SLHS 1150: EXAM 1
219 Cards in this Set
| Front | Back |
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What is this course about?
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Communication, how we do it, and what it looks like when it goes wrong
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What are the three models for this class?
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Medical Model, WHO-IFC Disability Model, and the Model for Communication
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What is the Medical Model
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Someone with a problem seeks assessment, diagnosis, and treatment from a professional
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Why is the Medical Model important?
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It is the more prevalent model used today
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What is the WHO-IFC Model?
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A model to describe the process of disability for a person within their environment
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Why is the WHO-IFC Model important?
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Provides helpful definitions for terms associated with disability
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What is the Model for Communication?
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Sender (formulation/transmission) --> Message (spoken, sign, written) --> Receiver (reception, comprehension)-->feedback-->
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Why is the Model for Communication important?
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Provides a framework for how we see communication disorders. Knocking out one will yield some form of disordered communication
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What three things contributed to the creation of "Speech Therapy"?
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1. Rise of scientific method
2. Rise of "professionals" as a career path
3. Rise of elocution
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What four things make up speech?
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1. Breath
2. Articulation
3. Voice
4. Fluency
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What five things make up language?
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1. Phonology
2. Morphology
3. Syntax
4. Semantics
5. Pragmatics
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What are phonemes?
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The sounds of a language
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What are morphemes?
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The conjugation/organization of sounds within a word
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What is syntax?
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The organization of words within a sentence
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What is semantics?
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Basic meaning of a message
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What is pragmatics?
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Underlying meaning of a message
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What is speech?
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The act of communicating language via verbal means (words formed by coordination of lips, vocal cords, tongue, etc.)
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What is language?
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A system of communication defined by rules shared between two people
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What is a communication disorder?
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A significant difficulty in the ability to formulate, transmit, or comprehend a message when both parties share the same language, dialect, and culture
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What is prevalence?
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The extent a disease/disorder exists in a population at a given time (x people in U.S. have y)
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What six things can affect prevalence?
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1. population growth
2. aging population
3. early identification
4. increased scope of practice
5. increased visibility/awareness
6. increased survival of at-risk babies
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What is incidence?
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The rate of occurrences of new cases (x out of every y are born z)
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Why are baby boomers relevant?
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70 million new old people. The older they get, the more problems they'll have
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What are Speech Language Pathologists?
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Professionals involved in prevention, diagnosis, and treatment of hearing and balance disorders
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Where do most Speech Language Pathologists work?
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Elementary school settings
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What is entry level for Speech Language Pathologists?
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Masters, 400 hours of clinical experience, 9 months of clinical fellowship
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What is an Audiologist?
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Professionals involved in prevention, diagnosis, and treatment of speech, language, and swallowing disorders
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Where do most Audiologists work?
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Non-residential health-care, independent from hospital settings
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What is entry level for Audiologists?
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AuD or PhD, 1820 hours of clinical experience, 12 months of clinical practicum
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What is licensure?
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Legal requirements to practice that varies by state
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What is certification?
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Nationally recognized professional credential that represents a level of excellence
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What is assessment?
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Systematic process of gathering information about an individual
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What are four reasons we do assessments in CDIS?
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1. identify skills in an area of communication a person lacks
2. guide design of intervention
3. monitor a person's communicative growth over time
4. qualify a person for special servies
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What are three caveats/warnings to assessment tools?
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1. Culture and value dependent
2. Change over time
3. Not necessarily based on good thinking
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What is sensitivity?
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A measurement of how well something can catch a disease/disorder
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What is specificity?
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A measurement of how well something can rule out a disease/disorder
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Result: Positive
Disease: Present
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True Positive
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Result: Negative
Disease: Present
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False Negative
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Result: Positive
Disease: Negative
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False Positive
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Result: Negative
Disease: Negative
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True Negative
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What is the process of assessment?
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1. Screening and referral
2. Designing administering assessment
3. Interpret findings
4. Develop intervention plan
5. Monitor progress and outcomes
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What is screening?
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A quick check on performance. Pass or refer
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What are three pros of screening?
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1. Inexpensive
2. Easily administered
3. Weeds out people who need additional testing
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What are two types of chart review/interview/case history?
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1. IFSP (Individualized Family Service Plan, for kids up to 3 years old)
2. IEP (Individualized Education Plan , for 3+)
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What is the pro to chart review/interview/case history?
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Good for huge problems
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What is the con to chart review/interview/case history?
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Bad for subtle problems
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What is instrumentation?
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Use of machines to diagnose someone
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What are the two kinds of instrumentation?
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1. Online (real-time)
2. Offline (measure after)
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What is static assessment?
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Focuses on the skills and knowledge the individual has gained from experience
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What is dynamic assessment?
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Highlights the things a person can do and their ability to acquire new skills and knowledge
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What three things make up Evidence Based Practice?
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1. Clinical expertise and opinion
2. Client/patient/caregiver perspectives
3. External scientific evidence
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What five steps make up Evidence Based Practice?
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1. Pose a clinically answerable question
2. Search for some evidence (best is peer reviewed and double blind)
3. Appraise the evidence for relevance
4. Make a decision integrating science, expertise, and patient values
5. Evaluate performance based on that evidence
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What is an intervention?
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The step after assessment. The implementation of a plan of action to improve one or more aspects of an indivdudal's communication abilities
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What are the three key words to intervention?
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1. Effective
2. Efficient
3. Feasible
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What are the three types of intervention?
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1. Prevention (disorder doesn't exist yet)
2. Remediation (disorder exists and this may fix it)
3. Compensation (disorder exists, can't be fixed but helped)
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What are three types of goals?
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1. Long-term
2. Short-term
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What are the three Models of Intervention?
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1. Pull out/direct service
2. Co-teaching
3. Intervention consultation
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What are the four schools of thought for intervention?
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1. Behaviorist Approach
2. Linguistic-Cognitive Approach
3. Socio-Interactionist Approach
4. Family Centered Approach
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What is the Behaviorist Approach?
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-B.F. Skinner and operant conditioning
-reinforce desired behavior
-extinguish non-desired
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What is the Linguistic-Cognitive Approach?
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-Noam Chomsky and Jean Piaget
-individual stalled at a language development stage
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What are the three rules to the Linguistic-Cognitive Approach?
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1. Goals must stem from research of normal communication
2. Goals focus on helping the individual learn rules
3. Learner must be fully engaged
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What is the Socio-Interactionist Approach?
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-Lev Vygotsky
-scaffolding the zone of proximal development
-what I can do -> what I can do with help -> what I can do without help
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What is the Family Centered Approach?
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-emphasis on family participation
-honors the family's values and beliefs
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What is acoustics?
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The study of mechanical waves in the air, sound, and water
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What is sound?
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Vibratory energy transmitted by pressure waves through a medium
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What are the three physical properties of sound?
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1. Frequency
2. Intensity
3. Duration
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What are the three psychological perceptions of sound?
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1. Pitch
2. Loudness
3. Time
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What is frequency?
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How often there are repetitions of compression and rarefactions. Wave forms over time
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What is amplitude?
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The magnitude/strength of a sound (intensity)
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What is period?
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How long it takes for the cycle to repeat
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What is constructive interference?
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Waves line up and multiply the sound
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What is destructive interference?
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Waves are out of phase and produce no sound
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What are simple sounds?
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One wave exhibited periodically
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What are complex sounds?
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Multiple waves that may or may not occur periodically
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What three things does neuroscience help us better do?
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1. Better understand and identify neurological causes of communication disorders
2. Recognize signs and symptoms associated with specific neurological problems
3. Find solutions to neurological problems resulting in improved clinical intervention
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Anterior
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Front (humans)
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Posterior
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Back (humans)
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Ventral
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Front (animals)
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Dorsal
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Back (animals)
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Proximal
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Close to the core
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Distal
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Far from the core
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Superior
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Top
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Inferior
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Inferior
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Medial
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Towards the body
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Lateral
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Away from the body
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What are the structures of the Central Nervous System?
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1. Brain
2. Brain stem
3. Spinal Cord
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What are the structures of the Peripheral Nervous System?
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1. 12 cranial nerves
2. spinal nerves
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What are the three important areas for speech, language, and hearing?
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1. Broca's Area
2. Wernicke's Area
3. Heschl's Gyrus
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Where is Broca's Area located?
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Left frontal lobe
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What is the purpose of Broca's Area?
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Process written language, speech comprehension, and speech output
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What occurs when Broca's Area is damaged?
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Person can hear and understand but not talk
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Where is Wernicke's Area located?
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Left temporal lobe
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What is the purpose of Wernicke's Area?
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To understand spoken and written language
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What occurs when Wernicke's Area is damaged?
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Person can talk but without meaning
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Where is Heschl's Gyrus located?
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Left temporal lobe
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What is the purpose of Heschl's Gyrus?
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Analysis of speech and sound. Where your ear sends information to your brain
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What occurs when Heschl's Gyris is damaged?
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Central deafness
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What are the six organizational principles of the brain?
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1. Interconnectedness
2. Hierarchy
3. Specialization
4. Plasticity
5. Critical period
6. Contralaterality
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What is interconnectedness?
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Everything in the brain is connected via neurons
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What is hierarchy in the brain?
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Organization in levels. Complexity determines location.
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What is specialization in the brain?
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Nerve cels in specific brain areas are specialized to process different kinds of information
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What is plasticity in the brain and what are the three types?
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The capacity to reorganize based on experience.
1. Developmental - sensory experience from the environment
2. Learning - result of instruction
3. Injury-Induced - reorganization and rehabilitation
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What is the critical period in the brain?
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A period of time in the brain of rapid growth
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What is contralateralization in the brain?
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Each hemisphere of the brain responds to sensory stimulation from the opposite side of the body. This cross occurs in the brain stem
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Issues with the Nervous System result in _____ disorders
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Motor speech
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Issues with the Respiratory System result in _____ disorders
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Breath
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Issues with the Phonatory System result in _____ disorders
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Voice
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Issues with the Articulatory System result in _____ disorders
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Articulation
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What two things make up the Nervous System?
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1. Central Nervous System
2. Peripheral Nervous Sysyem
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What is the role of the CNS?
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Controls and regulates almost all motor sensory, and cognitive processes.
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What three things make up the CNS?
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1. Brain
2. Brain stem
3. Spinal cord
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What is the role of the PNS?
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Carries messages to and from the CNS, both voluntary and involuntary
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What two things make up the PNS?
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1. 12 cranial nerves
2. Spinal nerves
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What are the two branches of the Respiratory System?
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1. Upper
2. Lower
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What four things make up the Upper Branch Respiratory System?
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1. Trachea
2. Larynx
3. Oral cavities
4. Nasal cavities
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What three things make up the Lower Branch Respiratory System?
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1. Lungs
2. Bronchi
3. Alveoli
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What is the purpose of the Respiratory System?
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To provide oxygen and exchange with carbon dioxide
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What are the two types of breathing?
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1. Passive: reflexive, 40:60
2. Speech: voluntary 10:90
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What three things make up the Phonatory System?
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1. Pharynx
2. Larynx
3. Trachea
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What three things make up the pharynx?
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1. Nasopharynx
2. Oropharynx
3. Larngopharynx
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What makes up the larynx?
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Vocal cords
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What is adduction of the vocal cords?
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Vocal cords come together
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What is abduction of the vocal cords?
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Vocal cords separate
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What makes up the trachea?
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Windpipe
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What is the purpose of the Phonatory System?
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To convert airflow/energy into sound and provide a resonating chamber for air flow
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What four things make up the Resonatory System?
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1. Nasal cavity
2. Oral cavity
3. Laryngeal cavity
4. Velopharengeal port
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What is the velopharengeal port?
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Decides if air leaves via the mouth or nose
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What is the purpose of the Resonatory System?
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Modification of airflow from the pharynx into the oral and nasal cavities
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What is the purpose of the Articulatory System?
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Manipulates/shapes airflow from the phonatory system into precise speech sounds
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What are the 8 articulators?
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1. Maxilla
2. Mandible
3. Alveolar ridge
4. Hard palate
5. Soft palate
6. Teeth
7. Tongue
8. Lips
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What are the three important aspects to speech?
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1. Place: any point two articulators meet (where)
2. Manner: how the air leaves (continuants vs stops)
3. Voice: whether or not the vocal folds vibrate
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What are the two ways to describe phonemes?
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1. Vowels: the power of the word, voiced
2. Consonants: the information, constricted airflow
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What is communicative competency?
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The knowledge and awareness that speakers of a language have to communicate effectively
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What is co-articulation?
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Overlapping of motor commands and movements. Influence of one sound on another during connected speech
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What four things that make up linguistic competence?
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1. phonological communicative competence
2. grammatical
3. lexical
4. discourse
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What four things make up pragmatic competence?
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1. Functional communicative competence
2. Sociolinguistics (communication with friends positively)
3. Interactional (behavior changes depending on who)
4. Cultural (change based on the culture)
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What are the five Stark Stages of Vocal Development?
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1. Reflexive (0 - 2 months)
2. Control of phonation (1 - 4 months)
3. Expansion (3 - 8 months)
4. Canonical syllables (5 - 10 months)
5. Advanced forms (9 - 18 months)
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What are the three parts to infancy?
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1. Joint attention
2. Intentional communication
3. First word
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What is joint attention?
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The baby can focus on the speaker and the object they're referring to
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What is intentional communication?
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Infant tries to communicate. Parents are not putting a message where one isn't
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What three things are important for first words?
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1. Clear intention
2. Close to recognizable
3. Object, not a name for a person
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What are the five parts to toddlerhood?
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1. Mean length utterances
2. Phonological processes
3. Vocabulary
4. Under-extension
5. Over-extension
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What is Mean Length Utterances?
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The average number of morphemes in what a child says
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What are the seven parts to phonological processes in toddlerhood?
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1. Final consonant deletion
2. Reduplication
3. Weak syllable deletion
4. Consonant harmony
5. Diminutization
6. Cluster reduction
7. Liquid gliding
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What is the state of vocabulary during toddlerhood?
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Spurt at 18-24 months with 7-9 new words per day
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What is under-extension?
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Cautious labeling
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What is over-extension?
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Overgeneralization of new words
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What are the three important parts to pre-school and school?
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1. Form: increase morphemes, complex sentences
2. Content: increase vocab
3. Use: taking turns, abstract thought
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What is a speech disorder?
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The inability to produce sounds correctly/fluently
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What is an articulation disorder?
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The child does not have the ability to make the sound and is consistently absent
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What is a phonological disorder?
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The sound is in their system but not always present
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What is the Goldman Fristoe?
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An easel-style book with 43 picture places that focus on 51 words and 61 consonant words. Easy way to administer but hard to score in real time. Tests articulation but not phonological disorders
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What are three ways to treat articulation disorders?
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1. Drilling
2. Oral Motor Method
3. Traditional
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What is drilling?
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Professionals guide the client towards the expected behavior.
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What is the pro to drilling?
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Fastest route to behavior modification
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What is the con to drilling?
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Not interesting for the client/student
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What is the Oral Motor Method?
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The goal of improving physical speaking abilities but has little to no evidence/support
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What are the four steps to the traditional method?
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1. Identify the sound
2. Vary and correct the atypical production
3. Strengthen and stabilize the sound in different contexts (beginning, middle, end)
4. Long-term goals
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What is Wendell Johnson's monster study?
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Involved the modification of 22 kinds in an orphanage. One group was talked down to when they spoke incorrectly, resulting in all having stuttering issues
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What is fluency?
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Speech with appropriate rate and rhythm. Must be smooth, effortless, and automatic
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What is disfluency?
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Any pause, interjection, or revision in your speech that is unplanned
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What are the four primary features of a fluency disorder?
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1. Monosyllabic whole-word repetitions (but-but-but)
2. Part word repetitions
3. Sound prolongations (stuck on a sound)
4. Blocks (stop mid-word)
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What are the four secondary features of a fluency disorder?
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1. lip tremor
2. tensing
3. eye blinking
4. negative feelings
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What are the five parts to assessing fluency disorders?
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1. Referral
2. Case History/Interview
3. Speech Observation
4. Questionnaire
5. Speech Testing
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What four warning signs call for a referral for a fluency disorder?
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1. Repetition of parts of words
2. More than 3 repetitions of a single speech unit
3. Prolongation of sounds
4. Frustration/embarrassment
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What does speech observation involve in terms of fluency disorders?
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Fluency charting grid and the number of disfluencies per 100 words
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What are the two questionnaires regarding assessing fluency disorders?
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HRQL and OASES
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What are the two types of treatment for fluency disorders?
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1. Wait and See: 75% of stuttering resolved itself
2. Environmental Modification
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What five things are part of the environmental modification?
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1. Family centered
2. Avoid putting the child on the spot with attention
3. Show you are listening to the child
4. Both question and comment on what the child says
5. Destress the home environment
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What makes a voice normal versus disordered?
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When the vocal cords are working symmetrically, voice is pleasant, clear, and unremarkable
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What three things impact symmetricalness of the vocal cords?
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1. Growths
2. Abuse
3. Overuse
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What is aphonia?
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The loss of ability to phonate because of damage to the larynx or mouth (absent, no voice)
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What is dysphonia?
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Difficulty in producing voice due to laryngeal issues (disfunction)
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What are five causes of voice disorders?
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1. Nodules (growths)
2. Granuloma (due to irritation)
3. Swelling
4. Cancer
5. Vocal abuse
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What are the seven parts to assessing voice disorders?
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1. Medical history/history of the problem
2. Daily voice use
3. Motivation for seeking help
4. Questionnaire (VHI)
5. Oral Motor Exam (rule out structural issues)
6. Clinical observation
7. Instrumentaiton
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What four things do clinical observations look for in voice disorders?
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1. Roughness
2. Breathlessness
3. Strain
4. Pitch
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What are the four types of instrumentation in regards to voice disorders?
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1. Acoustic assessment
2. Videostroboscopy
3. Aerodynamic assessment
4. electroglottography
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What is the intervention for voice disorders?
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Hygiene change (avoid certain beverages, avoid talking loud/shouting/whispering, stick to your optimal pitch, avoid smoking and excessive throat clearing, and GERD)
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How do we treat alaryngeal communication?
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With an artificial larynx or esophageal speech
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What is dysphagia?
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The difficulty in the passage of things from the mouth to the stomach (swallowing disorder, deglutition=swallowing)
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What are the 4 stages of swallowing?
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1. Oral Preparatory
2. Oral
3. Pharyngeal
4. Esophogeal
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What is involved in the oral preparatory stage?
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Prepare the substance to be swallowed by creating a bolus. Breathing is continuous and normal
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What is involved in the oral stage?
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Move the bolus to the rear of the nasal cavity and prepare for propulsion down the throat. Breathing is continuous and normal
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What is the two dangers during the pharyngeal stage?
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1. Penetration (food enters the larynx/trachea)
2. Aspiration (food in lungs, leads to asphyxiation, infection, and pneumonia)
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What five things are in place to protect us during the pharyngeal stage?
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1. Soft palate elevates so the swallow is a straight shot down
2. Epiglottis covers the trachea
3. Vocal fold adduction
4. Reflexive cough
5. Breathing is paused
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What occurs during the esophogeal stage?
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Move the bolus from the esophagus to the stomach
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What are five possible causes of dysphagia?
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1. Brain injury
2. Neurological disease
3. Cancer treatment to the head/neck
4. Dysarthia
5. Cerebral Palsy
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What are the three parts to assessing dysphagia?
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1. Case history/questionnaire
2. Observation/evaluation/feeding trials
3. Instrumentation: FEES, videogluroscopy/modified barium swallowing test
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What are seven signs of dysphagia in infants?
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1. Arching/stiffening while feeding
2. Irritability
3. Coughing/gagging
4. Excessive drooling
5. Food/liquid coming out of the mouth
6. Gurgly voice
7. Frequent spitting up
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What are the two parts to intervention for dysphagia?
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1. Diet modification (change what you eat/texture)
2. Compensatory (change how you eat)
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What is the short-term treatment for dysphagia?
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Alternative way of eating
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What is the long-term treatment for dysphagia?
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Socio-Interactionist (practice new skills, different textures) or a gastrostomy tube
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What is a language disorder?
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When an individual exhibits significant/persistent difficulties with the comprehension/expression of spoken/written language
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What is a primary language disorder?
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Occurs without any other disability that would be accountable (developmental language disorders)
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What is a secondary language disorder?
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Occurs as a consequence of another disorder (intellectual disability, hearing loss, autism)
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What is Specific Language Impairment (SLI)?
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Significant impairment of expressive or receptive language in school-age children. Not attributed to a single cause, likely genetic, and does not correlate with intellect. Affects morphology, syntax, semantics, and pragmatics
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What are five deficits associated with SLI?
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1. Inconsistent skills across different domains
2. Slow vocabulary development
3. Anomia
4. Grammar issues
5. Social and behavior issues
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What is Intellect Disability?
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An IQ of 70 or below and impaired independence. Affects syntax, semantics, and pragmatics
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What are four deficits associated with Intellect Disability?
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1. Short sentences
2. Small vocabulary
3. Omit function words
4. Difficulty understanding complex tasks
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What is Autism Spectrum Disorder?
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Includes Asperger's, Childhood Disintegrative Disorder, and Pervasive Development Disorder
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What are the symptoms of Autism Spectrum Disorder?
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-symptoms must show during childhood
-must affect everyday functioning
-social communication and interaction problems
-restricted and repetitive patterns of behavior
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What are three deficits associated with Autism Spectrum Disorder?
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1. Inability understanding non-verbal cues
2. Difficulty with pragmatics
3. Difficulty with spoken language (expressive and/or receptive)
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What are the two types of treatment for language disorders?
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1. Recasting
2. Extension/Expansion
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What is recasting?
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Correcting speech by not reprimanding but showing how it is used correctly
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What is extension/expansion?
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Talking more about the subject. Asking questions and commenting on it to further the conversation
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Why is literacy important?
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It is used as a form of communication that can be passed on through time
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What are the four phases of emergent literacy?
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1. Oral Language
2. Phonological Awareness
3. Print Awareness
4. Alphabetic Awareness
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What is oral language in regards to emergent literacy?
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A person's expressive/receptive language ability (phonological, grammatical, lexical, and discourse)
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What is phonological awareness?
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A child's understanding of the sound units of oral language. Learn to combine phonemes/blocks to create new words.
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What is print awareness?
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A person's understanding of the form and function of written language. Develops as a continuum
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What is alphabetic awareness?
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The knowledge of the letters that make up the alphabet.
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What is the alphabetic principle?
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Knowing speech and print correspong
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What is decoding regarding alphabetic awareness?
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The application of the alphabet
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What is reading comprehension regarding alphabetic awareness
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Drawing meaning from the text
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What are the five stages of developing literacy?
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1. Initial reading and decoding
2. confirmation and fluency: reinforce words resulting in mastery
3. Reading to learn: reading leave egocentricity
4. Reading from multiple view points
5. Reading in a world view: analysis, synthesis, and prediction
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If someone has poor comprehension and poor decoding, they have _____
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Mixed reading disorder
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If someone has poor comprehension but good decoding, they have _____
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Reading comprehension disorder
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If someone has good comprehension but poor decoding, they have _____
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Dyslexia
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If someone has good comprehension and good decoding, they have _____
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Normal reading
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SLHS 1150: QUIZ 2