase - Begins putting two words together - Over extensions

Halliday's 7 functions of Communicative Intent (1975)

- Imaginative: Use language to create environment -Heuristic: Explain environment - Regulatory: Control behavior of others - Personal: Express feelings and attitudes - Informative: Tell someone something - Instrumental: Attempt to get assisted/material things from others - Interactional: Initiate interactions with others

Critical diagnostic features of right hemisphere syndrome include?

- Impaired narrative skills - Deficits in attention - Deficits in perception - Interprets only the literal meaning of language - Difficulty identifying relevant information - Inability to interpret body language and facial expressions - Flat affect - Problems with conversational rules - Impulsivity - Confabulation (untrue statements that are not deliberate lies) - Disorientation to time and direction - Left side neglect - Anosognosia - Visuospatial deficits

Public Law 99-457

- Increased federal support for services to children with disabilities 3 to 6 years of agenda provided finding for infants and toddlers - Requires the development of individualized family services plans - It allows at-risk preschool children (not just those with documented disabilities) to be eligible for special education services

What will increase tension in the vocal folds?

- Increasing muscular effort through pushing or lifting will vocalizing - Attempting quick onset of phonation - Using drills with exaggerated contrastive stress on words

Larynx

- Innervated by CN X Vagus

Symptoms of ASD?

- Lack of social reciprocity - Averted eye gaze - Repetitive motor mannerisms

When does symptom onset of stuttering usually occur?

- Most often occurs in the range of 2 to 5 years old - It is usually earlier for girls than for boys

Three areas included in pragmatic language assessment during conversation

- New topic initiation - Discourse cohesion - Repair strategies

Asian-Influenced English Articulation

- Omission of final consonants - Truncate polysyllabic words and make most monosyllabic - Devoicing of voiced consonants - /r/ and /l/ confusion

Asian-influenced english language characteristics:

- Omission of plurals - Omission of copula (he going home now) - Omission of past-tense morpheme - Past tense double marking

Characteristics of Spanish-influenced english morphology - language:

- Omission of plurals - Omission of possessives - Omitted past tense morpheme - Adjectives following nouns (The house green) - Auxillary past tense construction (Did he bit somebody) - Double negatives

What factors contribute to UES opening

- Partial relaxation of the cricopharyngeal portion of the inferior constrictor muscle - Superior and anterior hyolaryngeal excursion

Standardized assessment good for receptive language

- Peabody picture vocabulary - Clinical evaluation of language fundamentals- preschool - Preschool language scale

Management of which of the following examination observations alone will produce the best improvement in the pneumonia risk of an adult patient with chronic dysphagia? - Poor oral bolus control - Poor oral hygiene and dependence on oral care - Delayed onset of the pharyngeal stage of swallowing - Impaired dissension of the upper esophageal sphincter

- Poor oral hygiene and dependence for oral care

Typical Development: 4 - 6 months

- Raises arms to be picked up - Moves looks towards named family members - Makes raspberries - Growls - Adult-like vowels - Marginal babbling - At 5-months-responds to name

Typical Development: 7-9 months

- Recognizes names of common objects - Comprehends "no" - Plays peek-a-boo - Uses a wide variety of sound combinations - Variegated babbling at months

Conduction Aphasia

- Repetition deficits - Written expression deficits - Auditory comprehension deficits - Presence of literal paraphasias

Typical Development: Birth - 3 months

- Startle response to loud sound - Visually tracks to sound - Smiles reflexively - Attends toward voice - Cries for assistance - Quiets when picked up - Produces vowel sounds

A null hypothesis

- States that there is no cause-effect relationship between two specified variables - It means a zero hypothesis - It is the one researchers try to reject

Indirect therapy approaches to childhood stuttering

- Teaching caregivers to support their child's communication attempts but to avoid acknowledging the child's fluency performance -Teaching children to describe their emotional state to their caregiver when stuttering is anticipated on an upcoming word - Teaching children to present nonverbal cues to their caregivers when stuttering is anticipated in an upcoming word

Intrinsic muscles serve important functions in phonation. - Some are vibrating muscles - Others, by their actions, affect the actions of the vocal folds and the resulting quality of phonation

- The thyroarytenoids are divided into two muscle masses - The internal thyroarytenoids are also known as vocals muscle - The cricothyroid muscle lengthens and tenses the vocal folds

Group designs

- They are effective in establishing internal validity - They can help establish cause-effect relationships - Their requirement of randomization may be difficult to meet

Typical Development: 10 - 12 months

- Understands 10+ words - First words - Obeys some commands - Object permanence - Recognizes own name - Jabbers loudly

semantic deveoplment in 2 -3 yr

- at 3 yrs comprehends about 3600 words -first pronouns used are self-referencts such as I and me -answers simple wh- questions -can identify body parts -carries out one and two part commands -at 36 mos can give simple account of experiences

Characteristics of stuttering

- excessive frequency of part-and whole-word repetitions - active attempts to avoid or conceal communication difficulties - Use of word avoidance and circumlocution in response to anticipated disfluency

Transcortical sensory apahasia

- fluent speech - normal prosody - good articulation - Can't comprehend

Transcortical motor aphasia

- nonfluent - paraphasic speech - agrammatic speech

Genioglossus

- prime mover muscle of tongue -Inervated by CN XII hypoglossal

Typical variations for a spanish-speaking student may be?

- t/th substitutions (ting/thing) - a/ae substitution (block/black) - Devoicing of final consonants (luff/love)

Characteristics of SLI

-Use words that begin with sounds they can produce (leads to problems with academic linguistic skills) -delay in first word (~23 mos), slow to add words (~17 words at 24 mos), less verbs than nouns, slower to use two-word combos (~36 mos), more trouble with narrative comprehension *require twice as much to comprehend and four times as much to use -shorter MLU, use simple sentences, omit or confuses grammatical elements, subject case marking problems, inconsistent verb tense marking -passive or inactive communicators, low assertiveness, fail to use language to establish relationship with peers

Typical Development: 5 - 6 years

-Uses tenses consistently - Begins to tell jokes - Uses comparisons - Understands humor - Can identify politeness

Structures of the Cover-body model

-____: epithelium and superficial layer of lamina propria -Transition/vocal ligament: intermediate and deep layers of lamina propria -____: thyroarytenoid

multiple-baseline-across-settings design

-a behavior is taught one by one in different settings to demonstrate that the behavior changed only in a treated setting and thus treatment was effective

diagnosis of stuttering may be made using one of serveral diagnostic criteria

-a dysfluency rate that exceeds 5% of spoken words when all kinds of dysfluencies are counted -a certain frequency of part-word repetitions, speech-prolongations, and brocken words (at least 2% of the words spoken -excessive duration of dysfluencies (1 sec of longer) -other

transcortical motor aphasia (TMA) symptoms

-absent or reduced spontaneous speech -nonfluent, paraphasic, agrammatic, and telegraphic speech -intact repetitions skills -attempts to initiate speech with the help of motor activities

the parts of the outer ear

-auricle or pinna: outer-most part of ear, funnels the sound to the ear -external auditory canal (external auditory meatus): from the pinna to the typanic membrane or eardrum

syntax development 4-5 yrs

-averages 6-.5 words per sentence by 5 yrs, average MLU 4.5-7.0 -speaks in complete sentences -uses future tense -uses if, so in sentences -passive voice

syntax development 2-3 yrs

-beginnning sentence formation -MLU 2.0-3.0 at 36 mos -asks wh- questions and yes-no questions - uses telegraphic speech, object-verb -expresses negation by adding no infront of verbs

parts of the inner ear

-begins with the oval window: small opening in the temporal bone that houses the inner ear -vestibular system: contains 3 semicircular canals that are responsible for equilibrium -cochlea: snail shaped, filled with endolymph

pragmatic development in 3-4 yrs

-can maintain conversation without losing track of topic -begins to modify speech to age of listener (simpiler for younger children) -produce indirective (are the cookies done? aka I want a cookie) -requesting (yes-no questions and wh- questions) -politeness markers -uses a language for a variety of communicative functions (role-playing, protests and objections, jokes, game markers, claims, warnings, teasing)

common etiologic factors of neurogenic stuttering

-cerebral vascular disorders that cause strokes and head trauma -extrapyramidal diseases: parkinson's, progressive supranuclear palsy, tumors, brain surgery, seizures disorders, and dementia -drug toxicity: asthma, depression, schizophrenia, and anxiety

semantic development 3-4 yrs

-comprehends 4200 at 42 months - uses 900-1000 words expressively -asks how, why and when questions -understand some common opposites -knows full name, street, several nursery rhymes -lables most things inthe environment -relates experiences and and tells about activites in sequential order -can complete opposite analogies -use pronouns -understand agent-action -can answer "what if " questions

Hodson and Paden's Cycles Approach

-designed for children with multiple misarticulations and highly unintelligible speech, error patterns are targeted for remediation based on stability, intelligibility and percentage of occurrence -cycle runs 5-16 weeks and each child usually requires three to six cycles -each sound in an error pattern receives 1 hour of treatment per cycle before the clinician proceeds to the next sound in the error pattern.

suprahyoid muscles

-digastric -geniohyoid -mylohyoid -stylohyoid -hyoglossus -genioglossus

birth-3 months milestones

-displays startle response to loud sound -visually tracks, or moves eyes to source of sound -attends to and turns head towards voice turns toward sound source -smiles reflexively -cries for assistance -quiets when picked up -ceases activity or coos back when person talks (2 months) -vocalizes predominantly vowels

conduction aphasia symptoms

-disproportionate impairment in repetition! -fluent, but less fluent than Wernicke's -paraphasic speech -word-finding problems -efforts to correct errors in speech -near-normal auditory comprehension -better at pointing to a named items then naming it -*made difference is they have good to normal auditory comprehension!

wernicke's aphasia symptoms

-effortlessly produced, flowing speech with normal or abnormal fluency with normal phrase length -rapid rate of speech with normal prosodic features and good articulation -severe word finding problems -neologisms (meaningless words) -circumlocution (talking around words that can't be recalled) -empty speech (substitution of "this, that, stuff, and thing") -poor auditory comprehension -impaired conversational turn taking -impaired repetition skills -reading and writing problems

multigroup pretest-posttest design

-evaluate the effects of two or more treatments, to find out which treatment is more effective

subcortical aphasia caused by lesions in the basal ganglia symptoms

-fluent speech -repetition skills -normal auditory comprehension -articulation problems (like broca's) -prosodic problems -word finding problems -reserved writing skills

transcortical sensory aphaisa (TSA) symptoms

-fluent speech with normal phrase length, good prosody, normal articulation, and apparently appropriate grammar and syntax -paraphasic and empty speech -severe naming problems and pauses in speech due to the naming difficulties -good repetition skills but poor comprehension of repeated words!!!!! -echolalia of grammatically incorrect forms and nonsense syllables (unlike pt with TMA) -impaired auditory comprehension -normal automatic speech -good read aloud skills

angelman syndrome characteristics

-genetic syndrome -seizures, stiff or jerky gait, laughter and a happy demeanor, an excitable personality, hypermotoric behaviors, hand-flapping movements and a short attention span.

extrinsic muscles of the tongue

-genioglossus -styloglossus -chondroglossus -palatoglossus

fluency shaping method

-goal: establish normal fluency not fluent stuttering -teach airflow management -teach gentle, soft, relaxed, and easy onset of phonation, beginning after the initiation of exhalation -reduced rate of speech through syllable prolongation, with no pauses -induced stutter-free speech, not normal sounding fluency 0implement maintenance strategies: teaching self-monitoring skills and training family to monitor and reinforce fluency in natural settings and over time

fluent stuttering method

-goal: not normal fluency but more fluent stuttering -teaching stuttering identification -desensitizing the client to his or her stuttering (voluntary stuttering) -modifying stuttering: cancellations, pull-outs, preparatory sets -stabilizing the treatment gains: use stuttering modifications -counseling the client

subcortical aphasia caused by lesions to the left thalamus symptoms

-hemiplegia, hemisensory loss, right-visual field problems -initial mutism -severe naming problems -good auditory comprehension -good repetition skills -impaired reading and writing skills

syntax development in 1-2 years old

-holophrastic: 12-18 mos use one-word sentences -average MLU is 1.0-2.0 -18mos produce 50 words -18-24 mos begin putting two words together -2 yrs: 3 to 4 word utterances

morphology at 2 -3 yrs

-ing, in, on, were, -ed, is, some irregular past tense -still overgeneralizes

morphology development 3-4 yrs

-irregular plural forms (mice) -third-person singular, past tense (he runs) -uses simple past and present progressives (running) and negatives (not) -uses inflection to convert adjective to causation (sharp, sharpen) -plural forms correctly (boys) -uses is at the beginning of a sentence -uses contracted forms of modals (can't won't) -uses and as a conjunction -uses is, are, and am in sentences -uses possive markers consistently (the boy's clothes) -reflexive pronouns (myself) -conjunction becuase

electromyogrphy (EMG)

-is an invasive procedure, insert needles electrode into the peripheral laryngeal muscle -directly measures laryngeal function to study the pattern of electrical activity of the vocal folds and to view muscle activity patterns

behavioral theory of language acquisition

-language is not an innate skill, the child's environment and social interactions are important

syntax development 3-4 yrs

-learns clause-connecting devices (and, because) -begins uses complex verb phrases -modal verbs (could, should, would) -tag questions (you want to go, don't you) -passive voice -48 mos: sentenc averages 5-5.5 words per utterance -MLU about 3.0-5.0 -uses mostly nouns, verbs, and personal pronouns -do insertions (does the kittly run around) -uses negation in speech -begins uses complex and compound sentences

MIxed transcortical aphasia (MTA) symptoms

-limited spontaneous speech -automatic, unintentional, and involuntary nature of communication -severe echolalia (parrotlike) -impaired fluency, auditory comprehension -marked naming difficulty -mostly unimpaired automatic speech

7-9 months milestones

-looks are some common objects when the object's names are spoken -comprehends "no" -begins to use some gestural langauges (plays pat a cake, peek a boo) -uses a wide variety of sound combinations -used inflected vocal play, intonation patterns -imitates intonation andspeech sound of others (9mos) -uses variegated babbling (mabamaba) -un covers hidden toys (beginning of object permanence)

single-subject designs

-measure the dependent variables continuously -may only have one, but could have up to 6 participants -mostly experimental

muscles of the lips and cheeks

-mentalis -platysma -risorius -bussinator -depressor labii inferiors -depressor anguili oris -zygomatic minor -zygomatic major -orbicularis oris -levator anguli oris -levator labii superioris -levator labii superioris alaeque nasi

pragmatic development 4-5 yrs

-modifies speech as function of listener age -begins to judge grammatical correctness and appropiateness of sentences -can maintain topic over successive utterances -uses egocentric monologue about a third of the time -uses indirect speech acts -tell jokes and riddle (emerging)

semantic development 1-2 years

-most frequent lexical categories are nominals (ball mommy) and verbs (drink run) -uses over-extensions -answers questions (whats this, yes-no) -says all gone (emerging negation) -follows one step commands -listens to simple stories -asks for more -refers to self with pronoun and name -begins to use some verbs and adjectives

anomic aphasia symptoms

-most pervasive word-finding difficulty! -no impairment of pointing to named objects -generally fluent speech -verbal paraphasia -circumlocation -intact repetition -normal oral reading skills, comprehension and writing skills

broca's aphasia symptoms

-nonfluent, effortful, slow, halting and uneven speech -limited word output, shorts phrases and sentences -misarticulated or distorted speech sounds -agrammatic or telegraphic speech -impaired repetition of words and sentences, especially the grammatical elements of a sentence -impaired naming -writing problems

Vocal Tremor and Essential Tremor

-one of most common voice disorders. Period modulation of frequency or intensity of voice. Modulations between 4-7 Hz. Isolated to the larynx or generalized to other speech structions. Occurs most often in women Can co-occur with Adductor or Abductor type spasmodic dysphonia. Most often associated with ET. -Most common neurological disorder. Begins with modulation of hand, may affect head, legs and voice. Affects ~3-4 million people in US. Modulation will occur at rest and gets worse with movement. Manage with pharmaceuticals, botox injections, thalamotomy, DBS, or thalamic stimulation if debilitating. Voice therapy may be difficult but includes lighter voice, higher pitch, and breath groups

otitis media serous otitis media acute otitis media chronic otitis media

-ototis media: middle ear infection -serous otitis media: middle ear is inflamed and filled with watery or thick fluid, estachian tube is blocked -acute otitis media: sudden onset due to infection. quick buildup of fluid and pus can cause moderate pain and fever -chronic otitis media: there is permanent damage to middler ear structures

fragile X syndrome

-physical characteristics: large, long and poorly formed pinna, big jaw, enlarged testes, and high forehead -communication: jargon, echolalia, perseveration, inappropriate language or talking to ones self. autistic-like

fluency reinforcement method

-positively reinforce fluent speech in naturalistic conversational contexts -Lidcombe Program -clincian models a slow, relaxed speaking rate that ensures stutter-free speech

pragmatic development 1 -2 years old

-presuppostitions emerge: child uses expressions that have shared meaning for the listener and speaker -begins to understand some rules of dialogue -uses nonverbal and verbal to signal intent

global aphasia symptoms

-profoundly impaired language skills and no significant profile of differential skills -greatly reduced fluency, expressions limited to a few words, exlamations and serial utterances -impaired repetitions, naming and auditroy comprehension -reseveration (repetition of short utterances) -intact response to whole-body commands

What does the CADL-2 measure?

-receptive and expressive language - social use of language - gestures - humor

assimilation processes reduplication regressive assimilation progressive assimilation voicing assimilation

-reduplication: repeats a pattern -regressive assimilation: occurs due to the influence of a later occurring sound on an earlier sound -progressive assimilation: earlier occurring sound influences a later occurring sound -voicing assimilation: can be voicing or devoicing

4 -6 months milestones

-responds by raising arms when mother says "come here" -moved or looks toward family members when they are names -explores vocal mechanism through vocal play (bilabial trills) -begins to produce adult-like vowels -begins marginal babbling; produces double syllable "baba" -varies pitch of vocalizations -responds to name (5 mos) -vocalizes pleasures and displease -varies volume, pitch and rate of vocalizations

direct stuttering reduction methods

-seek to reduce stuttering directly, without teaching specific fluency skills or modifying stuttering into less abnormal forms -pause-and-talk (time-out): the person is taught to pause after each dysfluency and then resume talking. -response cost: for every instance of stuttering the clinician takes away a token, which is awarded for every fluent production

characteristics of asperger's

-seemingly excellent vocabulary -seemingly normal syntatic skills -speech that often seems to be a "monologue" -doe not allow conversational partners to take turns

multiple-baselines-across-behaviors design

-several behaviors are taught one by one to show that only treated behaviors changed, untreated behaviors show no change, and thus the treatment was effective

multiple-baseline design

-shows the untreated skills did not change and only the treated skills did -several participants are taught behaviors one by one with baseline test for everyone before the next person is treated

intrinsic muscles of tongue

-superior longitudinal -inferior longitudinal -transverse -verticle

pretests-posttest control group design

-there are two groups: an experimental group and a control gorup. single treatment -each participant in each group undergoes a pretest and a posttest

psychological methods of treatment of stuttering

-these methods involve the assumption that stuttering is a psychological disorder with underlying conscious or unconscious psychological conflicts or that stuttering and psychological problems coexist -treatment consists of attempts to resolve those conflicts -there isn't strong evidence that offered exclusively its effective. should be in conjuction with other methods

all intrinsic muscles and their function

-thyroarytenoid: vibrates to make sound -lateral cricoarytenoid: adducts vocal folds increases medial compression -transverse arytenoid: adducts -oblique arytenoid: pulls apex of arytenoids in a medial direction -cricothyroid: lengthens and tenses vocal folds -posterior cricoarytenoid: abducts vocal folds

infrahyoid muscles

-thyrohyoid -omohyoid -sternothyroid -sternohyoid

parts of the middle ear

-tympanic membrane: aka ear drum, cone-shaped -ossicular chain: suspended in the middle ear by ligaments, composed of 3 tiny bones. malleus, incus and stapes -eustachian tube: connects the middle ear to with the nasopharynx

10-12 months milestones

-understands up to 10 words, understand simple direction -begins to relate symbol and object, uses first word -gives block, toy, object upon request -obeys some commands -understands and follows simple directions regarding body action -looks in correct place for hidden toy (obejct permanence) -turns head instantly to own name -gestures or vacalizes to indicate wants and needs -jabbers loudly -uses all consonant and vowel sounds in vocal play

spoonerisms

-unintentional interchanges of sounds in a sentence -ex many thinkle peep so (many people think so) -part of cluttering

syllable structure processes unstressed- or weak-syllable deletion final-consonant deletion epenthesis consonant-cluster simplification or reduction diminutization methathesis

-unstressed-syllable deletion: omission of an unstressed syllable -final-consonant deletion: final consonant is omitted -epenthesis: schwa vowel is inserted between the consonants in an initial cluster -consonant-cluster simplification: a consonant in a cluster are deleted -diminutization: addition of /i/ to a target word -metathesis: production of sounds in a word in reversed order

range and categories of hearing loss

-up to 15dB: normal hearing for children (25 for adults -16 to 40dB: mild (25 to 40 for adults) -41 to 55: moderate -56 to 65: moderately severe -66 to 89: severe -91+ profound

morphology development 4-5 yrs

-uses comparatives (bigger, nicer) -uses could and would in sentences -uses irregular plurals (mice, teeth)

semantic development 4-5 yrs

-uses concrete meanings and words -can name items in a category -5 yr about 9600 word comprehension -most pronouns and possessives -uses why and how -understands time concepts -asks meaning of words -tells long stories accurately -identifis past and future verbs - demands explanation with frequent use of why

substitution processes vocailization gliding velar fronting stopping deplatalization affrication deaffrication backing glottal replacement

-vocalization: vowel replaces a syllabic consonant -gliding: glide replaces a liquid w->l -velar fronting: alveolar or dental replaces a velar k->t -stopping: fricative or affricate is replaced by a stop -deplalatization: alveolar affricate for a palatal affricate -affrication: affricate replaces a fricative or a stop -deaffrication: fricative replaces an affricate -backing: -glottal replacement: a glottal stop replaces a consonant

masking and delayed auditory feedback techniques

-when a person hears his own speech with a fraction of a second's delay, most dysfluencies are reduced

loci of stuttering examples consonants vs vowels location in the word location in the sentence length of word frequency of word types of words

-with consonants rather than with vowels -on the first sound of syllable of a word -on the first word in a phrase of sentences -on the first word in a grammatical clause -on longer words -with less frequently used words -on content words (nouns, verbs, adjectives, and adverbs)

In the speech of an African American child, what is most likely to represent a dialectal variation rather than an articulation error?

/f/ for /th/ in postvocalic position

a 4.5 year old has th/s, t/f, w/r, d/j, and j/l what sound would you begin therapy by addressing?

/f/ is developmentally earlier then the other sounds

low sounds

/h/ tongue is lowered from neutral schwa

back sounds

/k/ /g/ ng

lateral sounds

/l/

Characteristics of AAE articulation and phonology

/l/ lessened or omitted ("too" for "tool" /r/ lessened or omitted ("doah" for "door") /f/ substitution for voiceless /th/ at the final or medial position ("tee" for "teeth")

what group of sounds are the earliest to be acquired -nasals -glides -fricatives -stops

/n/ /m/ ng

Typical order of acquisition of /p/, /k/, /ʒ/, /θ/

/p/ - between ages 1 and 3 /k/ - by age 3.5 /θ/ - between ages 3 and 8 /ʒ/ - between ages 6 and 8

What sounds are typically mastered by the time a child turns 3?

/p/, /b/...

Lingua-alveolar voiceless fricative

/s/

What is the average duration of a normal pharyngeal swallow?

1 second

two factors that are associated with mroe rapid, rich language development in infants and young children

1. amount of talking 2. caregiver responsiveness

primary cortical areas involved in speech

1. area 4: primary motor cortex 2. area 44: broca's area 3. areas 3, 1, 2: somatosensory cortex 4. area 6: supplementary motor cortex

the seven types of dysarthria

1. ataxic 2. flaccid 3. hyperkinetic 4. hypokinetic 5. spastic 6. mixed 7. unilateral upper motor neuron

Three major types of CP and their characteristics

1. ataxic: disturbed balance, awkward gait, and uncoordinated movements 2. Athetoid: slow, writhing, involuntary movements 3. Spastic: increased muscle tone, rigidity of muscles, stuff, abrupt, jerky, slow movements

pyramidal system tracts

1. corticopinal tract 2. corticobulbar tract: critical for speech production, fibers control all the voluntary movements of the speech muscles -LMN: motor neurons in the spinal and cranial nerves -UMN: motor fibers within the CNS

how to decide whether a child should receive treatment for speech sound disorder

1. development 2. differs from peers 3. intelligibility

the three layers of the vocal folds

1. epithelium 2. lamina propria 3. vocalis muscle

the corpus striatum is composed of three nuclear masses

1. globus pallidus 2. caudate nucleus 3. putamen

breakdown of the assessment of stuttering

1. hearing screening 2. orofacial exam 3. case history: onset of stuttering, family prevalence... 4. frequency and types of dysfluencies 5. associated behaviors 6. speech rate and articulatory rate 7. negative emotional reaction

name and say the function of the muscles between the ribs

1. intercostal muscles: 11 paired, pull the ribs downward to decrease the diameter of the thoracic cavity for exhalation 2. external intercostal muscles: 11 paired, raise the ribs up and out to increase the diameter of the thoracic cavity for inhalation

children with SLI have abnormalities in two specific areas of the brain

1. language-specific areas 2. frontal brain areas that influence development of executive functioning skills

the structures of the brain stem

1. midbrain (mesencephalon): postural reflexes, visual reflexes, eye movements, and coordination of eye and head movement 2. pons (metencephalon): hearing and balance 3. medulla (myelencephalon): control vital automatic bodily functions (very important for speech production because it contains descending fibers that transmit motor information)

two major explanations of SLI

1. normal variation: in linguistic skills and that children with SLI are at the lower end of the normal continuum of language skills 2. underlying deficits: is due to deficits in cognitive, audiological, perceptual, and intellectual functions that underlie language

the general procedures for assessment of children of all ages

1. obtain results of visual or audiological evaluations 2. obtain any available relevant medical data that might be important 3. obtain psychological data, including the results of cognitive functioning and intelligence testing 4. interview family members to better understand the problem as they see it, obtain information about the child's language development, assess family communication patterns, and ascertain caregiver preferences about treatment targets

CN

1. olfactory (S) 2. optic (S) 3. oculomotor (M) 4. trochlear (M) 5. trigeminal (B) 6. abducens (M) 7. facial (B) 8. acoustics (S) 9. glossopharyngeal (B) 10. vagus (B) 11. spinal accessory (M) 12. hypoglossal (M)

phases of swallowing

1. oral prep: mastication and bolus making 2. oral phase: bolus moved posteriorly 3. pharyngeal phase: reflex of the swallow. start at anterior faucial pillars end at esophagus 4. esophageal phase: involuntary,

muscles that contribute to velopharyngeal closure through tensing or elevating the velum are the

1. palatoglossus 2. tensor veli palatini 3. levator veli palatini

stages of vocal development

1. phonological stage (birth-1 month): reflexive sounds, crying, burping 2. cooring or gooing stage (2-4 months): productions are acoustically similar 3. expansion stage (4-6 months): bilabia trills, CV-like combinations and vowel-like sounds 4. cononical or reduplicated babbling stage (6-8 mos): CV syllables 5. varigated or nonreduplicated babbling stage (8 mos - 1 year)

temporal lobed contains two areas that are critical to adequate hearing and speech

1. primary auditory cortex: receives sound stimuli from acoustic CN (VIII) then synthesizes that information so it can be recognized. 2. auditory association area: analyzes speech sounds so that the person can recognize words and sentences

frontal lobe contains areas that are especially critical to speech production:

1. primary motor cortex (motor strip): located in the precental gyrus, controls voluntary movements of skeletal muscles on the opposite side of the body 2. supplementary motor cortex: motor planning of speech 3. broca's area (motor speech area) controls motor movements involved in speech production

overall goals of stuttering treatment

1. reduction in the amount of stuttering 2. establishing normal-sounding fluency that is naturally produced 3. reduce associated behaviors 4. reduce avoidance 5. counseling the client and family members about stuttering in general 6. counseling the client and family members about the treatment goals and procedures

piaget's stages of cognitive development

1. sensorimotor (0-2yrs) -one (0-2 mos) reflexive behaviors -two (2-4 mos) coordinated movements -three (4-6 mos) actively looking and imitating -four (8-12 mos) walk, first word, move objects -five (12-18 mos) imitate behavior -six (18-24 mos) cause-effect, symbolic play 2. preoperational (2-7 yrs) -preconceptual (2-4): egocentric, overextends words, underextends -intuitive (4-7 yr): concrete thought, deals with one variable at a time 3. concrete operations (7-11 yr) -less egocentric, acquires conversation skills, effective classification skills 4. formal operations (more than 11) -able to see other's POV, think and speak in the abstract, verbal reasoning

accessory muscles involved in respiration

1. sternocleidomastoid: elevates sternum 2. trapezium: controls the head and elongates the neck

two areas of the parietal lobe that are important for speech and language

1. supramarginal gyrus: damage can cause conduction aphasia, apgraphia (writing disorder) 2. angular gyrus: damage can cause writing, reading and naming difficulties and sometimes transcortical sensory aphaisa

passive sentences active sentences interrogatives declaratives imperatives exclamatory

1. the subject receives the action of the verb 2. subject performs the actions of the verb 3. questions 4. make statements 5. state commands 6. express strong feelings

what is a normal ratio for adepquate velopharyngeal closure using a oral manomete to measure

1.00 ratios less than that indicate velopharyngeal incompetence

"my birthday party was fun- we ate cake and cookies" how many words and how many morphemes

10 words and 11 morphemes

Identification of SLI

10th percentile, -1.25 SD, or standard score of 80-81 Verb morphology: later onset of tense marking at 2 years, inconsistent morphological markers Non-word repetition: lower performance due to processing

typical fundamental frequency of a man vs a woman

125hz 225hz

A child being assessed for a possible language impairment says to you "My dad put my shoes on my feet before he drove me to school. How many words and morphemes are in this sentence?

14 words and 15 morphemes

When a normal distribution if scores shows that the mean is 100 and 68% of the sampled children have scored between 85 and 115, the standard deviation of that distribution is?

15

how many morpheme's does daddy's have

2

child has an MLU of 3.0 and expressive vocab of 350 what developmental age are they

2 to 3 years old

intelligibility expectations for 2 year 3 years 4 years

2 years: 60-70% 3 years: 75-80% 4 years: 90-100%

Approximately when is the past tense regular -ed mastered by typically developing children?

26-48 months

what age are stops mastered -2 to 4 -3 to 4.5 -4.5 to 5 -2 to 3

3 t o4.5

At what age should a typically developing child be able to understand agent-action relationships?

3-4 years old

the therapy technique of phonetic placement is used to teach 1. auditory discrimination 2. stimulabiltiy 3. production of a phoneme in isolation 4. minimal pair contrasts 5. phonological processes

3. phonetic placement is used when a client cannot imitate the modeled production of a phoneme such as /s/ or /r/. the clinician uses a combination of verbal instructions and physical guidance to show the client how to produce the phoneme in isolation

Phonological awareness development order?

30 - 36 months - Recognizing words that rhyme 4 years - counting syllables 5 years - creating words by blending onset and rime 6 to 7 years - listing words that start with the same sound

How many CEU's are needed in a 3 year period for ASHA recertification?

30 contact hours

number of spinal nerves and cranial nerves

31 SN and 12 CN

what percentage is judged as dysfluent or stuttered by most listeners

5%

You would diagnose a disorder of fluency when the disfluencies in speech reach?

5% of the words spoken

Palatal surgery should occur around ____

5-6 months (SLP will advocate for this), but most will be around 1 year

in order to begin producing two-word combinations, how many words does a toddler need to have in his expressive vocab

50

normal speech varies between how many dB

50-70dB SPL

The maximum time allowed by IDEA from the official referral for eligibility determination to completion of the evaluation

60 days

how many vertebrae are there and what are the sections

7 cervical 12 thoracic 5 lumbar 5 sacral 3-4 coccygeal

The concrete operation stage of cognitive development, defined by piaget, occurs at what age?

7-11 years

the hard palate fuses between what developmental ages in utero

8 and 9 weeks

How many areas are likely to be included in a speech/language screening?

8 areas: - Articulation - Phonology - Comprehension - Expression - Voice - Resonance - Fluency - Pragmatics

When does early intentional communication develop?

8 to 10 months of age

When does the hard palate fuse in utero?

8-9 weeks/ 6-8 weeks

The acoustic reflex is triggered in a person with typical hearing when the listener is exposed to a sound above approximately

85 dB HTL

ABAB design

A - initial baseline stage B- Treatment Stage A - return to baseline B- Another treatment stage

You are working closely with an orthodontist who frequently refers children to your private practice. Many of these children have protrusions of the maxilla and repression of the mandible accompanied by a condition in which the upper teeth from the molars forward are positioned excessively anterior to the lower teeth. What do these children have?

A class II malocclusion accompanied by overrate

Define Scaffolding

A clinician models the strategy or task to be learned then gradually shifts of removes instructional support for the child.

Meniere's disease

A disorder of the inner ear that causes episodes in which you feel as if you're spinning (vertigo), and you have fluctuating hearing loss with a progressive, ultimately permanent loss of hearing, tinnitus, and sometimes a feeling of fullness or pressure in your ear. In most cases it only affects one ear. Usually occurs between ages of 20 and 50 and is considered a chronic condition.

Gerunds definition

A form that is derived from a verb but that functions as a noun, in English ending in -ing E.g. Asking in "Do you mind my asking you?

Lisa, a 19-year-old college student, was in a car accident and was airlifted to the trauma center at a local hospital. The paramedics at the accident scene had to perform an emergency intubation to permit her to breathe. A week after the accident, Lisa was discharged from the hospital and was breathing normally. A month later, she returned to the hospital complaining of hoarseness and breathiness. The laryngologist performed an evaluation and noticed that a unilateral localized inflammatory vascular lesion had developed on the vocal process of her arytenoid cartilage. The laryngologist believed that the intubation may have caused?

A granuloma

Mourning theory

A grieving person is most receptive to new information about the source of grief after just having entered the recovery stage.

Which of the following provides the most important diagnostic information to an SLP making a differential diagnosis between childhood apraxia of speech and flaccid dysarthria in a child?

A history of the child's development of chewing, eating, and swallowing. - A child with childhood apraxia of speech does not have difficulties with chewing, eating, and swallowing, whereas a child with flaccid dysarthria is likely to have such difficulties.

The thalamus?

A majory relay system for sensory information

A patient who presents with a unilateral hearing loss that falls between 56dB and 70dB in all frequencies what does this mean?

A moderate hearing loss in one ear

Reduplication

A multisyllabic production different from the target where the syllables are phonetically identical - baba for bottle - wawa for water

A study that is used to quantify the time and frequency of gastroesophogeal reflux into the esophagus is called?

A pH probe or intraluminal pH monitoring study.

If an African American adult patient in a hospital setting says, " I been had the measles when I was a kid," this is an example of

A perfective construction

What ration of reinforcement will most quickly cause a newly acquired behavior to be habituated?

A random ration of tokens to correct responses

What ratio during an oral manometry would require a referral to a craniofacial team for possible further surgery or a pharyngeal flap?

A ratio of .87

The Weber Test?

A screening employing a tuning fork in the middle of the forehead to detect unilateral conductive hearing loss and unilateral sensorineural hearing loss.

Response Cost Method

A token is given for each fluent production, and one is withdrawn for each disfluency.

A 9-year old child was seen for an evaluation because of a major dysfunction in his gastrointestinal tract. The child had short bowel syndrome, resulting in the removal of a major part of the the intestines. The gastroenterologist most likely would recommend?

A total parenteral nutrition (TPN)

Total Parenteral nutrition (TPN)

A way of supplying all the nutrition needs of the body by bypassing the digestive system and dripping nutrient solution directly into a vein

ABAB design

A: base line B: new treatment is offered A: treatment is withdrawn B: same treatment is reinstated

ABA design

A: base line B: skills are taught (application of independent variable) A: treatment is withdrawn

Broca's Aphasia site of lesion

ACA or MCA. premotor cortex, posterior inferior frontal lobe

Following placement of a tracheostomy tube, a patient recovering from cardiothoracic surgery is successfully wanted from mechanical ventilation. A day later the SLP receives a consult to assess patient candidacy for using a one-way tracheostomy valve. Which of the following observations is the most important contraindication for safe and successful patient tolerance of the one-way valve?

Ability of patient to pass air to the oral cavity while exhaling with the tube cannula occluded by the SLP

Maximal damage occurs when an artery is blocked below or above the circle of willis?

Above the circle of willis - below the circle of willis there are alternate paths for blood flow

A patient with aphasia and apraxia of speech who is able to write but often muscles words, initiates communication, recognizes and categorizes picture symbols and comprehends familiar word phrases. But has communication that is fragmented and inefficient would benefit from what AAc treatment strategy?

Accessing stroed messages in a speech-generating device

An SLP uses evidence based practice by integrating the perspectives and values of the client, patient, or caregivers into the treatment plan. What best reflects simultaneous incorporation of the host culture's perspectives and values and the maintenance of the native culture's perspectives and values?

Acculturation

When evaluating the hearing of a juvenile client, it is best to measure hearing thresholds as well as the opposition or resistance to sound energy transmitted through the middle ear. What is the second hearing measure called?

Acoustic Impedence

A transgender client who has undergone several procedures to become more feminine. Taking estrogen, seeking help to speak in a more feminine way. She is also dealing with emotional issues surrounding gender reassignment: In this, case, you should:

Advise her that a combination of voice therapy to teach more feminine pitch levels and communication patterns, counseling, and surgery would be the best course of action.

afferent vs efferent neurons

Afferent: ascending, towards that brain Efferent: descending, away from the brain

Suprasegmental system mastery complete by ____

Age 13

All vowels produced correctly by ___

Age 3

Most consonants produced correctly by ___

Age 6

Consonant clusters produced correctly by 75% of children by _____

Age 8

For a test of expressive morphology and syntax for speakers of AAVE, the test item that would be considered LEAST biased against such speakers would be one requiring

Agreement of personal pronouns with their antecedents in gender and number

For a test of expressive morphology and syntax for speakers AAVE, the test item that would be considered LEAST biased against such speakers would be one requiring?

Agreement of personal pronouns with their antecedents in gender and number.

Fluency shaping targets and order to teach them

Airflow management Gentle phonatory onset Syllable prolongation

You plan to write a treatment program for an adult who stutters. You wish to use the fluency-shaping procedure. What would you include in your program?

Airflow management, gentle onset of phonation, slower speech, and normal prosodic features

What is the best indicatory that a screening tool has high sensitivity?

All of the children who failed the screening were found to have a communication disorder

/k/ produced in slightly different manner in words kitten, bucket, and cook is called an?

Allophone

Compensations in normal aging include?

Alterations in the prefrontal areas in particular are some of the changes seen in normal aging. This is in part to compensate from reduced frontal activation.

Type of attention targeted when - sorting playing cards by color, then sorting by number, then sorting by color again?

Alternating attention

A patient with pervasive loss of short-term memory, aphasia, disorientation, disinhibition with behavioral changes is likely suffering from what disease?

Alzheimer's Disease

Dysphagia Lusoria

An abnormal condition characterized by difficulty in swallowing caused by aberrant right subclavian artery. This disorder is difficult to diagnose and often diagnosed late. Most patients do not actually have any symptoms.

Disorders of the oral phase of a swallow are mainly due to?

An anterior, as opposed to a posterior, tongue movement

Disorders of the oral phase of a swallow are mainly due to?

An anterior, as opposed to posterior tongue movement

Interference or transfer refers too?

An error in a student's second language that is directly produced by influence of the first language.

Interference and transfers refer to?

An error in a student's second language that is directly produced by the influence of the first language.

What is an Octave?

An indication of the interval between two frequencies.

Defense mechanism - Projection

An individual denies the existence of their own feelings, impulses, and qualities but attributes those same things to other people

Defense mechanism - Repression

An individually unconsciously pushes away thoughts and feelings.

A patient referred to an SLP with recurrent otitis media with effusion should also have the primary physician refer them to?

An otolaryngologist as they would be able to clinically manage otitis media and make provisions to obtain an audiological assessment

What assessment descriptions represents an s/z ration that is indicative of a vocal pathology?

An s/z ration greater than 1.4 is indicative of possible laryngeal pathology.

Types of evaluations of swallowing disorders and what they do?

An ultrasound exam can measure oral tongue movement and hyoid movement. - An electromyograhic assessment can be conducted by attaching electrodes to structures of interest (e.g. oral, laryngeal, or pharyngeal muscles) - A laryngeal examination can be conducted with indirect laryngoscopy or endoscopic examination to inspect the base of the tongue, vallecula, epiglottis, pyriform sinuses, vocal folds, and ventricular folds.

Genetic syndrome resulting in severe learning difficulties and developmental delay with normal facial appearance and behavior?

Angelman Syndrome

The region of the brain involved in language and cognitive processes which lies in the parietal lobe near the superior edge of the temporal lobe and posterior to the supra marginal gyrus is called the:

Angular Gyrus

Sara has arterial damage that causes her to have cognitive deficits such as impaired judgement, problems concentrating, and difficulties with reasoning. According to the surgeon, damage to the affected artery can also cause a person to have paralysis of the feet and legs. Damage to which artery produces these effects?

Anterior cerebral

Allophone definition

Any of the speech sound that represent a single phoneme. E.g. aspirated k in kit and inspirited k in skit.

Athetoid Cerebral Palsy

Appear hypotonic but over time see abnormal posture and movement, more movement with emotion. cognitive impairment, dysarthria, dysphagia laryngeal involvement, low subglottal pressure, unstable movement, low tone, irregular articulation breakdowns, difficulty positioning head and articulators for speech patterns, voice stoppages, excess loudness variation, inconsistent/uncoordinated vp function, paradoxical breathing, decreased respiratory control basal ganglia involvement

A typical three year old can understand how many words?

Approximately 1000 words

Brown's Morphemes

Are acquired by children in an order that is determined by semantic and syntactic complexity, with the simplest forms acquired first. The order of acquisition is typically followed by all children

The family education rights and privacy act (FERPA) guarantees parents access to their child's educational records. However, this mandate does not apply to the daily records kept by an SLP working in a school setting if these records?

Are kept in the sole possession of the SLP

Deictic terms?

Are words whose meaning shifts depending on the point of view of the speaker. Difficulties with these terms is a core feature of semantic pragmatic language disorders

When does using jaw movements to initiate chewing begin?

Around 5 to 7 months

Brown's Stage IV

Articles 'a' and 'the' appear, regular past tense and third person regular present tense emerges. verbs 'think', 'guess', 'show' emerge, complex sentences emerge, embedding sentence elements, clausal conjoining with 'and' and 'because'. Inversion of auxilary and subject in wh- questions. Inversion of copula and subject in yes/no questions. 2;11-3;4 MLU 3.0-3.75

Ataxic Dysarthria

Articulation: imprecise consonants, distorted vowels, irregular breakdowns Prosody: excess and equal stress, prolonged phonemes and intervals, slow rate, monopitch and monoloudness Phonation: harshness Respiration: paradoxical breathing, reduced vital capacity, incoordination of breathing patterns unbalanced gait, dysmetria, intention tremor, incoordination, balance problems, hypotonia associated with MS, vascular damage to PICA, Neoplastic, trauma, toxic, hypothyroidism, normal pressure hydrocephalus

Which of the following should an SLP recommend to best help a patient who has advanced to late stages of dementia of the Alzheimer's type?

Assistance from caregivers to improve the patient's communication skills

An otolaryngologist has referred a 45 year old man for voice treatment following medicalization thyroplasty for a paralyzed vocal fold. What is the most appropriate therapeutic strategy for the SLP to use?

Assisting the patient to produce a hard glottal attack

Slow expressive language development (SELD)

At about 24 mos will see 50 word vocabulary, no two-word utterances, risk factor for SLI

What the of cerebral palsy is characterized by slow, arrhythmic writhing and involuntary movements of the extremities?

Athetosis Cerebral Palsy

A child is born with his external ear canal completely closed. This is called?

Aurel Atresia

What causes Hurler's syndrome?

Autosomal recessive deficiency of X-L iduronidase

Hypokinetic Dysarthria site of damage

Basal ganglia and associated circuits (substantia nigra, putamen, caudate nucleus, globus pallidus), possibly due to Ach/Dopamine imbalance

Hyperkinetic Dysarthria site of damage

Basal ganglia control circuit (caudate nucleus)

Why can mental age be used as a performance criterion in some genetic disorders such as down syndrome?

Because using chronological age would over identify language disorders by making the child's language deficit seem more pronounced than it is.

Oral Phase of the Swallow

Begins with the stripping action of the tongue and ends when the bolus passes the anterior facial pillars

Functional Communicative Behaviors are?

Behaviors that promote communication in natural settings.

dB's for normal conversation?

Between 50 and 70 dB SPL

Attribute+entity

Big Kitty

Spastic Dysarthria site of damage

Bilateral UMN, corticobulbar, corticospinal damage, global in nature

A client exhibits weakness, atrophy, and fasciculations of the right side of the tongue and lower face. The client also has right sided vocal fold weakness and nasal regurgitation of fluid when swallowing. These problems are the result of damage to which part of the nervous system?

Brain Stem - Weakness, atrophy, and fasciculations are all consistent symptoms of lower motor neuron locus and suspected cranial nerve abnormalities (primarily CN x and XII). These cranial nerves emerge directly from the brain stem and help mediate the transfer of messages from the brain to the brain stem and to the structures of the head and neck.

Mrs. W. Is a 72-year old patient who has just had a stroke. She has been diagnosed with apraxia of speech, which is often associated with lesions in

Broca's area

Various arteries help supply blood to the face and the brain. Neurogenic communication disorders are associated with interrupted blood supply to the brain. Of the following statements about the arteries that supply blood to the brain, which one is correct? - The internal carotid artery supplies the muscles of the face - Damage to the external carotid artery causes aphasia -Broca's area and Wernicke's area are supplied by the middle cerebral artery - If an artery below the circle of willis is blocked brain damage is maximal

Broca's area and Wernicke's area are supplied by the middle cerebral artery

When is weak syllable deletion suppressed?

By 3 years of age

what vertebrae does the trachea begin and end at

C6 and T5

x-ray beams circle through segments of the brain and pass through tissues

CAT computerized axial tomography

The ability to pucker lips and spread them wide to smile depends on the bilateral integrity of what cranial nerve?

CB VII - Facial nerve

taste and sensation in posterior 1/3 of tongue

CN IX (glossopharyngeal)

initiation of pharyngeal swallow

CN IX (glossopharyngeal) and CN X (vagus)

tactile sensation in anterior 2/3 of tongue

CN V (mandibular)

tactile sensation in hard and soft palate

CN V (maxillary branch)

velopharyngeal valving

CN V (trigeminal) - mandibular branch

anterior hyolaryngeal excursion

CN V (trigeminal) - mandibular branch and CN XII (hypoglossal)

Facial Nerve

CN VII

mastication

CN VII (facial)

taste in anterior 2/3 of tongue

CN VII (facial)

oral bolus containment

CN VII (facial), CN X (vagus)

PES relaxation and opening

CN X (vagus)

airway closure

CN X (vagus)

sensation in subglottic regions

CN X (vagus) RLN

posterior pharyngeal wall sensation

CN X (vagus) SLN

sensation of vocal folds

CN X (vagus) SLN

tactile sensation in epiglottis and pyriform sinuses

CN X (vagus) SLN

bolus manipulation, formation, containment and transport

CN XII (hypoglossal)

tongue based retraction

CN XII (hypoglossal)

Before a surgeon performs a glossectomy, she informs the patient that the cranial nerves that innervate the tongue muscle will probably be damaged. Which of the following cranial nerves that innervate the tongue muscles will be affected by the operation? - Cranial Nerve X, Vagus - Cranial Nerve IX, Glossopharyngeal - Cranial Nerve XII, Hypoglossal - Cranial Nerve VII, facial

CN XII, Hypoglossal

What neuroimaging studies specify which artery or arteries is/are occluded in a patient with a stroke?

CT or MR angiography

An electromyographic assessment

Can be conducted by attaching electrodes to structures of interest (e.g. Oral, laryngeal, or pharyngeal muscles)

A laryngeal examination:

Can be conducted with indirect laryngoscopy or endoscopic examination to inspect the base of the tongue, vallecula, epiglottis, performs sinuses, vocal folds, and ventricular folds.

Using light articulatory contacts?

Can help decrease the perception of mild nasal emission

An ultrasound examination

Can measure oral tongue movement and hyoid movement

You have just completed an evaluation of Tanveer, a 6-year old who speaks Urdu at home and English at school. You have discovered that he has a language impairment, and you are creating an intervention plan for him. It has been found that Urdu is his stronger language, and that he is still in the process of learning English. What intervention principle should most strongly guide your treatment plan?

Carrying out treatment in Urdu will be more effective and efficient that carrying out therapy in English.

Service Delivery models in EI

Center based, home based, home-center combinations, NICU

What ideas do the universalist-linguistic school of phonological acquisition theories include?

Children acquire phonological concepts as passive learners rather than actively.

Define Assimilation

Children apply new information to existing cognitive scheme

Define Mediated Learning Experience

Children learn through interaction with more experienced adults or peers who interpret the environment for them

Define Accommodation

Children modify on existing cognitive scheme to include new information

Language generativity

Chomsky

What dental condition is most likely to have a negative effect on articulation?

Class III malocclusion - It can affect all anterior sounds

Which of the following is the most common phonological problem evidenced by young children aged 18-29 months?

Cluster reduction

Error patterns that are phonological in nature?

Cluster reduction and stopping etc. - These error patters are not consistent with a deficit in language comprehension (receptive language), dialectal differences, or problems with auditory discrimination.

Language intervention for a child at the one-word stage should be most strongly influenced by a consideration of the child's?

Cognitive Skills - The cognitive skills of a child at the one-word stage will most strongly influence the child's speech-language responses. Therefore language intervention should take into account the child's cognitive skills.

A child with discourse problems is most likely to need remediation at which of the following?

Cohesive Devices - Such as pronominal references, coordinating conjunctions, and conjunctive adverbs, are used to link clausal and sentential elements to form a coherent and unified message.

Van der Woude Syndrome

Common cause of cleft lip and palate. 3% of cleft lips. variety of cleft patterns. 80% have lip pits. autosomal dominant, development usually normal, no other associated anomolies, hypodontia (lack normal number of teeth), speech problems related to cleft.

What is most important for an SLP to do when assessing a child who has an acquired brain injury?

Compare premorbid performance with present performance.

Infant feeding/swallowing therapy

Compensatory: positioning, consistency, texture, taste, environment, adaptive utensils, swaddling, monitor state, different nipple size or shape, cheek/jaw support restorative: establish NNS, external pacing and internal rhythm, chewing skills, reduce aversions, coordinate suck-swallow-breathe, oral motor stimulation

Effective treatment for patient with spastic dysarthria?

Completing head and neck relaxation exercises

You are taking a language sample from an 8 year-old child. One of his utterances is "I will go to school tomorrow if I am not sick." This is an example of a?

Complex sentence with an independent and dependent clause

What are the following sentences? - "I like to play football, and I also like Mario Cart Wii" - My football team won the championship last Saturday; later, we celebrated at a pizza place"

Compound sentences containing two independent clauses

You are evaluating Tatyana, a Russian speaking child with a suspected language impairment. To accurately estimate her language skills, you engage a Russian-speaking interpreter and count Tatyana's responses to test questions in both Russian and english. You are employing?

Conceptual scoring

Developing a new test of language acquisition in children correlated the scores of children studied with the scores on an established test of known validity. What kind of validity is this?

Concurrent Validity

Which aphasia is characterized by good syntax, prosody, and articulation?

Conduction Aphasia

A patient is diagnosed with a cerebrovascular accident of the temporal lobe. The patient exhibits deficits in repetition, written expression, and auditory comprehension. In addition, literal paraphasia are noted. This is consistent with what type of aphasia

Conduction aphasia

A child's cochlea is normal but there are problems with the middle ears. This is what type of hearing loss?

Conductive hearing loss

A physician told the spouse of a client that melodic intonation therapy (MIT) would improve the client's speech considerably. The most appropriate next action by the SLP would be to?

Consider the potential value of incorporating MIT into the client's treatment.

What is the most likely error to persist the longest in the speech of children who are learning Standard American English as a first language and are following the normal developmental course for speech and language acquisition?

Consonant cluster reduction

Last phonological process to be suppressed

Consonant cluster substitution

What is construct validity?

Construct validity is based on consistency of scores with a theoretical expectation

Individual in 40's under chronic stress, uses voice extensively, has a hand-driving personality and exhibits glottal fry. This client has the classic profile of a person at high risk for?

Contact Ulcers

Medulla

Contains cranial nerve nuclei. regulates respiration, phonation, heart beat, and blood pressure.

A researcher who developed a language acquisition test claims that her test measures what is is supposed to measure because the scores are progressively higher across age groups. She is claiming that her test has what kind of validity?

Content Validity

According to Brown's stages, what is the last morpheme to be acquired by a typical child?

Contractible auxiliary

Maximal oppositions approach

Contrasts two errors sounds differing across place, manner, and voicing to gain the greatest amount of generalization

What are cartilages that are cone shaped and are located at the posterior of the aryepiglottic folds and are occasionally fused with the arytenoid cartilages?

Corniculates

Pseudobulbar Palsy

Cortico-bulbar tract degeneration bilaterally. Lability (cry easily, laugh easily), masked face, weak voice, monotone, problem with upward gaze. Want to introduce AAC device, start counseling family. Very rapid disorder. reduced range, speed, and force, severe oral compromse

Compound word (birthday) in an MLU?

Counted as one morpheme

Primary motor innervation to the larynx and velum is provided by which cranial nerve?

Cranial Nerve X - Primary innervation to the larynx and velum is provided by the vagus nerve

What condition is primarily characterized by premature closure of the sutures of the skull?

Craniosynostosis

What is a developmental milestone of a typically developing 7 month old that will most likely be demonstrated during a swallow evaluation?

Creating vertical jaw movements.

Control Over the fundamental frequency of the laryngeal tone is most closely related to the activity of which muscle?

Cricothyroid

Nicole, a voice major, is having problems raising the pitch of her voice. Her speech-language pathologist recommends that she lengthen and tense her vocal folds to increase her pitch. Which muscle is involved in achieving this goal?

Cricothyroid

What muscle lengthens and tenses the vocal folds?

Cricothyroid

What muscle is responsible for changing vocal pitch?

Cricothyroid is responsible for changing vocal pitch as it tenses the vocal folds

to distinguish neruogenic stuttering from that of early onset stuttering, you will assess the effects of

DAF and adaptation

A 67 year old male patient with no history of swallowing problems has undergone a cardiothoracic surgical procedure. Postoperatively, he is found to be aspirating while swallowing and is diagnosed with a left vocal-fold paralysis and left pharyngeal pareses. What is the most likely etiology?

Damage to the left recurrent laryngeal nerve

Intermittent reinforcement schedule to reinforce an already acquired behavior

Decreases the clients dependence on the token reward

An SLP is planning treatment for a 5 year old child with multiple speech production errors. The most effective strategy the clinician can use to treat the child is to?

Delineate phonological processes in operation and address them through minimal contrast pairs

An SLP is planning treatment for a 5-YO with multiple speech-production errors. The most effective strategy the clinician can use to treat the child is to:

Delineate phonological processes in operation and address them through minimal contrast pairs.

Esophageal and tracheoesophageal (TEP) techniques for producing alaryngeal voice are similar in that both?

Depend on adequate vibration of the pharyngeal (PE_ segment

Dependent variable

Depends on other factors in the study - usually dependent on the independent variable which is the variable manipulated by examiners.

A primary factor that may cause a patient's psychogenic aphonia is the presence of?

Depression

What is most likely to help a client who has aphonia?

Development of phonation through coughing or throat clearing.

A woman independently contacts you for a voice evaluation. You determine there are some issues with her voice. Is it within your scope of practice to diagnose the disorder and begin treatment immediately?

Diagnosis must be made by an otolaryngologist (or neurologist). You must refer woman to the appropriate physician/professional. Treatment may begin once the doctor refers back to the SLP (Do NOT begin treatment without diagnosis from physician).

Other symbolic dysfunction

Diagnosis to use when treating a patient for a cognitive impairment not caused by a stroke

What is a dialect?

Differences in language as well as pronunciation

Symptoms that indicate an SLP should not be the professional treating the swallowing disorder?

Difficulty in passing the bolus through the cricopharyngus muscle, formation of diverticulum, back flow of food to larynx.

What is a core feature of semantic-pragmatic language disorders?

Difficulty with deictic terms because they are words whose meaning shifts depending on the point of view of the speaker

Temperament

Difficulty with distractibility, adaptability, and rhythmicity

Prader willi syndrome

Directly linked to missing genes on chromosome 15

A family that gets angry at the SLP for pointing out reasonably unattainable goals is using which defense mechanism?

Displacement

A large metropolitan school district wants to determine the prevalence of developmental stuttering among all enrolled students during the past year? How would they accomplish the task?

Divide the total number of students who currently stutter by the total number of students who were enrolled in the past year.

Two combined vowels that result in a continuous change in the shape of the vocal tract are?

Dupthongs

Cleft palate is a birth defect which occurs during what part of development of the embryo?

During the first six to eight weeks of pregnancy

Hyperkinetic Dysarthria

Dyskinesia: ballism, chorea, athetosis, tremor, ticks, dystonia, myclonus, spasm, dystonia -Chorea: rapid involuntary movements Phonation: breathiness, strained, harsh, voice stoppages Resonance: intermittent hypernasality Articulation: slow and irregular AMR's Prosody: prolonged intervals and phonemes, variable rate, inappropriate silences, variable and inefficient patterns of stress Respiration: sudden forced in/exhalation, excess loudness variations -Dystonia: sustained muscle contractions, results in twisting, repetitive movements, and abnormal postures Phonation: strained, harsh, stoppages, tremor Resonance: hypernasality Articulation: distorted vowels, irregular breakdowns, slow and irregular AMR Prosody: inappropriate silences, inefficient patterns of stress Respiration: audible inspiration, excess loudness variations, alternating loudness associated with huntington's, tourrettes, torticullis dystonia, spasmodic dysphonia, athetoid CP

A 45-year old completes a barium esophagram showing an oblique filling defect in the posterior esophagus. She also has an aortic arch anomaly (an aberrant right subclavian artery. The right subclavian artery arose from the left side of the aortic arch and was externally compressing the esophagus). This vascular anomaly in the thorax, particuarly in the aortic arch, was compressing the tracheal and esophagus and resulted in the patient experiencing significant respiratory distress and feeding difficulties. This condition is called?

Dysphagia Lusoria

records and measures electrical impulses of the brain through small surface electrodes attached to the scalp

EEG electroencephalography

Individuals diagnosed as having hemifacial microsomia are also likely to have

Ear malformation

What does the serrates anterior muscle do?

Elevates ribs 1-9

A patient who has a total laryngectomy speaks by taking air into through the mouth, trapping it in the throat, and then releasing it. What type of speech treatment is this?

Esophageal speech

What is the Injection Method

Esophageal speech that requires the speaker to impound air into the oral cavity, push it back into the esophagus, and vibrate the cricopharyngeus muscle.

Naturalistic teaching involves what?

Establishing successful and useful communication.

Hearing loss in infants who are born with a cleft palate is usually related to what?

Eustachian Tube Dysfunction - Eustachian tube dysfunction, a major factor contributing to middle-ear disease and conductive hearing loss, is nearly universal in infants with cleft palate.

An infant with a cleft palate will most likely have hearing problems because of:

Eustachian tube dysfunction

Senbo is a third-grade student who speaks Afrikaans. Her teacher refers her for assessment because she is having academic difficulty. To evaluate Senbo's language skills, you use dynamic assessment, an alternative approach in which the clinician?

Evaluates her over time in a test-retest format

What is the CADL-2 best for?

Evaluating functional communication skills in people with neurologic communication disorders.

Naturalistic contexts

Everyday situations - These provide opportunities for the use of functional and meaningful linguistic forms

A type of research in which independent variables have occurred in the past and the investigator tries to find potential causes of the dependent variable is called what?

Ex post facto research

Muscular Tension Dysphonia (MTD)

Excessive tension of laryngeal or extralaryngeal muscles, results in altered phonatory function, more likely due to abnormal muscle patterning (rather than increased contraction levels). May be psychological, postural, from reflux, or from vocal behavior. Many sources of tension in throat and neck region (e.g. strap muscles, jaw excursion, shoulder and neck motion, etc.).

What phonological process is a child expected to suppress by 3 years of age?

Exhibiting weak syllable deletion

Hemorrhagic CVA

Extracerebral: subdural or epidural (linked to TBI), or subarachnoid (linked to aneurysms, saccular, ateriovenous malformation) intracerebral: linked to hypertension

when a speaker is producing a vowel and the vowel is being acoustically analyzed, one can state as a general rule that

F1 vareis mostly as a result of tongue height F2 varies mostly as a result of tongue advancement

CN VII

Facial nerve

Assessing the ability to learn a new language

Fast Mapping (how fast child can get meaning from words) and Quick incidental learning (how fast child can get meaning from words and syntax) Dynamic Assessment (effort of learning; related to zone of proximal development)

For a patient with potential pharyngeal phase dysphagia and pooling of secreations following open-heart surgery with suspected recurrent laryngeal nerve damage, what instrumental examination for swallowing provides the most direct view for evaluating the patient based on history and suspected difficulties?

Fiberoptic endoscopic evaluation of swallowing (FEES)

Phonological processes that may persist after age 3?

Final consonant deletion Consonant cluster reduction Stopping Epenthesis Gluiding Depalatization Vocalization

A child is provided a sticker after 10 correct responses during a task targeting wh-questions. What type of reinforcement is this?

Fixed-Ratio

Dysarthria in a patient with lower motor neuron damage generally manifests as?

Flaccid dysarthria

Sensorineural hearing loss as a result of Meniere's disease causes?

Fluctuating levels of hearing loss

You are asked to design a treatment program for young children who stutter, including preschoolers. Among the following choices, which would you most likely select? - Delayed auditory feedback - Masking noise - Fluency reinforcement - Fluent stuttering

Fluency Reinforcement

Fluency shaping

Fluency shaping is about producing fluent speech! It first establishes fluent but abnormal sounding speech in the speech clinic. This is then shaped into normal sounding speech, and then transferred outside the speech clinic.

Which of the following is a type of perturbation that can be measured to determine the amount of noise in the voice?

Fo cycle-to-cycle variations of sound energy over time. - Perturbation is a disturbance in the quality of the laryngeal tone, or fundamental frequency of the voice.

A 15-year old high school sophomore with th/s substitutions comes to you for therapy. She is frustrated because she wants to act in high school plays but has been told she cannot do that because of her "speech problem". She is highly motivated to produce /s/ correctly, and you begin seeing her for therapy. If you are using Van Riper's approach, what will you do?

Focus on phonetic placement, auditory discrimination, and drill-like practice at increasingly complex motor levels until accurate /s/ production is automatized.

A father is at home with his baby daughter. He is trying to stimulate her language skills, and has read some literature about how to do this. When he sees his daughter looking at the family cat, he looks at the cat along with her and comments about it. This father has just:

Followed his baby daughters line of regard

What is a primary reinforces?

Food, sex, touch

Providing services to a patient with Parkinson's Disease and consequent dysarthria, to help him sound more intelligible. You can expect that you will need to address challenges related to?

Forced inspirations and expirations that interrupt speech.

According to Bloom and Lahey's model what is morphology considered?

Form

When taking a speech-language sampling you should?

Frequently repeat what the child says

Acoustic characteristics of Nasals

Generally low intensity with anti-formants and nasal murmor. Anti-resonance/Anti-formants- acoustic energy damped and attenuates frequencies in bandwidth (depending on how wide VP port). Nasal murmor- extra resonances because two branches (oral and nasal), low frequencies energy at high intensity is the nasal formant

Hemifacial microsomia is a?

Genetic diagnosis within the oculo-auricular-vertebral spectrum

When a patient has a TBI, what test is used to identify the motor, verbal, and eye opening response?

Glasgow Coma Scale

When writing goals for the annual IEP what is appropriate?

Goals must be specific, measurable, realistic, time limited, and address the student's specific needs

When are language disorders typically identified?

Grades 4 - 6 - Because there is a shift between "learning to read and write" and "reading and writing to learn"

To compensate for the effects of normal aging on cognitive functions, older adults will naturally demonstrate?

Greater amounts of bilateral activation of prefrontal brain regions

Life participation approach to aphasia (LPPA)

Has the overriding philosophy to maximize the clients re-engagement in life and bases all decision making on the life concerns identified by the clients and their families.

the extent to which a study's results are affected by participants' knowledge that they are taking part in an experiment

Hawthorne effect

You are assessing an Ibo-speaking child from Nigeria who learned Ibo first (from birth) and then was exposed to English in preschool when he was 3 years of age. His parents continue to speak Ibo at home, and he is often cared for by his Ibo-speaking grandparents while his parents are at work. Unfortunately, his Ibo skills were not well developed when he was exposed to english. What would not expect to be true for this child?

He will not be interested in maintaining his skills in Ibo, and he will become a monolingual English speaker

What assists in reducing hyper adduction of the vocal folds?

Head and neck relaxation exercises

CN XI- Spinal Accessory

Head movement and shoulder elevation.

In spite of their significant disadvantages, standardized tests are used by most clinicians in assessing clients because such tests

Help qualify children for clinical services in public schools

What is a strategy that an SLP can use to most effectively engage a patient with psychogenic aphonia in monitoring their progress?

Help the patient recognize his control over his own vocal quality.

Light and gentle vocal fold contacts for hypperadduction

Help to reduce tension

The presence of hypertension can lead to what?

Hemorrhagic stroke

According to Halliday, what are four of the seven functions of communicative intent that develop between 9 and 18 months of age?

Heuristic, imaginative, interactional, personal

What formants do high vowels tend to have?

High vowels tend to have low F1 frequencies because F1 is inversely associated with tongue hight.

Consonant characteristics

Higher degree of constriction (partial or total). Can be sonorant or obstruent. Serve as the onset or coda of a syllable

Parts of tracheostomy tube

Hub, inner cannula, outer cannula, pilot baloon, cuff, flange, fenstration

Bulbar Amyotrophic Lateral Sclerosis

Hypernasal, slow/weak VP closure, nasal regurgitation and swallowing difficulties, reduced volume, breathy and weak voice, muscle fasiculations in tongue (signs of dennervation), slurred speech. may need tracheostomy

James, a 4-year old boy, attends your cleft palate center for a speech evaluation. James was born with a complete bilateral cleft lip and palate. He is unable to close his velopharyngeal port and, as a result, has difficulty producing non-nasal sounds. This patient's non-nasal speech sounds would have what characteristic?

Hypernasality

You are an slp serving in an area with many African American patients. You will remember that?

Hypertension is prevalent among African American adults, and it can result in hemorrhagic stroke.

Oropharyngeal dysphagia in a child with Down syndrome is most likely caused by what factor?

Hypotonia

Cranial Nerves

I Olfactory II Optic III Oculomotor IV Trochlear V Trigeminal VI Abducens VII Facial VIII Acoustic (vestibulo-cochlear) IX Glossopharyngeal X Vagus XI Spinal Accessory XII Hypoglossal

A Cambodian child is referred to you because the teacher "can't understand a word he says." In the course of your speech-language screening, you record the following utterances. Which might be typical of an articulation disorder, not a difference?

I am derry (very) happy (happy) to meet your kids (kids)

Which of the following utterances would be an example of the use of the perfective construction 'been' to indicate an action that took place in the distant past? - I been had chicken pox when I was 5 - Our family been gonna see a movie - My grandparents be watchin TV - We don't have no more Halloween candy for y'all

I been had chicken pox when I was 5.

You are developing a treatment plan for a 30-year-old man who sustained traumatic brain injury from an auto accident. Pre morbidly, this man had excellent language skills; he had a graduate degree in linguistics and was a college lecturer. Among several others, what is a set of goals and procedures you could select in treating this person?

I would give such signals as "listen carefully." "I am going to say something different now." and "pay attention to what I am about to say" to improve attention to communication.

ASHA Code of Ethics I II III IV

I: hold the welfare of persons II: maintain the highest level of professional competence III: shall honor their responsibility to the public IV: shall honor their responsibilties to their profession

Two parts of categorical perception

Identification (label stimuli on continuum) and discrimination (same or different stimuli; acoustic distinction)

Both ASHA and state governments regulate the practice of speech-language pathology. Clinicians often have to meet different requirements for different professional settings. Which of the following is incorrect? - In many states, it is not essential to get the ASHA certification to work as a clinician in public schools. - In most states, both the state licensure and ASHA certification are required to work as an SLP in public schools - Although widely recognized by employers, the ASHA certifications do not have the legal authority of state licensure - A state education departments credential is not the same as the the same state's licensure.

In most states, both the state licensure and ASHA certification are required to work as an SLP in public schools

The description of the different phases of normal swallow suggest that?

In spite of being analyzed in terms of phases, swallowing typical is a continuous process.

Basic Infant/Toddler states

In-turned: ill, unable to interact with environment, caused by illness and degree of sensory stimulation Coming out: begin to respond to environment, able to form attachment to caregiver, no longer acutely ill, some relapse may occur although transition considered positive, not a good time for direct services Reciprocity: child responds in specific and predictable ways, optimal time of environmental opportunity, good time to sample behavior, will provide services once physician orders

What is a clear indicator of apraxia of speech?

Inability to repeat two-syllable words

What is a limitation of standardized speech-language tests?

Inadequate participant and response sampling

Which of the following is a limitation of standardized speech-language tests? - Generally exhaustive time required to administer them - Lack of statistical norms - Inadequate participant and response sampling - Unnecessarily extensive testing of each individual skill sampled in the test

Inadequate participant and response sampling

A child with inconsistent speech sounds, poor intelligibility and dropping, would most benefit from provided activities that?

Increase the accuracy of CV, VC and CVC syllable sequences.

Treatment goals for an adolescent with limited discourse skills would include goals that target?

Increased conversational skills over a wide range of topics while interacting with peers.

FERPA's stance on an SLP's daily notes?

Increasing Daily notes can be kept in the sole possession of an SLP as long as the purpose is to serve as a memory jogger for the creator of the record.

What will most effectively decrease fundamental frequency?

Increasing the mass of the vocal folds

In the scientific method, what is the experiment first-and-explain -later approach?

Inductive method

Reflux Laryngitis

Inflammatory from acid coming over arytenoid/mucosal covering. Caudal stoning- posterior, irregular appearance of mucosal covering. Problems include increased mass, report lump in throat, loss of sensation (leads to difficulty swallowing)

You have been asked to council with John, a 70-year-old man who smoked and drank alcohol since he was a teenager. He now has laryngeal cancer, and, before surgery, the surgeon asks you to talk with John about esophageal speech. You explain to John that there are two basic types of esophageal speech. In one method, the patient is taught to keep the esophagus open and relaxed while inhaling rapidly. In the other method, the patient impounds air in the oral cavity, pushes it back into the esophagus, and vibrates the cricopharyngus muscle. What is the second method called?

Injection method

Right Hemisphere Dysfunction

Insensitivity, difficulty empathizing, self-absorption, oblivious to social conventions, do not understand social cues, lack of insight into status and unaware of deficits, (extreme cases may disown limbs), verbose, difficulty interpreting abstract or figurative info, motor and sensory weakness, possible diminished arousal and attention. prosody affected, monotone, does not match emotion, difficulty comprehending prosody. Verbal deficits and poor comprehension of gestures, problem with attention and conceptualization, follow simple compands but breakdown if abstract, difficulty with complex sentences, themes, idions, irony, and making inferences redundant vertical strokes of same letter in writing (l,t,m,n), neglect reduced problem in writing Left Neglect of extremities, agnosia/anasagnosia, visuoperceptual compromise, achromatopsia

A 72-year-old patient was diagnoses with apraxia of speech post CVA. The clinician instructed the patient to "watch and listen to me" and then "say it with me". The aim of the treatment approach was to use simultaneous practice to bring to consciousness the look and sound of the target speech output. This is an example of

Integral Practice

Establishment of what validity is most important in ensuring that the results of any diagnostic test of speech or language are replicable?

Interjudge reliability

A clinician measured the disfluency rates of a client from a speech sample. She then asked another clinician to measure disfluencies using the same method she had used. The first clinician calculated a reliability index based on her measure and that of the second clincian. This index is a measure of?

Interobserver reliability/agreement

A clinician measured the number of misarticulating in a childs speech sample. She then when on a 2 week vacation. After returning she decided to gather another speech sample from the child and remeasure the number of misarticulating. She did this to establish?

Intraobserver reliability

CN XII- Hypoglossal

Intrinsic and extrinsic muscles of the tongue.

Selective attention

Involves a simple short term task such as listening for a specific word in a list

Working memory

Involves holding information in your head and manipulating that information

Sustained attention

Involves maintaining attention over a period of time

Alternating attention

Involves switching between two tasks or two parts of a task

Apraxia of Speech (AOS)

Is a neurogenic speech disorder

Response to intervention (RTI)

Is an approach used to identify and support students with learning and behavior needs. - Students are given interventions at tiered levels of difficulty to assess whether further or different interventions are needed.

Defense mechanism - Rationalization

Is an attempt to justify immoral, devient, or generally unacceptable behavior.

Fundamental frequncy

Is inversely proportional to mass of the vocal folds. As mass increases fundamental frequency decreases.

Tensor veli palatini

Is the muscle that when contracted opens the auditory tube, equalizing middle ear pressure. When the tensor is not functioning properly, the auditory tube is not opened, pressure is not equalized, and fluid may accumulate in the middle ear. The tensor veil palatine travels around the humans of the sphenoid bone, where it has a fanlike appearance, and becomes the palatine aponeurosis, extending from the hard palate to the free border of the soft palate.

Ranchos Los Amigos Scale of cognitive function

Is the only truly "scaled" instrument developed specifically for rehabilitation documentation following TBI

What is normal distribution

It is based on the arithmetic mean of scores or values.

What is normal distribution based on?

It is based on the arithmetic mean scores or values

What is an accurate statement about whispered speech?

It is composed largely of aperiodic sounds. - As the vocal folds do not vibrate while whispering is taking place.

The Lidcombe Program for childhood stuttering

It is considered a direct therapy approach in which primary caregivers explicitly provide feedback on the childs level of fluency.

Where is damage most commonly found in patients with Broca's aphasia?

It is often, but not always located in Brodmann's areas 44 and 45.

What is the role of the facial nerve (cnVII)

It is the major nerve innervating the face (eg. lips)

A discrete trial procedure:

It is the most researched procedure, and it is useful in establishing the skills, but it may not promote generalization to natural settings.

The diaphragm in inhalation?

It is the muscle that creates the most volume in the lungs

Chin tuck development

It was initially developed to eliminate thin liquid aspiration in people with delayed pharyngeal stage onset after having a stroke.

What is a goal of Van Riper's approach to stuttering treatment?

Its goal is fluent stuttering

Reversible passive sentence

Jared was bullied by Micheal - It can be changed around at the word "by" to still make sense but be opposite - Micheal was bullied by Jared

Variations in vocal frequency, or frequency perturbation are known as:

Jitter

Jitter

Jitter is a measurement of vocal stability or frequency instability. It is a change of frequency from cycle to cycle

An example of an entity + locative?

Juice [in] glass

To make distinctions between similar-sounding words, using a combination of suprasegmentals such as intonation and pausing, which mark special distinctions or grammatical divisions in speech. This type of vocal punctuation is also called:

Juncture

16 year old male who has not yet developed facial hair and seems overall underdeveloped. He has expressive language disorder and has difficulty making friends due to social pragmatic impairments. You suspect that he presents with which genetic syndrome?

Klinefelter's Syndrome

Flaccid Dysarthria site of damage

LMN impairment, cranial, spinal, pns. Ipsilateral damage, CN V, VII, IX, X, XII

In a preschool child who stutters what area of performance is likely weaker than a typical preschooler?

Language - Some young children who stutter present with concomitant language delay/disorder.

A teacher has referred a fifth-grade boy to you for a speech-language assessment. She is concerned because she feels that he is academically behind his peers. He and his family are Vietnamese refugees, and they have been in the United States for 5 months. Because the boy has been in refugee camps most of his life, his schooling in Vietnam was limited. His parents tell you that they estimate that he has approximately 2 years of schooling in disability, and she wonders if he is eligible for speech-language series. What is the best combination of assessment techniques to use with him?

Language samples in Vietnamese, dynamic assessment, and observation of the boy's interaction with family members and other Vietnamese children.

Measures of jitter and shimmer are becoming more common in use with voice patients because they can be useful in early detection of vocal pathology. Even if you suspect a vocal pathology given a history of prolonged hoarseness, you still want to obtain measures of jitter and shimmer because these can serve as excellent baselines. Especially if phono surgery will be conducted. When you take these measures, you might expect to see?

Large amounts of both jitter and shimmer, with more than 1dB of variation across vibratory cycles when shimmer is measured

55 year old man-sounding hoarse for the last few months. Difficulty swallowing, ear pain, and a lump in his neck. He has an ongoing sore throat. Suspect his diagnosis to be?

Laryngeal Cancer

Which of the following views make up a standard video fluoroscopic swallow study?

Lateral and Anterior Posterior views - A lateral view is best for seeing all stages of the swallow, and an anterior-posterior view shows the symmetry (or asymmetry) of the swallow.

Speech evaluation after CVA revealed; intact grammatical structure, normal prosody, meaningless sentences that don't fit context and included non-sensical paraphrasic errors. Also, poor repetition and naming skills, not responding appropriately to many simple commands, and difficulty reading. Finally, the client did not appear to be aware of communication deficits. What is the most likely location of the lesion?

Left posterior superior temporal gyrus

Prelinguistic Period

Less than 6 mos: reflexive vocalizations, cooing, phonation, full vowels and marginal babbling 6-7 mos: Babbling- canonical and reduplicated, use babbling and gestures 8-9 mos: uses CV syllables, imitates sounds 10 mos: Babbles in own language, jargon

Candidacy for infant alternative and supplemental feeding

Less than 80% of caloric needs, weight loss or no gain in 3 months, weight and height ratio below 5th percentile, feeding time greater than 5-6 hours a day.

Methods of segmentation in speech perception

Lexical cues, acoustic cues, phonotactics, stress

The structure at the inferior portion of the tongue that connects the tongue with the mandible is called the

Lingual frenum

Parkinson's disease

Loss of neurons in substantia nigra portion of basal ganglia, loss of dopamine resulting in hypokinesia. Cognitive impairments include visuospatial abilities, verbal fluency, learning and verbal memory. Speech and voice characteristics include low intensity, breathiness, monoloudness, monopitch, imprecise articulation. Hypokinetic dysarthria. myoclonus, delayed bolus formation, delayed oral transport and swallow reflex, pharyngeal statis, aspiration risk. Treated with pharmeceuticals, surgery (DBS), LSVT.

You are evaluating a 5-year old boy whose mother has a history of alcohol abuse while she was carrying her son. In our assessment, you would look for specific speech and language problems; in addition, you would look for which of the following positive or negative signs?

Low birth weight and length, behavior problems, and possible swallowing difficulties

What formant typically characterizes a high vowel?

Low-frequency first formant (F1)

Non-instrumental Measures for Voice Disorders

MPT (max phonation time), s/z ratio, perceptual assessment or scaling (CAPE-V, GRBAS, pitch, vocal effort)

A patient with advanced dementia, under hospice care, currently showing signs and symptoms of aspiration on all consistencies. An instrumental exam is inappropriate due to cognitive condition and the family and patient have decided against a feeding tube. The SLP has recommended NPO except for pleasure. What is the primary ethical responsibility of the SLP here?

Making recommendation based on clinical judgement. - The role of the SLP is to keep the patient as safe as possible. As the family does not want a feeding tube, the slp has to choose the diet that is most appropriate for the patient.

Among the following symptoms, what is not an especially significant feature of traumatic brain injury in children?

Marked deficiency in producing grammatical morphemes.

Select the two properties of a medium that affect sound transmission. - Amplitude and intensity - Mass and elasticity - Compression and rarefaction - Pressure and force

Mass and Elasticity

Two phonologically dissimilar target sounds are contrasted (chip and rip)

Maximal oppositions approach

Laryngeal Paralysis

May be Abductor or Adductor; Unilateral or Bilateral. Damage to anywhere on the Vagus from brainstem to muscles. Presentation depends on location of damage. Symptoms may include breathy, insufficient loudness, choking on liquids, not enough air while speaking, deviation of larynx, increased effort, difficulty with repeated glottal stops. Manage surgically with thyroplasty of arytenoid adduction. Voice therapy for vocal hygiene, and dysphagia management.

Allophones do which of the following? - Change word meaning - Are variations of phonemes - Are not perceived the same - May vary from production to production

May vary from production to production

Which articulation therapy approach emphasizes both the syllable as the basic unit of speech and the concept of phonetic environment?

McDonald's sensory-motor approach

An s/z ration grater than 1

Means the client prolonged the /s/ phoneme longer than the /z/ phoneme. - The client was able to produce a longer sound with the vocal folds were not involved such as in /s/.

Wallenberg Syndrome

Medullary CVA, level of the brainstem, unilateral VF paralysis, dysphagia, facial paralysis, contralateral sensory arm abnormalities. Only disorder in CNS that produces a full unilateral VF paralysis. aspiration during and after swallow, decreased UES opening

Treatment options for Broca's Aphasia

Melodic intonation therapy (MIT), voluntary control of involuntary utterances (VCIU), sentence production program for aphasia (SPPA), Naming Cue Hierarchy, teach self-cueing (describe it, put in category, common words, synonyms, semantic relationships), increase length and complexity, decrease familiarity.

What is a characteristic of a mild traumatic brain injury?

Memory loss of events immediately preceding or following the trauma incident.

Swallowing exercises

Mendolsohn, masako, shaker maneuvers, effortful swallow, brushing and icing, vocal fold adduction exercises, postural (chin tuck, head turn

54 year old man complains to ENT of vertigo, fluctuating hearing loss, tinnitus, nausea, and a fullness of pressure in the ear. The vertigo lasts around 30 minutes at a time. The ENT conducted tests including, videonystagmography, rotary-chair test, vestibular evoked myogenic potential testing, and posturography. The doctor diagnosed

Meniere's disease

Research regarding the use of intensive phonemic-awareness treatment for children who have difficulty learning to read has demonstrated that the treatment:

Might have no direct relationship to improvement in reading abilities.

In which type of therapy does the clinician use pairs of words that differ by only one feature?

Minimal Pair Contrast Therapy

Hearing loss that occurs when the middle ear and the inner ear are not functioning properly is known as?

Mixed hearing loss

A 6 year old with difficulty producing both irregular and regular plural forms would benefit from intervention that targets language at the level of?

Morphology

To work in public schools, most states require?

Most states require both the state licensure and ASHA certification to work as an SLP in public schools

CN IX- Glossopharyngeal

Muscles for swallowing. Sensation to posterior 2/3 of tongue and internal surface of tympanic membrane. Taste posterior 1/3 of tongue.

CN VII- Facial

Muscles of facial expression. Parasympathetic to all glands of head except the parotid, sensory for ear and tympanic membrane, taste anterior 2/3 of tongue

CN V- Trigeminal

Muscles of mastication. Sensation to head/neck, sinuses, meninges, and external surface of tympanic membrane

CN X- Vagus

Muscles of pharynx and larynx, parasympathetic to neck, thorax, and abdomen, sensory from pharynx, larynx, and viscera, sensory from external ear.

Possessor+possession

My doggie

Myasthenia Gravis

Myoneural junction disorder, fatuge over time, neck and limb weakness, some cognitive changes, dysarthria (slurred, hypernasal, weak voice), dysphagia present with diminished pharyngeal constriction and laryngeal excursion, at risk for GERD. evaluate with tensilon test, EMG, or surgical removal of thymus gland (younger onset), or medications (older onset), test re-test evaluation

Which of the following instrumental assessment tools provides the most direct dynamic view of velopharyngeal movement during speech?

Nasopharyngoscopy

Assessing TBI

Neurological examination of general function, attention, concentration, memory, orientation, speech of processing, pragmatics, executive functioning, visuospatial and perceptual motor function, problem solving, abstract reasoning. discourse analysis, contextualized hypothesis analysis, Ranchos Los Amigos Scale (RLAS), Glasgow coma scale (GCS), assess posture (decorticate/decerebrate). Must consider time in coma and length of PTA

Denial

No Kitty

Vowel characteristics

No constriction with more open vocal tract. Perceived as louder. Most sonorant. Serve as the nucleus of a syllable.

When should infant hearing screenings be conducted?

No later than 1 month of age - for those who fail the newborn hearing screening, the diagnostic ideologic evaluation should deb completed as soon as possible but no later than 3 months of age.

Oller's stages of infant phonological development, reduplicated babbling precedes what?

Non reduplicated or variegated babbling

A premature infant with difficulty bringing her hands to her mouth to initiate sucking. While breast feeding the clinician noted that the infant had bursts and pauses with about two up-and-down cycles of the jaw per second. This is called:

Non-nutritive sucking

Types of MR

Non-syndromic: Anoxia or malnutrition (non-familial), Genetic (familial) Syndromic: Down, Fragile X, FAS, Williams, Angelman, Prader-Willis, Toxicity

Assessing language knowledge/performance

Norm-referenced tests to determine what child knows (not just what they have been taught)

Muscles of the Oral Prep/Oral Phase

Obicularis Oris and Buccinator (VII)= opening of lips Mylohyoid (V), Geniohyoid (XII), Anterior belly of digastrics (V)= floor of the mouth Lateral pterygoid (V), Platysma (VII)= opening of jaw Medial pterygoid, temporalus, masseter (V) = closing the jaw Intrinsic and extrinsic muscles of the tongue

Spasmodic Dysphonia

Occurs with upper respiratory infection, laryngeal injury, emotional stress. May occur with vocal tremor (30%). gradual onset, symptoms progress over 1-2 years and remain chronic. usually affects women (80%). Affects voluntary laryngeal activity, worsens with prolonged voice use, worsen when stressed or tires, appear task-specific. Adductor: effortful voice production, strained voice quality, voice stoppages during vowels in connected speech, liquids, nasals, and with overclosure of VF. Normal cough and laughter. may include hyperfunctional voicing patterns similar to MTD. Abductor: intermittent breathy breaks during production of voiceless consonant ans with over-abduction of vocal folds, pitch breaks, normal cough and laughter

In selecting the fluency-shaping technique, clincians should consider that it

Often leads to relapse of stuttering

Characteristics of AAE morphology and syntax

Omission of plurals Omission of possessives (That the women car) Omission of third-person singular present tense (She walk to school) Omission of coppula (She a nice lady) Use of perfective (distant past) constructive "been" (I been had a marble collection when I was 7.)

Infant deficits of swallowing phases

Oral phase: labial seal drooling, inability to form or propel bolus, poor tongue movement, poor buccal tension, slow transit time pharyngeal phase: delayed swallow reflex, nasal reflux, residue on ppw and in vallecula, penetration, coating of larynx, aspiration, residue post swallow in pyraforms and vallecula, delayed transit time esophageal phase: dismotility, decreased peristalsis, spasms, echolachia, hiatal hernias, strictures, rings

Infant physiology of swallowing phases

Oral prep/oral phases: latching on, hold material between tongue and palate, medial groove, nutritive suck, non-nutritive suck, tongue loading pharyngeal phase: small hyolaryngeal excursion, constriction, epiglottal folding, false and true vf approximation esophageal phase: 6-10 seconds, peristaltic wave, ues opening

Cohesion is defined as?

Ordering and organizing utterances in a message so that they build logically on one another.

What type of scale is this? - 1 almost none - 2 slight - 3 moderate -4 great amount

Ordinale Scale

Granuloma

Organic or phonotraumatic voice disorder. Vascularized lesion, may hemorrhage, irritation from contact between arytenoids, intubation, and/or reflux. Problems include breathiness, sudden onset in voice changes, pitch breaks, throat clearing, stabbing pain during speech and swallowing (sometimes in ear). Treatment with inhaled steroids to reduce swelling, vocal hygiene, surgical management, voice therapy (confidential voice,reduce hard glottal attack, botox to weaken impact, eliminate compensatory strategies)

Laryngeal Webs

Organic voice disorder. Bridging of the VF mucosa. Problems depend on length of VF and include breathing problems, stridor, increased pitch, and reduced pitch range. Manage with surgical incision (must ensure they do not adhere again) and voice therapy after surgery to learn how to use mechanism

Sulcus Vocalis

Organic voice disorder. Form of scarring on the surface of VFs. may be unilateral or bilateral. scarring joins mucosa to underlying areas and results in absent mucosal wave. incomplete development of the cover, grooves on the VF, rare. Unknown etiology, usually congenital, may be acquired. Problems include weak voice/low intensity, breathy, hoarse/raspy, excessive air wastage (reduced closure, one or both sides not vibrating). Manage with collagen or fillers to separate the cover so it can move more.

Contact Ulcers

Organic voice disorder. Inflammatory growth, small ulcerations, irritation greatest in posterior area from reflux, swelling in back. Causes are larygopharyngeal reflux, use and overadduction, slamming of arytenoids during low freq vibration, intubation. Problems include breathiness, rough and sore voice, hoarsness, lower pitch, pain in larynx or ear during phonation, throat clearing, deterioration of voice when prolonged, a lot of irritation. Manage reflux, engage in voice therapy (reduced effort and volume). Surgery helpful only in conjunction with voice therapy.

Papilloma

Organic voice disorder. Viral cause. growths on, below, and/or above the VF. Juvenile cases typically stop by puberty (20% persist). Problems include stridor or whistling, shortness of breath, breathiness, hoarseness, higher pitch from increased effort. Manage surgically with CO2 laser, or some children may require trach (SLP not involved in this process)

Cyst

Organic voice disorder. Whitish well-defined mass, unilateral, between membranous fold in body underneath the epithelium in VF. Unknown cause, see a lot in singers, may be congenital, blocked pores, or related to traumatic contact/use. Problems include hoarseness/roughness, difficulty regulating pitch, strained quality, breathiness, pitch breaks, lower pitch, irregular vibration (due to mass difference). Manage surgically and with voice therapy following surgery (voice rest to reduce swelling, eliminate compensatory strategies) or before surgery (to reduce size)

When treating a cognitive impairment not caused by a stroke what is the diagnosis?

Other symbolic dysfunction

An infection in the middle ears known as what?

Otitis Media

type of emission-computer tomography that allows imaging of metabolic activity through measurements fo radioactiity in the section of the body being viewed

PET positron emission tomography

a technique that uses emissions-computed tomography to allow imaging of metabolic activiity throug measurements of radioactivity is called

PET scan

What muscle produces the opposing action to those that produce velopharyngeal closure?

Palatoglossus - It produces soft palate depression, versus soft palate elevation which is needed for velopharyngeal closure.

Most crucial part of EI process is ___ involvement.

Parent involvement. Must ensure parents are involved and that interactions are appropriate

Discourse analysis of communication in SLI

Passive conversationalists (non-assertive but will respond to initiation) or Inactive conversationalists (non-assertive and little or no response to initiation)

Flaccid Dysarthria

Phonation: breathy, audible inspiration, harshness Prosody: monoloudness, monopitch Resonance: hypernasality, nasal emission Articulation: imprecise consonants, short phrases Respiration: may be compromised with phrenic nerve damage atrophy, hypotonia, hyporeflexia, fasiculations and fibrillations associated with Bulbar's palsy, muscular dystrophy, arnold-chiari, wallenberg's, myasthenia gravis

Unilateral Upper Motor Neuron Dysarthria

Phonation: harsh, strained, breathy, unsteady Resonance: possible hyper/hyponasality or nasal emission Articulation: primary issues, imprecise, slow AMR, irregular SMR Prosody: slow rate, reduced loudness contralateral symptoms to one side, weakness in lower face/tongue, increased tone, dysphagia, hemmiplegia/paresis associated with stroke, focal damage,

A patient was referred for therapy to an outpatient rehabilitation facility because of a diagnosis of apraxia of speech post CVA. The clinician decided to use a shaping technique that focused on orofacial and articulatory postures with specific instructions about how to change current speech and non-speech movements to achieve the target sounds. This is an example of:

Phonetic derivation

Recording procedure to preserve most information about speech sound productions

Phonetic transcription

A native speaker of spanish with fair proficiency in english and aphasia produces shoes as [tsuz] on a repetition task. This is most likely due to what?

Phonological interference from the speakers native language.

Which area should be evaluated first for a 5 year old who says pun for spoon and top for soap?

Phonological system

Vocal Fold Hemorrhage

Phonotraumatic voice disorder. Burst blood vessel, no nodules or polyps present, interferes with muscle function. Problems include raspiness, breathiness, roughness, lower pitch, weakness. Voice may be unaffected. Manage with voice therapy (voice rest and confidential voice, vocal hygeine and hydration, yawn-sigh, uh-hum, easy onset. counseling and manipulation of phonotraumatic behaviors)

Reinke's Edema

Phonotraumatic voice disorder. Fluid fills superficial layer of lamina propria. cause is chronic phontrauma, chronic mucosal irritation (smoking), behavioral. Problems include rough, hoarse, raspy quality, low pitch, breathing problems, increased effort, higher subglottal pressure for vibration. Manage with voice therapy, change environment and behavior, look at inflammatory issues. Prefer to avoid surgery but may intervene surgically if necessary (suck out watery substance)

Traumatic Laryngitis

Phonotraumatic voice disorder. Inflammatory reaction, short term infection, swollen vocal folds from yelling, throat clearing, coughing excessively. Due to slamming of VF from increased subglottal pressure. Problems include irregular vibration, loss of sensation. Manage with voice therapy to eliminate behaviors, include voice rest; will resolve in 2-5 days if eliminate voice abuse.

Vocal Nodules

Phonotraumatic voice disorder. small fibrous bumps/callous-like. bilateral on anterior 2/3 of VF, thickening of BMZ, most common benign lesion. Problems include breathiness, aphonia, roughness, pitch breaks, strained. Due to persistent phonotrauma and has high recurrence (15-35%). Manage with voice therapy (vocal hygiene, confidential voice, resonant voice, accent therapy).

Polyps

Phonotraumatic voice disorder. small fluid filled sac, occurs anywhere in the larynx, broad based or pedunculated, unilateral mass lesion, possibly hemorrhagic. Problems include breathiness, hoarseness, and diplophonia. Manage surgically with microflap, laser, or epithelial cordotomy. Voice therapy includes voice rest, lighter voice/breathy, few words at a time, slow and easy speaking style, resonant voice, chewing sound for relaxation (reduce friction on VF that is adding to mass)

Object permanence

Piaget

An important characteristic of articulation therapy for a 2 year old with a repaired cleft palate and compensatory errors?

Play based learning approach to address goals

Characteristics of CAPD

Poor: sound localization, auditory discrimination, auditory pattern recognition, temporal aspects of audition, auditory performance in noise, and auditory performance in degraded signals.

What muscle is primarily responsible for vocal fold abduction?

Posterior cricoarytenoid

A condition that is singularly caused by a genetic abnormality

Prader willi syndrome

A child that is short, has intellectual delay, cryptorchidism, sleeps excessively, a speech delay, hyperphagia, and is obese. They also have a prominent nasal bridge, high narrow forehead, thin upper lip, downturned mouth, almond-shaped eyes, and small hands and feet. The child frequently picks at skin. The condition is caused by autosomal dominant inheritance and deletion in the long harm of chromosome 15. The child has?

Prader-willi syndrome

Cerebral Palsy can be:

Prenatal, perinatal, post natal; hemiplegia, paraplegia, monoplegia, diplegia, quadriplegia - Ataxic: disturbed balance, awkward gait, uncoordinated movements (cerebellar damage). - Athetoid: Slow, writhing involuntary movements (basal ganglia and indirect motor pathways) - Spastic: Increased muscle tone, stiff, abrupt, jerky, slow movements (motor cortex and direct motor pathways)

To best facilitate the functional and meaningful use of linguistic forms, a language intervention program for a child with language impairments should?

Presence and elicit the forms in naturalistic contexts

In treating a pre-school child who stutters you have several options. You select the response most method, which includes which of the following steps?

Present a token for each fluent production and withdraw a token for each disfluency

You are treating a 4 year old boy with specific language impairment (SLI) for intervention. You notice that he omits all grammatical morphemes in his speech. Which one of the following morphemes would you target first in therapy with him?

Present progressive -ing

The therapy technique of phonetic placement is used to teach or establish what?

Production of a phoneme in isolation

You are about the begin intervention with a 7 year old child with developmental delays who reportedly has the language skills of a typically developing 4 year old child. Which of the following skills would not be appropriate to work in treatment? - Use of future tense - Production of gerunds - Definition of common words - Topic maintenance over successive utterances

Production of gerunds

Children diagnosed as having specific language impairment are likely to exhibit the greatest deficits in what?

Production of sentences with appropriate inflectional morphology and syntax

Spastic Dysarthria

Prosody: excess and equal stress, slow rate, monopitch, monoloudness, reduced stress, short phrases Articulation: imprecise consonants, distorted vowels, no refined movements Resonance: hypernasal due to rigidity and poor seal Phonation: low pitch, harshness, strangled vice, pitch breaks, short phrases Respiration: shallow breathing, reduced capacity hyperreflexia, hypertonia, persistent and abnormal reflexes, resistance to movement, reduced movement, stiff muscles, pseudobulbar affect (spontaneous response of showing emotion) associated with cerebral palsy, pseudobulbar palsy, diffuse vascular infarct, ALS, TBI, dementia, encephalitus

Hypokinetic Dysarthria

Prosody: monopitch, monoloudness, reduced stress, variable rate, inappropriate silences, short rushes of speech Articulation: distorted and incorrect production, palilalia, replace stops with fricatives, repeat phonemes Phonation: harsh or breathy voice, periods of dysphonia Resonance: possible mild hypernasality Respiration: decreased vital capacity, shallow breath support, uncoordinated movement of chest and diaphragm resting tremor, bradykinesia, masked face, festination/shuffling gait, askinesia, rigidity, pill-rolling associated with Parkinson's

Early intentional communication typically emerges in the months leading up to a child's first birthday. What communicative function typically emerges first in this period?

Protesting

What is the first function that emerges in early intentional communication?

Protesting

What instrument is often used to document stages of recovery after TBI?

Ranchos Los Amigos Scale of cognitive function

Jamal is an 8-year old boy who transfers to your school district. The report from the previous slp is missing from his cumulative file, but you see a note that says "Jamal has childhood apraxia of speech (CAS)." Which one of the followingg characteristics would you NOT expect Jamal to present with? - repetition of sounds and syllables - rapid speech that becomes faster as Jamal gets more deeply involved in a conversation - unusual errors of articulation, such as metathesis - deviations in prosody

Rapid speech that becomes faster as Jamal gets more deeply involved in a conversation

When vibrating objects return to equilibrium, air molecules become thinner. This process is called?

Rarefaction

A client who stutters mentions to his speech-language pathologist that his social life is limited. He states, "No one will talk to me because I stutter." This is an example of the common defense mechanism known as?

Rationalization

Anosognosia

Reduced awareness of deficits

Phonological processes that should be eliminated by age 3?

Reduplication, consonant assimilation, fronting of velars, diminutization

Internal validity definition

Refers to how well an experiment is done, especially whether it avoids confounding (more than one possible independent variable acting at the same time).

Concurrent validity

Refers to the extent to which the results of a particular test, or measurement, correspond to those of a previously established measurement for the same construct.

Intraobserver reliability

Refers to the stability of an individuals observation of phenomenon at two or more intervals of time.

Lingual festination

Repeated non propulsive lingual movements

What sign of dysphagia is the most common ora-stage observation when assessing a patient with Parkinson's Disease?

Repeated non propulsive lingual movements

What task is most appropriate for a patient when assessing verbal apraxia of speech?

Repeating words of increasing length

Individualized Education Plan (IEP)

Requires referral and assessment for eligibility consideration. Includes concerns and child strengths, evaluation results, PLOD, annual goals, short term objectives, special education services required and amount, supplementary services, least restrictive environment, test modifications, transition services, notification of transfer rights, evaluation procedures and measurement methods, team members. Part B of IDEA

TEP speech (tracheoesophageal)

Requires the patient to cover the stoma to redirect air and initiate vibration. Fundamental frequency is different to that of laryngeal phonation (eg. variability and prosody.

Brown Waves in people who stutter

Research has shown both normal and abnormal brain waves may be found in people who stutter.

Acoustic measurements of voice are becoming extremely popular, especially as a means of evaluating the effectiveness of voice therapy. Sound spectrography, the graphic representation of a sound wave's intensity and frequency as a function of time, yields a spectrogram or picture that reflects?

Resonant characteristics of the vocal tract and the harmonic nature of the glottal sound source

Acoustic measurements of voice are becoming extremely popular, especially as a means of evaluation th effectiveness of voice therapy. Sound spectrography, the graphic representation of a sound wave's intensity and frequency as a function of time, yields a spectrogram or picture that reflects?

Resonant characteristics of the vocal tract and the harmonic nature of the glottal sound source.

To assess a patient's phrase length the most appropriate task is?

Responding to open ended questions

Evaluation of an eighth grade student through giving her increasing amounts of targeted individual and small group support within the classroom setting before a special education referral is made. What assessment model is this?

Response to Intervention

Which of the following is used to improve the performance of struggling students who receive scientifically based instruction in a general education classroom?

Response to intervention

Role of the SLP in Voice Disorders

Responsible for voice function--> Assess voice use, voice needs, what they need to change, how they can change, whether the patient can hear/feel the change, and whether they can change (consider pt motivation)

What is generally the most appropriate treatment goal for clients who have had a laryngectomy?

Restoration of oral communication

You are conducting therapy with a kindergartener with a speech sound disorder and language impairment. He has deficient phonological awareness skills, and you are targeting these skills in therapy along with other treatment targets. Which of the following are you working on as part of phonological awareness treatment? - Auditory discrimination skills - Metaphor skills - Awareness of print and print conventions - Rhyming, phoneme isolation, sound blending

Rhyming, phoneme isolation, sound blending

What disorder is anosognosia common in?

Right hemisphere disorder

Broca's Aphasia

Right side paresis. Non-fluent, telegraphic, phonemic paraphasias, lack articles, prepositions, and conjunctions (except 'and'), no adverbs, agrammatism, better comprehension but break-down with multi-step commands, repetition variable, naming generally poor, macrographia, written language full of paraphasias, silent reading better than oral reading

What speech sampling context would best assess hypo nasality?

Saying single words with nasal consonants

A null hypothesis

Says that there is no relationship between two variables being studied.

Type of attention targeted when - Listening to a list of spoken words for a target word

Selective attention

According to research on the development of Brown's morphemes in young children, which of the following is a determinant of acquisition order?

Semantic and syntactic complexity

According to research on the development of Brown's morphemes in young children, which of the following is a determinant of acquisition order? - Phonological ease of production - Figurative-language ability - Semantic and syntactic complexity - Sequencing and segmentation strategies

Semantic and syntactic complexity - Brown's morphemes are acquired by children in an order that is determined by semantic and syntactic complexity with the simplest forms acquired first. The order of acquisition is typically followed by all children.

A patient with a Glasgow Coma Scale of 5 indicates what?

Severe Traumatic Brain Injury

After stroke, most weight should be placed on what medical factor to determine prognosis?

Severity of the stroke

What is Shaker's head lift exercise designed to change in swallow biomechanics?

Shaker's head lift exercise is designed to create an increase in diameter and duration of the upper esophageal sphincter (UES) opening.

You are assessing an African American elementary-age child, Takissha. The fourth-grade teacher has referred her to you because "Takissha often talks when other children are talking, and when she tells a story, she is not very structured." At this point, before you see Takissa, you suspect that

She is demonstrating verbal behavior that is consistent with that of many members of the African American Community.

Shimmer

Shimmer is a measure of amplitude instability. Change of amp from cycle to cycle

Discourse cohesion

Shows an individuals understanding of not interupting and responding when appropriate during conversation

The Blom-Singer prosthetic device is used by laryngectomees to?

Shunt air from the trachea to the esophagus so that the patient can speak on pulmonary air that enters the esophagus

Gestural assisted augmentative and alternative communication with a child who has some proficiency in American Sign Language. Which type of symbols would be helpful to use in this situation?

Sig-Symbols

65 year old man with presbycusis complains when he is in social situations, like parties, people don't speak loud enough. He says that noise creates a problem for him in hearing what people are saying. With what does this client have difficulty?

Signal-to-noise ratio

The back and forth movement of particles when that movement is symmetrical and periodic is called?

Simple harmonic motion

The back-and-forth movement of particles when that movement is symmetrical and periodic is called?

Simple harmonic motion

An infant is exposed to Croatian and English in the home since early infancy. The child is experiencing the phenomenon of?

Simultaneous bilingual acquisition

Treatment for Wernicke's Aphasia

Single word (drill, synonym/antonym training, short term auditory memory with functional words), Sentence level (attention and retention, yes/no questions, sentence verification, task switching), Discourse level (more functional, open ended sentences and questions, retelling info about own life, etc.), decrease familiarity and redundancy, increase length, compensate with asking for context, repetition

An experimental design involving one or a few subjects?

Single-subject experimental design

Discriminative stimulus

Skinner

Evidence that suggests potential laryngeal dysfunction in persons who stutter include:

Slightly delayed voice onset time

You are a clinician in a school district where increasing numbers of children are being diagnosed with childhood apraxia of speech (CAS). As you plan intervention for these children, what can you anticipate they will display?

Slow, effortful speech, inconsistent and multiple articulation errors, and more difficulty with consonant clusters than fricatives

A student presents with speech and language delay, poor attending skills, delayed cognitive development and low muscle tone. Her mother reports that this child had difficulty feeding as an infant, chronic middle ear-infections, does not sleep well and has sudden and severe tantrums. You believe this child could have which genetic syndrome?

Smith-Magenis Syndrome

Acoustic characteristics of Glides

Sonorant, formants change based on tongue movements and transitions, more rapid formant transitions than diphthongs, no steady-state portion of formant (quick), less mouth pressure and little constriction, lower amplitude than vowels bilabial (lower freq), palatal (large transition to high F2), transition into formants of following sounds

Excessive nasality is associated with inadequate velopharyngeal closure. An SLP is training a client to self-monitor nasality during speech. What tactic will best allow the speaker to determine whether there is excessive basal airflow?

Speaking/phonating while alternately leaving the nostrils open and pinching them closed. - This technique allows one to determine the difference in airflow pattern when speech is produced with nostrils occluded as compared with speech produced when the nostrils are open. For a speaker with velopharyngeal incompetence, closure of the nostrils will eliminate the nasal airflow in production of /s/.

A test that correlates responses to the first 50 questions with the last 50 questions during the development is evaluating what?

Split-Half Reliability

Velocardiofacial Syndrome/22q11.2

Spontaneous occurrence, autosomal dominant, 1/4000 births, accounts for 8% of clefting, diverse characteristics, velum affected, heart defects, distinct facial features (long face, wide nasal bridge, small nostrils, abundant scalp hair, low muscle tone with reduced movement). VPI with or without cleft, may have hypotonia, oral apraxia, or schizophrenia and depression. High incidence of learning disorders

A study designed to evaluate a treatment procedure for hoarseness of voice recruited all subjects who had witnessed a football game the previous day. The treatment, conducted over the following two weeks and offered to all subjects, resulted in improved voice quality. A critic said that the study lacked internal validity because of?

Statistical regression to the mean

Stimulability in articulation assessment

Stimulability information is a core feature of a comprehensive assessment for speech sound disorders and shows the level of readiness for therapy

Define Stimulus control

Stimulus sets the occasion for performing behavior

What is generally considered most effective and appropriate for viewing the vocal folds during phonation?

Stroboscopy

Instrumental Information/Measures possible for Voice Disorders

Structural viewing, Signal/Noise ratio, perturbation measures, spectral analysis, average airflow rate and volume, laryngeal resistance, PTP, glottal flow, measure vocal fold contact (contact quotient, open quotient), record and measure muscle activity

Why is oral hygiene important for patients with pneumonia risk and chronic dysphagia?

Studies have identified poor oral hygiene (including presence of decayed teeth) and dependency for oral care as significant independent predictors of pneumonia in people with chronic dysphagia

What have studies on the incidence and prevalence of stuttering shown?

Stuttering is evident in most (if not all) societies studied.

Muscles of the Pharyngeal Phase

Styloglossus (XII), Medial and lateral pterygoid, masseter, temporalis (V)= tongue movements up and back Tensor and levator veli palatini (X)= VP port closure anterior belly (V), posterior belly (VII) of digastrics, stylohyoid (VII), geniohyoid (XII)= hyoid/laryngeal excursion superior pharyngeal constrictor (X)= constrictor function Intrinsic laryngeal muscles, thyrohyoid = epiglottis meets aryepiglottic folds Cricoarytenoid muscles (X) = VF closure inferior laryngeal constrictor (X) = UES opening

Location of Head and Neck Cancer

Subglottic at 5%, remove tumor, may have swallow problems in airway problems supraglottic at 35%, remove epiglottis, false VF, and arytenoids. airway closure problems and aspiration (may use supraglottic swallow maneuver) glottic at 60%, remove tissue or total laryngectomy depending on tumor. voice and speech will be first complaints in VF tumor

A condition in which the surface tissues of the soft or hard palate fuse ,but the underlying muscle or bone tissue do not?

Submucous or occult cleft palate

Which of the following would not be predictable based on a student's first language Mandarin? - Substitutions of t/th (eg. tin/thin) - Epenthesis in words with consonant blends - Confusion of /r/ and /l/ - Substitutions of f/th (eg. fick/thick)

Substitutions of f/th (eg. fick/thick)

A correlation coefficient

Suggests the was in which two variables are related to each other

Intrinsic muscles of the tongue

Superior longitudinal, inferior longitudinal, transverse, vertical (XII)

What swallow maneuver has been found to produce cardiac arrhythmia (irregular heartbeat) in patients with stroke or cardiovascular diseases?

Supraglottic swallow maneuver

Type of attention targeted when - Focusing on hearing a person speaking while the television is on

Sustained attention

Language Impaired show most difficulties with

Syntax and morphology

What are T-units?

T-units contain independent clause and one or more subordinate clauses

dysarthria, confused language, auditory comprehension problems, confrontation naming problems, perseveration of verbal responses, pragmatic language problems, and reading and writing difficulties are typical of pt with: -dementia -TBI -parkinson's -huntington's

TBI

Prelinguistic communication intervention

Tactics (contingent responsivity, scaffolding, social routines), topic initiation (pointing, gazing, handing objects), topic maintenance, requesting/commenting, imitation (vocal/gestural),

Children with semantic-pragmatic language disorders often have difficulty learning deictic words because such terms

Take the perspective of the communication partner

Cleft palate prelinguistic intervention

Teach parents to be louder, exaggerate, and use body language to encourage vocalization, encourage variety of CVs that are easily produced, pinch nose, prevent glottal stops, encourage turn taking, pair sounds with movements

The major objective of auditory training in the treatment of a client with hearing loss is to?

Teach the client to make discriminations among speech sounds. - Auditory training focuses on the interpretation of auditory input and would thus teach a client to discriminate speech sounds.

What is a principal component of the Lidcombe Program for childhood stuttering?

Teaching caregivers to provide feedback to their child about the child's fluent and stuttered speech

Define Response Generalization

Teaching or modifying a behavior results in changes in other similar behavors

A 5-year old child with specific language impairment may say something like "Dog bark" instead of "The dog is barking." This is known as?

Telegraphic speech

You are administering a formal language test to a student who speaks AAE. what is a task that is NOT biased against him?

Tell me what you like to watch on TV

You refer a patient to an audiologist because you suspect the patient might have a hearing loss. You ask the audiologist to inform you about the patient's threshold of hearing for selected frequencies. In response to your request, the audiologist will

Tell you that the threshold of hearing is the quietest sound a human can detect

F0 depends on ___ of the vocal folds

Tension, Elasticity, and Mass more tense, less elastic, smaller mass= higher freq less tense, more elastic, larger mass = lower freq

What is the muscle that exerts the pull that allows the eustachian tube to open during yawning and swallowing?

Tensor palatini

Assessing language processing

Test auditory memory of digits (carry less meaning) Non-word repetition tasks (eliminate meaning but follow phonotactics)

The concept of adequate construct validity means that

Test scores are consistent with theoretical concepts or expectations

A father comes to you regarding his daughter, who is 8 months old. The daughter's hearing loss is bilateral, and she is profoundly deaf. The father states that he wishes for his daughter, as she grows older, to "fit" in with children with normal hearing. He is interested in any possible amplification and says that he wants his daughter to lead a life that is "as normal as possible" Which training approach would best fit this fathers wishes?

The Aural/oral method

How would a FEES help to evaluate a patient with suspected recurrent laryngeal nerve damage, pharyngeal phase dysphagia, and pooling of secretions following open-heart surgery?

The FEES allows for both the assessment for pharyngeal phase dysphagia by presenting foods and liquids during the procedure. It also provideds a direct view of the function of both vocal folds as well as determining the pooling of secretions.

Which of the following primarily vibrate and produce sound? - External thyroarytenoids - Internal thyroarytenoids -Transverse arytenoids - Cricothyroid

The Internal Thyroarytenoids primarily vibrate and produce sound

What can an slp do for a patient with severe bilateral sensorineural hearing loss that prevents participation in social activities?

The SLP can train the patient in speech reading

Errorless learning

The SLP stops the patient from guessing and intervenes with support before a mistake can be made.

What is the definition of fast-mapping?

The ability to learn a new word on the basis of just a few exposures to it.

Linguistic approaches to the treatment of sound production errors in children are based on the notion that the errors are systematic and rule-based and that the goal of treatment is to modify a child's rule system to approximate the rule system used by adults. Which of the following is a treatment objective that reflects a linguistic approach to treatment?

The child will contrast alveolar stops with velar stops in meaningful word pairs.

If a child's language exhibits the phonological process of gliding, the child might say wed for red. When asked, do you mean wed? the child may respond, No wed! such a response demonstrates that?

The child's linguistic performance lags behind linguistic competence.

What population is the chin-down/tuck posture ineffective at eliminating thin liquid aspiration

The chin tuck posture does not work for individuals who aspirate residue from the pyriform sinuses.

Cricothyroid muscle

The cricothyroid muscle has the greatest control over the fundamental frequency of the laryngeal tone by lengthening or tensing the vocal folds

Which model contends that a child who is unable to cope with the expectations of fluent speech production may begin to stutter?

The demands and capacities model

Inhalation during respiration is primarily carried out through the movement of which muscle/muscle group?

The diaghragm

What does the cover-body theory of phonation state?

The epithelium, the superficial layer of the lamina propr., and much of the intermediate layer of the lamina propr. vibrate as a 'cover' on a relatively stationary "body" that is made up of the remainder of the intermediate layer, the deep layer and the TA muscle.

What does the cover-body theory of phonation state?

The epithelium, the superficial layer of the lamina propria, and much of the intermediate layer of the lamina propr. vibrate as a "cover" on a relatively stationary "body" that is made up of the remainder of the intermediate layer, the deep layer, and the TA (thyroarytenoid) muscle

Cognitive deficits are sometimes associated with TBI, recovery is most dramatic within what time frame after TBI?

The first 6 months

Appropriate treatment focus for Broca's aphasia?

The improvement of expression, particuarly syntax

Acculturation

The incorporation of the host culture's perspective and the native culture's perspective and values

What is the speech reception threshold (SRT)?

The intensity level at which spondee words are recognized at least 50% of the time

What is one difficulty with cross-sectional studies?

The investigator observes differences between subjects of different ages to generalize about developmental changes that would occur within subjects as they mature.

Reccurent laryngeal nerve damage during open heart surgery would affect what structure?

The left vocal fold

Stuttering is more common on?

The less frequently used words

What artery supplies blood to Broca's and Wernicke's areas?

The middle cerebral artery

Why can damage to the left recurrent laryngeal nerve result in swallow problems?

The nerve courses under the aortic arch in its course back to innervate the left larynx of the inferior pharynx. The nerve can be damaged in cardiothoracic operations including aortic arch or valve repairs.

Linguistic approach to treatment?

The objective refers to speech sounds in term of general distinctive-feature classes, rather than in terms of isolated phonemes or overly specific classifications.

To diagnose stuttering, the clinician needs a definition of it. Although there are different definitions of stuttering, a majority of the include forms of disfluencies? What is a definition of stuttering that includes disfluencies?

The one offered by Van Riper

During an examination of the oral peripheral mechanism of an adult who has had a right hemisphere stroke in the territory of the middle cerebral artery, testing for lingual motor function reveals protrusion of the tongue to the left of midline.

The patient exhibits unilateral left lingual weakness

Treating swallowing disorder by the tilting the head forward while swallowing, switching between liquid and semi-solid swallows, and applying gently pressure on the side of the thyroid cartilage during the swallow is good for disorders of which swallow phase?

The pharyngeal phase

Statistical regression to the mean definition

The phenomenon that if a variable is extreme on its first measurement, it will tend to be closer to the average in its second measurement.

Defense mechanism - Displacement

The placement of feelings/blame on another individual often uninvolved and not to blame. i.e. parents who are upset their child has been diagnosed with autism may yell at the slp.

Craniosynostosis

The premature closure of one or more of the cranial sutures of the skill. It can be associated with a cleft palate.

One major distinction between the pyramidal and the extrapyramidal system is that

The pyramidal system controls voluntary and fine motor movements, whereas the extrapyramidal system controls the postural support for fine motor movement.

You are working in a hospital. A patient, Mr. M., has been referred to you because he is having difficulty adducting his vocal folds. He had surgery for thyroid problems, during which he sustained damage to another structure, Because he has been especially having difficulty with vocal-fold adduction, to what might you suspect he had damage?

The recurrent laryngeal nerve

A silent prolongation is?

The same as an articulatory posture without voicing.

An SLP administers langauge test to all kindergarten children in a particular school and finds that 40% fall below the tenth percentile of the normative sample? What is the most reasonable interpretation of this finding?

The school's kindergarten population differs from the standardization population in the language skills measured.

A patient with aphasia who has trouble writing because he "can't think of the correct letters" and does not want to look at the full model may benefit from what course of action?

The slp could introduce anagramming the words using letter tiles to form the target word

Social interactionist theorists believe that:

The structure of human language may have arisen from language's social communicative function in human relations.

A professor is teaching a class anatomy and physiology and mentions that closure of the airway occurs at anatomically different locations and functionally separate levels in the larynx. A student in the class answers that the appropriate choice would be? - Vallecula - Pyriform sinus - The supraglottic portion of the laryngeal vestibule - Cricopharyngus muscle

The supraglottic portion of the laryngeal vestibule

Infants with cleft lip and palate are susceptible to middle ear disease because which muscles is commonly impaired?

The tensor veil palatini

What structure is a relay center for sensory information?

The thalamus

Treatment goal after laryngectomy?

The ultimate treatment goal for clients who have had a laryngectomy is the restoration of oral communication, no matter how it is addressed.

Broad phonemic transcription involves which of the following?

The use of IPA symbols to transcribe phonemes by enclosing them within slash marks (e.g. /f/)

Anagramming in speech therapy treatment for writing

The use of letter tiles to form target words.

The goal of treatment in a 30 month old is to facilitate growth in play as a precursor to the acquisition of two-word semantic relationship. How is an SLP to do this?

The use of pretend play, such as brushing a doll's hair or feeding a doll with a bottle.

What causes cleft lip?

There are both genetic and environmental factors

A researcher teaches a new book reading program to caregivers of children on the autism spectrum and evaluates the children's literacy skills one year later. The researcher's goal is to evaluate whether or not there is a relationship between caregivers' implementation of the program and children's literacy skills. The researcher finds that there is an r=.15 correlational relationship between caregivers reported implementation of the program and the children's literacy skills. The researcher can safely conclude that:

There is no significant relationship between the caregivers implementation of the program and children's literacy skills.

In your private practice, you receive a referral of a sixth-grade girl who is not speaking; the pediatrician thinks that she might have functional aphonia. A diagnosis of functional aphonia means that

There is no voice

A 58-year-old patient who had undergone a total laryngectomy came to an outpatient clinic complaining of coughing when swallowing. The patient was puzzled because he had been told that he would not run the risk of aspiration because there was a physical separation of the gastrointestinal tract and the respiratory tract. The patient had a prosthetic valve in his tracheoesophogeal segment to facilitate speaking. The patient said he had understood the the duckbill prosthesis would prevent back flow from the esophagus to the trachea and eliminate aspiration. After completing trial feedings, the speech-language pathologist informed the client that he was coughing because?

There was a leakage around the prosthesis

what is the nature of the error patterns pun for spoon and top for soap?

These error patterns are phonological in nature

In which order are Browns morphemes acquired?

They are acquired from the syntactic and semantic simpliest forms to the most complex

An 81-year old bilingual man from Thailand has had a stroke, and you are seeing him for therapy. He is recovering both his primary language and his English skills, but you are working inly in English. No interpreters are available, unfortunately, and the family has indicated that they would prefer treatment to be conducted in English, anyway, because many of the patient's grandchildren speak English fluently. What would be an example, on the patient's part, of English influenced by his primary language of Thailand and not the stroke?

They going over there today.

Standardized tests are limited in their usefulness because

They sample participants (children) and responses in a limited manner

What is incorrect about group designs?

They usually have results similar to those of single subject designs. - This is not accurate, group designs do NOT usually have similar results to single subject designs.

Brown's Stage V

Third person irregular, uncontractible auxiliary, contractible copula, contractible auxiliary. Relative clauses, multiple embeddings in later stage, infinitive phrases, three-clause declaratives, clausal conjoining with 'if' appears, compound sentences. 3;5-3;10 MLU 3.75-4.5

Stuttering Modification Therapy

This has two key elements: - Teaching you to modify your moments of stuttering, so that stuttering is less severe - Reducing your fear of stuttering, and eliminating avoidance behaviors associated with this fear. The goal of stuttering modification therapy is not to eliminate stuttering, but to reduce its severity to an acceptable level and to reduce the fears and anxieties associated with stuttering.

Example of a modeled trial?

This is a dog. Can you say the word dog?

What does inability of a patient to pass air to the oral cavity while exhaling with the tube cannula of a one way tracheostomy valve occuluded represent?

This represents an upper-airway obstruction.

Medialization thyroplasty?

This surgery moves the paralyzed vocal fold closer to the mid-glottis to allow better compensation by the unaffected vocal fold.

To assess phrase length of a patient why use open ended questions?

This task allows the SLP to assess phrase length and ability to spontaneously produced speech.

How to encourage a child to proceed to the two word production stage?

Through the use of pretend play, it will encourage action object two word phrases such as feed baby and brush hair when playing with a doll.

Intrinsic muscles of the larynx

Thyroarytenoid, posterior and lateral cricoarytenoid, cricothyroid, oblique and transverse interarytenoids

The amount of air inhaled and exhaled during a normal breathing cycle is?

Tidal volume

A clinician is measuring communicative behaviors in a child with a cleft palate. The clinician measures the time intervals during which the speech behaviors selected for observation occurred. What are the methods of measurement called?

Time sampling measures

A 72 year old right handed female is evaluated following a left hemisphere stroke. Findings reveal a moderate Broca's aphasia. What is the primary goal if intervention for the client?

To improve the client's ability to express production of syntactically appropriate sentences

Hyponasality

Too little nasal resonance

The total volume of air in the lungs is?

Total Lung Capacity

Cranial nerves important for speech/swallow

Trigeminal, facial, vestibulocochlear, glossopharyngeal, vagus, spinal accessory, hypoglossal

What assessing the ability of a student with cerebral palsy to access an augmentative and alternative communication device what factor should be evaluated first?

Trunk stability and control

Why should trunk stability and control be evaluated first for a student with cerebral palsy who wants a n AAC device?

Trunk stability will guide the clinician in making an appropriate recommendation for the type of device a client can access as it influences more distal movements

Brown's Stage I

Two word utterances (agent+action; agent+object), prepositions 'in' and 'on', serial naming in early stage with 'and' appearing in later stage. 1;0-2;4 MLU 1.0-2.0,

It is most appropriate for a SLP to treat hypperadduction of the vocal folds by having the client?

Use light and gentle vocal-fold contacts

A speaker of Spanish, learning english is most likely to do what when speaking english in a casual conversation with teachers at school?

Use multiple negation improperly. - Multiple negation is a grammatical feature of Spanish but not of standard english.

Interobserver reliability

Used to assess the degree to which different raters/observers give consistent estimates of the same phenomenon

Halliday's Regulatory communicative intent

Used to control actions of others

Halliday's Personal communicative intent

Used to espress feelings/opinions

Halliday's Instrumental communicaive intent

Used to get something/show needs

Halliday's Representational communicative intent

Used to give facts + information

Halliday's interactional communicative intent

Used to make contact/relations

Hallidays's Heuristic communicative intent

Used to question the environment

Esophageal speech

Uses or from stomach/lower esophagus to upper esophagus/pharynx where it vibrates the wall.

What would an SLP recommend to a parent of an infant with cleft lip and palate to encourage best optimze feeding for adequate nutrition and appropriate growth?

Using a bottle with a modified nipple during feedings. - This allows for greater control over the quantity of liquid expressed and the pacing of the feeding.

Language impairment in a child with down syndrome is often determined by comparing performance on one or more standardized language tests with the child's mental age, rather than with the child's chronological age. Although mental age should not be used to specify the need for treatment, mental age can legitimately be used as a performance criterion because

Using chronological age would over identify language disorders.

What strategy is most appropriate for an SLP to try in an effort to minimize the perception of mild nasal emission in a patient?

Using light articulatory contacts

What is a strategy to treat compensatory articulation errors for a child with hyper nasality and glottal stop substitutions following surgery for veloppharyngeal insufficiency?

Using tactile cues to elicit phonemes

Congurence in councelling

Using words and body language that matches.

CN involved in speech, language, or hearing

V, VII, VIII, IX, X, XI, XII trigmeninal, facial, acoustic, glossopharyngeal, vagus, spinal acessory, hypoglossl

CN more directly connected with speech, language and hearing

V, VII, VIII, IX, XI AND XII

Syndromes associated with cleft palate

VCF, Pierre Robin Sequence, Van der Woude, FAS, Stickler, Crouzon, Apert, Treacher Collins, Hemifacial Microsomia, CHARGE

Clinical Markers for later language performance

Verb Morphology and Non-word repetition tasks

What is a secondary reinforcer?

Verbal praise with food

Instrumental Techniques for Voice Disorders

Videoendoscopy/videostroboscopy, Acoustic recording/analysis, aerodynamic measurement, electroglottography, electromyography

Treatment for Global Aphasia

Visual Action Therapy (VAT) if good attention and cooperation

Among other functions - The right hemisphere specializes in?

Visual and Spatial information

The volume of air that the patient can exhale after a maximal inhalation is?

Vital Capacity

Zone of proximal development

Vygotsky

Delay is a treatment procedure in which the clinician

Waits for the child to initiate a response, prompts or models if there is no response, and gives the desired object if there is no response after three models.

You just completed an assessment of an 8-year old boy who stutters. When you are offering post-assessment counseling to the boy's parents, they ask you, "What do you think caused stuttering in our son?" How would you answer their question?

We can't say for sure in individual cases, but both complex genetic susceptibility and environmental factors may be involved in its causation.

A screening test that uses a vibrating running fork (which is placed in the middle of the forehead) to detect unilateral conductive hearing loss and unilateral sensorineural hearing loss is called the?

Weber Test

According to mourning theory when are parents normally most receptive to information and advice by professionals regarding their child?

When the parents have acquired greater confidence in their capacity to care for the child and greater motivation to cope with the child's disabilities

Halliday described seven functions of communicative intent that develop between 9 and 18 months of age. Which of the following is an example of the heuristic function?

Why doggy bark?

In treating the communication deficits of a young adult with traumatic brain injury, you would do what?

Withhold attention from irrelevant and inappropriate responses

Type of attention targeted when - Solving a complex math problem in your head

Working memory

the cranial nerve that innervates the larynx, levator veli palatini, palatoglossus, and palatopharyngeus muscles

X vagus nerve

You are a new clinician in a hospital that has a neonatal intensive care unit (NICU). Your job title is that of a newborn development specialist (NDS). Which of the following would be false regarding your role as an NDS? - You would support the families and infants with issues involving infant development and behavior. - You would support the families and infants with issues involving hearing conversation and aural habilitation - You would not serve as a primary care coordinator or case manager for the infant and families because a medical doctor usually fills this role. - you would create individualized assessment and intervention strategies to support infants and their caregivers

You would not serve as primary care coordinator or case manager for the infants and families because a medical doctor usually fills this role

escape

a behavior that reduces or terminates an aversive event after client comes in contact with that event

nominal scale

a category is present or absent ex hypernasality or normal nasality ex never, sometimes, always

quick incidental learning or fast mapping

a child's ability to learn a new word on the basis of just a few exposures to it

phonological awareness

a child's specific ability to detect and manipulate sounds and syllables in words

milieu teaching

a group of techniques that have been experimentally evaluated and shown to be effective in teaching a variety of language skills. the method teaches functional communication skills through the use of typical, everyday verbal interactions that arise naturally

videokymography

a high-speed medical imaging method used to visualize human vocal fold vibration dynamics.

specific language impairment (SLI) definition

a language disorder in a child who is otherwise typically developing. no know etiology learn language in the same sequence as typically developing heterogeneous group

split-half reliability

a measure of the internal consistency of a test. show the items on the first half of the test are correlated with responses given to items on the second half of the test

response cost

a method of reducing responses by withdrawing reinforcers contingent on each response (taking a token away for every incorrect production)

CSG system

a metric system of measuring length in cm, time in seconds, and mass in grams. can be contrasted with the MKS system (m, kg, secs)

interval scale

a numberical scale that can be arranged according to rank orders or levels 1-2-3-4-5

ordinal scale

a numerical scale that can be arranged according to rank orders or levels. use relative concepts such as greater or less than, the numbers and their corresponding categories do not have mathematical meaning

world knowledge

a persons autobiographical and experiential memory and understanding of particular events

compression or condensation

a phase of sound in which the vibratory movements of an object increase the density of the air molecules

elasticity

a property that makes it possible for matter to recover its form and volume when subjected to distortion

intermediate response

a response that helps move toward the final target in a shaping procedure

government binding theory:

a revision of Chomsky's theory of TGTG. attempts to describe the way the mind represents the autonomous system of language.

hyperkeratosis

a rough, pinkish lesion that can appear in the oral cavity, larynx, or pharynx

carhart's notch

a specific loss at 2000 Hz, as indicated by bone-conduction testing

exemplar

a specific target response that illustrates a broader target behavior. they are individual items trains in therapy sessions

generative phonology theory

a theory of the sound structure of human languages, 1. phonological descriptions are dependent on information from other linguistic levels 2. phonological rules map underlying representations onto surface pronunciations not broadly applied in SLP

fading

a treatment procedure in which the controlling power of a stimulus is gradually reduced while the response in maintained

cognitive theory

a variant of the nativist theory. emphasizes cognition or knowledge and mental processes. language acquisition is made possible by cognition and general intellectual processes. child must first acquire concepts before using words

sinusoidal motion

a wave with horizontal and vertical symmetry because it contains one peak or crest and one valley or trough. contains a single frequency and is the result of simple harmonic motion

VI

abducens: eye movement (motor)

auditory sequencing

ability to identify the temporal order in which auditory stimuli occurs.

auditory attention

ability to ignore irrelevant acoustic stimuli and focus on important information. they might focus on everything and experience sensory overload

post-reinforcement pause

absense of responses following the delivery of a reinforcer. these pauses are more commonly observed under fixed-interval schedules of reinforcement

Dysphagia in TBI

absent or delayed swallow reflex most frequent, reduced lingual control, reduced pharyngeal peristalisis, prolonged oral transit. 50-80% of population. Make sure patient alert and undistractible while feeding

a child who is 3.5 years old consistently uses morphemes: present progressive -ing, prepositions in and on, and regular plural -s. Which morphemes would you beging with when he starts therapy

according to Brown's list of morphemes, irregular past tense verbs would be next to develop

VIII

acoustic: hearing and balance (sensory)

adducting vs abducting

adduct: closing abduct: opening

picture exchange communication system (PECS)

aided AAC a low-tech method of communication. the clinician initially teaches the child to exchange specific pictures to communicate with a partner

premack-type symbols or carrier symbols

aided AAC are abstract plastic shapes, each shape is associated with a word or phrases and children can arrange the plastic shapes as one would printed words

picsyms

aided AAC are graphic symbols that represent nouns, verbs and prepositions

sig symbols

aided AAC are ideographic or pictographic symbols based on ASL and often used in conjunction with ASL

rebuses

aided AAC are pictures that represent events or objects along with words, grammatical morphemes, or both

blissymbols

aided AAC are semi-iconic and abstract symbols that can be taught to speakers of any linguistic and cultural background

gestural-assisted AAC

aided AAC gestures of movements are combined with an instrument or message-display device

pic symbols

aided AAC pictogram ideogram communication. are white drawings on a black background

neuro-assested AAC

aided AAC useful for children who have such profound motoric impairments and limited hand mobility that they cannot use a manual switching device. uses bio-electrical signals such as muscles action potentials to active and display messages on a computer monitor

quadriplegia

all four limbs are paralyzed

brutten and shoemaker proposed that -stuttering is limited to part-word repetitions and sound prolongations -stuttering is due to classically conditioned negative emotion -some dysfluencies are operantly conditioned -all -none

all of the above

research on the prevalence of stuttering has shown -familial incidence is higher than in the general population -sons of stuttering mother run a greater risk than sons of stuttering fathers -blood relatives of a stuttering woman run a greater risk of stuttering themselves than those of a stuttering man -all of the above -none of the above

all of the above

overextension vs underextension

all round items are balls vs only an oreo is a cookie

the part of the mandible that houses the teeth

alveolar arch

outer edges of the maxillary bone

alveolar process

silent prolongations

an articulatory posture held for a duration longer than average but with no vocalization aka block

octave

an indication of the interval between two frequencies. each octave doubles a particular frequency

satiation

an internal body state that renders primary reinforcers (food) temporarily ineffective. ex pt is full so isn't motivated by food

Tracheostomy tube related swallowing problems

anchoring of larynx, diminished laryngeal excursion, normalized subglottic pressure. increased laryngeal drag puts patient at risk for aspiration

Extrinsic muscles of the larynx

anterior belly of digastrics(V), posterior belly of digastrics (VII), mylohyoid (V), geniohyoid (XII), stylohyoid, thyrohyoid, sternohyoid, sternothyroid, omohyoid

Transcortical Motor Aphasia site of lesion

anterior superior frontal lobe

orofacial myofunctional disorders (OMD)

any anatomical or physiological characteristsic of the orofacial structures that interferes with normal speech or physical, dentofacial, or psychosocial development

bloodstein advocated that stuttering may be caused by -any belief that speech is a difficult task, resulting in tension and speech fragmentation -parental diagnosis of stuttering in normally fluent children -demands exceeding a child's capacities for fluency -an approach-avoidance conflict -an emotionally traumatic experience in childhood

any belief that speech is a difficult task, resulting in tension and speech fragmentation

Anomic Aphasia site of lesion

any lesion in/near language zone, posterior lesion, smaller

a transmitting medium

any matter that carries or transmits sound

contrast approaches

approaches that very in terms of how the sound contrasts are used in treatment. different kinds of contrasts lead to different pairs of treatment stimulus words

Conduction Aphasia site of lesion

arcuate fasiculus, possibly supramarginal gyrus or inferior parietal lobe

noniconic symbols

are arbitrary, abstract and gemoetric. they do not resemble the objects they represent and must be specifically taught

semantic categories

are used to sort words.

discrete trial procedure

are useful in the initial stages of treatment, when skills have to be shaped or established. but is not efficient for generalizing that skills. ex: SLP: places stimulus picture infront of kid and asks the kid a relevant question. immediately models the correct reponse for the child and waits a few seconds for the child to imitate the modeled response. reinforces the child and gives correct feedback.

allomorphs

are variations of morphemes, they do not alter the original meaning of the morphemes. ex: boxes (ez), leaves (z)

comprised of a ring of connective tissues and muscle extending from the tips of the arytenoid to the larynx. serparate the laryngeal vestibule from the pharynx and help preserve the airway

arepiglottic folds

pyramid-shaped cartilages connected to the cricoid

aryntenoid cartilages

these are composed of a ring of connective tissue and muscles extending from the tips of the arytenoid cartilages to the larynx. they separate the laryngeal vestubule from the pharynx and help preserve the airway

arytepiglottic folds

intermixed probes

assessment of generalized production of trained responses by alternating trained and untrained stimulus items contrasts with pure probes

"red crayon" is an example of

attribute + entity

Hurler's syndrome is caused by

autosomal recessive deficiency of X-L iduronidase

spanish-speaking children typically make what sound substitutions

b/v d/th (voiced)

articulation differences seen in spanish speakers

b/v ch/sh d/ voiced th z/voiced th t/ voiceless th

developmental approach to speech sound disorders

based on selection of early-developing targets that follow a developmental sequence and are assumed to be easier for children to produce ex: /p, b, m/ develop earlier in life

McDonald's Sensorimotor approach

based on the assumption that the syllable, not the isolated phoneme, is the basic unit of speech production. principles of coarticulation are important bottom-up drill approach training should start at the syllable level

Breakdown theories of stuttering

behavior: environmental pressure/stress causes fluency issues. etiology: fluency issues may be attributed to organic predisposition (speech-motor control, convulsive disorder, perseveration during psychomotor tasks), cerebral dominance, or psycholinguistics (speech-language encoding, covert repair hypothesis, demand and capacities model)

Anticipatory Struggle theories of stuttering

behavior: stutter because fear speaking will be difficult. fluency occurs when not thinking about it. failure of automaticity, approach-avoidance, preparatory set etiology: Diagnosogenic (parent incorrectly diagnosis child's normal disfluencies. in expectation of normal disfluencies, abnormal disfluencies result) or the communication-emotional model and internal role (interaction between speech/language planning and temperamental factors)

strong cognition hypothesis

believe in cognitive precursors to language. there are cognitive abilities that are essential prerequisites to language skills aka. language development is dependent on cognitive development

leukoplakia

benign growths of thick, whitish patches on the surface membrane of the mucosa.

manner place and voice of all consonants

bilabial labiodental linguadental alveolar palatal velar glottal

Embolic CVA

blockage from foreign matter, migration into smaller vessels, abrupt onset. No signs but possibly headaches or seizures

Transient Ischemic Attacks (TIA)

blockage, short term (30 min), near complete recovery, TIA, RIND, and PRIND are warning signs. Symtoms include aphasia and hemiparesis if in the carotid

vestibular branch is concerned with

body equilibrium or balance

cul-de-sac resonance definition

bottom of the sack produced by backward retraction of the tongue, the tongue is carried too far posteriorly in the oral cavity. person's voice sounds muffled or hollow

list of nonfluent aphasias

broca's transcortical motor aphasia mixed transcortical aphasia global

a baby, Jason, is looking at the family cat. His grandma sees him looking at the cat and directs her gaze toward the cat, also. She prepares to comment about the cat. Jason's grandma is:

by seeing the baby look at the cat then looking at the cat as well she is following his line of regard

videostroboscopy

can be performed by using a flexible fiber-optic laryngoscope or ridge. helpful in differentiating between functional and organic voice problems. the strobe light is a pulsing light.

bound or grammatical morphemes

can not convey meaning by themselves, must join with free morphemes in order to have meaning example: -ing, -s, -ed

Pierre Robin Sequence

can occur in isolation or associated with syndromes (50%), cleft palate usually present but not always, mandible either deformed (catch-up after birth) or malformed (no catch-up). rare with 1/8500 births, occur with VCF or DiGeorge. Characteristics include wide u-shaped cleft, micrognathia glossoptosis, chin doesnt grow out, tongue doesn't drop, palatal shelves unable to come together; tongue position affects feeding and breathing, shallow pharynx, may need feeding tube or trache

apraxia definition and location damaged

caused by central nervous system damage motor planning disorder

bernoulli effect

caused by increased speed of air passing between the vocal folds, is the sucking motion of the vocal folds towards one antoehr

dysarthria definition

caused by peripheral or central nervous system damage causes paralysis, weakness, or in-coordination of the muscles of speech

the theory that stuttering is caused by a lack of a unilateral dominant hemisphere is the

cerebral dominance theory

Non-typical variation for a spanish-speaking student may be?

ch/f substitutions (chan/fan)

Acoustic definition of Prosody

changes in duration, F0, and/or amplitude across speech. Intonation: changes in F0 across speech Stress: perceptual, relative to salience of syllables, F0 is best perceptual correlate to stress

Thalamus

channels senorimotor information to cortex, cortex-mediated functions, regulates crude awareness of sensation

Deaffrication

chew pronounced shu

phonological process approach

child's errors are grouped and described as phonological process (john manifests the use of consonant-cluster reduction and weak-syllable deletion) not as discrete sounds (john makes w/r, t/s, and w/l substitutions use the cycles approach

independent analysis

child's speech patterns are described without reference to the adult model of the language. used with very young children or speakers with limited phonological repertoires

nativist theory

children are born with a language acquisition device (LAD). it knows about languages in general because it contains the universal rules of language

which on of the following piagetian stages, which include object permanence, corresponds with the emergence of a typically developing child's first words 1. peroperational 2. formal operations 3. sensorimotor 4. concrete operations 5. sensorimotor concreteness

children usually use their first word between 10 and 14 months of age, which corresponds to the sensorimotor cognitive development age

print knowledge

children's emergent knowledge about functiosn and forms of written langauge

evoked trial

clinical procedure in which no modeling is given to the client, pictures questions and other stimuli are used to provoke a response

extension

clinician comments on the child's utterance and adds new and relevant information

consequences of target responses

clinician reactions when the client gives a correct or incorrect response to fails to respond includes: positive reinforcement and corrective feedback, contrast with antecedents

weak cognitive hypothesis

cognition accounts for some of a child's language abilities. it cannot account for all of them, some aspects of language do not develop directly as aresult of underlying cognitive skills

Traumatic Brain Injury (TBI)

cognitive-communication deficits; problems with language based activities due to aspects of cognitive function (attention, memory, perception, etc.). Look at lingusitics (coherence, cohesion, word selection, story grammar), paralinguistics (intonation, tone, rhythm), extralinguistics (gestures, body posture, affect) . 1/3 of population has some form of dysarthria.

Acoustic characteristics of Affricates

combination of stop and fricative. Frication follows silent gap or voice bar. Shorter in duration than fricatives but look similar on spectrogram

otosclerosis

common cause of conductive hearing loss spongy growth starts on the footplate of the stapes. results in carhart's notch, frequency found in those pt's, a pattern of bone-conduction thresholds characterized by reduced bone-conduction sensitivity predominantly at 2000 Hz

Cephalometric assessemtn of velopharyngeal structures (CAVS)

computer program designed to analyze the ratio relationship between the depth of the nasopharynx and the length of the soft palate 60-80 is normal higher than 80: velum is too short less than 60: nasopharynx is too shallow

larynomalacia

congenital condition. involves soft "floppy" laryngeal cartilages. causes strider

clause

contains a subject and a predicate

Pons

contains cranial nerve nuclei and sensory motor regulating fibers

complex sentence

contains independent clause and one or more dependent or subordinate clauses ex: I will drive my care to Reno if I have enough gas

compound sentence

contains two or more independent clauses joined by a comma and a conjunction or be a semicolon

autonomic nervous system (ANS) function and branches

controls and regulates the internal environment of our bodies two branches: sympathetic (fight or flight) and parasympathetic (back to relaxed state)

explain what percentile ranks mean on a standardized test

converted scores that show the % of subjects who scored at or below a specific raw score ex: 25% means that 75% of children did better on the test than the child did

child comes up to another child and says, "let's play house. you be the mommy, and I'll be the daddy, and we'll make dinner" the one child is suggesting that they engage in which type of play?

cooperative play

Cerebellum

coordination of movements and regulation of equilibrium

cone-shaped, sit on the apex of the arytenoids, assist in reducung the laryngeal opening when swallowing

corniculate cartilage

nuclear masses of the basal ganglia

corpus striatum 1. globus pallidus 2. putamen 3. caudate nucleus

uppermost tracheal ring, linked with the thyroid cartilage and the paired aryntenoid cartilages

cricoid cartilage

cricopharyngeal myotomy

cricopharyngeal muscle is split from top to bottom to create a permanently open sphincter for swallowing -for pt with parkinson's, ALS, and oculopharyngeal dystophy

located under the mucous membrane that covers the aryepiglottic folds, serves to stiffen or tense the vocal folds

cuneiform cartilages

ototoxic drugs

damage the cochlear hair cells or the acoustic nerve fibers

Unilateral Upper Motor Neuron Dysarthria site of damage

damage to UMN, internal capsule; contralateral deficits

Ataxic Dysarthria site of damage

damage to cerebellum or input/output pathways (superior, middle, inferior peduncles)

retrochlear disorders

damage to the nerve fibers along the ascending auditory pathways from the internal auditory meatus to the cortex -caused by unilateral tumors or acoustic neuromas (thicken of nerve tissue) -unilateral high-frequency hearing loss

differential reinforcement of low rates of responding (DRL)

decreasing undesirable behaviors gradually by reinforcing progressively lower frequencies of that behaviors

constituent definitions

definitions of target behaviors in dictionary terms, defining concepts with the help of other conceptual terms

operational definitions

definitions that describe how what is defined is measured. helpful in quantitatively measuring changes in target behaviors during treatment, contrasts with constituent definitions

apert syndrome

deformed cranium, facial distortion, hyponasal, digital fusion mostly normal intelligence

construct validity definition

degree to which test scores are consistent with theoretical constructs, concepts, or expectations

The disorders of the pharyngeal phase of swallow include

delayed or absent swallow reflex

Core vocabulary (consistency) approach)

designed for children with functional speech sound disorders who have inconsistent errors on the same words in the absence of childhood apraxia of speech. these children have impaired ability to phonologically program the sequence of phonemes to make up a word therapy revolves around 70 core vocab words that are selected (ideally) with the help of parents and teachers. functional words, used in the child's environment and selected for training

prevalence

determined by counting the number of individuals who currently have it

nonlinear phonology theories

developed as an alternative to account for the influence of stress and tone features in levels of representation independent of segmental or linear representation.. focus on prosodic phenomena

Assessment principles in early intervention

developmental log, serial assessment, monitor patterns of change, determination of infant/toddler state, correction for prematurity, settings for assessment

malocclusions

deviations on the shape and dimensions of the mandible and maxilla and the positioning of individual teeth

important structure that contains the hypothalamus and the thalamus

diencephalon

ADHD definition

difficulties in two major areas 1. inattention 2. hyperactivity and implusivity. must be long lasting and evident for at least 6 months, with onset before age 7.

Global Aphasia site of lesion

diffuse; perisylvian region

Characteristics of acquired stuttering

disfluencies present regardless of environment, no adaptation effect, no anxiety associated with disfluencies, occur on initial and final consonants. occur on content and function words

Classification of stuttering

disfluent behavior with varying frequency, duration, and type from person to person, distinguishable from normal disfluencies in that individuals exhibit >10% TD and >3% SLD's

cerebral palsy (CP) definition

disorder of early childhood in which the immature nervous system is affected. this results in muscular incoordination and associated problems

apraxia of speech defintition

disorder of motor planning and sequencing difficulty with executing voluntary movements involved in speech

intellectual disability (ID) definition

disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. it is believed that language of children with ID is delayed not deviant. AKA their skills are like younger kids.

ataxic CP

disturbed balance, awkward gait, and uncoordinated movements (cerebellar damage)

Agent+Action

doggie ball

Acoustic characteristics of Diphthongs

dynamic with well defined formants, tongue movements change formant structure, onglide and offglide, movement within the vowel space, F2 tracks tongue position (high F2=high tongue position, low F2=low tongue position)

basic behavioral technique: modeling

effective to teach a skills that is nonexistent. the clinician's modeling should be followed by the child's imitation and positive reinforcement

functional outcomes

effects of treatment that are generalized, broader, and socially and personally meaningful to clients

diplegia

either the two legs or the two arms are paralyzed

social interactionism theory

emphasize language function over language structure. believe that language develops as a function of social interaction between a child and his environment (including significant others in that environment). motivation is considered to be a key in using language

SCERTS model

emphasizes the importance of targeting goals in social communication and emotional regulation by implementing transnational supports, which include visual supports, environmental arrangements and communication-style adjustments

The americans with Disabilities Act (ADA)

employment discrimination employers must make "reasonable accommodations"

Hydrocephalus

enlarged ventricles from intracranial pressure or atrophy. obstructive or non-obstructive. Symtpoms include lethargy, reduced responsiveness, cognitive decline. Treatable which reverse effects possible.

achalasia definition

esophageal swallowing disorder due to esophageal motility impairment or a failure of the lower esophageal sphincter to relax. the food is not passed into the stomach but remains in the esophagus

an infant with cleft palate will most likely have hearing problems because of -aural atresia -an incompletely formed cochlea -eustachian tube dysfunction -malformed ossicles -tympanic membrane dysfunction

eustachian tube dysfunction

Narrative Sample use and function

evaluate story grammar. stress the system. aspects weighted on developmental complexity

how to evaluate oral-motor coordination skills

evaluated through diadochokinetic rate (DDK)

aversive stimuli

evetns people tend to avoid, events people describe as unpleasant and hence work to avoid them

abdominal muscles =

expiration

child: plane sky mom: yes, I see that big silver plan flying up in the blue sky! wow! what technique did the mom use

extension

CAS treatment

extensive drills that stress sequence of movement involved in speech production; imitation; decreased rate of speech; normal prosody; and increased accuracy in the production of individual consonants, vowels, and consonant clusters dynamic temporal and tactile cueing (DTTC): intensive, motor-based, drill-like treatment

aural atresia definition

external ear canal is completely closed -happens in kids with cleft palate, causes conductive hearing loss

interjections definition

extraneous elements introduced into the speech sequence -sound or syllable interjection: "um" -pauses: silent intervals in the speech sequence -broken words: silent intervals within words -incomplete sentences: often described as incompleted phrases, these are grammatically incomplete productions ("last summer I was.... last summer ... we went to paris") -revisions: changes in wording that do not change the overall meaning of an utterances (let me have coffee, maybe tea)

stenosis definition

extremely narrow external auditory canal

muscles that support the larynx and fix its position. all are attached to the hyoid bone and lower or raise the position of the larynx

extrinsic laryngeal muscles

Common characteristics of dialectal difference?

f/th substitution reversal of sk in ask

cranial nerves important in the larynx

facial (VII) vagus (X): superior laryngeal nerve and recurrent laryngeal nerve

VII

facial: tongue (sensory), face (motor)

a 90 year old in a SNF is in the late stages of dementia. the top treatment priority would be -improving her sentence structure -facilitating communication with the staff during daily routines -working on her word retrieval skills -increasing orientation to date and time -increasing functional vocab

facilitating communication with the staff

pyramidal system function:

facilitating voluntary muscle movement

Conduction Aphasia

fluent but paraphasic, less prosody, more hesitations, conduite d' approach errors , comprehension okay but impaired with higher task demands, severely impaired repetition with marked paraphasias in repeated attempts. Naming ranges, has tendency to explain instead. writing impaired, UE more than LE, difficulty sequencing, oral reading may be spared.

Wernicke's Aphasia

fluent speech, intelligible or non-intelligible, poor conveyance of meaning, good intonation and inflection, logorrhea, hard time stopping speech, poor self-monitoring, impaired comprehension, impaired repetition abilities, semantic paraphasias, jargon, neologism, paragrammatism, writing similar to verbal output, whole word deafness, visual disturbances

Anomic Aphasia

fluent, good articulation, syntax, prosody, and phrase length. Many circumlocutions. mild deficits if any in comprehension and repetition. Breakdown in naming. fairly proficient with reading and writing, problem with writing names and labeling. Many aphasia's evolve into this with recovery.

nasogastric feeding

for pt who can't feed orally -tube inserted through the nose, pharynx, and esophagus into the stomach; feeds the pt

pharyngostomy

for pt who can't feed orally -tube is inserted into the esophagus and stomach through a hole that has been surgically created through the pharynx

esophagostomy

for pt who can't tolerate oral feeding -procedure involves inserting a feeding tube into the esophagus and stomach through a hole (stoma).

gastrostomy

for pt who can't tolerate oral feeding -inserting a feeding tube into the stomach through an opening in the abdomen; blending table food is directly transported to the stomach

of the following symptoms, the one associated with dysarthria is -even and consistent breakdowns in articulation -impaired syntactic structures -forced inspiration and expirations that interrupt speech -invariably slower rate of speech -increased rate of speech under pressure

forced inspiration and expiration that interrupt speech

neurogenic stuttering definition

form of a fluency disorder associated with documented neuropathology, other neurogenic speech disorder (apraxia or dysarthria) or language disorder (aphasia) may or may not be evident

public law 94-142

free and appropriate education for disabled students from ages 3 to 21 (IEPs)

stuttering in preschool children is more likely on

function words

procedure yeilds information that allows doctors and researchers to examine brain activity while the pt is engaged in a specific processign task

functional MRI

Public Law 99-457

funds services to infants and toddlers up to 2 years old with disabilities Individualized Family Service Plans (IFSPs)

crouzon syndrome

fusion of the cranial suture, and hypolasia of the midface, maxilla or both eyes are set far apart, parrotlike nose, tall forehead

two main theories of stuttering

genetic hypothesis: there are potential genes that may be linked to stuttering neurophysiological hypothese: position that people who stutter have an abnormal neurophysiological or neuromotor organization

the muslce that is most involved in producing the voiced and voiceless /th/ is the

genioglossus

Extrinsic muscles of the tongue

genioglossus, styloglossus, hypoglossus (XII), palatoglossus (X)

basic behavioral technique: instructions

giving adequate instructions regarding the targeted language skills and how it is performed is essential to being treatment

most pharyngeal muscles are innervated by cranial nerves

glossopharyngeal IX vagus X

IX

glossopharyngeal: tongue and pharynx (sensory) and pharynx (motor)

distinctive feature approach

goal is to establish missing distinctive features or feature contrasts by teaching relevant sounds. it assumes that teaching a feature in the context of a few sounds will result in generalized production of other sounds with the same feature or features aka: train one or a few sounds to generalize to overall pattern minimal pairs

Apraxia of Speech (AOS) treatment

goal is to relearn motor sequencing for speech production using functional stimuli, focus on accuracy and prosody, use auditory and visual signals, patient should learn to monitor own speech, develop task hierarchy integral stimulation, resenbek 8-step continuum, multiple input phoneme therapy, PROMPTS, touch-cue method, MIT, contrastive stress drills, gestural methods

linear phonology theories

goals: 1. describe phonological patterns that occur in natural languages 2. create rules that account for these systems 3. identify universal principle that apply to various phonological systems

a school-based SLP is conducting classroom-based intervention with several students diagnosed with SLI. this means the SLP is

going into the classroom and helping these students in a small-group format, to achieve classroom curriculum goals

mean fundamental frequecy over the life span

graudal and discernible decline. as people age their voice becomes lower in pitch

criteria

guildelines for making such clinical decisions as when to judge whether a response has been learned

independent or main clause

has a subject and a predicate and can stand alone ex: the policeman held up the sign, and the cars stopped.

Van Riper's Traditional Approach

he focused on auditory discrimination/perceptual training, phonetic placement, and drill-like repetition and practice at increasingly complex motor levels until target phonemes were automatized bottom-up drill approach: from the simplest to the most complex movements

presbycusis

hearing impairment in older people due to the effect of aging and is associated with sensorineural hearing loss affects high frequencies

CHARGE syndrome

heart defects, atresia, genitourinary anomalies, ear anomalies, coloboma, retarded growth

supraglottic swallow

helps close the airway at the level of the vocal folds to prevent aspiration. pt is asked to hold the food in mouth, take a deep breath and hold it soon after initiating a slight exhalation, swallow while holding the breath, and cough soon after the swallow.

super-supraglottic swallow

helps close the airway before and during swallow. promotes false vocal fold closure -pt is asked to inhale and hold the breath tightly by bearing down and swallow while holding the breath and bearing down

mendelsohn maneuver

helps elevate the larynx and thus widen the cricopharyngeal opening -pt is asked to palpate the laryngeal elevation when swallowing saliva and then eventually taught to hold laryngeal elevation during swallowing

cri du chat syndrome

high-pitched cry of long duration in the infant low-set ears, a narrow oral cavity, laryngeal hypoplasia, microecephaly, hypertelorism, micrognathia, and oral clefts

information-processing theory

how language is learned. view the human information-processing system as a mechanism that encodes stimuli from the environment, operates on interpretations of those stimuli, stores the results in the memory and permits retrieval of previously stored information

interjudge reliability definition

how similarly a subject's performance is independently rated or measured by two or more testers

discourse

how utterances are related to one another, it has to do with the connected flow of language. when people talk to one another they are engaging in discourse

tongue muscles are innervated by

hypoglossal (xII)

XII

hypoglossal: mostly tongue movements (motor)

Ataxic Cerebral Palsy

hypotonic at birth, wide stance/gait, action tremor, incoordination of movement, possible cognitive involvement damage to cerebellum or its pathways, aquired or congenital

functional disorder definition

idiopathic disorder can not be explained on the basis of neurological damage, muscle weakness or paralysis, or structural problems

aphasia general definition

impaired language-specific behaviors caused by recent brain injury.

Apraxia of Speech (AOS)

impaired planning or programming of sensorimotor commands for normal speech. Inconsistent errors, groping behaviors, stereotypic behaviors (severe), trial and error. right side weakness, spasticity, positive babinski. associated with broca's aphasia, Spastic and UUMN dysarthria damage to motor speech programmer, broca's area, and the supplemental motor area

agnosia definition

impaired understanding of the meaning of certain stimuli, even though there is no peripheral sensory impairment. pt can see, feel, and hear stimuli but cannot understand their meaning disorder of recognition

paradoxical vocal fold motion disorder (PVFM)

in inappropriate closure of adduction of the true vocal folds during inhalation, exhalation or both.

vocalic sounds

include all vowels and the consonants /r/ and /l/. they have little constriction and are associated with spontaneous voicing

Infant respiratory issues

incoordination of suck-swallow-breathe, pulmonary disease, obstructive issues, allergies, asthma

effortful swallow

increase the posterior motion of the tongue and increase pharyngeal pressure -pt is asked to squeexe as hard as possible while swallowing

Spastic Cerebral Palsy

increased muscle tone, stiffness with growth, pain, hyperactive stretch and babinski reflexes, hemi/di/quadriplegia (quad related more to dysarthria and dysphagia) low pitch, hypernasal, pitch breaks, breathy, excess and equal stress, decreased vital capacity and inefficient valving CNS damage pre or perinatal

spastic CP

increased spasticity (increased tone, rigidity of the muscles) as well as stiff, abrupt, jerky, slow movements (due to damage to the motor cortext or direct motor pathways)

Relationship between F0 and subglottal pressure

increased subglottal pressure will increase F0 if no other factors are manipulated. stressed syllables will have higher subglottal pressure and F0, statement stress will have decreased pressure and F0, questions stress will have increased F0 and unchanged pressure

treatment for childhood dysarthria

increasing muscle tone and strength, increasing range and rate of motion and treating other parameters (respiration)

independent variable vs dependent variable

independent: directly manipulated by the experimenter dependent: effect, the variable that is affected by manipulation of the independent variable

parent would like their child to say "I wonder if we could get a spiderman DVD at the story" instead of "Get me the spiderman DVD" this is an example of

indirect requests

Limited English Proficient

individuals age 3-21 who were not born in the US or whose native language is not English and who are enrolled in or preparing to enroll in school.

external otitis definition

infection of the skin of the external auditory canal cause conductive hearing loss

Wernicke's Aphasia site of lesion

inferior MCA, posterior language zone, posterior superior temporal lobe

corrective feedback

information given to the client on incorrect or unacceptable responses in an effort to decrease those responses

Components involved in language learning

information processing, perception, memory, access/recall of events, attention, cognition and intelligence, vision, interactions and experiences, metalinguistics and metacognition,

cochlear implants deliver electrical impulses to what part of the ear?

inner ear

thoracic muscles =

inspiration

nasometer

instrument, allows patients to receive visual feedback through a computer display, gives information about the oral-nasal ration and amount of nasalance the pt is producing

parietal lobe function

integrates contralateral somesthetic sensations, such as pressure, pain, temperature and touch

muscles responsible for controlling sound production in the larynx

intrinsic muscles

ridge endoscopy

introduce orally. stroboscopic (flashing light) source.

flexible endoscopy

introduced through the nose. nasopharyngoscope can be lowered further to view the laryngeal mechanism

basic behavioral technique: manual guidance

involves offering physical assistance to produce a response. ex: hand over hand

Cardiac arrhythmia

irregular heartbeat

verbal behavior

is a form of social behavior maintained by the actions of a verbal community. are acquired under appropriate condition of stimulation, response and reinforcement. part of the behavior theory

laryngeal web

is a membrane that grows across the anterior portion of the glottis.

augmentative and alternative communication (AAC) definition

is a multimodal intervention approach that uses forms of communication such as picture communication boards, manual sign language, and computerized or electronic devices that produce speech (aka speech-generating devices)

circle of willis

is formed at the base of the brain where the two carotid and the two vertebral arteries join

authentic assessment definition

is naturalistic observation of a skill

frequency

is one of the two characteristics of vibratory motion. it is the rate of vibratory motion that is measured in terms of cycles completed per second or in hertz

word knowledge

is primarily verbal and contains words and symbol definitions

the adaptation effect

is systematic reduction in the frequency of stuttering when a short printed passage is repeatedly read aloud -by the 5th reading the most reduction will have occurred

pressure

is the amount of force per unit area

subglottal stenosis

is the narrowing of the subglottic space

adjacency effect

is the occurrence of new stuttering on words that surround previously stuttered words

the consistency effect

is the occurrence of stuttering on the same word or loci when a passage is read aloud repeatedly. it is the opposite of the adaptation effect

pharyngoesphageal segment (PES)

is the vibratory souce of esophageal speech

phonetic placement

is used when the client cannot imitate the modeled production of a phoneme such as /r/. begin with having the child produce a sound in isolation. clinician uses verbal instructions, modeling, physical guidance and visual feedback to show the client

a four year old has typical language and then suddenly "lost her words" and is having seizures

landau-Kleffner syndrome

segments of the pharyngeal cavity

laryngopharynx oropharynx nasopharynx

muscles for expiration

latissimus dorsi rectus abdmoninis trasversus abdmoninis intenal oblique abdominis quadratus lumborum

newton's laws of motion

law of inertia: a body tends to remain in motion and a body at rest tends to stay at rest law of reaction forces: every force is associated with a reaction force or opposite direction

apraxia of speech is often associated with -lesions in broca's area -lesions in wernicke's area -lesions in subcortical structures -lesions in the occiptal area -lesions in the cerebellum

lesions in Broca's area

Narratives in SLI

less information, less mature, may have word-retrieval problems, increased demands result in morphological and syntactic deficits

muscles/function of the soft palate

levator veli palatini: elevator of the velum tensor veli palatini: tenses the velum palatoglossus: elevates and depresses velum palatopharyngeus: narrows pharyngeal cavity, lowers velum

muscles and their function of the soft palate

levator veli palatini: elevator of velum tensor veli palatini: tenses velum palatoglossus: elevates and depresses the velum

MR characteristics

limitations in adaptive behavior (conceptual, social, practical, and language skills) Cognition impaired (generalization difficult, poor organization), attention impaired (short span, cannot attend to multiple items or multiple features of stimulus), and memory impaired (poor storage/encoding, slower retrieval) Syndromic and Non-syndromic (familial/non-familial)

the structure at the inferior portion of the tongue that connects the tongue with the mandible

lingual frenum

which approach is best for highly unintelligible children with multiple sound errors a. motor-based approaches b. linguistic approaches

linguistic approaches

Spinal cord

links body with central nervous system. regulates reflexes.

Oral Preparatory Phase of the Swallow

lip closure and seal, gathering of bolus, rotary chewing motion, cohesive bolus formed

phonological analysis

list the phonological processes the child uses and the percentage of time those processes are used

granuloma

localized, inflammatory, vascular lesion that is usually composed of granular tissue in a firm, rounded sac.

diencephalon: structures and functions

located between the brainstem and the cerebral hemispheres 1. thalamus: largest structure, regulates sensory information 2. hypothalamus: controls emotions

a child who says "down" when a cup of juice spills off the dinner table is using the relation of? 1. action 2. possession 3. locative action 4. attribution 5. recurrence

locative action

you are working with "in, on, out, on top" with a student. what skill are you working on?

locatives

Bel

logarithmic unit of measure of sound intensity

iconic symbols

look like the object or picture they represent

articulation approach

looks at children's acquisition of individual phonemes and emphasizes speech motor control

communicative potency definition

looks at how functional words are within an individual child's communication environment

alexia definition

loss of previously acquired reading skills due to recent brain damage

sternum parts

manubrium corpus xiphoid process

Fetal Alcohol Syndrome

may or may not have cleft palate. Characteristics include LBW, microcephaly, short nose, maxillary hypoplasia, hair whorls, smooth philtrum, cognitive impairment, joint anomalies, hypertelorism (eyes further than expected), protruding ears

developmental research

measure changes in subjects over time, as they mature or get older. used to created developmental norms

speech audiometry

measures how well a person understands speech and discriminates between speech sounds read a list of words at variety of loudness's

correlational coefficient

measures reliability is a number or index that indicates the relationship between two or more independent measures r=0.00 mores no relationship r=1.00 the greater the reliability

Midbrain

mediates auditory and visual reflexes, regulates cortical arousal, house cranial nerve nuclei

______fires impulses to the respiratory system

medulla oblongata

mand-model

milieu teaching -clinician then mands a response from the child ("tell me what you want)

incidental teaching

milieu teaching -the adult waits for the child to initiate a verbal response. -pays full attention to the stimulus that prompts a response from the child -prompts an elaboration of the response (you want that ball! what do you want) -praises child and hands over desired object

time delay

milieu teaching -the clinician waits for the child to initiate verbal responses to stimuli that are separated by a predetermined waiting period -the clinician gives the desired object when the child imitates, spontaneously requests, or fails to say anything after three models, each separated by 15 seconds

minimal pairs vs maximal pairs

minimal pairs: uses words that differ by only one feature maximal pairs: uses word pairs that contain a maximum number of phonemic contrasts

basic behavioral technique: fading

minimizes the need for special procedures to evoke language responses. ex: prompts may be faded by a progressively soft voice so the child continues to respond

narrative skills training

monologue expository discourse conversation

relational analysis

more commonly used in clinical settings child's speech is compared to the adult model ex "the child produced a w/r substitution"

a child omits endings like -est what is he having difficulty with?

morphology

of the following what does not occur between 8 and 10 months of age in typically developing children 1. comprehension of no 2. using the phrase "all gone" (emerging negation) 3. using variegated babbling 4. uncovering a hidden toy (beginning object permanence) 5. use of gestural language, such as shaking head no, playing peek-a-boo

most children use "all gone" to express negation between 1 and 2 years of age

Stickler Syndrome

most common identifiable cause of cleft palate (57%), 1/7500-9000 births, autosomal dominant. Characteristics include cleft palate, SNHL, progressive myopia, retinal detachent and cataracts, progressive arthropathy (joint disease). Craniofacialfeatures include maxillary and mandibular hypoplasia, flat midface impression, prominant eyes, long philtrum, depressed nasal bridge with epicanthal folds, cleft palate. Co-occur with pierre robin sequence

the fact or facts about stuttering adaptation include the following -the greatest reduction in stuttering occurs only on the seventh reading -there is transfer from one reading passage to the other -most of the reduction in stuttering occurs by the fifth reading -a higher magnitude of adaptation occurs with an increased time interval between readings -most people who stutter do not show the adaptation effect

most of the reduction in stuttering occurs by the fifth reading

which approach is best for children with several sounds in error (/r/ /s/ /l/) a. motor-based approaches b. linguistic approaches

motor-based approaches

Myoelastic Aerodynamic Theory of Phonation

muscle activity adducts VF, subglottal pressure builds up and overcomes muscular force, VF open from bottom to top, air velocity increases and pressure of VF decreases, VF closes from bottom to top. Does not account for mucosal wave.

Side effects of Surgery in Head and Neck Cancer

must relearn swallowing and talking to make up for new anatomy. May have varying difficulties depending on if it was a partial or total glossectomy. affects oropharyngeal swallowing and articulation

hyponasality vs hypernasality

nasal resonance absent on nasal sounds too much nasal resonance on non-nasal sounds

natural phonology theory

natural phonological processes are innate processes that simplify the adult target word.

dysarthria definition

neurologically based speech disorder, characterized by abnormal strength, speed, range, steadiness, tone, and accuracy of movement involved in speech production

Transcortical Motor Aphasia

non-fluent, problems with executive function and initiation, agrammatic, good comprehension, naming limited, telegraphic writing, macrographia, Able to repeat.

The nasal mark, when placed above a phoneme indicates that the phoneme is usually?

non-nasal and has become nasalized.

electroglottography (EGG)

noninvasive procedure yields an indirect measure of vocal fold closure patterns. surface electrode are placed on both sides of the thyroid cartilage, and a high-frequency electric current is passed between electrodes while the pt phonates. glottal wave forms. can detect breathy and abrupt glottal onset of phonation

in Oller's stages of infant phonological development, reduplicated babbling precedes 1. nonreduplicated babbling 2. expansion 3. phonation 4. reduplicated expansion

nonreduplicated babbling

type-token ration (TTR)

number of different words in sample divided by number of words in sample

Mean length of utterance calculation

number of morphemes divided by the total number of utterances

mixed hearing loss

occurs when neither the middle nor the inner ear is functioning properly

III

oculomotor: eye movements (motor)

I

olfactory: sense of smell (sensory)

hemiplegia

one side of the body, is paralyzed

monoplegia

only one limb or a part thereof is paralyzed

paraplegia

only the legs and lower truck are paralyzed

what is the three parts of a syllable

onset (initial consonant) nucleus (vowel or diphthong) coda (consonant at the end)

open syllables vs closed syllables

open: end in vowels closed: end in consonants

II

optic: vision (sensory)

Oropharyngeal treatment following Head and Neck Cancer

oral motor retaining (therabite resistance for tongue), laryngeal elevation (medelshohn and shaker), compensatory strategies (head turn to weak side, chin tuck)

the primary muscle of the lips is

orbicularis oris

portion of the maxillary bone that forms most of the hard palate

palatine process

technique in which parents play with Hannah and describe and comment upon what she is doing and the objects she is interested in ex: you are making the care go fast"

parallel talk

Components of stuttering assessment

parent interviews, spontaneous speech sample (disfluencies, rate, MLU), standardized testing of speech and language, additional measures (stocker probe, C.A. Inventory/kiddy cat/cat-r, locus of control battery)

temporal auditory processing

part of information-processing theory deals with the ability to perceive the brief acoustic events that comprise speech sounds and tracks changes in these events as they happen quickly in the speech of other people

phonological processing

part of information-processing theory deals with the processes involved in the ability to mentally manipulate phonological aspects of language (rhyming, word segmentation)

what types of dysfluences are judged abnormal at lower frequencies

part-word repetitions sound prolongations (2%)

Health Insurance Portability and Accountability Act (HIPAA)

patient privacy

direct stuttering reduction methods include

pause and talk response cost

PCC

percentage of consonants correct ration of the number of consonants produced to the total number of consonants

direct larngoscopy

performed while pt is under anesthesia in outpatient surgery. laryngoscope is introdcued through the mouth into the pharynx and positioned above the vocal folds valuable for a biopsy if laryngeal cancer is suspected

peripheral hearing problems vs central auditory disorders

peripheral hearing problems: problems in the outer, middle, or inner ear central auditory disorders: disrupted sound transmission between the brain stem and the cerebrum

Phonetic sound/Articulation disorders

peripheral motor based problems. Preservation of phonemic contrasts. Fairly consistent errors

pragmatics stages for birth - 1 year

perlocutionary stage: "signals" have an effect on the listener/observer but lack communication intent illocutionary stage: 9-10 mos intentional communication such as pointing and laughing locutionary stage: about 12 mos, begin use words. the child establishes joint reference, the ability to focus attention on an event or object as directed by another person

autism spectrum disorder (ASD) definition

persistent deficits in social communication and social interaction across multiple contexts -social emotional reciprocity -nonverbal communicative behaviors used for social interaction -developing, maintaining, and understanding relationships

Process in working memory to achieve the sounding out of unfamiliar words

phonetic coding

structural theory of phonology

phonological development follows an innate, universal, and hierarchical order of acquisition of distinctive features.

SLP tx principles in cleft palate

place of articulation, airstream management, recommendation of surgery

place-voice-manner paradigm

place: describes the location of the constriction voicing: the presence or absence of vocal fold vibration in the production of consonants manner: describes the degree or type of constriction in the vocal tract

"my doggy"

possession

Brown's Stage III

possessive -s, uncontractible copula, noun phrase elaboration, 'but', 'so', 'or', 'if' appear, auxiliary verbs 'can', 'do', 'have', 'will' emerge and appear in questions later stage; inversion of SVO appears in yes/no questions. 2;7-2;10 MLU 2.5-2.75

Transcortical Sensory Aphasia site of lesion

posterior superior parietal lobe

The primary motor cortex in the frontal lobe is located on the

precentral gyrus

front portion of the maxillary bones

premaxilla

Brown's Stage II

present progressive -ing, plural -s, basic SVO structure, 'gonna', 'wanna', 'gotta' appear. 2;4-2;6 MLU 2.0-2.5

postcentral gyrus (sensory cortex or sensory strip)

primary sensory area that integrates and controls somesthetic sensory impulses

TBI Mechanisms of Injury

primary: Lacerations, contusions, Diffuse Axonal Injury (DAI), skull fractures secondary: hypoxemia, hypotension, anemia, hyponatremia, emboli, ischemia, hematoma, intracranial pressure (ICP)

Phonemic sound/Phonological disorders

problem with the rules of language rather than production of sounds. Loss of phonemic contrasts. Errors often inconsistent.

basic behavioral technique: shaping

procedure in which a complex response is broken down into smaller components that are taught sequentially to achieve the final target skills.

pure probes

procedures for assessing generalized production when only untrained stimulus items are presented, contrast with intermixed probes

probes

procedures to assess generalized production of responses without reinforcing them. probes involve a criterion to be met before training advances to a more complex level or to another target behavior

Characteristics of infant with cleft palate

produce fewer consonants, vocalize less frequently, less variety in productions, fewer multi-syllabic productions, prefer nasals glides and /h/, produce more glottals, use compensatory productions, differences persist following surgical management

coronal sounds

produced with the tongue blade raised above the neutral schwa

basic behavioral technique: prompting

prompts are like hints, when modeling is no longer needed

Focus and Principles of Intervention in Dysarthria

provide greatest functional benefit quickly (what has greatest effect on other components), and provide greatest support for improvement in other aspects of speech. Consider Speed, accuracy, and naturalness. Patients concern is intelligibility. Will mostly compensate and adjust for difficulties. may need to establish other functional means of communication (e.g. AAC)

Individual Family Service Plan (IFSP)

providers and family work as a team, intervention tailored to family needs, concerns, and priorities. Contains present level of development (physical, cognitive, communication, social/emotial, adapative), major outcomes (criteria, procedure, timelines, progress, modifications), specific services needed (PT, OT, SLP), delivery model, service environments, projected dates for initiation and duration, transition plan, case manager. Part C of IDEA

Progressive Supranuclear Palsy

rapid progression, accumulation of tau protein in basal ganglia, brainstem, prefrontal cortex, and cerebellum, severe swallowing problems, mild to moderate memory problems, slowness of thought, apraxia, severe motor planning deficit, learning deficits

cerebellum function

recieves neural impulses from other brain centers and helps coordinate and regulate those impulses. regulates balance, body posture, and coordinated fine motor movements

complexity approach to speech sound disorders

recommend targeting sounds that are nonstimulable, always incorrect and later developing.

repeated surgeries can cause someone's voice to sound gravely and rough, which is primarily a result of

reduced mucosal wave

cluttering definition

reduced speech inteligibility, rapid and irregular rate, imprecise articulation, dysfluencies, disorganized language, poor prosody, and inefficient management of discourse

direct methods of response reduction

reducing behaviors by immediately providing corrective feedback

indirect methods of response reduction

reducing undesirable behaviors by positively reinforcing and thus increasing desirable behaviors

phonological processing that disappear before age three

reduplication weak/unstressed syllable deletion consonant assimilation prevocalic voicing fronting of velars final-consonant deletion diminutization

a 4.5 year old does the following phonological processes: gliding, consonant-cluster reduction, stopping, reduplication and final-consonant deletion. you would begin treatment by addressing:

reduplication is the4 earliest of the listed phonological processes to phase out. normally phased out by 2 years 4 months

frequency perturbation or jitter

refer to the variations in vocal frequency that are often heard in dysphonic pts

acoustic immitance

refers to a transfer of acoustic energy. an energy transformation takes place when a sound stimulus reaches the external ear canal and strikes the TM

example of an embedded form

refers to adding or rearranging elements within a sentence "the boy who got a haircut looks nice"

oscillation

refers to the back-and-forth movement of air molecules because of a vibrating object

loci of stuttering definition

refers to the locations in a speech (or oral reading) sequence where stutterings are typically observed. certain classes of sounds, words in certain positions in a sentence, and certain kinds of words have a high probability of being stuttered

audience effect

refers to the observation that the frequency of stuttering increases with an increase in audience size

Hypothalamus

regulates body temperature, food intake, water balance, hormonal secretions, emotional behavior, and sexual responses. controls activities of autonomic nervous system

Basal ganglia

regulates motor movements and muscle tone. Includes caudate nucleus, putamen, claustrum, globus pallidus and amygdaloid nucleus

differential reinforcement of incompatible behaviors (DRI)

reinforcing a desirable behaviors that cannot coexist with the undesirable behavior to be reduced

differential reinforcement

reinforcing the correct response while ignoring response to the same stimuli

Acoustic characteristics of Stops

release of air pressure is major source of sound. Silent gap (voiceless) or voice bar (voiced). Burst in initial and medial positions (sometimes final) voiceless: longer in duration and higher F0, vowel before is shorter. voiced: F1 low, F2 related to length of cavity, vowel before is longer bilabial (low freq, back coupling, shorter voice onset time), alveolar (high freq, mid vot), velar (mid freq, longest vot)

Intervention TBI

remediation and compensation, hierarchical, systematic, process-specific (attention, memory, problem solving, etc.), functional skills approach (personally relevant, context sensitive), compensatory techniques (AAC, cognitive aids). Compensatory training (errorless learning, fade cuing and support, task specific routines), direct attention training

types of disfluencies repetitions

repetitions: saying the same element of speech more than once -part-word repetitions (sound of syllable) -whole-word repetition -phrase repetition

cross-sectional method

researchers select participants from various age levels and observe the behaviors or characteristics of the groups formed on the basis of age make observations of differences between subjects of different ages to observe differences that occur within subjects as they mature

Criteria for Infant swallowing/feeding referral

risk for aspiration, prior URI issues, possible pharyngeal/laryngeal etiology, need to define oral-pharyngeal-laryngeal interactions for care planning

ratio scale

same as interval scale but the numerical values it satrts with zero 0-1-2-3-4-5

nasopharyngoscopy

scope is passed through the middle meatus and back to the area of velopharyngeal closure. the examiner can then observe the posterior and lateral pharyngeal walls as well as the nasal aspect of the velum and the adenoid pad as the client produces sentences

Target production is /s/, what is a word that provided best coarticulatory conditions?

sea

other muscles involved in rib cage elevation (inhalation)

serratus posterior superior levator costarum brevis levator costarum longis external intercostals

Cerebrum

serves higher mental functions (cognition, memory, language), regulates sensorimotor integration, relates perceptions with experiences

story grammar

setting statements initiating events theme of the story

Global Aphasia

severe expressive and receptive difficulties across all levels, diminished responsiveness, automatic speech, may attempt to speak when addressed, reading and writing only used in treatment (not for classification), assessment difficult

Transcortical Sensory Aphasia

severe language comprehension difficulties, logorrhea, able to repeat, echolalia (may be severe, difficult to get pt to stop repeating)

the position that stuttering indicates a social role conflict was taken by? -van riper -wischner -sheehan -bloodstein -brutten and showmaker

sheehan

Repair stratgies

shows an individuals ability to respond based on what the conversational partner has said.

man with presbycusis comes to you complaining that when he is in social situations such as parties, people don't speak loudly enough. he says that the noise creates a problem for him in hearing what people are saying. this client has difficulty with -signal-to-noise ration -auditory discrimination -figure-ground discrimination -pragmatic skills -auditory memory

signal to noise ratio difficulty separating the signal of interest (speech) from background noise

hemangioma

similar to granulomas but are soft, pliable and filled with blood

extinction

simply withholding such reinforcers as attention to reduce a response

pure tone

single frequency. also called a simple harmonic motino. sinusodial motion

procedure evaluates the amount of blood flowing through a structure

single-photon emission-computed tomogrphay (SPECT)

auditory discrimination

skills that enable children to identify differences between sound stimuli. ex: cat vs bat

athetoid CP

slow, writhing, involuntary movements (damage to the indirect motor pathways, basal ganglia)

polyps

softer than nodules and may be filled with fluid or have vascular tissue. tend to be unilateral

Acoustic characteristics of Vowels

sonorant, relatively open VT, sound source is the vocal folds F0: pitch changes with higher tongue positions although independent of filter. culturally learned (not seen in all children). F1/F2/F3 change without changing F0 [Front= wide F1 and F2, close F2 and F3; back= close F1 and F2, wide F2 and F3; mid= evenly spaced] Duration: Longer (tense, followed by voiced, final position, stressed), shorter (lax, followed by voiceless, within phrase, unstressed) Amplitude: increase amp will increase energy in harmonics and increase pitch (but still can increase amp without changing pitch)

Acoustic characteristics of Liquids (rhotic and lateral)

sonorant, steady state formants. ___= lowering of F3, difficulty distinguishing with high freq loss due to distinct F3 ____= midline cavity and anti-resonances at high freq, closer F2 and F3 with little energy between them

air conduction definition

sound waves strike the tympanic membrane. this movement of the TM causes the ossicles to move, creating the fluids of the inner ear. these movements cause vibrations in the basilar membrane of the cochlea

marked

sounds are less natural and tend to be acquired later

sound prolongations definition

sounds produced for a duration longer than typical llllllllike it

unmarked

sounds that appear to be natural; they tend to be easier to acquire and thus are acquired earlier than marked sounds

reflection

sounds waves traveling back after hitting an obstacle

most common type of CP

spastic

differential reinforcement of other behaviors (DRO)

specifying one behavior that will not be reinforced, while reinforcing many unspecified desirable behaviors any one of which is accepted and reinforced

Sawtooth wave

spectrum of the larynx. period of cycle relates to F0, Harmonics decrease 12dB per octave as frequency increases, and become more spaced as F0 increases

XI

spinal accessory: shoulder, arm, and throat movement (motor)

evoked response

spontaneous response given to a natural stimuli, response given without modeling, contrast with imitated responses given on a modeled trial

Most valid sample of speech sound production

spontaneous speech (as opposed to single-word, reading, or imitation)

Esophageal Phase of the Swallow

starts as bolus moves past the cricopharyngeus via the peristaltic wave. Takes about 8-20 seconds

Thrombotic CVA

stationary bloackage either from hypertension or increased cholesterol buildup. slow onset, usually at level of bifurcation of internal and external carotids. signs include dizziness, blurred vision, tingling in extremeties, TIA's, headaches, seizures

negative reinforcement

strengthening of behaviors by the termination of an aversive event

phonological approach

studies children's acquisition of sound patterns and the processes underlying such patterns

the basic structure of english sentences

subject + verb + object

mucosal wave travels across

superior surface of the vocal folds about 2/3 or the way to the lateral edge

teflon injection into the vocal folds

surgical implant method designed to improve airway closure during swallowing. -teflon is injected into a normal or reconstructed vocal cord or any remaining tissue on top of the airway to increase the muscle mass that helps close the airway

Which articulation difference is not commonly observed among Asian speakers of English as a second language?

t/k substitution (eg. tin/kin)

Cleft palate preschool intervention

teach identity, location, and actions of oral structures with visual and tactile feedback, teach placement, orthographic symbol, and difference between nasal and oral airflow

differential reinforcement of alternative behaviors (DRA)

teaching a child to verbally request instead of whining to get something desired

mandy has difficulty rhyming words and sounding out words and remembering what she hears. what areas is she struggling with 1. temporal auditory processing 2. divergent semantic production 3. phonological processing

temporal auditory processing and phonological processing

wernicke's area location and function

temporal lobe critical to the comprehension of spoken and written language damage causes person to produce fluent but meaningless speech

mandible is attached to the temporal bone of the skull by what joint

tempromandibular joint

the muscle that exerts the pull that allows the eustachain tube to open during yawning and swallowing is the -tensor palatini -levator palatini -tensor tympani -stapedius muscle -levator veli palatini

tensor palatini

periodic waves

that repeat themselves at regular intervals and are predictable

cohesion

the ability to order and organize utterances in a message so that they build logically on one another

auditory rate

the ability to process acoustic stimuli that are presented at different rates or speeds. research shows that children with language impairments has a difficult time processing stimuli presented at a fast rate

predictive validity

the accuracy with which a test predicts future performance on a related task ex GRE

density

the amount of mass per unit volume

period

the amount of time needed for a cycle to be completed

Class I malocclusion

the arches themselves are generally aligned properly, but some individual teeth are misaligned

simple harmonic motions

the back-and-forth movements of particles when the movement is symmetrical and periodic, aka a sine wave

refraction

the bending of sound waves due to change in its speed or propagation, ex when sound waves move from one medium to another

protective layers of the brain

the brain has three protective structures: a layer of skin, the skull bones, meninges 1. dura mater (tough mother) 2. arachnoid (spider web) 3. pia mater (tender mother)

formant frequencies

the center frequency of a formant

central tendency

the central tendency of a distribution or set of scores is an index indicating the average or typical score for that distribution. the mean is most commonly used

displacement

the change in position, air molecules are said to be displaced because of the vibratory actions of an object

behavioral theory of phonology

the child develops the adult-like speech of his or her community through interactions with the caregiver

recasting

the child's own sentence is repeated in modified form, but the clinician changes the modality or voice or the sentence rather than simply adding grammatical or semantic markers ex: child "the baby is hungry" clinician "is she hungry?"

self-talk

the clinician describes her own activity as she plays with the child

s/z ratio

the clinician divides the longest /s/ and the longest /z/. a ratio more than 1.4 is indicative of possible laryngeal pathology

expansion

the clinician expands a child's telegraphic or incomplete utterance into a more grammatically complete utterance

parallel talk

the clinician plays with the child and describes and comments upon what the child is doing and the objects the child is interested in

focused stimulation

the clinician repeatedly models a target structure to stimulate the child to use it. the clinician does not correct the child's incorrect responses but instead models the correct target

test-retest reliability

the consistency of measures when the same test is administered to the same person twice

alternate form reliability

the consistency of measures when two forms of the same test are administered to the same person

reliability definition

the consistency with which the same event is repeatedly measured must be consistent across repeated testing or measurement of the same skill or event

intrajudge reliability definition

the consistency with which the same observer measures the same phenomenon on repeated occasions

concurrent validity definition

the degree to which a new test correlates with an established test of known validity

validity definition

the degree to which a test measures what it purports to measure

williams syndrom is caused by

the deletion of approximately 25 genes on one copy of chromosome 7q11.23

air-bone gap

the difference between a bone-conduction hearing threshold and an air-conduction hearing threshold for a given frequency in the same ear a difference of more than 10 implies a conductive hearing loss

conductive hearing loss definition

the efficiency with which the sound is conducted to the middle or inner ear is diminished the inner ear, acoustic nerve and auditory centers of the brain are working normally *the bones of the skull still vibrate so conductive hearing loss is never profound and there is always some hearing left

cover-body theory of phonation states that

the epithelium, the superficial layer of the lamina propria, and much of the intermediate layer of the lamina propria vibrates as a "cover" on a relatively stationary "body" which is made up of the remainder of the intermediate layer, the deep layer, and the TA muscle

suprasegments

the features of prosody, add meaning, variety, and color or running speech 1. length: length of vowels 2. stress 3. rate: speed of speech 4. pitch: the auditory sensation of the frequency the vocal folds vibrate 5. volume: intensity or loudness 6. juncture: vocal punctuation, combination of intonation and pausing to mark special distinctions or grammatical division in speech

initial response

the first, simplified component of a target response the client can imitate while shaping a target response ex: putting the lips together for production of the word mom

such skills as airflow management, gently phonatory onset, and reduced rate of speech are targets in

the fluency shaping techniques

cancellations, pull-outs, and preparatory sets are taught in

the fluent stuttering approach

bone conduction definition

the fluids of the inner ear are housed in the skull. the larger bones of the skull conduct sound, as does the ossicular chain of the middle ear. the skull bones vibrate in response to airborne sound waves, causing movement in the inner ear fluids.

natural frequency

the frequency at which a system naturally oscillates or vibrates

the opening between the vocal folds is called

the glottis

sound spectography

the graphic representation of a sound wave's intensity and frequeny as a function of time. the spectrogram reflects the resonant character of the vocal tract and the harminoc nature of the glottal sound source

"why doggy bark" is a example of which one of Halliday's intents

the heuristic function involved children attempting to have events in their environment explained to them

coarticulation

the influence of one phoneme upon another in production and perception wherein two different articulators move simultaneously to produce two different speech sounds

the muscles most involved with adducting the vocal folds

the lateral cricoarytenoids and the transverse arytenoids

agraphia defintion

the loss or impairment of normally acquired writing skills due to lesions in the foot of the medial frontal gyrus of the brain (also called Exner's writing area)

fundamental frequency

the lowest frequency of a periodic wave, it is the first harmonic

amplitude

the magnitude and direction of displacement. in acoustics it is the strength or magnitude of a sound signal. the greater the amplitude the louder the sound signal

aorta

the main artery of the heart. carries blood from the left ventricle to all parts of the body except the lungs

class III malocclusion

the maxilla is receded and the mandible is protruded

sensorineural hearing loss

the middle ear may conduct sound efficiently to the inner ear by damage to the hair cells of the cochlea or to the acoustic nerve prevents the brain from receiving the neural impulses of the sound IS PERMANENT

resonance

the modification of sound by other sources. ex the oral cavities

rhyme is

the nucleus and coda collectively

voice quality definition

the physical complexity of the laryngeal tone

injection method

the pt impounds the air in the mouth as in saying /t/ or /p/. the impounded air is pushed into the esophagus and then expelled

inhalation method

the pt is taught to inhale rapidly while keeping the esophagus open and relaxes

intensity

the quality of sound that creates the sensation of loudness. physically, intensity is the amount of energy transmitted per second over an area of 1 square meter. it is measured in terms of watts per square mete and is also expressed in decibels

incidence

the rate of occurrence in a specified group of people

morphological awareness

the recognition, understanding and use of word parts that carry significance

impedance

the resistance to motion or sound transmission

longitudinal research

the same participants are studied over time. investigator follows participants and observes the changes that occur within these participanys

morpheme

the smallest meaningful unit of a language

indirect laryngoscopy

the specialist uses a bright light source ad a small round mirror angled on a long slender handle to lift the velum and press gently against the patients posterior pharyngeal wall area

psychacoustics

the study of how humans respond to sounds as a physical phenomenon

Pragmatics

the study of rules that govern the use of language in social situations.

syntax

the study of sentence structure -the arrangement of words to form meaningful sentences -the word order and overall structure of a sentence -a collection of rules that specify the ways and order in which words may be combined to form sentences in a particular langauge

semantics definition

the study of the meaning of language

acoustics

the study of the physical properties of sound

morphology

the study of word structure

construct valiadity

the test scores are consistent with the theoretical predictions

rarefaction

the thinning of air molcules when the vibrating object returns to equilibrium

Blom-singer tracheoesophageal puncture (TEP)

the tracheoesophageal wall, which separates the trachea and the esophagus, is punctured. a shunt or tunnel is opened to connect the two structures. to keep the tunnel open the prosthetic device is inserted. designed to prevent the passage of fluid and food into the trachea

class II malocclusion

the upper jaw or maxilla is protruded and the lower law or mandible is receded. this is also referred to as an overbite. overjet occurs when the child has a class II and the upper teeth from the molars forward are positioned excessively anterior to the lower teeth

broad phonemic transcription

the use of IPA symbols to transcribe phoenemes by enclosing them within slash marks

scanning

the user is offered available messages by a mechanical device or communication partner

direct selection

the user selects a message by touching a keypad, touching an item or object, depressing and electronic key, point or some other direct means

source filter theory

theory that states that energy from the vibrating vocal folds (the source) is modified by the resonance characteristics of the vocal tract (the filter)

transparent messages

those likely to be understood with no additional cues by an observer without special training

aperiodic waves

those that do not repeat themselves at regular intervals

forms the anterior and lateral walls of the larynx and protects the larynx

thyroid cartilage

auditory discrimination/perceptual training

to teach clients to distinguish between correct and incorrect productions of speech sounds

computerized radiographic method of taking pictures of different planes of body structures

tomography

Pharyngeal Phase of the Swallow

tongue moves up and back and approximates palate, velopharyngeal port closes, hyoid/laryngeal excursion, constrictor function, epiglottic folding to meet aryepiglottic folds, closure of the true/false vocal folds, cricopharyngeus/UES opening. occur simultaneously in about 1 second

ankyloglossia

tongue-tied lingual frenum is too short

transformational generative theory of grammar

transforming sentences by adding. deleting, substituting or rearranging words to form a different kind of sentences

extrapyramidal system function

transmits impulses that control the postural support needed by fine motor movements (indirect, involuntary muscle movement)

to help Myron communicate more effectively with others so that they understand his messages better, the clinician needs to make sure that the symbols on Myron's AAC device are 1. PECS friendly 2. opaquely referenced 3. noniconically opaque 4. opaque 5. transparent

transparent

booster treatment

treatment given any time after the client has been dismissed from the initial treatment

phonological awareness treatment

treatment is designed to increase children's awareness of the sound structure of language. (blending, rhyming, alliteration...)

discrete trials

treatment methods in which each opportunity to produce a response is counted separately. each opportunity is a trial and all trials are clearly separated in time

V

trigeminal: face (sensory) jaw (motor)

IV

trochlear: eye movement (motor)

Complex tones

two or more pure tone frequencies, waveform depends on phase/times relationship between tones. periodic. Analyze for jitter and shimmer measures (perturbation).

spondee words are

two-syllable words with equal stress on each syllable

american sign lanaguage

unaided AAC

american indian hand talk (AMER-IND)

unaided AAC a sign-language system developed by North american indians

left-hand manual alphabet

unaided AAC composed of concrete gestures that approximate printed letters of the alphabet. most appropriate for people with right-sided paralysis

limited manual sign systems

unaided AAC composed of several different systems with a limited number of gestures and signs. often used by patients in medical settings to communicate self-care and other basic needs and to say yes and no

pantomine

unaided AAC mostly uses gestures and dynamic movements that involve the entire body or parts of the body. the child uses transparent messages, facial expressions, and dramatizations of meanings

eye-blink encoding

unaided AAC simple system in which the child learns to communicate a message by a specific number of blinks

gestual AAC

unaided. no instrucments or external aids are used. the child uses gestures and other patterned movements, which may be accompanied by some speech

Reasons for tracheostomy

upper airway obstruction, endotracheal tube not appropriate, long term mechanical ventilation, risk or known pulmonary aspiration, retention of secretions

Halliday's imaginative communicative intent

used to tell stories + jokes

distinctive feature paradigm

uses a binary system; the features are either present or absent.

flexible fiber-optic laryngoscopy

uses a thin tube containing a lens and fiber-optic light buncles. inserted through the nose

pragmatic development at 2 -3 yrs

utterances occasionally egocentric generally have a communicative intent

Which of the following would not be typical in terms of predictable productions based on spanish influence? - Insertion of schwa before word-initial /s/ clusters - Devoicing of final consonants - b/v substitutions v/f substitutions in medial postion of words

v/f substitutions in medial position of words

You are working with a 7 year old Spanish speaking girl, who is in the process of learning English as a second language. Which of the following would NOT be typical for her in terms of predictable productions based on Spanish influence? - Insertion of schwa before initial /s/ clusters - Devoicing of final consonants - b/v substitions -v/f substitutions in medial position of words

v/f substitutions in medial position of words

most pharyngeal muscles are innervated by what cranial nerves

vagus (X) and glossopharyngeal (IX)

X

vagus: larynx, respiratory, cardiac, and gastrointestinal (motor and sensory)

the fluent stuttering treatment was developed by

van riper

antecedents or treatment stimuli

various objects, pictures, instructions, modeling, prompts and other stimuli the clinician uses to evoke target responses from clients

false vocal cords

ventricular folds

functional units (behavioral theory)

verbal behavior is broken down into cause-effect (functional units), not structures of language. -mands: demands and commands. involve requests -tacts: verbal responses stimulated by physical objects and events -echoics: imitative verbal responses whose stimuli are the speech of another person -aoutclitics: are secondary verbal behaviors that comment upon, or clarify the causes of, such primary verbal behaviors as tacts and mands -intraverbals: are determined by the speaker's own prior verbal behaviors

myoelastic-aerodynamic theory

vocal folds vibrate because of the forces and pressure of air and the elasticity of the vocal folds

Sound affected longest by stopping

voiced 'th'

the surgical method of cleft palate repair that involves raising two bipredicled flaps of mucoperiosteum, bringing them together, and attaching them to close the cleft is called the

von Langenbeck surgical method

which is acquired first vowels or consonants

vowels

typical articulation development for children

vowels first in order: age 3ish: m, n, p, h, w, b age 4ish: k, g, j, ng, t, d f, l, v, sh, ge, th, r, s, z, ch

Rosalia is a third0grade Mexican American Spanish speaking 8-year old girl who is in the process of learning English. Her parents emigrated from Mexico 2 years ago; thus, Rosalia was exposed first to Spanish at home and to English in first grade, when she was 6 years old. The classroom teacher shares with you that she thinks Rosalia may have an articulation disorder but the teacher is not sure. The teacher provides you with some examples of things that Rosalia has said in the past 2 or 3 weeks. As you look at these examples, which one of the following would not be a typical predictable production based on Spanish influence?

w/r substitutions (e.g. wing/ring)

papilloma

wart-like growths caused by HPV. they are pink, white, or both and may be found anywhere in the airway

list of fluent aphasias

wernicke's transcortical sensory aphasia (TSA) conduction aphasia anomic aphasia

line of regard

what the infant is looking at. important for the parent to follow

complex tone

when two or more single-frequency tones of different frequenices are combined. can be periodic or aperodic

content validity definition

whether the test items adequately sample the full range of the skill being measured

Acoustic characteristics of Fricatives

wide band of energy over a broad frequency range. Continuous sound so energy longer in duration, intensity depends on place of articulation in oral cavity, smaller front cavity will have higher freq, energy resonates strongest in front cavity, stridents have more energy voiced: period and aperiodic components

Free morphemes (base or root)

words that have meaning, cannot be broken down into smaller parts and can have other morphemes added to them. ex ocean, book, color

Side effects of Radiation in Head and Neck Cancer

xerostoma, soreness/tenderness with more effort and pain with swallow, chronic problems of reduced hyolaryngeal elevation and UES opening