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SPA 4476

Voice disorders & Fluency disorders

A voice disorder exists when a person's _____,_____, and ______ differ from those of similar age, gender, and cultural background QUALITY PITCH LOUDNESS
A voice disorder exists when either the _____, the ______ function or both the laryngeal mechanism no longer meet the requirements STRUCTURE FUNCTION
Quality breathy, high pitch voice, strain
Pitch too high or too low
Loudness volume
mechanism meet the voice demand
What is the role of the SLP? Evaluation of the laryngeal Identify the voice disorder Develop a therapy plan
Sound PHONATION is produced by the vibration of the vocal folds
Vocal folds PHONATION lie within the laryngeal cavity
Larynx PHONATION is the superior continuation of the respiratory passage
Airway protection prevents foreign substances
Nonbiological function larynx voice production (can produce sound without the vocal folds)
Biological function of the larynx prevent certain substances into the lungs vocal folds close when we swallowing coughing closing off the airway to create a pressure
Laryngeal Elements 1 bone 9 cartilages (3 pairs) Intrinsic and extrinsic laryngeal muscles
Voice Elements Pitch-fo Loudness-amplitude Quality-harsh, breathy, hypernasal, hyponasal
Larynx Lies superior in the respiratory passage way opposite approximately the 5th or 6th cervical vertebral body
Cartilages of the larynx are held together by ______ and ________ MEMBRANES LIGAMENTS
Organic Systemic disease physical cause cancer, tuberculosis, papilloma
Neurogenic damage to the central or peripheral nervous system or both innervates the larynx vocal folds not moving properly
Functional voice disorders that occur from behaviors the way we use our voice (voice demand) sick(cough) clear your throat can't control in the environment poor vocal folds vibration from misuse or abuse boy going through maturity
Organic Physical cause example web-band of tissue fuses b/w both vocal folds it could be congenital or acquired
Neurogenic Physical cause example Paralysis lack of the vocal folds could be unilateral or bilateral
Functional Physical cause example raising their voice Oscar the grouch
Organic Voice Problems can affect how the vocal folds vibrate reduced vocal loudness short phrases (asthma)
Lung important for _______ and ____ ______ assessment= info about the contribution of the respiration and the larynx respiration arrow dynamic method
Lower and upper airway causes...... change and reaction to the larynx
Impairment in Phonation Visualizing
neurogenic voice problems caused within the peripheral and central nervous system
spinal cord injury, brainstem injury, cerebral palsy, CNS disease has a hard time with..... respiration
Most common voice problem unilateral paralysis one sided lack of innervation of the recurrent laryngeal nerve vagus nerve
lack of innervation cause a vocal fold paralysis
any interruption of the recurrent laryngeal nerve can cause a vocal fold paralysis
recurrent laryngeal nerve can regenerate... function connects through the vagus
Spasmodic dysphonia common neurologic voice problem voice strangled, great effort to push voice out over over-adducted pair of vocal folds; laryngeal stutter. Patient typically experiences normal voice when laughing or singing.
Spasmodic dysphonia Neurologic disorder spasms in the laryngeal squeeze their voice out; they push and struggle to speak. To evade this struggle they whisper, talk on inhalation, speak with a lower or higher pitched voice or their voice sounds squeeky.
Dysphonia any alteration in normal phonation
Laryngectomy Total removal of larynx
TEST 3 forms of communication 1. Electrolarynx (tool that goes on the throat) electromechanically shapes the oral cavity 2. Esophageal speech (burp speech) pulimary airflow you create the source supraglottic 3. TEP placed into the stoma becomes the speaking
What is Fluent Speech? "the consistent ability to move the speech production apparatus in an effortless, smooth, and rapid manner resulting in a continuous, uninterrupted forward flow of speech."
Stuttering "…characterized by involuntary repetitions of sounds and syllables, sound prolongations, and broken words [pauses]."
Forms of Stuttering 1. Developmental Stuttering 2. Neurogenic Stuttering 3. Cluttering
Developmental Stuttering Begins in preschool years. general trends regarding stuttering behaviors, reactions to stuttering, and conditions that seem to promote stuttering
Neurogenic Stuttering neurological disease or trauma; differs from developmental in many ways
Cluttering Characterized by rapid bursts of unintelligible speech A problem in speech rhythm and rate.
Monosyllabic whole-word repetitions he-he-he-he-he hit me
Sound repetitions b-b-b-ball
Syllable repetitions ba-ba-ba-ba-ba-baseball
Audible prolongations sssss-snow
Inaudible prolongations g----irl
Phase One The preschool years, ages 2-6 stuttering tends to be episodic, characterized by periods of stuttering interspersed with periods of relative fluency
Phase Two Early elementary years Stuttering has progressed. Disfluencies are chronic (habitual) without many periods of fluency.
Phase Three 8 years to young adulthood Stuttering in response to specific situations. Common situations include telephone use, strangers, speaking to groups, complex explanations.
Phase Four Now, stuttering advanced. Fearful anticipation of stuttering now apparent. Speaker fears certain sounds, words, situations.
Organic Theory Proposes a physical cause. Cerebral dominance theory has been the most common organic theory: Cerebral dominance theory: AKA "handedness theory"
Behavioral Theory Proposes stuttering behaviors as learned responses "Diagnosogenic" theory
Psychological Theory Stuttering as neurosis: Stuttering as a neurotic manifestation of unconscious needs and internal conflicts. Psychotherapy recommended to treat stuttering.
Differences nodules bilaterally
Unilaterally polyps unilaterally
Normal Disfluencies Revisions (He can't—he won't play baseball) are the dominant type at 3 years of age Normal adult disfluencies include: whole word repetitions, interjections (fillers, place-holders), phrase repetitions, sentence revisions
Therapy for Stuttering Fluency-shaping techniques Stuttering modification techniques
what happens when we are not fluent? whole word repetitions, (fillers, place-holders), phrase repetitions, sentence revisions
Created by: jnater