HESP 202 Study GuideFinal Exam Language Disorders of Adults (Part 2, pages 152-157) You should know:- Risk factors of Aphasiao History of previous strokeo High blood pressureo Smokingo High cholesterol o Diabeteso Obesity - Prognostic signs for Aphasiao Ageo Severity of damageo General healtho Family supporto Etiology of damageo Educational level - General characteristics of and differences between:o Traumatic Brain Injury Most often young adults (males 18-25 most common) Car/motorcycle accidents most common cause Damage is more generalized Not really aphasia, patients do well on aphasia testing Primarily cognitive-linguistic deficits - Attention - Memory/word finding problems- Learning difficulties (especially new info)- Decreased inhibition, poor pragmatic skills (frontal lobe)- Decreased organizational skills (frontal lobe)- Decreased ability to plan and execute actions- Decreased problem solving Recovery - Go through stages that are relatively predictable- Need ongoing evaluation and treatment- Often going from comatose to re-entry into community- Often may have swallowing and/or speech problems as well as cognitive-linguistic oneso Right Hemisphere Disorders More difficult to detect Include some cognitive-linguistic problems- Memory- Orientation- Awareness of deficits Visual neglect- usually unilateral- Problems reading- Problems using any visual materials Visual disturbances- Poor visual perception Language is often confused, tangential, irrelevant due to poor organization MANY pragmatic problems  Assessment/Treatment- Has its own set of tests since aphasia tests aren’t good at seeing the deficits- Need to look at visual, attention, neglect, memory, and organizational skills- Teaching pragmatics, facial expression, initiation of communication- Like aphasia, progress depends on the amount of damageo Dementia  Progressive, irreversible, generalized damage in all cognitive abilities including language Most common type: Alzheimer’s Earliest symptoms are memory loss and word finding problems End stage patients may use stereotypical responses or be mute Usually also have swallowing problems Treatment- Early- may provide memory strategies or orientation information (memory books)- Counseling families about how best to communicate with family member- Evaluate swallowing to determine safety for eating or most appropriate diet- May need to make recommendations regarding tube feedingAnatomy and Physiology of Speech Production (Chapter 2, pages 27-41)You should know:- The four processes of speech production o Respiration- breathingo Phonation- producing voiceo Resonance- shaping and refining voice soundso Articulation- making sounds into speech - The anatomy and physiology related to the four processes of speech production- Be able to identify disorders of each of the processeso Disorders of respiration Decreased amount of air held in lungs - Emphysema, aging Poor coordination of breath control and speech production, usually neurological etiology - ALS, Parkinson’s Disease o Disorders of phonation Abuse or misuse- Damage to vocal cords Cancer- Removal of vocal cords Stroke, head injury, neurological etiology- Damage to nerves which control vocal cordso Disorders of resonance Damage to brain or nerves that control velum Opening between the oral and nasal cavities (cleft palate) Hearing impairmento Disorders of articulation Physical- damage to brain or nerves that control articulators- Stroke, head injury, cerebral palsy Hearing impairment Behavioral- developmental delays, faulty learningNormal Speech Sound Development Articulation and Phonological Disorders (Chapter 3)You should know:- The 3 characteristics that are used to describe consonants o Place of articulationo Manner of articulationo Voicing - Why do you need to know these- Understand the concept of the progression of speech sound developmento Children learn sounds in a fairly predictable ordero Single sounds are learned firsto Blends and combinations learned latero At least partially dependent on fine motor developmento Girls tend to have better articulation earlier than boys - Understand the Speech Sound Development Chart- What is articulation and articulation disorders and what are the possible etiologieso Articulation: one of the processes of SPEECH (the physical production of speech sounds)o Articulation disorders: problems with the actual production of SPEECH soundso Etiologies: Organic- a structural problem of physical reason Functional- no identifiable cause, faulty learning - What are phonological disorders and why are they different from articulation disorderso Phonology Apart of LANGUAGE DEVELOPMENT Part of LANGUAGE that involves RULES and PATTERNS for the use of soundso Phonological disorders Involve children not learning the RULES or PATTERNS of sound use- How do you evaluate a child for these 2 disorders- An example of a goal for a phonological disorder vs. a goal for an articulation disorderoo- Why do we care?- Differences in therapy approachesVoice Disorders: (only from PowerPoint slides posted in CANVAS)You should know:- 4 measures of voiceo Pitcho Loudnesso Qualityo Resonance - Possible etiologies and a disorder that goes with each oneo Organic voice disorderso Neurological voice disorderso Functional disorders- Terms related to voice- Voice evaluationo First step= medical examo SLP’s role Case history Perceptual evaluation (listening) Instrumental measurements Establish therapeutic plan- Treatmento Surgeryo Behavioral voice therapyo Medicineo Psychological counseling- Intervention goalso Restore healthy vocal fold tissueo Regain full vocal functiono Eliminate abusive habitso Improve vocal hygiene Fluency Disorders (Chapter 10 – most questions will come from PowerPoint slides)You should know:- ABC’s of stuttering, definitions and exampleso Affective  Feelings, emotions, attitudeso Behavioral Speech, non-speecho Cognitive  Personal strategies, beliefs- Developmental Dysfluencyo Normal for children as they develop speech and languageo Makes diagnosis of stuttering in children more difficulto Spontaneous recovery rate ~80%o Factors influencing spontaneous recovery: Duration of symptoms (<12-18 months) Gender Age of onset Language profile Family history o Severity of stuttering or child’s awareness do not predict recovery, but may influence decision to treat