Phoneme Categorization

Phoneme Categorization

• Phonemes are categorized as vowels (open) or consonants (constricted).

Consonant Definitions

• Places, manners, and voicing are used in order to define and differentiate consonants.

Place of Consonants

• Place is classified by what articulator is used
• /b/ is a bilabial sound
• /s/ is an alveolar sound
• /k/ is a velar sound

Manner of Consonants

• Classified by degree of constriction/closure in the vocal tract, or consonant production
• /b/ is a stop sound
• /s/ is a fricative sound
• /k/ is a stop sound

Voice

• Classified by the presence/absence of laryngeal vibration
• /b/ is voiced sound
• /s/ is a voiceless sound
• /k/ is a voiceless sound

Phonological Patterns

• Phonological processes and phonological patterns are the same.
• Age of Instinction refers to the typical age when specific phonological processes or sound simplification strategies are expected to be suppressed during speech development.
• Common phonological patterns occur when a child simplifies adult language using specific patterns and substitutions.
• Data describes the age of extinction, which is when a child should stop making certain sounds.

Risk Factors for Speech Sound Disorders

• Being male
• History of middle ear infections with fluid buildup
• Hearing status
• Diminished speech sound perception and discrimination ability
• Oral motor and feeding difficulties
• Family history
• Low maternal education

Cleft Lip and Palate Speech Characteristics

• Nasality is when air escapes through the nose during speech, causing a nasal tone.
• Articulation Errors are present with difficulty producting certain sounds.
• Velopharyngeal Incompetence is the inability of the soft palate to close properly, resulting in nasal air emissions.
• Compensatory Articulation involves using alternate ways to make sounds.
• Glottal Stops are when certain sounds are replaced with a "pop" sound produced by vocal chords.
• Delayed Speech Development is when children with cleft palates experience delays in acquiring speech sounds.

Dysarthria

• A group of motor speech disorders caused by neuromuscular deficits.
• 90% of children with CP exhibit some form of motor speech impairment, ranging from very mild dysarthria to having no understandable speech.
• Weakened, paralyzed, and/or poor conditions of the speech musculature are characteristics
• Symptoms include Slurred, breathy, or nasally sound, horse or strained voice, speaking too loud or quiet, difficulty speaking in regular rhythm, gurley or monotone speech, difficulty moving tongue or lips, slowed speech, difficulty articulating longer words.

Childhood Apraxia of Speech

• Neurological speech sound disorder affecting the ability to plan/program the movement sequence for accurate speech production.
• Children with apraxia of speech have impaired motor planning/programming and are unable to learn the motor plans/programs required for rapid, accurate speech production.
• Symptoms consist of inconsistent errors on consonants/vowels in repeated production of syllables/words, lengthened/disrupted transitions between sounds/syllables, inappropriate prosody, limited consonant/vowel repertoires, groping/trial-and-error behaviors, frequent omissions, inappropriate additions, produces single words better than running speech

Fluent Speech

• Consistent ability to move the speech production apparatus in an effortless, smooth, and rapid manner, resulting in a continuous, uninterrupted flow of speech.

Stuttering Characteristics

• Involuntary repetitions of sounds and syllables (b-b-b-ball)
• Sound prolongations (mmmmmm-ommy)
• Blocks (b-oy)

Stuttering Incidence

• 5-8% of people have stuttered sometime in their lives.
• Spontaneous recovery and natural recovery variables include 71% naturally recover after 2 years, and 85% recover after a couple of years.

Stuttering Recovery

• Recovery variables are not well understood, but certain factors seem to contribute to the persistence of stuttering in some children.
• Females recover from stuttering more quickly and frequently than males.
• A family history of stuttering increases the risk of persistence.
• Child with late onset of stuttering after 3.5 years.
• A child who continues to stutter for more than one year post onset

Stuttering Facts

• Stuttering effects more males than females
• Stuttering has a high degree of familiar incidence
• If one twin stutters, the other will also likely stutter
• Sex ratio differences are age dependent
• First grade ratio is 3 males to 1 female
• 30-60% of those who stutter have a relative who stuttered at some point

Typical Disfluencies

• Whole word repetitions (I-I-I want a cookie)
• Interjections (can we, uh, go now?)
• Syllable repetitions (I like bas-baseball)
• Revisions such as "he cant- he wont play baseball)

Stuttering Definition

• Stuttering/stuttered speech involves core behaviors including repetitions of sounds, syllables, or one syllable words, prolongations of sounds, or blocks during speech production where an appropriate stop in the flow of air or voice occurs .
• Characteristics include part word repetition, single syllable word repetition, blocks, and prolongations.

Secondary Characteristics

• Accessory behaviors are adopted to reduce stuttering, distract from speaking, and to avoid an instance of stuttering.
• Facial tension, blinking of the eyes, and exaggerated movements are some examples

Stuttering Onset

• Stuttering can develop at any age.
• The onset of developmental stuttering occurs between 2 and 5.
• 75% of the risk of developing stuttering occurs before the age of 3 1/2.

Stuttering Progression

• Developmental stuttering is the most common form, it begins at 2.5-3 years old.
• 2.5-3 years the child is unaware, stuttering is highly variable, 6-10 disfluencies/100 words.
• 4-6 years it is still variable, but child may notice it and get frustrated, sounds irregular/rapid, secondary behaviors begin to form.
• 6-13 years of age characterized by a fear of stuttering, attempts to avoid conversation, certain words regarded as more difficult, secondary behaviors become more complex.
• 14+ years stuttering is at the apex of development, fearful anticipation of stuttering, strategies are developed to avoid certain words.

Stuttering Theories

• Organic Theory proposes an actual physical cause, suggests that people who stutter do not exhibit left cerebral hemisphere dominance for speech/language the way fluent individuals do.
• Behavioral Theory asserts that stuttering is a learned response to external conditions, such as anxiety/fear caused by parents, this has no evidence.
• Covert Repair Hypothesis assumes that stuttering is a reaction to some flaw in the speech production plan, people who stutter have poorly developed phonological encoding skills that cause them to introduce errors into their speech plan.
• Demands and capacities model asserts that stuttering develops when environmental demands placed on a child to produce fluent speech exceeds a child's physical/learned capacities, a child's capacity for fluent speech depends on motor skills, language production, emotional maturity, and cognitive development skills, children who stutter lack one or more of these capabilities.

Stuttering Evaluation

• Obeservation of the child speaking
• Detailed case history with relevant individuals in child life
• Detailed analysis of the child's speech behavior.

Stuttering Indicators

• Presence of interjections
• Revisions
• Whole world repetitions which are more common in non stutterers.
• Sound prolongations
• Blocks and part word repetitions
• An SLP will also measure the number of units that occur in each repetition or interjection
• More than two repetitions likely represent stuttering versus typical disfluencies.

Stuttering Risk Factors

• A family history of one or more relatives who required treatment to recover from persistent stuttering.
• Child is male.
• Receptive and expressive language, phonological skills or overall intellectual abilities are below average.
• Stress brought on by high expectations
• More sensitive temperament, greater emotional reactivity for stuttering.

Stuttering Treatment Approaches

• Stutter Affirming Therapy focuses on conditioning the speaker's reaction to stuttering in ways that move toward and embrace stuttering rather than in ways that move away from and reject stuttering.
• Fluency-Shaping Technique seeks to reduce/eliminate stuttering by teaching the individual who stutters to speak in a way that prevents stuttering.
• Stuttering Modification Technique teaches the person who stutters to react to their stuttering calmly, without unnecessary effort or struggle.