Classifications
Briefly describe a phonological disorder versus artic disorder.
Phon.:Difficulty in speech sound production resulting in multiple speech sound errors ultimately involving the sound system of a language
Artic: Difficulty in coordinating the articulators in production of a limited set of sounds; difficulty with the motoric aspects of speech production
BUT KEEP IN MIND THAT THEY ARE BOTH CLASSIFIED AS Functional or Unknown (no known cause)
what do these symptoms indicate?
• Blue line and high narrow arched palate
• Wide uvula or bifid uvula
• V pattern upon phonation
• Translucency along the middle of the soft palate
• Notch in the back of the hard palate.
• Hypernasal speech
• Weak pressure consonants
Submucous Cleft Palate
please demonstrate how someone with dysarthria may produce this speech sample (be prepared to explain):
I went to the park with my brother and we played on the slide and swings. After that, we got ice cream and walked home together.
may vary depending on dysarthria demonstrated
apraxia
The child is a 7-year-old who is generally understood by familiar listeners but difficult for unfamiliar listeners to understand. Speech is slow and often sounds “mumbled,” especially in longer sentences. When asked to repeat a phrase with more effort, speech becomes slightly clearer but still imprecise. Pitch and loudness are fairly flat, and the child runs out of breath during longer utterances. Oral motor exam shows reduced strength and rapid alternating movements are slow and effortful.
The clients presents with a speech sound disorder characterized by...
dysarthria
Briefly define dysarthria
Weakness and/or discoordination of the muscles needed for speech-may include muscles for respiration, phonation, resonance, and articulation
What are some common errors for VPD or VPI?
Distortions/substitutions/omissions
• Plosives
• Oral pressure phonemes (fricatives, affricates)
• Glottal stop substitutions /ʔ/
• /mʌʔi/ “muddy”
• /ʔæʔi/ “daddy”
• /ʔʊʔ/ “good”
• /h/ substitutions
Glottal stops - Using the larynx to make sounds instead of the lips or tongue. This sounds like the first sound in "uh-oh" and is often used for sounds like "p," "b," "t," "d," "k," and "g"
• Backing – using velar sounds (k, g, ng) to substitute for sounds produced more forward in the mouth.
• Nasal substitutions: Using the lips and tongue correctly, but air coming out of the nose. For example, "p" and "b" may sound more like "m"
• Nasal emissions: audible nasal air
• Nasal turbulence: nasal rustle or nasal snort, distracting sound that occurs when air pressure is forced through a small opening in the velopharynx. This causes friction and bubbling of secretions above the opening.
• Pharyngeal fricatives: A type of compensatory articulation using the pharyngeal wall for closure and build up of air pressure.
• Pharyngeal affricate substitutions: A type of compensatory articulation.
• Pharyngeal (lingual–pharyngeal) stops: A type of compensatory articulation
***These errors are often attempts to adjust for nasal air loss. Children with cleft palate may develop these errors even if the structure has been repaired
please demonstrate how someone with a phonological disorder may produce this speech sample (be prepared to explain):
I went to the park with my brother and we played on the slide and swings. After that, we got ice cream and walked home together.
I went to the pawk with my bwother and we played on the side and swings. After that, we got ice cream and wawked home together
What are some tests/speech samples/things you should have a child suspect of dysarthria perform to differentiate from other disorders?
Comprehensive single-word sample from a standardized test
Monosyllabic word repetition with same consonants (mom)
Monosyllabic with different consonants (e.g., mop)
Bisyllabic word repetition (mama, mommy, patty)
Multisyllabic word repetition
Repetition of words of increasing length (e.g., zip, zipper, zippering)
Phrase repetition of increasing length
Automatic speech (e.g., counting, days of the week) to novel utterances
Connected speech assessment: juncture, intelligibility, prosody (look for inappropriate phrasing, rate, stress)
Stimulability testing: what type of cues does the child need?
Oral structure and function: particularly DDK (slower trisyllabic repetition)
Inventory of specific sounds, syllable and word shapes, stress patterns
The child is a 5-year-old who can say words clearly at times but produces the same word differently across attempts. In a connected speech task, productions break down more as word length increases, with noticeable pauses between syllables. The child shows visible groping movements when trying to start words and often inserts extra vowel-like sounds between consonants. Simple monosyllabic words are more consistent than multisyllabic words, which become highly variable. Rhythm and stress patterns sound unusual, with equal emphasis on most syllables.
The clients presents with a speech sound disorder characterized by...
CAS
Briefly define apraxia:
A motor speech disorder in which children have difficulty planning and programming the movements needed for accurate speech production despite normal muscle strength
why is minimal pair or perceptual testing so important for a child presenting speech sound errors?
phonemic contrasts should be observed:
phonemic contrasts are preserved in artic but impaired in phonological (can help differentiate)
Typically
Prosody is intact
Vowels are intact
Will have predictable patterns that affect a class of sounds
Phonological disorder
Investigate
Child’s use of sounds
Sounds in a child’s phonemic inventory
Phonological patterns and age of suppression
Comprehensive single-word sample from a standardized test (sentences, if relevant)
Connected speech assessment: load specific areas of difficulty (e.g., clusters, fricatives, affricates, etc).
Informal probes of pattern errors, perhaps using minimal pairs (e.g., spot-pot)
Speech perception ability (e.g., can the child identify target sounds from an array of pictures or items?)
Investigate areas of phonemic and phonologic awareness skills, as relevant
Vowel errors
Voicing errors
Distorted substitutions
Difficulty achieving articulatory configurations
Groping
Intrusive schwa
Increased difficulty with multisyllabic words
The child is a 7-year-old with generally age-appropriate speech except for one persistent sound difficulty. In conversation and structured tasks, /r/ is produced inconsistently and often sounds distorted or approximated. The child is stimulable for correct /r/ placement with cueing but loses accuracy in connected speech. Intelligibility is high, though the error becomes more noticeable in longer or faster utterances. The client was able to identify the difference between /r/ and /w/ in minimal pairs.
The child presents with a speech sound disorder characterized by...
artic
Briefly describe some structural causes of speech difficulties
Cleft palate/submucous cleft or other craniofacial anomalies (e.g., weak oral pressure consonants: correct articulation but air is escaping, glottal replacement)
Structural deficits due to trauma or surgery
Can be articulatory/oral structure
May be congenital or acquired
please demonstrate how someone with CAS may produce this speech sample (be prepared to explain):
I went to the park with my brother and we played on the slide and swings. After that, we got ice cream and walked home together.
other participants will judge adequacy
I… went to the park… with my brother… and we played on the slide and swings. After that… we got ice cream… and walked home together.
Typically
Restricted to errors on one or two sounds including /r, s, z/
Phonemic contrasts are preserved
Errors are consistent, but might be influenced by phonetic contexts
Prosody intact
Vowels intact
Articulation:
Comprehensive single-word sample from a standardized test (sentences, if relevant)
Articulatory placement or error sounds
Determine phonotactic constraints (i.e., word positions, number of syllables)
Informal probes of the error sound that allow you to go a bit deeper (e.g., World of R)
Connected speech assessment to gauge intelligibility and acceptability
Stimulability for production and level of needed support
List some SUPRASEGMENTAL errors typical of apraxia:
Syllable segregation
Slow rate/slow DDK
Equal stress or lexical stress errors
The child is a 6-year-old with a history of repaired cleft palate and presents with speech that is mildly difficult to understand. Speech contains frequent nasal airflow during oral sounds, and pressure sounds are weak or “hollow.” Certain consonants are replaced with glottal or pharyngeal-like productions, especially when attempting high-pressure sounds. Resonance is noticeably hypernasal across most connected speech tasks, and vowel sounds are clearer than consonants. Despite effort, increasing loudness does not significantly improve clarity of pressure consonants.
The child presents with a speech sound disorder characterized by...
cleft palate
briefly describe sensory/perceptual
Speech is slower with more frequent pauses
Aberrant stress, pitch , nasality, and vocal quality
Omissions (e.g., final/initial consonant deletion, /s/)
Distortions (e.g., hypernasality, lateralized /s/)
Substitutions (e.g., cognates, voice/place/manner)
Additions (e.g., inserting a vowel between consonants)’
Please demonstrate an artic errors while reading this paragraph:
I went to the park with my brother and we played on the slide and swings. After that, we got ice cream and walked home together.
I went to the pawk with my brother and we played on the slide and swings. After that, we got ice cream and walked home together.
List at least 2 of the 3 hallmark features of apraxia
-disrupted/lengthened transitions between sounds and segments
-inappropriate prosody
-inconsistent productions of vowels and consonants across repeated attempts
Typically
Errors are fairly consistent
Articulation is imprecise and distorted in general
Speech will improve when there is an increase in drive or muscular effort, as in the case of yelling
Prosody will most likely be affected
May have difficulty controlling pitch and loudness variation
dysarthria
Comprehensive single-word sample from a standardized test (sentences, if relevant)
Informal probes of the error sound that allow you to go a bit deeper
Intelligibility test
Connected speech or reading assessment to gauge respiration, phonation, prosody
Stimulability for production and level of needed support
Oral structure and function: shorter phonation for prolonged /a/ and slow monosyllabic repetition rates for “pu pu pu”
Tests specific to dysarthria include:
Communication Function Classification System Quick Assessment for Dysarthria
The child is a 4-year-old with generally intelligible speech in context Prosody and vowel production are appropriate for age. Consonant errors are consistent and affect multiple sound classes.
Speech Sample (IPA)
/ɪ wɛnt tə ðə pɑk wɪð maɪ ˈbʌðə ænd wi pleɪd ɒn ðə saɪd ænd swɪŋz. æftə ðæt wi gɑt aɪs kwiːm ænd wɑkt hoʊm təˈɡɛðə./
The client presents with a speech sound disorder characterized by...
phonological disorder