CDS 602 - Post Midterm 2 (Artic/Phono)

• describe the artic/phonological development status of the client
• determine if speech deviates enough from norms to warrant concern/investigation 
• ID factors related to presence/maintenance of the disorder (known or unknown physical cause, secondary disorder, etc.)

make prognostic judgments about change with(out) intervention Monitor changes over time

• client history 
• artic/phono assessment
• OME
• hearing assessment
• language assessment
• diagnosis
• info reporting

• Written case history
• interview
• collab with other professionals

• hearing impairment 
• medical or neurological factors (dysarthria and apraxia)
• dental problems
• malnutrition 
• motor development 
• intelligence, sex, birth order, motivation and concern, dialect

• motor speech disorder
• damage to peripheral or central nervous system 
• symptoms: paralysis, weakness, in-coordination of speech muscles 
• all speech production systems are affected 
• causes: cerebral palsy, ABI, degenerative disease, tumors, strokes

• phonation
• articulation 
• respiration 
• resonance

• monotonous pitch
• deviant voice quality (devoicing)
• variable speech rate
• hyper-nasality

• bilabial and velar sounds easiest 
• stops, glides, and nasals easiest 

**KEY FEATURE: reduced intelligibility and slurred speech

• motor programming disorder
• damage to central nervous system
• no muscle weakness or paralysis 
• difficulty with precise movements needed for speech

• groping behaviors 
• poor intelligibility 
• prolongation of speech sounds
• repetition of sounds and syllables
• most difficulty with consonant clusters (then fricatives, affricates, stops, and nasals)
• difficulty with volitional, oral, nonspeech movements 
• unusual errors including metathesis 

**KEY FEATURE: inconsistent artic errors

error pattern where sounds in words are reversed 

ex) desk said as "deks"

• screening
• artic tests
• speech sampling
• stimulability of errors

• number of errors 
• error types
• form of errors
• consistency of errors
• intelligibility
• rate of speech
• prosody

boys more likely to have speech sound disorder

only associated with defective speech production when significantly below normal

• first borns have better artic 
• greater age difference = better artic for child #2

• low SES doesn't cause disorder 
• low SES has more artic errors than high/mid SES (access to treatment)

• phono disorders have greater risk for reading and writing trouble 
• severe phono disorder more likely to have lang problems

• inconclusive link to artic/phono disorders 
• some with disordered speech score within normal limits, others don't
• may aid improving artic skills

• quickly ID who may have disorder
• not in-depth assessment (few min. tops)
• formal:written measure 
• informal: picture to elicit sounds, reading passage, simple oral tasks

(+) ID artic errors in quick, systematic fashion

(-) elicit phonemes in one context

(-)  elicited at word level in IMF positions

(-) only examine consonants 

(-) don't predict if a sound may be outgrown

(-) reliability questionable in disorders with variable sound production

imitation (immediate or delayed-banana, this banana is yellow, what is this?)

naming (what is this?)

sentence completion (here is a yellow___)

• client ability to imitate correct model of misarticulated sound 
• model in isolation, nonsense syllables, and words 
• debate on prognostic value 
• may be initial goal of intervention
• assessed through imitation, diff environments, key words, phonetic placement and shaping, or any combo)