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80 Cards in this Set
- Front
- Back
Dysarthria
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Neuromotor speech disorder affecting one, various, or all parameters of speech production: respiration, phonation, resonance, articulation, and prosody. pg 361. motor speech disorder resulting from neurological damage. Has trouble with the act of speaking.
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Apraxia
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Motor programming disorder resulting from neurological damage, observed mostly in adult and older populations. there is childhood/dev apraxia. Reactions are inconsistent, as processing has gone awry. Good receptive lang, bad expressive. Trouble with volitional movement and finding the right word. There is no motor difficulty.
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Universal Precautions *
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Universally protecting you and your client from germs and diseases. Wipe tables, chairs, use non-latex gloves, to not get sick. protect surfaces, dispose of all materials properly
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Orofacial Assessment
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Biggest test to assess fluidity of movement. Diadochokynetic rate-PTK. bilabial, dental, velar.
skills are assessed with an exam observing the intactness of structures as well as fluid movement and stability over time |
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Gathering a Case History
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Need a detailed report on speech and language evaluation.
*written case history *reports written by other professionals *oral interviews of child's parents. If there is trouble getting this, email/mail it to parents for them to fill out. |
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articulation
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physical movements of the articulators and the motor skills involved in prod. of speech sounds.
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phonology
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system of rules underlying sound production and sound combinations in formation of words.
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articulation disorder vs phonological disorder
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artic=phonetic errors resulting in nonstandard speech sounds. Phonological errors result in a neutralization of sound contrast and a collapse in phonemic contrast that affect meaning.
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Phonological Awareness
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A child's underlying knowledge that words are created from sounds and sound combinations.
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Metalinguistics
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individuals ability to analyze, think about, and talk about language.
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Syllable Structure Processes
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*final consonant deletion
*cluster reduction *unstressed syllable deletion *reduplication *epenthiesis (insert letter to make a word easier) |
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Substitiution Processess
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*stopping
*liquid gliding *vocalization *depalatalization *velar fronting *deaffrication *stridency deletion |
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Assimilation Processess
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*labial assimilation
*velar assimilation *nasal assimilation *voicing assimilation |
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Class I Malocclusion
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Few individual teeth are misaligned
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Class II Malocclusion
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lower jaw is receded and upper jaw is protruded.
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Class III Malocclusion
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lower jaw is protruded and upper jaw is receded.
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ankyloglossia
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short lingual frenulum resulting in limited tongue movement.
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Velopharyngeal Inadequacy
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Difficulty in closing the VP port and inadequate pressure consonants such as fricatives, stops, and affricates.
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PP-Final Consonant Deletion
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/do/=dog final syllable or consonant is deleted.
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PP Initial Consonant Deletion
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/op/=soap a word or syllable initial consonant is deleted. watch for apraxia.
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PP Weak Syllable Deletion
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/naena/=bannanna an unstressed syllable is deleted
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PP Reduplication
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/wawa/=water an entire syllable is deleted
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PP Cluster Reduction
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Consonant is deleted from the cluster or blend
*/s/ cluser, /tor/=store *nasal cluster, /tet/=tent *liquid cluster, bu/=blue |
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PP Coalescence
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/fim/=swim two adjacent sounds combine at a new place of articulation
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PP Epenthesis
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/gerin/=green a schwa is inserted between the two consonants in a cluster.
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PP Metahesis
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/aeks/ =ask two sounds are reversed
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PP Assimilation
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One sound is influenced by another and becomes more similar or identical to it.
*/gog/=dog velar assimilation */naem/=lamb nasal assimilation */lElo/=yellow liquid assimilation */bebl/-table labial assimilation |
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*PP Depalatalization (Palatal Fronting)
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/su/-shoe palatals are replaced by alveolars (ts=s)
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PP Velar Fronting
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/do/-go velars are replaced by alveolars
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PP Backing
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/do/=go sounds are replaced by others further back in the mouth (non-developmental process, watch for dysarthria)
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PP Stopping
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/tsu/=shoe fricatives are replaced by stops or affricates
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PP Deaffrication
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/dumping/=jumping affricates are reduced to fricatives or stops
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PP Gliding of Liquids
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/wun/=run liquids are replaced by glides.
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PP Glottal Replacement
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/pe-I/=penny glottal stops are inserted for intervocalic consonants (non-developmental, issues w/craniofacial palate)
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PP Denasalization
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/spud/=spoon Nasals are replaced by...stops or anything (hyponasality, congestion, adenoids, sounds like a cold)
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PP Voicing
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/doy/=toy voiceless sounds become voiced.
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PP Devoicing
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/bik/=big voiced sounds become voiceless
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Minimal Place of articulation shifts
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Not Phonological Processess
*/fum/=thumb (f,v,s,z for th) *frontal lisp-shi=see *lateral lisp-thei=see *other tongue protrusions |
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Longitudinal vs Cross sectional studies
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longitudinal-single study of kid over a long period of time
Cross sectional-group study of a particular population |
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Phonological Processes
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Operations that change or delete phonological units.
-kids simplification of adult forms/words -they appear regardless of native language -used by all kids in early development (2-5 years old) -more thank one process can apply to a word |
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Whole Word Processes
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*final consonant deletion
*cluster reduction *unstressed syllable deletion *reduplication *assimilation |
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Segment Change Processes
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*Velar fronting
*Palatal fronting *Gliding *Stopping *Deaffrication *Voicing *Devoicing *Coalescence-new place of artic *Epenthesis-schwa added *Metathesis-two sounds reversed *Minimal place articulation shifts |
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Nondevelopmental Phonological Processes
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*Glottal replacement-glottal stop is inserted for an intervocalic consonant (dysarthric maybe...)
*Backing to velars-sounds are replaced by those further back in the mouth *Initial consonant deletion |
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Developmental Norms for Phonological Processes
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*Research studies suggest that most kids are intelligible by age 3
*Understood at least 1/2 the time *you can tell by age 5 if kids normal-whole classes of sounds are generally affected. |
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Phonological Processes Disappearing by 3 years
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*Unstressed syllable deletion
*FCD final consonant deletion *Assimilation/consonant harmony *Reduplication *Velar fronting (up to 4 years old) *Prevocalic voicing |
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Phonological Processes Disappearing by 6 years
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*Epenthesis
*Cluster reduction (gen. 5 years) *Gliding *Stopping/stridency deletion *Palatal fronting *Final devoicing *Deaffrication (generally 5) |
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Hearing as it Relates to Phonological Disorders
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*Hearing loss
*Speech sound perception *Structural variations *Oral sensory function |
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Hearing Loss Measures, Cause as it relates to PD
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*Hearing sensitivity is measured through pure tone audiometry and speech recognition tasks.
*Age of onset results in different articulation and phonological processess *Otitis media is the most common etiology affecting young kids May have conductive or sensorineural hearing loss resulting in artic problems, voice resonance, prosodic, language and literacy problems |
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Speech Sound Perception / Auditory Discrimination
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The skill to detect differences between words
*also involves phonological awareness which includes pre-literacy skills of rhyming, segmentation, isolation, decoding, and blending |
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Structural Variations Affecting Phonological Processes
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*lips
*teeth *tongue *hard and soft palate *nasopharynx |
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Oral Sensory Function
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*Oral tactile sensitivity (one vs two point discrimination)
*Oral form recognition (oral stereognosis) |
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Oral Myofunctional Disorders (Tongue Thrust)
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*excessive anterior tongue movement during speech, swallowing or at rest.
*Tongue thrust can be habitual or obligatory *Leads to malocclusion, altered facial development, reverse swallow and articulation problems |
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Childhood Apraxia of Speech
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These children tend to...
-have delayed or deviant articulation -present with increased language comprehension and decreased expression -have difficulty imitating and sequencing oral movements -to be more intelligible with single words than connected speech -have inconsistent sound errors, lack of cooing or babbling as infants -progress slowly and lack generalization -display other soft neurological signs such as generalized low muscle tone, fine and gross motor incoordination, drooling, lingual tremor, asymmetry of oral structures -reveal family history of s & l disorders |
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Cognitive Linguistic Factors of Phonological Processes
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-Learning disabilities (read/ spell /write)
-Intelligence (mental impairment) -Language development (autism, PDD, cognitive delays) |
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Psychosocial Factors of Phonological Processes
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-age
-sex -familial history -socioeconimic status -sibling influence |
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1st Step to Phonological Assessment
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Start with a case history
-demographic info -birth history -developmental milestones -medical hisory -family history -history of speech, language or hearing related services -present concerns and examples -impact on education/social relationships |
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2nd Step to Phonological Assessment
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Oral Facial Exam
-Always use universal precautions -inspect all structures (occlusions) -Assess fluidity of movement and diadochokinetic rates -refer to other professionals if needed -recommend pertinent oral exercises or cessation of oral habits-pacy, sippy, finger suck |
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3rd Step to Phonological Assessment
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Audiological Screening
-pure tone audiomentry -impedence or tympanometry -speech discrimination -referrals to ENT if necessary |
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4th Step to Phonological Assessment
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Language Assessment
-Assess receptive and expressive language skills either through a screening or in-depth testing |
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Screening
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brief check of skills that determines need for further testing (not diagnostic-informal)
-state name and address, count to 10, 20, 60-70, or name days of week, tell about TV show, read sentences, read passages |
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In Depth Testing
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Uses standardized meausres to determine amount of deviation from the norm. diagnostic. much more expensive, find age equivilancy and percentile rank.
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5th Step to Phonological Assessment
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Phonological Assessment
1. determine if sounds are deviant from the norm and warrant intervention 2. Determine goals and strategies to be used 3. make a prognostic statement relative to artic/phon change with or w/o intervention (aka, will therapy work, or surgery needed. Change occurs under what cond.) |
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Stimulability Testing *
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*Imitative productions after the examiner are elicited using isolated movements, isolated sounds, non sensical or sensical syllables, words, or sentences
Can child produce the errored sound in isolation? Where is the break down? Use voice, place, manner to start. |
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Purpose of Stimulability Testing
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1. Determine if a sound is likely to be acquired with or without intervention (kid is using in conversation, not a problem)
2. Determine the level of production from which to begin therapy |
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Formal Screening Measures of Phonological Processes
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-Quick screen of phonology
-Fluharty preschool speech and language test. most popular, miller loves, loyola uses, takes 7-10 min. -Preschool language scale 4. no pictures. *tests are expensive |
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Formal Standardized Measures of Articulation
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-Goldman Fristoe Test of Articulation (classic/most popular takes 15-30 minutes) test phoneme in initial, medial final positions of word. normed ages 2-9.
Structured photographic-dudly the dog pics. same as goldman. Arizona test is better for older kids bc there are better pics. Photo articulation test good for adults, because it's just pictures Secord Contextual Artic will only tell you motor processes-not phonological processes. |
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Formal Standardized Measures of Phonological Processes
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Khan Lewis-made to go with the goldman fristoe and tells you phonological errors.
Hodson's is a separate test. |
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Method of Recording Responses
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-omissions, substitutions, distortions, additions
-Narrow phonetic transcription *Be sure to sample words, sentences, and conversational speech because sound errors can increase and intelligibility can decrease with length and complexity of utterances |
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How to determine the need for intervention?
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*Which sounds are easy or hard to produce? (stimulability measures)
*What are age appropriate errors and which are deviant from the norm (see standard norms and developmental charts) |
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PCC
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percentage of consonants correct= # of correct consonants/# of correct+ incorrect consonants
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Severity Rating
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85-100% mild
65-85% mild/moderate 50-65% moderate/severe <50% Severe |
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Questions to ask about language & artic assessment
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*what's client's overall intelligibility?
*What phonological press or distinctive feature patterns are in error? *What is appropriate for the client's culture and dialect? *What are the social attitudes of the client and family *What other medical conditions may impact the treatment goals? |
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Cerebral Palsy
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Non progressive neuromotor disorder resulting from brain damage before, during, or shortly after birth. is congenital. functional movement may deteriorate. Maybe spastic (common increased muscle tone), athetoid (writhing), ataxic (balance prob), rigid (rigid muscles), or mixed. Symptoms are resonance prob, phonatory prob, respiratory prob, prosodic prob, or assosiated prob (slow jerky jaw mvmt, slow ddchokinetic rate)
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Cleft Lip and Palate
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kid has trouble with voiced sounds, weak intraoral pressure resulting in weak affric, fricat, and stops. Nasal resonance or pharyngeal inadequacy, nasal emissions, distortions, compensatory errors. pharyngeal inadequacy leads to hyper functionality of the voice. May need surgical intervention,
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After Assessment: Traditional Analysis
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-consider position which sounds are misarticulated (initial, med, final)
-the types of errors made |
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After Assessment: Pattern Analysis
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Voice, Place, Manner analysis-train classes of sounds of affected sound class.
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After Assessment: Distinctive Feature analysis
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refers to a unique characteristic that distinguishes one sound from all others (voice, nasal, posterior, anterior)
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After Assessment: Phonological Process analysis
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patterns found in children's misarticulations. sound production errors.
1. syllable structure 2. substitution 3. assimilation look at freq. and percent of occurrence. |
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Prognosis of Disordered Speech
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severity, age, motivation, inconsistency, associated conditions, treatment history, family support
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Final Step in Speech Language Diagnosis
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Final interview, diagnostic report.
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