Podcast
Questions and Answers
What type of hearing loss occurs due to deformation, malfunction, or obstruction of the outer or middle ear?
What type of hearing loss occurs due to deformation, malfunction, or obstruction of the outer or middle ear?
What is the primary purpose of newborn hearing screenings?
What is the primary purpose of newborn hearing screenings?
Which of the following tools is typically used to examine the ears?
Which of the following tools is typically used to examine the ears?
What does a cochlear implant do?
What does a cochlear implant do?
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What distinguishes aided communication systems from unaided systems?
What distinguishes aided communication systems from unaided systems?
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Which category of AAC systems includes devices that do not use built-in rechargeable batteries?
Which category of AAC systems includes devices that do not use built-in rechargeable batteries?
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What is one method of indirect selection in AAC communication systems?
What is one method of indirect selection in AAC communication systems?
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Which of the following examples represents no tech AAC communication?
Which of the following examples represents no tech AAC communication?
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What is resonance in terms of voice quality?
What is resonance in terms of voice quality?
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What defines Velopharyngeal Insufficiency (VPI)?
What defines Velopharyngeal Insufficiency (VPI)?
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How is vocal pitch perceived?
How is vocal pitch perceived?
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What is the typical loudness of conversational speech?
What is the typical loudness of conversational speech?
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What are vocal nodules?
What are vocal nodules?
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What is a consequence of unilateral vocal fold paralysis?
What is a consequence of unilateral vocal fold paralysis?
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Which cranial nerve's damage is associated with vocal fold paralysis?
Which cranial nerve's damage is associated with vocal fold paralysis?
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How is hypernasality defined?
How is hypernasality defined?
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What is the primary function of Melodic Intonation Therapy?
What is the primary function of Melodic Intonation Therapy?
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What occurs during the Oral Preparation Phase of a normal swallow?
What occurs during the Oral Preparation Phase of a normal swallow?
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What triggers the swallow reflex in the Oral Phase of swallowing?
What triggers the swallow reflex in the Oral Phase of swallowing?
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What happens to the velum during the Pharyngeal Phase of swallowing?
What happens to the velum during the Pharyngeal Phase of swallowing?
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What is the primary role of the pyramidal tracts in the nervous system?
What is the primary role of the pyramidal tracts in the nervous system?
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What is a common feature seen during a disordered swallow in the oral preparation/oral phase?
What is a common feature seen during a disordered swallow in the oral preparation/oral phase?
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What indicator may suggest a child is experiencing failure to thrive?
What indicator may suggest a child is experiencing failure to thrive?
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Which type of dysarthria is characterized by weakness and loss of inhibitory motor control?
Which type of dysarthria is characterized by weakness and loss of inhibitory motor control?
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What is hyponasality?
What is hyponasality?
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What is the definition of deafness?
What is the definition of deafness?
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Which characteristic best describes hypokinetic dysarthria?
Which characteristic best describes hypokinetic dysarthria?
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What structure is responsible for providing auditory input to the central auditory system?
What structure is responsible for providing auditory input to the central auditory system?
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What happens to the motor neurons in Amyotrophic Lateral Sclerosis?
What happens to the motor neurons in Amyotrophic Lateral Sclerosis?
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Which of the following describes ataxic dysarthria?
Which of the following describes ataxic dysarthria?
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What is a key characteristic of hypernasality?
What is a key characteristic of hypernasality?
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What is a common cause of Cerebral Palsy related to speech disorders in children?
What is a common cause of Cerebral Palsy related to speech disorders in children?
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Study Notes
Voice and Resonance
- Voice quality is produced by sound vibrations in the pharyngeal, oral, and nasal cavities
- Velopharyngeal Insufficiency (VPI) is the failure of the velopharyngeal mechanism to separate the oral and nasal cavities during speech and swallowing
- The velum, when activated, separates the oral and nasal cavities
- Vocal pitch is perceived as the rate of vocal fold vibrations (frequency, measured in Hertz). Vocal loudness is perceived as intensity (measured in decibels), determined by the pressure of air from the lungs on vocal folds.
- Normal conversational speech averages around 60dB
- Vocal Nodules: Localized growths from frequent, hard vocal collisions. Usually bilateral, occurring in the juncture of the anterior and posterior two-thirds of the vocal folds. Soft and pliable. Most common in adult women (20-50 years old), and in children prone to excessive talking or screaming. Characterized by hoarseness and breathiness. Treatment involves vocal rest and plenty of water.
- Vocal Polyps: Fluid-filled lesions caused by ruptured blood vessels. Usually unilateral. Larger than nodules. Vascular, prone to hemorrhage. Commonly caused by a single traumatic event. Characterized by hoarseness and breathiness.
- Contact Ulcers: Small, reddened ulcerations on the posterior surface of the vocal folds (arytenoids region). Usually bilateral and painful. Replaced by granulated tissue. Result from trauma (like intubation). Characterized by hoarseness, breathiness, and throat clearing. Treatment efficiency is questionable, some reappear after removal.
- Vocal Fold Paralysis: Bilateral or unilateral paralysis is dangerous due to increased risk of aspiration if vocal folds are abducted. Cause damage to CN X (vagus nerve).
- Cleft: Abnormal opening in an anatomical structure due to failure of structures to fuse during development
- Hyponasality: Blockage in the nasopharynx preventing sounds from traveling through the nose, resulting in a nasal sound defect.
- Hypernasality: When the velopharyngeal mechanism fails to separate oral and nasal cavities adequately, causing nasal sounds to be overly prominent.
Motor Speech Disorders
- Pyramidal tracts (direct activation pathway) connect the cortex to the neurons
- Extrapyramidal tracts (indirect activation pathway) regulate reflexes and maintain posture/muscle tone
- Peripheral nervous system provides framework for movement
Dysphagia/ Disorders of Swallowing
- Aspiration: Silent aspiration is not further described
- Oral Preparation Phase: The tongue cups fluid to form a bolus, cheeks/teeth move bolus towards the back of the mouth
- Oral Phase: Bolus is formed and moved from the front to the back of the mouth, triggering the swallow reflex.
- Pharyngeal Phase: Velum contacts the rear wall of the throat, muscles squeeze the bolus down, vocal cords close, and the epiglottis lowers.
- Disorder Characteristics: Lips may not seal, impaired chewing, insufficient saliva, food may pocket, muscles may not function properly
Audiology and Hearing Loss
- Hearing loss prevalence: 20% of Americans report some degree. 3-1,000 births result in hearing loss.
- Deaf definition: Hearing loss of 90dB or more
- Outer ear components: Pinna and external auditory meatus
- Middle ear space: An air-filled space lined with mucous membranes, containing the Eustachian tube opening.
- Cochlea function: Processes auditory input for the central auditory system
- Otitis media: Middle ear infection that requires ventilation for resolution.
- Conductive hearing loss: Defects in outer or middle ear
- Sensorineural hearing loss: Inner ear damage (permanent)
- Mixed hearing loss: Combined conductive and sensorineural hearing loss
- Hearing loss causes in adults: Injury or other problems.
- Newborn hearing screenings: Important to detect and identify. occur in hospitals before release
- Hearing assessment tools: Pure-tone audiometry, tympanometry, behavioral observation, visual reinforcement audiometry.
Augmentive and Alternative Communication
- Unaided vs. aided AAC: Unaided uses body to communicate, Aided utilizes equipment.
- AAC system types: No tech, low tech, mid tech, and high tech
- Selection types: Direct (touch) vs indirect (scanning).
- AAC sample devices: Icons, PECS, Big Mack buttons, speech generating devices, iPads
Screening and Evaluation
- Screening: Determines if a problem exists.
- Evaluation: Provides diagnosis.
- Referrals: Can happen at any age by a variety of individuals (parent, oneself, pediatrician)
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