CSD 2230HUMAN COMMUNICATION

DISORDERS

Topic 7Speech Disorders

Articulation and Phonology

Some Definitions…

Phonemes: individual speech sounds that have meaning in a language Consonants and vowels

Phonology: linguistic rules that govern how phonemes are combined to make words Form

Articulation: the ability to produce sounds in sequence by moving the articulators

Articulation and Phonology Disorders

People with articulation and phonological disorders produce words that sound different than the words that are produced by most other speakers

Severe articulation and phonological disorders can really affect the way linguistic knowledge (semantics, syntax, pragmatics) is expressed, and in turn can have a negative impact on communication ability

The most common communication disorder treated by SLPs of both adults and children

Definitions and Incidence

Articulation disorders involve problems producing the sounds and sound sequences of the language Difficulty with the movements of the articulators

necessary for the production of a sound

Phonological disorders involve trouble understanding and implementing the underlying rules for producing sounds and sound sequences Deficiency in the abstract system of knowledge that

forms the rule system for sounds Inadequate mental representation of the language

sound system

Important Factors

Delay vs disorderWe make this distinction based on comparison of

the child’s speech to the articulation and phonological patterns of others of a comparable age who are developing normally Children who are considered delayed in articulation

development have speech production patterns that typically occur in children who are younger

CD-ROM Ch.10.05 Children with speech disorders do not produce speech

that is like children who are developing normally

Important Factors

Severity of involvement Determined by:1. the number of sounds produced correctly2. the accuracy of the productions3. the ability to produce sounds in different word

positions (initial, medial, and final positions)4. the ability to produce sound sequences (sound

blends)5. the ability to produce various types of words

(multiple syllables)Intelligibility

Severity Classification

Mild impairments Problems producing only a few sounds Substitution errors are common Intelligible to most listeners Treatment is usually very successful

CD-ROM Ch.10.02 is an example of a 3 year old exhibiting a mild disorder for his age

Severity Classification

Moderate impairments More overall difficulty producing speech sounds correctly

compared to people with mild impairments May use sounds incorrectly in different word positions and

often have difficulty producing all the syllables in a multisyllable word

Leaving off sounds at the ends of words Simplifying some consonant clusters (blends) Most intelligible to familiar listeners and oftentimes are not

well understood by strangers, especially if the context of the conversation is unknown

Good prognosis for improvement, but the course of therapy may be longer than for those with mild impairments

Severity Classification

Severe artic or phonological involvement

Found in people who are unintelligible to most listeners or who can’t use speech consistently to communicate

Usually produce more that six sounds in error Don’t sequence sounds consistently to produce intelligible

words Ability to use sounds to communicate is really limited Kids with severe artic/phonology problems use gestures

In very severe cases an SLP may decide to use an augmentative communication system as an alternative method for communication

Usually the prognosis with these people is not very favorable.

Some Examples of A Severe

Articulation/Phonology Disorder

CD-ROM Ch.10.03 is a 7 year-old who has a severe artic/phonology impairment. He is talking to his clinician about his dog. He says that he has a new dog and his big dog knows how to swim. He is very difficult to understand.

In Ch.10.04 the same child is using gestures to supplement his comments about where he is going. This is common because it helps to convey the message to the listener, but even in this example, his gestures aren’t enough to help the clinician understand what he’s trying to say.

Important Factors

Language and dialect Bilinguals are speakers who have some

competence in English but have a different primary language

Ability to produce speech sounds is not impaired Different rules for producing sounds based on

their own language Widely varying pronunciations

Children usually aren’t placed in speech therapy

Adults may choose intervention

Important Factors

Etiology Functional speech impairment

No obvious cause for the delay or disorderCommon for children with respect to

phonological disorders Articulation disorders and delays are

more likely to have a known etiology or to be associated with a risk factor for developmental delay

Examples of Etiologies Associated with

ArticulationDisorders

Hearing loss Reduces the exposure to the phonological rules

of language and the opportunity for feedback

Cleft lip and palate The oral-facial malformations associated with this

condition can make speech very nasal and some speech sounds may be hard to produce

Dysarthria Neuromuscular impairment

Apraxia Neurological condition that affects motor

planning and programming

Important Factors

Co-occurrence with other types of disorders:

Articulation and phonological disorders can co-occur with other types of speech and language problems

Assessment and Treatment

The goal of assessment is to determine the specific nature and severity of the disorder or delay

The specific assessment materials and procedures used depend on the suspected etiology, the chronological and developmental ages, and the primary language spoken

Analysis of the individual’s productions is done to understand the patterns of differences between the individual’s productions and the relevant comparison population

Treatment will depend on the results of this analysis

Collecting Information

Speech samples The use and integrity of speech production

skills in a spontaneous speech and language sample are evaluated

Articulation tests There are many of these kinds of formal

tests available These tests assess the ability to produce

consonants in varied word positions

Analysis

The goal of speech analysis is to describe typical patterns of speech production skills and compare these skills to an appropriate group and plan treatment

Articulation analysis The ways in which the articulators work together to

produce speech sounds and sequences are recorded in detail, and patterns of differences from the comparison group are described

Substitutions, omissions, distortions

Phonological analysis Focuses on describing how the client’s speaking reflects

underlying mental reps and or rules for producing speech

Treatment

Emphasis on teaching the client to use sounds and sound sequences of the language like that expected of peers in the community

Approaches Articulation based

Focus on repetitive practice of motor movements with feedback and attention to how the body is used to produce sounds

Phonological basedEmphasize the use of speech sounds to communicate

ideas