Phono development disorders

  1. Speech delay information
    • Inappropriate speech sound deletions and substitutions for age affecting multiple sounds.
    • multiple consonant or vowel errors, intelligibility below 75%
    • Phono deficits have academic, occupational and social consequences.
    • Comorbidity w/SLI
  2. Types of Speech delay
    • SD-GEN (genetic)
    • SD-OME (otitus media with effusion)
    • SD-DPI (developmental psychosocial involvment)
    • SD=DYS (Dysarthria)
    • SD-DAS (Developmental Apraxia of Speech)
  3. SD-GEN (genetic)
    • Problem age-inappropriate deletion/substition errors w/academic occupation or social consequences.
    • Coexisting conditions:
    • Expressive lang disorder from 3-5years: 40-60%
    • Disorders of lang., spelling and reading after 6 years
    • Percent of speech delay kids at 3-5 yrs: 56%
    • 50-60% of kids have 1 or more family members with similiar problems; 20-40% have first degree relatives affected (sibling or parents)
    • More males than females 3or5:1
    • Typically do not have deplayed start of speech.
  4. SD-OME Otitus Media with Effusion
    • 30% of SD children
    • Frequent OM; at least 6 episodes from birth to 2 years
    • At least 35dB threshod on 3-4 frequencies
    • Problem age-inappropriate deletion/substitutionerrors w/academic occupational or social consequences
    • Same portion of males to females
    • Increased risk for express lang disorder and academic difficulties
    • typically no delayed speech
    • likely highly familial
    • normalization unknown
  5. SD- GEN (Genetics)
    Diagnostic Markers
    typical phono processes profileMore relative omission errors compared to SD group as a wholeLow % of sibilant disorders compared to SD group as a wholeLow % of sibilant disorders compared to SD group as a whole
  6. SD-OME (Otitis Media with Effusion)
    diagnostic markers
    • backing of fricative and stops
    • Small intelligibility-speech gap(PCC and intelligibility very similar)
    • Epentheic vowels on glide consonants
    • Frequent glottal stops in all positions and before vowels in initial position of words.
    • Nasal interchanges/confusion
    • Initial /h/ deletions, /h/ insertions on word initial vowels, /h/ initial substitutions.
    • initial consonant deletions
    • NOT a typical process kid'
  7. SD-DPI Developmental psychosocial involvement
    • of SD 12% of SD children have this
    • By 9years 75% have normal speech with intervention
    • Typically no delayed start of speech
    • No one set of speech dx markers separate this from another group
  8. SD-DPI Developmental psychosocial involvement
    • Primary Continuum (must be excessive/extreme and break down social interaction
    • Approach related negative affect
    • aggressive, angry or manipulative/control seeking
    • Withdrawal-related negative afffect
    • Socially withdrawn, shy/fearful and extremely taciturn (disinclined to talk)
    • Other temporal characteristics (secondary almost)
    • Negative emotionally/mood
    • easily upset and frustrated; sensitive about speech
    • Task persistence/attention
    • Unmotivated to work on general speech tasks, unwilling to try difficult speech tasks, and short attn. span
    • Problem age-inappropriate deletion/substition errors w/academic occupational or social consequences
    • Across board speech delay
    • Coexisting conditions
    • evidence of psychosocial or psychoeducational needs
    • problem may stem from poor interactions or inability to account for listener needs
    • May result in limited practice time, limited feedback, or both
    • We are often first people to link families with other professionals
  9. SD-DYS Dysarthria
    • Coexisting conditions, prevalence, delayed start of speech and normalization not known b/c new category
    • Assoc with Cerebral Palsy
    • Distortions and imprecise consonants
  10. SD-DYS Dysarthria
    Diagnostic features
    • Sensoriomotor task problems
    • Oral function task problems
    • higher proportion of imprecise production
    • smaller oral area used for vowels
    • slower speech rates
    • lower speech intensity
    • voice problems
    • nasal resonance problems
    • nasal emissions
  11. SD-DAS Developmental Apraxia of Speech
    • Problem with planning/organizing the movements of speech
    • Coexisting conditions: expressive language and learning difficulties
    • 1-2% of SD
    • Delayed start of speech
    • Normalization at 9 yrs is 75% with intervention
    • Usually genetic/familial based
  12. SD-DAS Developmental Apraxia of Speech
    Diagnostic Markers
    • Inappropriate lexical and sentential stress
    • Inappropriate timing with isocrony (syllable segregation)
    • Transpositional substition errors
    • Proportionally increased sound and syllable deletions and vowels/dipthong errors relative to level of severity of involvement
    • Articulatory struggles esp on onset
  13. RE-A (SD)
    Children over 9
    • Residual errors
    • Children with moderate to sever speech sound involement when first identified during preschool period
    • Average delay in achieving normalization is 5 years
    • Two periods of rapid gains: 4-6 and 7-8.5; other times are slower growth
    • Because of this kids may look normal because catch up will fall behind again, so don't dismiss from caseload right away (ie when 6 and look normal)
    • Persistence of distortion errors past 9 yrs is likely for the following /s, z, r, l, stressed and unstressed er/
  14. RE-B (SD)
    Children over 9
    • Kids without preschool speech delay
    • history of clinical distortion errors from 3-5 and 6-8 for fricatives/affricates and liquids
    • No history of early speech delay (2-3) or speech delay (3-8)
    • Normalization unknown
    • No coexisting conditions
    • Prevalence 5-8% of school age population
    • No familial link
    • Diagnostic markers; stressed er (boys>girls?), s(girls>boys)
  15. Speech Disorder Classification System
    • SD-GEN (Genetics)
    • SD-OME (Otitis Media with effusion)
    • SD-DPI (Developmental Psychosocial involvement)
    • SD-DAS (Developmental Apraxia of Speech)
    • SD-DYS (Dysarthria)
    • RE-A (SD) (Residual Errors id preschool period)
    • RE-B (SD) (Residual Errors no early preschool SD)
    • Typical Development
Card Set
Phono development disorders
disordered phonological development