Speech Sound Disorders--Articulation and Phonology

additions

"buhlack" for "black" is an example of what kind of error

omission/deletion

"cu" for "cup" and "poon" for "spoon" are examples o what kind of errors

substitutions

"thing" for "sing" and "wabbit" for "rabbit" are examples of what kind of errors?

50%

22 month old children should be ___% intelligible

75%

37 month old children should be ___% intelligible

100%

47 month old children should be ___% intelligible.

85-100

A PCC of ____-_____ is considered mild

less than 50

A PCC of less than ____ is considered severe.

syllable-level error

A child says "tephone" for "telephone." This is an example of what kind of error

-Otoscopic inspection of the ear canal and tympanic membrane -pure-tone audiometry and -immittance testing to assess middle ear function

A hearing screening typically includes:

gender (higher incidence in males than females) pre and perinatal problems (ex: maternal stress or infections) family history persistent otitis media with effusion

Although there is no known cause of functional speech sound disorders, what are some examples of risk factors that are frequently reported?

Speech sound disorders

An umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segments--including phonotactic rules governing permissible speech sound sequences in a language.

-Developmental -Non-developmental/theoretically motivated (complexity, dynamic systems, systemic) -Client-specific -Degree of deviance and impact on intelligibility

Approaches for selecting initial therapy targets for children with articulation and/or phonological disorders include the following:

- impairments in body structure and function - co-morbid deficits or conditions - limitations in activity and participation - contextual factors - impact on quality of life

Consistent with the WHO ICF framework, a comprehensive assessment is conducted to identify and describe:

reading and writing

Difficulties with the speech processing system (listening, discriminating speech sounds, remembering speech sounds, producing speech sounds) can lead to speech production and phonological awareness difficulties. These difficulties can have a negative impact on the development of _____ and _____ skills.

collect and phonetically transcribe a speech sample, then count the total number of consonants in the sample and the total number of correct consonants use the formula: Correct consonants/total consonants x 100

How do you determine PCC?

sound-symbol correspondence

Knowing that letters have sounds and knowing the sounds for corresponding letters and letter combinations

cleft palate/other orofacial anomalies

Name a condition where a patient might have an organic speech/sound disorder as a result of a structural condition.

dysarthria

Name a speech sound disorder that is organic resulting from a motor/neurological disorder with a primary deficit in execution

apraxia

Name a speech sound disorder that is organic resulting from a motor/neurological disorder with a primary deficit in planning

hearing impairment

Name an example of an organic cause of a speech sound disorder resulting from a sensory/perceptual deficit.

print awareness

Recognizing that books have a front and back, recognizing that the direction of words is from left to right, and recognizing where words on the page start and stop

screening of individual speech sounds in single words and in connected speech screening of oral motor functioning orofacial examination to assess facial symmetry and identify possible structural bases for speech sound disorders informal assessment of language comprehension and production

Screening typically includes:

organic or functional

Speech sound disorders can be _____ or ____ in nature.

-How well the child imitates the sound in one or more contexts (isolation, syllable, word, phrase) -The level of cueing necessary to achieve the best production -Whether the sound is likely to be acquired without intervention -Which targets are appropriate for therapy

Stimulability testing helps determine:

prevalence

The ___ of speech sound disorders refers to the number of children who are living with speech problems in a given time period

incidence

The ___ of speech sound disorders refers to the number of new cases identified in a specified period

screening

The purpose of _____ is to identify individuals who require further speech-language assessment and/or referral to other professional services

articulation approaches

This approach to speech sound disorder treatment focuses on targeting each sound deviation and targets are often selected by the clinician when the child's errors are assumed to be motor based; the aim is correct production of the target sound(s)

phonological/language-based approaches

This approach to treatment is to target a group of sounds with similar error patters, although the actual treatment of exemplars of the error pattern may target individual sounds. They are often selected in effort to help the child internalize phonological rules and generalize these rules to other sounds within patterns (final consonant deletion, cluster reduction)

minimal oppositions

This is an example of what kind of approach? therapy targets "door" vs "sore" "pot" vs "spot" and "key" vs "tea"

maximal oppositions

This is an example of what kind of treatment approach? Therapy targets include "mall" vs "call" "pot" vs "got"

treatment of the empty set

This is an example of what kind of treatment approach? uses pairs of words containing two maximal opposing sounds that are unknown to the child ex: "row" vs "doe" or "ray" vs "day"

multiple oppositions

This is an example of what kind of treatment approach? uses pairs of words contrasting a child's error sounds with three or four strategically selected sounds that reflect both maximal classification and maximal distinction ex: "door" "four" and "store" to reduce backing of /d/ to /g/

false Language testing is INCLUDED in a comprehensive speech sound assessment because of the high incidence of co-occurring language problems in children with speech sound disorders

True or false: Language testing is excluded in comprehensive speech sound assessments because there is a relatively low incidence of co-occurring language problems in children with speech sound disorders

True

True or false: Poor speech sound production in kindergarten children have been associated with lower literacy outcomes.

true

True or false: Dialectal variations of a language may cross all linguistic parameters including phonology, morphology, syntax, semantics and pragmatics.

true

True or false: Speech sound disorders are more prevalent in boys than in girls

misproduction detection task

Using computer-presented picture stimuli and recorded stimulus names (either correct or with a single phoneme error) the child is asked to detect mispronunciations by pointing to a green tick for "correct" or a red cross for "incorrect"

reading decoding

Using sound-symbol knowledge to segment and blend sounds in grade-level words

speech production--perception task

Using sounds that the child is suspected of having difficulty perceiving, picture targets containing these sounds are used as visual cues. The child is asked to judge whether the speaker says the items correctly (e.g. picture of a ship is shown; speaker says "ship" or "sip")

lexical decision/judgement task

Using target pictures and single-word recordings, this task assesses the child's ability to identify words that are produced correctly or incorrectly. A picture of the target word (e.g., "lake") is shown, along with a recorded word either "lake" or a word with a contrasting phoneme (e.g., "wake). The child points to the picture of the target word if it was produced correctly or to an "X" if it was produced incorrectly.

-Family's concerns about the child's speech -History of middle ear infections -Family history of S/L difficulties including reading and writing -Languages used in the home -Primary language spoken by the child -Family's and other communication partners' perceptions of intelligibility and -The teacher's perception of the child's intelligibility in the school setting and how the child's speech compares with that of peers in the classroom

What are some examples of information that should be gathered during the case history portion of a speech sound disorder assessment

Case history oral mech exam hearing screening speech sound assessment (single word testing and connected speech sampling) (uses both standardized assessment instruments and other sampling procedures to evaluate production in single words and connected speech)

What are the components of a speech sound disorder assessment?

minimal oppostions, maximal oppositions, treatment of the empty set and multiple oppositions

What are the four different phonological contrast approaches?

vertical horizontal cyclical

What are the three "target attack" strategies used for treatment of speech sound disorders

articulation (motor aspects) phonology (linguistic aspects)

What are two examples of functional speech sound disorders?

-Dental occlusion and specific tooth deviations -Structure of hard and soft palate (clefts, fistulas, bifid uvula) and -Function (strength and range of motion) of the lips, jaw, tongue and velum

What information should be gathered during an oral mech exam?

quantitative approach

What kind of approach uses the percentage of consonants correct (PCC) to determine the severity on a continuum from mild to severe?

spelling

When ____, children have to be able to segment a spoken word into individual sounds and then choose the correct code to represent these sounds.

reading

When ____, children have to be able to segment a written word into individual sounds, based on their knowledge of the code and then blend those sounds together to form a word.

-Gather information including language history and language use to determine which language(s) should be assessed, phonemic inventory, phonological structure, and syllable structure on the non-English language and dialect of the individual -Assess phonological skills in both languages in single words as well as in connected speech -Account for dialectal differences when present and -Identify and assess the child's common substitution patters (those seen in typically developing children), uncommon substitution patterns (those often seen in individuals with a speech sound disorder) and cross-liguistic effects (the phonological system of one's native language influencing the production of sounds in English, resulting in an accent--that is, phonetic trials from a person's original language (L1) that are carried over to a second language (L2)

When assessing a bilingual or multilingual individual, clinicians typically:

syllable-level errors

When weak syllables are deleted these are called ____ errors

single-word testing

Which speech sound assessment is being described? provides identifiable units of production and allows most consonants in the language to be elicited in a number of phonetic contexts; however, it may or may not accurately reflect production of the same sounds in connected speech.

connected speech sampling

Which speech sound assessment is being described? provides information about production of sounds in connected speech using a variety of talking tasks (e.g., storytelling or retelling, describing pictures, normal conversation about a topic of interest) and with a variety of communication partners (e.g., peers, siblings, parents, and clinician).

non-developmental/theoretically motivated

Which target selection is being described? Complexity—focuses on more complex, linguistically marked phonological elements not in the child's phonological system to encourage cascading, generalized learning of sounds (Gierut, 2007; Storkel, 2018). Dynamic systems—focuses on teaching and stabilizing simple target phonemes that do not introduce new feature contrasts in the child's phonological system to assist in the acquisition of target sounds and more complex targets and features (Rvachew & Bernhardt, 2010). Systemic—focuses on the function of the sound in the child's phonological organization to achieve maximum phonological reorganization with the least amount of intervention. Target selection is based on a distance metric. Targets can be maximally distinct from the child's error in terms of place, voice, and manner and can also be maximally different in terms of manner, place of production, and voicing (Williams, 2003b)

client-specific

Which target selection is being described? selects targets based on factors such as relevance to the child and his or her family (e.g., sounds in the child's name), stimulability, and/or visibility when produced (e.g., /f/ vs /k/).

degree of deviance and impact on intelligibility

Which target selection is being described? selects targets on the basis of errors (e.g., errors of omission; error patterns such as initial consonant deletion) that most effect intelligibility

developmental

Which target selection is being described? target sounds are selected on the basis of order of acquisition in typically developing children

dialect

___ is a rule-governed language system that reflects the regional and social background of its speakers

vertical

___ is intense practice on one or two targets until the child reaches a specific criterion level (usually conversational level) before proceeding to the next target or targets

accent

___ is the unique way that speech is produced by a group of people speaking the same language and is a natural part of spoken language.

distortions

____ errors are when sounds are altered or changed

picture identification

____ is a speech perception testing where the child is shown two to four pictures representing words with minimal phonetic differences. The clinician says one of these words, and the child is asked to point to the correct picture

phonological retrieval

____ is the ability to retrieve phonological information from long-term memory. It is typically assessed using rapid naming tasks (rapid naming of colors, objects, letters or numbers). This ability to retrieve the phonological information of one's language is integral to phonological awareness.

substitutions

____ one or more sounds are substituted, which may result in loss of phonemic contrast

omissions/deletions

_____ are certain sounds that are omitted or deleted

intelligibility

_____ is a perceptual judgement that is based on how much of the child's spontaneous speech the listener understands. It can vary along a continuum ranging from completely understood to message is not understood. It is frequently used when judging the severity of the child's speech problem and can be used to determine the need for intervention

auditory discrimination

_____ is a speech perception task where syllable pairs containing a single phoneme contrast are presented, and the child is instructed to say "same" if the paired items sound the same and "different" if they sound different

phonological processing

_____ is the use of the sounds of one's language to process spoken and written language.

articulation disorders

______ disorders focus on errors such as distortions and substitutions in production of individual speech sounds

phonological disorders

______ disorders focus on predictable, rule-based errors including fronting, stopping, and final consonant deletion that affect more than one sound.

speech perception

______ is the ability to perceive differences between speech sounds.

phonological awareness

______ is the awareness of the sound structure of a language and the ability to consciously analyze and manipulate this structure via a range of tasks, such as sound segmentation, and blending at the word, onset-rime, syllable, and phonemic levels

functional speech sound disorders

______ speech sound disorders are idiopathic--they have no known cause.

Organic speech sound disorders

_______ speech sound disorders result from an underlying motor/neurological, structural, or sensory/perceptual cause.

phonological working memory

_____involves storing phoneme information in temporary, short-term memory store. This phonemic information is then readily available for manipulation during phonological awareness tasks.

stimulability

____is the child's ability to accurately imitate a misarticulated sound when the clinician provides a model.

additions

____one or more extra sounds are added or inserted into a word

cyclical

___incorporating elements of both horizontal and vertical structures; the child is provided with practice on a given target or targets for a predetermined period of time.

horizontal

___less intense practice on a few targets; multiple targets are addressed individually or interactively in the same session, thus providing exposure to more aspects of the sounds system

distortion

a lateral /s/ is an example of what kind of error?

alphabet knowledge

including naming/printing alphabet letters from A to Z

reading fluency

reading smoothly without frequent or significant pausing

reading comprehension

understanding grade-level text, including the ability to make inferences

spelling

using sound-symbol knowledge to segment and blend sounds in grade-level words