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PhonDis SLP610

English phonotactics 3-consonant clusters at beginning of word start with /s/. No nasal onsets. No /h/ or glide codas.
Suprasegmentals Mechanisms superimposed on the verbal signal to change the form and meaning of the sentence by acting across the elements or segments of that sentence.
Prosody intonation/rhythm; lexical stress (correctly placing primary stress within multi syllable words); contrastive stress (placing vocal emphasis on important or new information within sentences to facilitate listener comprehension. )
Paralinguistics emotion, voice registers, pitch, volume, rate
suprasegmental treatment populations foreign accent reduction (Asian languages - lengthen vowels); dialect coaching (acting); ASD
Functional/developmental etiology Appearing in childhood with unknown cause, often improves with development. Can be the result of particular compensatory behaviors a person is doing, or a reaction to some traumatic event. (e.g., Arctic, CAS, phon. dis.)
Organic etiology Known medical cause from within the body: Congenital or Acquired
Congenital from birth. (e.g., CP – neurological motor disorder caused by perinatal anoxia)
Acquired after birth (18yrs?).
Articulation disorder Distortions and/or isolated substitutions. ~5 or fewer sounds. Intelligible. Low risk for language development and academic problems.
Phonological Disorders Omissions and substitutions. Multiple sounds/classes affected. Poor intelligibility. Problems in language and reading. Educational and occupational disadvantages in adulthood.
Factors in developmental articulation/phonological disorders a) oral-structural anomalies; b) otitis media; and c) environmental and psychosocial factors
Artic/phon. factors: Oral-structural anomalies Ankyloglossia (tong-tied), Tongue-thrust (reverse swallow);
Ankyloglossia Difficulty raising tongue to the roof can lead to misarticulating, and swallowing difficulties. Mechanical or social limitations.Effortful speech/ (Frenotomy)
Tongue-thrust Protrusion through incisors (thumb sucking, pacifier use, and “mouth breathing” from allergies, tonsillitis, nasal congestion). Anterior sound production. Difficulty with /s/ & /z/. Open bite. (Behavioral/ myofunctional Tx. Tongue thrust appliances.)
Artic/phon. factors: Otitis media Recent data shows very small associations between otitis media with effusion and speech and language development.
Artic/phon. factors: Auditory discrimination Phon. dis. children have significantly poorer discrimination skills than TD peers.
Prognosis factors (excellent, good, fair, guarded). Hx of therapy, parental concern, cooperative nature, client/caregivers motivation, level of impairment.
Prelinguistic performance Reflexive crying and vegetative sounds (0-2m). Cooing and laughter (2-4 m). Vocal play (4-6 m). Canonical babbling (6+ m). Jargon.
Early linguistic performance First words: stable, consistent, adult-like form. Proto-words. More compr. than expr. CV and CVCV syllable shapes. Stops, nasals, glides. Bilabials and alveolars. Pre-vocalic positions. Prosodic variation.
Llow-output two-year old assessment One-way mirror. Pre-recorded sample. Extended play. Prompt early-developing phonemes and syllable shapes (moo, baa if paying with farm). Modeling, cueing, imitation. Probe comprehension and communicative intent. Use Dudsberry Test (SPAT-D III).
Phonetic inventory for children in the prelinguistic stages of development (e.g., jargon stage) to identify the phones and syllables shapes they are capable of producing.
Phonemic inventory constructed using real words, once the child is in the first 50 stage.
Standard assessment battery: Goals Help determine if a disorder exists and its severity. To confirm or disconfirm our provisional diagnostic hypothesis. To identify and prioritize our preliminary therapy goals.
Standard assessment battery: Case History Decisions on which tests to administer. Relevant birth and development history. Parent or client concerns.
Standard assessment battery: Interview Clarify any questions. Relevant details that were not included earlier. Begin building rapport with the client and caregivers.
Standard assessment battery: Articulation/phonological test Sample all consonants in the pre- and post-vocalic positions, sometimes medial. Standard scores compare performance to age-matched peers (mean of 100; SD of 15); Percentile i.e. allows for completion of an error analysis
Standard assessment battery: Stimulability Assesses ability to correct or improve production with models and cues. Informs future therapy. Assists with prognostic statements: less stimulable --> more therapy
Standard assessment battery: Oral-mechanism exam Rules out functional/structural deficits impacting speech and language.Helps with appropriate referrals before start of therapy.
Standard assessment battery: Speech sample/ intelligibility Naturalistic and contextualized speech. Assesses speech rate, intelligibility, receptive and expressive skills, voice, fluency and pragmatics, identifies patterns, incorporates stimulability, saves time and effort.
Standard assessment battery: Hearing screening rule out any possible hearing loss that may impact speech or language and to make appropriate referrals to an audiologist as needed.
Auditory discrimination testing to determine if the child perceives the difference between his/her error and the correct (target) phoneme; assess substitutions, omissions and distortions
Highly stimulable Tx start Rvachew position More rapid therapeutic success Keeps frustrations lower while trying to build client rapport
Less stimulable Tx start By targeting the less stimulable sound (if they are of the same class/manner) the more stimulable sound is more likely to spontaneously correct itself. It will take longer to address the less stimulable sound and it is not going to resolve on its own.
Intelligibility Ability to be understood depending on familiarity, context, # and types of errors. Percentage words identified in picture naming. Commercial intelligibility tests ( for hearing impaired or adult dysarthric speakers), The Beginner's Intelligibility Test (
Created by: ashea01